Psycho-Babble Medication Thread 1111554

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Re: I can't take much more! Anxiety overwhelming!

Posted by linkadge on August 6, 2020, at 16:02:57

In reply to I can't take much more! Anxiety overwhelming!, posted by Englishman006! on August 6, 2020, at 7:39:04

If there was an alternative to valium, it might be worth exploring. The issues is that (to some extent) benzos can impair neuroplasticity. This might impede continued recovery. On the other hand, anxiety can also take its toll on the brain. Something like gabapentin (or pregabalin) might be worth considering. They can be effective for anxiety, and in some animal models they can improve neurogenesis.

https://pubmed.ncbi.nlm.nih.gov/25076225/

A supplement you might consider is niacin. I would recommend at least 100mg of that a day. I use this as part of my anti-anxiety stack. It can reduce anxiety, AND seems to have positive effects on stroke recovery.

https://www.sciencedaily.com/releases/2010/02/100224183111.htm

If you do take a benzo, make sure your magnesium levels are high. Magnesium synergizes with benzodiazepines and may reduce the effective dose. I would recommend 100mg of magnesium citrate a day. It can have an action similar to memantine (and may synergize with it to reduce anxiety).

https://pubmed.ncbi.nlm.nih.gov/18799816/

I'm not sure what else I would recommend. I mean you could try switching a more sedative anticonvulsant for the lamotrigine. For example, valproate probably has a might more significant anti-anxiety effect. However, it does have more cognitive side effects.

Linkadge


 

Re: I can't take much more! Anxiety overwhelming!

Posted by linkadge on August 6, 2020, at 16:05:08

In reply to Re: I can't take much more! Anxiety overwhelming!, posted by linkadge on August 6, 2020, at 16:02:57

Just to add. You may need to reduce the Dexedrine for a few days while you are trying to get the anxiety under control. Then perhaps slowly re-introduce it.

How is your sleep?

Linkadge

 

Re: I can't take much more! Anxiety overwhelming!

Posted by undopaminergic on August 7, 2020, at 0:31:57

In reply to I can't take much more! Anxiety overwhelming!, posted by Englishman006! on August 6, 2020, at 7:39:04

> 20mg Memantine (to offset the anxiety caused by Dex)

Memantine can also be a powerful antidepressant. However, tolerance can develop, and so you may need to increase the dose.

-undopaminergic

 

Re: I can't take much more! Anxiety overwhelming!

Posted by Englishman006! on August 7, 2020, at 2:47:10

In reply to Re: I can't take much more! Anxiety overwhelming!, posted by undopaminergic on August 7, 2020, at 0:31:57

Thanks for the help you guys. Some interesting ideas!

 

Re: I can't take much more! Anxiety overwhelming!

Posted by PeterMartin on August 8, 2020, at 0:11:29

In reply to Re: I can't take much more! Anxiety overwhelming!, posted by Englishman006! on August 7, 2020, at 2:47:10

Which generic manufacturer of Lamotrigine do you take? Have you switched between brands lately (pharmacy give you different pills?).

For some reason many people (myself included) can have significantly different responses to the different generic brands of Lamotrigine. For example if you were taking 300mg of TARO's generic, but the pharmacy filled your script this month w Unichem you're likely to have some turbulence. Most people seem to respond very badly to Zydus btw in cSe you're on that kind.

If you've been consistently taking the same generic than that's not your issue. But be mindful of poor generics/switching. I know there are some who complain about bad brands of generic Prozac but I haven't taken that in 10+ years.

Good luck!!

 

Re: I can't take much more! Anxiety overwhelming!

Posted by Englishman006! on August 8, 2020, at 22:06:24

In reply to Re: I can't take much more! Anxiety overwhelming!, posted by PeterMartin on August 8, 2020, at 0:11:29

> Which generic manufacturer of Lamotrigine do you take? Have you switched between brands lately (pharmacy give you different pills?).
>
> For some reason many people (myself included) can have significantly different responses to the different generic brands of Lamotrigine. For example if you were taking 300mg of TARO's generic, but the pharmacy filled your script this month w Unichem you're likely to have some turbulence. Most people seem to respond very badly to Zydus btw in cSe you're on that kind.
>
> If you've been consistently taking the same generic than that's not your issue. But be mindful of poor generics/switching. I know there are some who complain about bad brands of generic Prozac but I haven't taken that in 10+ years.
>
> Good luck!!

I think I've found it, 'Once a day Ebixa' (memantine). Have gone back on tablets twice a day and the anxiety seems to have resolved.

Thank you Pete!

 

Re: I can't take much more! Anxiety overwhelming!

Posted by SLS on August 11, 2020, at 14:19:39

In reply to Re: I can't take much more! Anxiety overwhelming!, posted by Englishman006! on August 8, 2020, at 22:06:24

I have found that there are unacceptable differences in the clinical effects of different brands of lamotrigine. Something should be done about it. To the best of my knowledge, no other anticonvulsant is so variable in its therapeutic effects. I have to jump through some hoops, but I use the Lamictal brand. Mylan lamotrigine was the worst. Teva lamotrigine was the best until they discontinued it and then resumed supplying it. All of their versions are now XR extended release. Obviously this isn't the same product they sold previously. My guess is that the drug is manufactured by the company they acquired, who was already making it. The first XR sold by Teva sucked, from what I understand. Still, it might be worth a try.

If anyone feels that their generic lamotrigine works as well as the original Lamictal, please share your observations. Generic company and dosages would be great information.


- Scott

 

Re: I can't take much more! Anxiety overwhelming!

Posted by Englishman006! on August 11, 2020, at 22:32:36

In reply to Re: I can't take much more! Anxiety overwhelming!, posted by SLS on August 11, 2020, at 14:19:39

> I have found that there are unacceptable differences in the clinical effects of different brands of lamotrigine. Something should be done about it. To the best of my knowledge, no other anticonvulsant is so variable in its therapeutic effects. I have to jump through some hoops, but I use the Lamictal brand. Mylan lamotrigine was the worst. Teva lamotrigine was the best until they discontinued it and then resumed supplying it. All of their versions are now XR extended release. Obviously this isn't the same product they sold previously. My guess is that the drug is manufactured by the company they acquired, who was already making it. The first XR sold by Teva sucked, from what I understand. Still, it might be worth a try.
>
> If anyone feels that their generic lamotrigine works as well as the original Lamictal, please share your observations. Generic company and dosages would be great information.
>
>
> - Scott

I have been on different brands of Lamotrigine and you're right, there is an extreme difference. I too take Lamictal. I've also reacted badly to dexamphetamine when it was made into extended release, high dose, by a compounding pharmacy. I think new xr versions or brands of any med should be taken with caution...

Lamotrigine also gives me bad melasma, a side effect not mentioned in any of the literature I've read. I think I may be the odd one out on that skin pigmentation disorder. There doesn't seem to be an alternative glutamate blocker in its class, so I'm stuck with it.

 

Re: I can't take much more! Anxiety overwhelming!

Posted by SLS on August 15, 2020, at 18:21:28

In reply to Re: I can't take much more! Anxiety overwhelming!, posted by Englishman006! on August 11, 2020, at 22:32:36

> > I have found that there are unacceptable differences in the clinical effects of different brands of lamotrigine. Something should be done about it. To the best of my knowledge, no other anticonvulsant is so variable in its therapeutic effects. I have to jump through some hoops, but I use the Lamictal brand. Mylan lamotrigine was the worst. Teva lamotrigine was the best until they discontinued it and then resumed supplying it. All of their versions are now XR extended release. Obviously this isn't the same product they sold previously. My guess is that the drug is manufactured by the company they acquired, who was already making it. The first XR sold by Teva sucked, from what I understand. Still, it might be worth a try.
> >
> > If anyone feels that their generic lamotrigine works as well as the original Lamictal, please share your observations. Generic company and dosages would be great information.
> >
> >
> > - Scott
>
> I have been on different brands of Lamotrigine and you're right, there is an extreme difference. I too take Lamictal. I've also reacted badly to dexamphetamine when it was made into extended release, high dose, by a compounding pharmacy. I think new xr versions or brands of any med should be taken with caution...
>
> Lamotrigine also gives me bad melasma, a side effect not mentioned in any of the literature I've read. I think I may be the odd one out on that skin pigmentation disorder. There doesn't seem to be an alternative glutamate blocker in its class, so I'm stuck with it.

I think you're right about glutamate inhibitors and depression. Valproate is pretty good at reducing glutamate activity through the inhibition of GABA transaminase, and possibly through the blocking of sodium channels upstream.


- Scott

 

Re: I can't take much more! Anxiety overwhelming!

Posted by SLS on August 15, 2020, at 19:28:00

In reply to Re: I can't take much more! Anxiety overwhelming!, posted by SLS on August 15, 2020, at 18:21:28

> > > I have found that there are unacceptable differences in the clinical effects of different brands of lamotrigine. Something should be done about it. To the best of my knowledge, no other anticonvulsant is so variable in its therapeutic effects. I have to jump through some hoops, but I use the Lamictal brand. Mylan lamotrigine was the worst. Teva lamotrigine was the best until they discontinued it and then resumed supplying it. All of their versions are now XR extended release. Obviously this isn't the same product they sold previously. My guess is that the drug is manufactured by the company they acquired, who was already making it. The first XR sold by Teva sucked, from what I understand. Still, it might be worth a try.
> > >
> > > If anyone feels that their generic lamotrigine works as well as the original Lamictal, please share your observations. Generic company and dosages would be great information.
> > >
> > >
> > > - Scott
> >
> > I have been on different brands of Lamotrigine and you're right, there is an extreme difference. I too take Lamictal. I've also reacted badly to dexamphetamine when it was made into extended release, high dose, by a compounding pharmacy. I think new xr versions or brands of any med should be taken with caution...
> >
> > Lamotrigine also gives me bad melasma, a side effect not mentioned in any of the literature I've read. I think I may be the odd one out on that skin pigmentation disorder. There doesn't seem to be an alternative glutamate blocker in its class, so I'm stuck with it.
>
> I think you're right about glutamate inhibitors and depression. Valproate is pretty good at reducing glutamate activity through the inhibition of GABA transaminase, and possibly through the blocking of sodium channels upstream.

Calcium channels, too.


- Scott

 

Re: I can't take much more! Anxiety overwhelming! SLS

Posted by Englishman006! on August 15, 2020, at 20:59:32

In reply to Re: I can't take much more! Anxiety overwhelming!, posted by SLS on August 15, 2020, at 19:28:00

> > > > I have found that there are unacceptable differences in the clinical effects of different brands of lamotrigine. Something should be done about it. To the best of my knowledge, no other anticonvulsant is so variable in its therapeutic effects. I have to jump through some hoops, but I use the Lamictal brand. Mylan lamotrigine was the worst. Teva lamotrigine was the best until they discontinued it and then resumed supplying it. All of their versions are now XR extended release. Obviously this isn't the same product they sold previously. My guess is that the drug is manufactured by the company they acquired, who was already making it. The first XR sold by Teva sucked, from what I understand. Still, it might be worth a try.
> > > >
> > > > If anyone feels that their generic lamotrigine works as well as the original Lamictal, please share your observations. Generic company and dosages would be great information.
> > > >
> > > >
> > > > - Scott
> > >
> > > I have been on different brands of Lamotrigine and you're right, there is an extreme difference. I too take Lamictal. I've also reacted badly to dexamphetamine when it was made into extended release, high dose, by a compounding pharmacy. I think new xr versions or brands of any med should be taken with caution...
> > >
> > > Lamotrigine also gives me bad melasma, a side effect not mentioned in any of the literature I've read. I think I may be the odd one out on that skin pigmentation disorder. There doesn't seem to be an alternative glutamate blocker in its class, so I'm stuck with it.
> >
> > I think you're right about glutamate inhibitors and depression. Valproate is pretty good at reducing glutamate activity through the inhibition of GABA transaminase, and possibly through the blocking of sodium channels upstream.
>
> Calcium channels, too.
>
>
> - Scott

Valproate, what do you think of this drug overall, including side effect profile? I would be extremely interested in getting rid of my melasma. Lamotrigine has been a god send as it gave me back my 'talking tackle' after the dexamphetamine+ memantine combo kind of pooped out in that regard.

I also get extreme fatigue but put up with it in order to have a sense of wit and humour. Coffee adds to it but stimulates me mentally. It's such a rough and juggle thing with meds don't you think?

 

Re: I can't take much more! Anxiety overwhelming! Englishman006!

Posted by Englishman006! on August 15, 2020, at 21:09:54

In reply to Re: I can't take much more! Anxiety overwhelming! SLS, posted by Englishman006! on August 15, 2020, at 20:59:32

Numbness is another side effect I struggle with. I dropped the low dose amisulpride due to it's lack of effect.

How are you doing lately Scott?

 

Re: I can't take much more! Anxiety overwhelming! Englishman006!

Posted by SLS on August 16, 2020, at 13:20:36

In reply to Re: I can't take much more! Anxiety overwhelming! Englishman006!, posted by Englishman006! on August 15, 2020, at 21:09:54

> Numbness is another side effect I struggle with. I dropped the low dose amisulpride due to it's lack of effect.
>
> How are you doing lately Scott?

That's kind of you to ask. I am still responding to the introduction of Nardil, but I still need to finesse the dosage to find a balance between side effects and therapeutic effect.

Where is the numbness located, and what do you think is causing it?


- Scott

 

Re: I can't take much more! Anxiety overwhelming!

Posted by creepy on August 18, 2020, at 2:57:22

In reply to I can't take much more! Anxiety overwhelming!, posted by Englishman006! on August 6, 2020, at 7:39:04

pdocs like to throw SSRIs at you and claim they help with anxiety in my experience they never have in fact for me they create irritability, add anxiety and the apathy is horrible.
the SSRI that I found that was the best for anxiety out of them all was escitalipram at max dose. YMMV.
Personally I would ditch prozac for something less activating, and / or look into another antipsychotic. aside from the more addictive and sedating drugs those are really the only potent ones that come to mind.

 

Re: I can't take much more! Anxiety overwhelming!

Posted by alchemy on August 23, 2020, at 19:47:30

In reply to I can't take much more! Anxiety overwhelming!, posted by Englishman006! on August 6, 2020, at 7:39:04

Offering some possibilities that may or may not be related.

If you were on beta blockers, I think they have been known to help with anxiety. Late withdrawals?

The other thing that changed is that you started Amisulpride, but it doesn't sound like that med would contribute.

--> I started getting it really bad on Sunday when I suddenly felt fatigued, weak and nauseous.

Interesting, there seems to be an immune system component with the fatigue and nausea, possibly with the gut which of course relates to anxiety. I don't have an answer, but
it's another angle. One random, although unlikely, thing to try is an antihistamine. I have found that this helps a little with my anxiety.

 

Re: I can't take much more! Anxiety overwhelming! SLS

Posted by Englishman006! on August 24, 2020, at 4:03:28

In reply to Re: I can't take much more! Anxiety overwhelming! Englishman006!, posted by SLS on August 16, 2020, at 13:20:36

> > Numbness is another side effect I struggle with. I dropped the low dose amisulpride due to it's lack of effect.
> >
> > How are you doing lately Scott?
>
> That's kind of you to ask. I am still responding to the introduction of Nardil, but I still need to finesse the dosage to find a balance between side effects and therapeutic effect.
>
> Where is the numbness located, and what do you think is causing it?
>
>
> - Scott
>
>
>
>
Good luck with that. Let us know how you go.

I get emotionally numb. You could also call it apathy. I think it's a result of being on Prozac. Any of the ssri's can cause it, apparently.

 

Re: I can't take much more! Anxiety overwhelming! undopaminergic

Posted by Englishman006! on August 24, 2020, at 4:16:49

In reply to Re: I can't take much more! Anxiety overwhelming!, posted by undopaminergic on August 7, 2020, at 0:31:57

> > 20mg Memantine (to offset the anxiety caused by Dex)
>
> Memantine can also be a powerful antidepressant. However, tolerance can develop, and so you may need to increase the dose.
>
> -undopaminergic
>

How much memantine did you end up taking? I've increased to 30mg now.

 

Re: I can't take much more! Anxiety overwhelming! linkadge

Posted by Englishman006! on August 24, 2020, at 4:20:47

In reply to Re: I can't take much more! Anxiety overwhelming!, posted by linkadge on August 6, 2020, at 16:05:08

> Just to add. You may need to reduce the Dexedrine for a few days while you are trying to get the anxiety under control. Then perhaps slowly re-introduce it.
>
> How is your sleep?
>
> Linkadge

Never had a problem except chronic nightmares before the stroke..

 

Re: I can't take much more! Anxiety overwhelming!

Posted by undopaminergic on August 24, 2020, at 4:48:23

In reply to Re: I can't take much more! Anxiety overwhelming! undopaminergic, posted by Englishman006! on August 24, 2020, at 4:16:49

> > > 20mg Memantine (to offset the anxiety caused by Dex)
> >
> > Memantine can also be a powerful antidepressant. However, tolerance can develop, and so you may need to increase the dose.
> >
> > -undopaminergic
> >
>
> How much memantine did you end up taking? I've increased to 30mg now.

I tried to use it to "self-destruct", so to speak (eg. to die or induce brain-damage) and took a massive dose of several grams. I'm probably the only being that has taken such a dose.

Otherwise, for therapeutic effect, I used up to maybe 60 mg.

-undopaminergic

 

Re: I can't take much more! Anxiety overwhelming! undopaminergic

Posted by Englishman006! on August 24, 2020, at 6:24:46

In reply to Re: I can't take much more! Anxiety overwhelming!, posted by undopaminergic on August 24, 2020, at 4:48:23

> > > > 20mg Memantine (to offset the anxiety caused by Dex)
> > >
> > > Memantine can also be a powerful antidepressant. However, tolerance can develop, and so you may need to increase the dose.
> > >
> > > -undopaminergic
> > >
> >
> > How much memantine did you end up taking? I've increased to 30mg now.
>
> I tried to use it to "self-destruct", so to speak (eg. to die or induce brain-damage) and took a massive dose of several grams. I'm probably the only being that has taken such a dose.
>
> Otherwise, for therapeutic effect, I used up to maybe 60 mg.
>
> -undopaminergic
>

Ouch!

Along with what? Adderall, Dex? What do you suffer with?

 

Re: I can't take much more! Anxiety overwhelming!

Posted by undopaminergic on August 25, 2020, at 0:37:26

In reply to Re: I can't take much more! Anxiety overwhelming! undopaminergic, posted by Englishman006! on August 24, 2020, at 6:24:46

> > > > > 20mg Memantine (to offset the anxiety caused by Dex)
> > > >
> > > > Memantine can also be a powerful antidepressant. However, tolerance can develop, and so you may need to increase the dose.
> > > >
> > > > -undopaminergic
> > > >
> > >
> > > How much memantine did you end up taking? I've increased to 30mg now.
> >
> > I tried to use it to "self-destruct", so to speak (eg. to die or induce brain-damage) and took a massive dose of several grams. I'm probably the only being that has taken such a dose.
> >
> > Otherwise, for therapeutic effect, I used up to maybe 60 mg.
> >
> > -undopaminergic
> >
>
> Ouch!
>
> Along with what? Adderall, Dex? What do you suffer with?

At least occasionally, I also took a stimulant called desoxypipradrol, which is somewhat like a long-acting analogue of methylphenidate (Ritalin).

I used it for depression.

-undopaminergic

 

Re: I can't take much more! Anxiety overwhelming! undopaminergic

Posted by Englishman006! on August 25, 2020, at 3:28:41

In reply to Re: I can't take much more! Anxiety overwhelming!, posted by undopaminergic on August 25, 2020, at 0:37:26

> > > > > > 20mg Memantine (to offset the anxiety caused by Dex)
> > > > >
> > > > > Memantine can also be a powerful antidepressant. However, tolerance can develop, and so you may need to increase the dose.
> > > > >
> > > > > -undopaminergic
> > > > >
> > > >
> > > > How much memantine did you end up taking? I've increased to 30mg now.
> > >
> > > I tried to use it to "self-destruct", so to speak (eg. to die or induce brain-damage) and took a massive dose of several grams. I'm probably the only being that has taken such a dose.
> > >
> > > Otherwise, for therapeutic effect, I used up to maybe 60 mg.
> > >
> > > -undopaminergic
> > >
> >
> > Ouch!
> >
> > Along with what? Adderall, Dex? What do you suffer with?
>
> At least occasionally, I also took a stimulant called desoxypipradrol, which is somewhat like a long-acting analogue of methylphenidate (Ritalin).
>
> I used it for depression.
>
> -undopaminergic
>

With me, the dex and memantine were great. Dex alone would give me rebound anxiety and depression. I also used fluoxetine and low dose amisulpride. Together that regimen brought me out of my shell. It gave me the best couple of years of my life before it started to poop out. I had less and less to say, but then I found Lamotrigine! That gave me back my 'talking tackle'. I'm not bipolar but it worked on my unipolar depression. That combination worked for 12-13 years until my stroke at the ripe old age of 45.

My only two complaints were emotional numbness and when the dex ran out I would have nothing to say. I got 3 hours out of 15mg of dex and I'd repeat it 4 times a day. The last few hours before bed sucked big time and I would take another 15mg more often than not. Now I take 2 dex (10mg) five times a day. So I've managed to drop from 75mg (most days) to 50mg since my stroke.

What's your diagnosis? If I may ask.

 

Re: I can't take much more! Anxiety overwhelming!

Posted by undopaminergic on August 25, 2020, at 3:55:24

In reply to Re: I can't take much more! Anxiety overwhelming! undopaminergic, posted by Englishman006! on August 25, 2020, at 3:28:41

>
> What's your diagnosis? If I may ask.

Officially or for real?

The doctors are thinking schizophrenia is my big problem. But I don't have psychosis (hallucinations or delusions). I just have "negative" symptoms (eg. apathy) that I attribute to the depression. It is the apathy that is my main complaint, followed by cognitive impairment. I have other things like depersonalisation, dissociative identity disorder, and residual schizoid personality and social anxiety. I also have pretty serious ADHD (predominatly inattentive type). I'm a smorgasbord(*) of different disorders.

* did you know this word is from Swedish (I'm Swedish) and means "sandwich table"?

-undopaminergic

 

Re: I can't take much more! Anxiety overwhelming! undopaminergic

Posted by Englishman006! on August 25, 2020, at 7:57:40

In reply to Re: I can't take much more! Anxiety overwhelming!, posted by undopaminergic on August 25, 2020, at 3:55:24

> >
> > What's your diagnosis? If I may ask.
>
> Officially or for real?
>
> The doctors are thinking schizophrenia is my big problem. But I don't have psychosis (hallucinations or delusions). I just have "negative" symptoms (eg. apathy) that I attribute to the depression. It is the apathy that is my main complaint, followed by cognitive impairment. I have other things like depersonalisation, dissociative identity disorder, and residual schizoid personality and social anxiety. I also have pretty serious ADHD (predominatly inattentive type). I'm a smorgasbord(*) of different disorders.
>
> * did you know this word is from Swedish (I'm Swedish) and means "sandwich table"?
>
> -undopaminergic
>

Yes I did understand. That must be hard for you. We have some things in common. I have ADHD inattentive type, social anxiety (which has gotten so bad it felt like I had no personality), emotional blunting (numbness or apathy), depression and I've only suffered 'derealisation' when I was young, like I was living in a dream, watching everything on tv, distant, receded, miles away - kind of feeling.

Anyway, have you tried Lamotrigine (Lamictal)?

 

Re: I can't take much more! Anxiety overwhelming!

Posted by undopaminergic on August 26, 2020, at 12:58:21

In reply to Re: I can't take much more! Anxiety overwhelming! undopaminergic, posted by Englishman006! on August 25, 2020, at 7:57:40

>
> Yes I did understand. That must be hard for you. We have some things in common. I have ADHD inattentive type, social anxiety (which has gotten so bad it felt like I had no personality), emotional blunting (numbness or apathy), depression and I've only suffered 'derealisation' when I was young, like I was living in a dream, watching everything on tv, distant, receded, miles away - kind of feeling.
>

Yes, much like that.

>
> Anyway, have you tried Lamotrigine (Lamictal)?

I'm on it, 200 mg.

-undopaminergic


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