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Re: Which benzo is *least* sedating? +other stuff Elizabeth

Posted by Mitch on November 1, 2001, at 23:37:38

In reply to Re: Which benzo is *least* sedating? +other stuff Mitch, posted by Elizabeth on November 1, 2001, at 14:43:29

> > Wow! I used to get by OK on 10mg tid! Of course, I am med sensitive and it generally takes about 1/6 to 1/3 of anything to do the same thing for me that it takes for other folks.

> I've heard many people say they are generally sensitive to meds. I wonder how that could come about (other than something major like liver disease).

Nah, it's not that. There is something else going on. I have had blood levels drawn for NT and lithium, i.e., and they show low or sub-therapeutic levels and I am experiencing all sorts of weird sfx. One thing my pdoc mentioned is the possibility that my receptor densities tend to be high in general for unknown reasons, which might explain the "knee-jerk" reaction to meds. I also think that it is related to neuronal firing instability as in epilepsy (I have family history of inheritable epilepsy). A neurologist I saw once told me I had an "atypical bipolar syndrome" or "possible frontal lobe dysfunction". The trick is to get me ATTENTIVE *and* CALM. I can get one or the other fairly easily, but BOTH is *THE* problem!

> > It is true that the low-potency benzos work better for GAD symptoms.
> I've never seen any data to suggest that. Klonopin, Ativan, and Xanax have all been found effective for GAD as well as PD.

From personal experience, yes, Klonopin/Ativan/Xanax does the trick for panic, BUT, just ordinary anticipatory GAD-like angst- chlordiazepoxide or diazepam seemed to work much better-I think you are onto something there.

> [re nortriptyline side effects]
> > Mainly cold extremities (cold nose/hands, ie.), also got some facial numbness on the front of my face and forehead (that was like high-dose Gabitril in some ways). Also, my arms and legs would go to sleep easily and get numb and tingle. A little bit of tachycardia as well.
> Huh. Those are pretty weird, except for the tachycardia. I wonder what was going on there.

I am guessing it has something to do with vasoconstriction that is experienced with drinking a lot of coffee or taking pseudo-ephedrine for example. The increased noradrenaline levels I think account for that.

> > BTW, I am thinking about starting a thread regarding Odansentron (ZOFRAN). It is a selective 5-HT3 antagonist which is used for chemotherapy/radiotherapy/postsurgical nausea and vomiting from the chemo drugs or from anesthetics/opioids.
> It's bloody expensive, too.

Yes, I am aware of that, unfortunately.

> > I heard somewhere that it decreased alcohol cravings in some people dramatically-also if my theory is correct it should be able to reduce nausea/diarrhea from SSRI's as well.
> Sure -- so would augmenting with Remeron. I think Zofran was being studied as a possible anxiolytic, too, but I don't think anything came of it.

No Remeron for this dude again! For some reason anything that is an alpha-2 adrenoreceptor antagonist makes me VERY hostile and irritable. I can't trust myself-it's that bad..really.
Remeron just hits way too many receptors for someone like me.

> > I haven't brought it up to my pdoc just yet. I was given Odansentron immediately after my thyroid surgery and I was sitting up in bed shortly after +morphine and eating a big tray of food with no nausea!
> Except for one time when I tried to start on too high a dose of buprenorphine (I need to start at 1/2 mL and then increase to 1 mL), I've never gotten nausea from opioids. How much morphine were you on?

Oh, I have no idea! They started to give me a Vicodan when I got back to the observation room, and hey my throat is sore you know??, so they gave me a morphine shot in the but. I just got back from surgery and my mouth was practically glued shut from all the anticholinergics they use, and I was asked if I wanted to eat some soft food, have some juice, etc. I really *did* feel hungry! No nausea at all! I didn't know about the Odansentron until I got the statement from the insurance a couple of weeks later.





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