Psycho-Babble Medication Thread 108623

Shown: posts 1 to 10 of 10. This is the beginning of the thread.

 

Horrific anxiety resurgence - help!

Posted by Emme on June 4, 2002, at 7:52:33

Hi All,

Well, the good news is that Lamictal is helping my depression and I feel much more like making plans to reclaim a life than I have in ages. I am at 100 mg and feel I may not tolerate a higher dose very well, though I could always try and see. I also take 900 mg neurontin, 25 mg atenolol (for anxiety), and klonopin as needed. DX Bipolar II.

Here's the problem. A couple of weeks back I was really sluggish. The anxiety was really toned down but I was too low-energy and feeling a bit down. I tried a low dose of provigil (some of you participated in the post) and then stopped it for a few days and my energy and mood were more normal so I stayed off.

Now...a couple of weeks later and one fantastic hiking/camping trip in between (felt good during trip), I've shifted to out-of-control anxiety, mostly physical symptoms. I still have good antidepressant effect from Lamictal at the moment - I've been at 100 mg for about 5 weeks. But for the last 5 days, I am really jittery, lump in throat, feel like I've consumed caffeine, wake up feeling like my heart is pounding. I find it hard to exercise because I'm so revved. I am belching an awful lot (sorry to be ungraceful) and have intermittent chest pain off to the side which I suspect has to do with the endless rising gas - my stomach must be really churning. You know, the whole flight or fight thing. I feel miserable.

I've upped the atenolol a bit and have upped klonopin to 1 mg - it helps some but doesn't compeltely do it. I'm sleepy and still revved. I can't figure out how I can essentially just switch on a dime from being sluggish to such a state, with one quasi-normal week in between. But I'm miserable and may go to the internist if it persists, though I'm not sure what she can do it for my that my pdoc can't advise. Maybe yet *another* thyroid test...? I don't know if it's my body continuing to adjust to Lamictal, or if it's my anxiety just waxing and waning of it's own accord.

What to do....? Anyone experienced anything similar?

Thanks,
Emme

 

Re: Horrific anxiety resurgence - help! Emme

Posted by Ritch on June 4, 2002, at 12:39:03

In reply to Horrific anxiety resurgence - help!, posted by Emme on June 4, 2002, at 7:52:33

> Hi All,
>
> Well, the good news is that Lamictal is helping my depression and I feel much more like making plans to reclaim a life than I have in ages. I am at 100 mg and feel I may not tolerate a higher dose very well, though I could always try and see. I also take 900 mg neurontin, 25 mg atenolol (for anxiety), and klonopin as needed. DX Bipolar II.
>
> Here's the problem. A couple of weeks back I was really sluggish. The anxiety was really toned down but I was too low-energy and feeling a bit down. I tried a low dose of provigil (some of you participated in the post) and then stopped it for a few days and my energy and mood were more normal so I stayed off.
>
> Now...a couple of weeks later and one fantastic hiking/camping trip in between (felt good during trip), I've shifted to out-of-control anxiety, mostly physical symptoms. I still have good antidepressant effect from Lamictal at the moment - I've been at 100 mg for about 5 weeks. But for the last 5 days, I am really jittery, lump in throat, feel like I've consumed caffeine, wake up feeling like my heart is pounding. I find it hard to exercise because I'm so revved. I am belching an awful lot (sorry to be ungraceful) and have intermittent chest pain off to the side which I suspect has to do with the endless rising gas - my stomach must be really churning. You know, the whole flight or fight thing. I feel miserable.
>
> I've upped the atenolol a bit and have upped klonopin to 1 mg - it helps some but doesn't compeltely do it. I'm sleepy and still revved. I can't figure out how I can essentially just switch on a dime from being sluggish to such a state, with one quasi-normal week in between. But I'm miserable and may go to the internist if it persists, though I'm not sure what she can do it for my that my pdoc can't advise. Maybe yet *another* thyroid test...? I don't know if it's my body continuing to adjust to Lamictal, or if it's my anxiety just waxing and waning of it's own accord.
>
> What to do....? Anyone experienced anything similar?
>
> Thanks,
> Emme


Wow,

Yes, I would get thyroid checked again for sure. There is a *tiny* chance the Neurontin is making you a little hyperthyroid (that has been reported with it occasionally). You didn't by any chance come off of an SSRI five weeks ago, did you? I just wonder what changed five weeks ago (besides the Lamictal addition). The last two times I stopped an SSRI cold I had a delay effect of a few weeks and then *panic*! Another possibility is just your cycling waxing and waning as you say. You probably have a few days of mixed stuff that you cycle through. Have you mood-charted to see what type of pattern your cycles make? It could be you are cycling roughly every three weeks. You might need to add on a different mood stabilizer. A little Depakote would probably settle it, but that would be a no-no with the Lamictal (it would cause your Lamictal blood level to spike up). Of course, the Lamictal might be the one agitating you and perhaps it needs to be decreased a little. Definitely need to see your pdoc about it. In the meantime you might want to bump the Klon up to 1.5mg/day so you won't feel so miserable.

hope this helps,

Mitch

 

Re: Horrific anxiety resurgence - help! Emme

Posted by Chloe on June 4, 2002, at 18:39:11

In reply to Horrific anxiety resurgence - help!, posted by Emme on June 4, 2002, at 7:52:33

> Hi All,
>
> Well, the good news is that Lamictal is helping my depression and I feel much more like making plans to reclaim a life than I have in ages. I am at 100 mg and feel I may not tolerate a higher dose very well, though I could always try and see. I also take 900 mg neurontin, 25 mg atenolol (for anxiety), and klonopin as needed. DX Bipolar II.
>
> Here's the problem. A couple of weeks back I was really sluggish. The anxiety was really toned down but I was too low-energy and feeling a bit down. I tried a low dose of provigil (some of you participated in the post) and then stopped it for a few days and my energy and mood were more normal so I stayed off.
>
> Now...a couple of weeks later and one fantastic hiking/camping trip in between (felt good during trip), I've shifted to out-of-control anxiety, mostly physical symptoms. I still have good antidepressant effect from Lamictal at the moment - I've been at 100 mg for about 5 weeks. But for the last 5 days, I am really jittery, lump in throat, feel like I've consumed caffeine, wake up feeling like my heart is pounding. I find it hard to exercise because I'm so revved. I am belching an awful lot (sorry to be ungraceful) and have intermittent chest pain off to the side which I suspect has to do with the endless rising gas - my stomach must be really churning. You know, the whole flight or fight thing. I feel miserable.
>
> I've upped the atenolol a bit and have upped klonopin to 1 mg - it helps some but doesn't compeltely do it. I'm sleepy and still revved. I can't figure out how I can essentially just switch on a dime from being sluggish to such a state, with one quasi-normal week in between. But I'm miserable and may go to the internist if it persists, though I'm not sure what she can do it for my that my pdoc can't advise. Maybe yet *another* thyroid test...? I don't know if it's my body continuing to adjust to Lamictal, or if it's my anxiety just waxing and waning of it's own accord.
>
> What to do....? Anyone experienced anything similar?
>
> Thanks,
> Emme

Emme,
Sorry you are having this awful anxiety. I have never been able to tolerate Lamictal, so I am so help in that area.
But I do find that sometimes even thouogh I take the same meds day in and day out, they don't have the same effect day in, day out. Some days or weeks, I feel over medicated and a bit foggy. Then a few days later, I can feel terribly under medicated, anxious, giddy, short fused, rageful. I find it extremely difficult to feel even or consistant. I don't see why I can't unite myself. I am constantly evolving in the mood department...

Lastly, have you had any hormonal changes or gone on or off a pill? I had to stop my BCP that i was taking active pills only. And when I stopped. SEvere depression. When I resumed, severe anxiety that is finally settling after three weeks...Thank God the anxiety is leaving. The angst and pressured feeling is awful for me. I am sorry you are suffering...So I guess thyroid, hormones and lamictal dosage would be good places to focus.

I apologize for the ramble.
Keep us posted
Chloe

 

Re: Horrific anxiety resurgence - help! Ritch

Posted by Emme on June 4, 2002, at 21:25:53

In reply to Re: Horrific anxiety resurgence - help! Emme, posted by Ritch on June 4, 2002, at 12:39:03

Hi Mitch,

Yeah, wow sums it up. I just don't feel right physically. I think I'll call in the morning to try to see the internist. No doubt she will want to do a thyroid test. I had no idea neurontin had the (small) potential to do that.

> Wow,
>
> Yes, I would get thyroid checked again for sure. >There is a *tiny* chance the Neurontin is making >you a little hyperthyroid (that has been reported > with it occasionally).

> You didn't by any chance come off of an SSRI five > weeks ago, did you? I just wonder what changed > five weeks ago (besides the Lamictal addition).

No, no SSRI. I hit 100 mg Lamictal 5 weeks ago, but that's it. Maybe a delayed effect from hitting that dose...? The godawful physical anxiety only hit 5 DAYS ago, with no changes in medication. The only thing that happened 5 days ago was that I had a great Memorial Day weekend in which I did many miles of hiking in the mountains. Now I can barely run and have no stamina.

> The last two times I stopped an SSRI cold I had a > delay effect of a few weeks and then *panic*!

Ewww..that sounds like loads of fun. What was your panic like? Was it more worry, or was there a physical sensation of panic, or both?

> Another possibility is just your cycling waxing > and waning as you say. You probably have a few > days of mixed stuff that you cycle through.
> Have you mood-charted to see what type of
> pattern your cycles make? It could be you are
> cycling roughly every three weeks.

I do keep a calendar, but there isn't a real pattern these days. In the past, I have cycled on the order of weeks when I was on some ADs. But the clycing was more exhaustion alternating with less exhaustion.

> You might need to add on a different mood
> stabilizer.

I think just trying a different drug would drive me off the deep end, I'm so burnt out on trying different things. Given how refractory my depression's been, I think we need to keep the lamictal and figure out tweaking the rest.

> Of course, the Lamictal might be the one
> agitating you and perhaps it needs to be
> decreased a little. Definitely need to see your > pdoc about it.

Yeah, I was wondering about dropping it a tad. But I communicated with her today and she suggested I try increasing the atenolol to 50 mg to help settle me down, and actually increase the lamictal a bit. I guess she figures it might provide more stabilization. We're not bumping it up much, so I'll see. I will probably take your suggestion and creep up the klonopin a little more. Anything to be comfortable and be able to work. Thanks for your helpful posts.

Emme

In the meantime you might want to bump the Klon up to 1.5mg/day so you won't feel so miserable.
>
> hope this helps,
>
> Mitch

 

Re: Horrific anxiety resurgence - help! Chloe

Posted by Emme on June 4, 2002, at 21:33:02

In reply to Re: Horrific anxiety resurgence - help! Emme, posted by Chloe on June 4, 2002, at 18:39:11

Hi Chloe,

So you still have swings of some sort even with the set of meds you can come up with right now? Consistency would be great. But maybe I need to rethink stability and think of it more like driving a car, with continual small variations in the path, and needing to change a bit here and there. At the moment I'd like to just know there's nothing else wrong with me, so I'll probably go to the internist.

No, no birth control pills.
Whoa, someone knocking at my door, gotta go.
Thanks for the good wishes.

Emme


> Emme,
> Sorry you are having this awful anxiety. I have never been able to tolerate Lamictal, so I am so help in that area.
> But I do find that sometimes even thouogh I take the same meds day in and day out, they don't have the same effect day in, day out. Some days or weeks, I feel over medicated and a bit foggy. Then a few days later, I can feel terribly under medicated, anxious, giddy, short fused, rageful. I find it extremely difficult to feel even or consistant. I don't see why I can't unite myself. I am constantly evolving in the mood department...
>
> Lastly, have you had any hormonal changes or gone on or off a pill? I had to stop my BCP that i was taking active pills only. And when I stopped. SEvere depression. When I resumed, severe anxiety that is finally settling after three weeks...Thank God the anxiety is leaving. The angst and pressured feeling is awful for me. I am sorry you are suffering...So I guess thyroid, hormones and lamictal dosage would be good places to focus.
>
> I apologize for the ramble.
> Keep us posted
> Chloe

 

Re: Horrific anxiety resurgence - help! Emme

Posted by Ritch on June 5, 2002, at 0:59:48

In reply to Re: Horrific anxiety resurgence - help! Ritch, posted by Emme on June 4, 2002, at 21:25:53

> No, no SSRI. I hit 100 mg Lamictal 5 weeks ago, but that's it. Maybe a delayed effect from hitting that dose...? The godawful physical anxiety only hit 5 DAYS ago, with no changes in medication. The only thing that happened 5 days ago was that I had a great Memorial Day weekend in which I did many miles of hiking in the mountains. Now I can barely run and have no stamina.

This may be an odd observation-but the exercise or *sunlight*, or altered sleep/wake patterns from the vacation might have triggered a hormone change/cascade of sorts that has rocked your HPA axis and set off this unpleasant stuff.

>
> > The last two times I stopped an SSRI cold I had a > delay effect of a few weeks and then *panic*!
>
> Ewww..that sounds like loads of fun. What was your panic like? Was it more worry, or was there a physical sensation of panic, or both?


At first the SSRI withdrawal just felt like being bored. It seemed like I lost my sense of humor. Then I started to feel GAD-like worry about all sorts of stuff. Then I started getting physical symptoms that aggravated the worrying (aches/pains/muscle tension, etc.) Then the worry developed almost into an agoraphobic like thing. That is when I started to panic (definitely LOTS of physical "sensations"!). I would get overwhelmed with worries and would just start to flip out. I am taking some imipramine now (first time I have tried it), and it seems to be working fairly well. I am going to try to withdraw what little Celexa I take and replace it with the imipramine. So I would be taking an all low-dose combo of Depakote, Neurontin, Clonazepam, and Imipramine. Desipramine (a metabolite of impramimne) worked GREAT for ADHD symptoms previously, but it made me too nervous. Imipramine is much more serotonergic and I haven't had any trouble with anxiety so far.


> > Of course, the Lamictal might be the one
> > agitating you and perhaps it needs to be
> > decreased a little. Definitely need to see your > pdoc about it.
>
> Yeah, I was wondering about dropping it a tad. But I communicated with her today and she suggested I try increasing the atenolol to 50 mg to help settle me down, and actually increase the lamictal a bit. I guess she figures it might provide more stabilization. We're not bumping it up much, so I'll see. I will probably take your suggestion and creep up the klonopin a little more. Anything to be comfortable and be able to work. Thanks for your helpful posts.
>
> Emme


good luck,

Mitch

 

Re: Horrific anxiety resurgence - help! Emme

Posted by JohnX2 on June 5, 2002, at 1:58:20

In reply to Horrific anxiety resurgence - help!, posted by Emme on June 4, 2002, at 7:52:33

> Hi All,
>
> Well, the good news is that Lamictal is helping my depression and I feel much more like making plans to reclaim a life than I have in ages. I am at 100 mg and feel I may not tolerate a higher dose very well, though I could always try and see. I also take 900 mg neurontin, 25 mg atenolol (for anxiety), and klonopin as needed. DX Bipolar II.
>
> Here's the problem. A couple of weeks back I was really sluggish. The anxiety was really toned down but I was too low-energy and feeling a bit down. I tried a low dose of provigil (some of you participated in the post) and then stopped it for a few days and my energy and mood were more normal so I stayed off.
>
> Now...a couple of weeks later and one fantastic hiking/camping trip in between (felt good during trip), I've shifted to out-of-control anxiety, mostly physical symptoms. I still have good antidepressant effect from Lamictal at the moment - I've been at 100 mg for about 5 weeks. But for the last 5 days, I am really jittery, lump in throat, feel like I've consumed caffeine, wake up feeling like my heart is pounding. I find it hard to exercise because I'm so revved. I am belching an awful lot (sorry to be ungraceful) and have intermittent chest pain off to the side which I suspect has to do with the endless rising gas - my stomach must be really churning. You know, the whole flight or fight thing. I feel miserable.
>
> I've upped the atenolol a bit and have upped klonopin to 1 mg - it helps some but doesn't compeltely do it. I'm sleepy and still revved. I can't figure out how I can essentially just switch on a dime from being sluggish to such a state, with one quasi-normal week in between. But I'm miserable and may go to the internist if it persists, though I'm not sure what she can do it for my that my pdoc can't advise. Maybe yet *another* thyroid test...? I don't know if it's my body continuing to adjust to Lamictal, or if it's my anxiety just waxing and waning of it's own accord.
>
> What to do....? Anyone experienced anything similar?
>
> Thanks,
> Emme

Hi Emme,

Been There.

Unless the hyperthryoid checks out, you probably need to
augment the Lamictal with another mood stabilizer.

I think that a dosing of Zyprexa might do the trick from
my experience. You may need to lower your benzo and neurontin
dose as a result. Zyprexa is quick acting (works in a few days).
I found it to smooth out mixed states pretty effectively.
Its a bit sedating at first. But after a week or 2 it wears
off some. Usually you start at 2.5-5 mg and can dose it upto
10-20mg depending on how much you need for mood stabilization.
Around 10mg is where it exerts moderate antimanic effects.

Depakote is possible, but there is a drug interaction.
You *could* carefully cut the lamictal dose in 1/2 to take the
Depakote (Depakote approximately doubles lamictal levels).

A 3rd option is the mood stabilizer Trileptal/Tegretol.

And then there is Lithium. IMO, I'd hold off on that one until
you've exhausted all other routes.

Good Luck,
John

 

Re: Horrific anxiety resurgence - help! Ritch

Posted by Emme on June 6, 2002, at 8:07:26

In reply to Re: Horrific anxiety resurgence - help! Emme, posted by Ritch on June 5, 2002, at 0:59:48

Hi Mitch,


> This may be an odd observation-but the exercise or *sunlight*, or altered sleep/wake patterns from the vacation might have triggered a hormone change/cascade of sorts that has rocked your HPA axis and set off this unpleasant stuff.

Interesting hypothesis. I keep feeling like this tiny little vacation knocked something awry, even though my pdoc thought if anything it should make me calmer. As you said, lots of sunlight, lots of hard exercise, definitely some altered sleep (too cold one night, etc.), and continual social interaction, might have been an awful lot of stimulation at one time. Felt great at the time. Reminded me more of what I used to be like, especially the social aspects. But I don't intend to give up vacations, so what's a gal to do? Just be prepared for what may come after and try to head it off at the pass...?

> At first the SSRI withdrawal just felt like being bored. It seemed like I lost my sense of humor. Then I started to feel GAD-like worry about all sorts of stuff. Then I started getting physical symptoms that aggravated the worrying (aches/pains/muscle tension, etc.) Then the worry developed almost into an agoraphobic like thing. That is when I started to panic (definitely LOTS of physical "sensations"!). I would get overwhelmed with worries and would just start to flip out.

That is scary stuff. How long were you suffering with this? Yesterday I had a total meltdown for a few hours, with runaway worry. I have really come to resent episodes of depression or anxiety for what they take away from me in time and work and play, etc.

Why did you choose to stop your SSRIs? (you may have mentioned and I forgot. I have zero memory BTW, which is very disturbing.) Have you been on Paxil ever?

I am giving it a few more days to try to control my symptoms with what I've got. The Zyprexa sounds like a good idea. I have to admit I'm a bit afraid of the pork-o-genic factor I keep reading about. I'm gonna see if the tiny amounts of seroquel I've added and increased clonazepam are enough to help. Without knocking me unconscious. :) I have a feeling if this keeps up, my pdoc will get around to suggesting zyprexa. The bummer is I can't exercise vigorously right now. Forget running. Maybe the atenolol is dropping my blood pressure a little too low.

> I am taking some imipramine now (first time I have tried it), and it seems to be working fairly well. So I would be taking an all low-dose combo of Depakote, Neurontin, Clonazepam, and Imipramine. Desipramine (a metabolite of impramimne) worked GREAT for ADHD symptoms previously, but it made me too nervous. Imipramine is much more serotonergic and I haven't had any trouble with anxiety so far.

Glad the imipramine looks promising. I hope it continues to work out well.
Glad the imipramine is working out well for you so far.

good luck,
Emme

 

Re: Horrific anxiety resurgence - help! Emme

Posted by Ritch on June 6, 2002, at 9:51:51

In reply to Re: Horrific anxiety resurgence - help! Ritch, posted by Emme on June 6, 2002, at 8:07:26

> Hi Mitch,
>
>
> > This may be an odd observation-but the exercise or *sunlight*, or altered sleep/wake patterns from the vacation might have triggered a hormone change/cascade of sorts that has rocked your HPA axis and set off this unpleasant stuff.
>
> Interesting hypothesis. I keep feeling like this tiny little vacation knocked something awry, even though my pdoc thought if anything it should make me calmer. As you said, lots of sunlight, lots of hard exercise, definitely some altered sleep (too cold one night, etc.), and continual social interaction, might have been an awful lot of stimulation at one time. Felt great at the time. Reminded me more of what I used to be like, especially the social aspects. But I don't intend to give up vacations, so what's a gal to do? Just be prepared for what may come after and try to head it off at the pass...?

I just thought of something else that might explain it. You had a down spell after you got back from the trip and then a lot of anxiety? You mentioned above about all of the stimulation. I was reading about some personality traits of folks with ADHD the other day and it was talking about a continual need for stimulation and that when big projects FINISH or stimulating events END the person often gets depressed (not to say you *have* ADHD-perhaps this is a relatively common reaction). If that is the case, then the depression could have set off the anxiety. When you got back from the trip did you get quickly very bored and melancholic?


>
> > At first the SSRI withdrawal just felt like being bored. It seemed like I lost my sense of humor. Then I started to feel GAD-like worry about all sorts of stuff. Then I started getting physical symptoms that aggravated the worrying (aches/pains/muscle tension, etc.) Then the worry developed almost into an agoraphobic like thing. That is when I started to panic (definitely LOTS of physical "sensations"!). I would get overwhelmed with worries and would just start to flip out.
>
> That is scary stuff. How long were you suffering with this? Yesterday I had a total meltdown for a few hours, with runaway worry. I have really come to resent episodes of depression or anxiety for what they take away from me in time and work and play, etc.

YES, it was very scary. By the time the panic attacks started, I *almost* went to the ER probably a half dozen times in three or four days. It just lasted a few weeks (overall). I didn't have *any* benzos handy so I was taking 25mg of Benadryl 4x a day and it helped quite a bit. However, when I finally got into see my pdoc I got put on diazepam 10mg 4x daily and it quickly settled all down within a few days. Then I went to Klonopin .5mg 3x daily, then 2x daily. Whew! I just take Klon. .5mg at bedtime now.


>
> Why did you choose to stop your SSRIs? (you may have mentioned and I forgot. I have zero memory BTW, which is very disturbing.) Have you been on Paxil ever?

I have tried *all* of the SSRi's. I don't like them because they trigger cycling (particularly the few days hypo and then a two or three day crash, then two or three days normal, over/over), and they set off lots of diarrhea and cramping, not to mention restless legs, disrupted sleep, acid reflux, reduced libido, joint pain, mild EPS..... But, they just do charming things for anxiety. If I could just get the mental effects without the physical ones I would be very pleased with them (I would even tolerate the cycling).


>
> I am giving it a few more days to try to control my symptoms with what I've got. The Zyprexa sounds like a good idea. I have to admit I'm a bit afraid of the pork-o-genic factor I keep reading about. I'm gonna see if the tiny amounts of seroquel I've added and increased clonazepam are enough to help. Without knocking me unconscious. :) I have a feeling if this keeps up, my pdoc will get around to suggesting zyprexa. The bummer is I can't exercise vigorously right now. Forget running. Maybe the atenolol is dropping my blood pressure a little too low.

If rapid cycling is what you are going through-you probably won't have to wait very long before it will lift again.


Mitch

 

Re: Horrific anxiety resurgence - help! Ritch

Posted by Emme on June 7, 2002, at 9:31:47

In reply to Re: Horrific anxiety resurgence - help! Emme, posted by Ritch on June 6, 2002, at 9:51:51

> I just thought of something else that might explain it. You had a down spell after you got back from the trip and then a lot of anxiety? You mentioned above about all of the stimulation. I was reading about some personality traits of folks with ADHD the other day and it was talking about a continual need for stimulation and that when big projects FINISH or stimulating events END the person often gets depressed (not to say you *have* ADHD-perhaps this is a relatively common reaction). If that is the case, then the depression could have set off the anxiety. When you got back from the trip did you get quickly very bored and melancholic?

Hmmm...well...I do tend to get the post-vacation depression. But then I am unhappy with several aspect of my life (including the need to job hunt and probably relocate). So after vacation it's back to reality. This time I was happy that I didn't experience post-vacation mood dip. I did have one day right after getting back where I slept all afternoon, evening, and night and figured I was just worn out. Then....the overdrive set in, not actually a depressed mood.

I've never exactly been an adrenaline seeker (no bungee jumping for me :), but I do like to have a interesting things going on. Funny you should mentiohn ADD. Over the last few years I have often wondered if I was ADD (not HD though) as I've had a hard time focusing and am easily distracted by ambient noises. However, I focused well on schoolwork as a child and in college. So I figured it was anxiety. At any rate, my pdoc thought stimulants were worth a try. Ritalin and dexedrine didn't help and make me jittery. My new hypothesis is that if anxiety and depression are controlled enough then I'll be able to try to use good study habits for work.

> YES, it was very scary. By the time the panic attacks started, I *almost* went to the ER probably a half dozen times in three or four days.

You wouldn't have been the only one had you gone. I ended up in the ER with my first panic attack. It is truly frightening to have your body go on autopilot in a bad way.


> It just lasted a few weeks (overall). I didn't have *any* benzos handy so I was taking 25mg of Benadryl 4x a day and it helped quite a bit. However, when I finally got into see my pdoc I got put on diazepam 10mg 4x daily and it quickly settled all down within a few days. Then I went to Klonopin .5mg 3x daily, then 2x daily. Whew! I just take Klon. .5mg at bedtime now.

My days of the intense panic attacks lasted a only few months. Since then I may get a mild one every couple of years just for kicks. I am glad you got on a benzo. I really do think that benzos are a quick, humane way to stop the panic misery. The sooner the cycle is broken the better.

So you find the klonopin and the imipramine are your best antianxiety agents? Klonopin is reliable for me. I think seroquel is going to continue to help if I can control the dose enough. We're talking crumbs here. I will be so glad if I can start to exercise again with some intensity.

> I have tried *all* of the SSRi's. I don't like them because they trigger cycling (particularly the few days hypo and then a two or three day crash, then two or three days normal, over/over), and they set off lots of diarrhea and cramping, not to mention restless legs, disrupted sleep, acid reflux, reduced libido, joint pain, mild EPS..... But, they just do charming things for anxiety. If I could just get the mental effects without the physical ones I would be very pleased with them (I would even tolerate the cycling).

Wow. That is one bad set of reactions. You mentioned imipramine. Do tricyclics not induce cycling for you?

> If rapid cycling is what you are going through-you probably won't have to wait very long before it will lift again.

Good grief I hope so. I'm a little better than I was yesterday. I'm calmer just sitting and working now, but easily tripped over into anxiety by external events. (I miss the antianxiety effects of things like Paxil and Remeron) I hate the lump in the throat and frequent feeling that my heart is pounding (internist says no probelms there). If I can get back more of an overall buffer, I'll be pleased.

Do you (or anyone else) feel vaguely embarrassed when you go to an internist or some other doctor and rattle off a long list of medications you take. Makes me feel like a weirdo.

Thanks to all for your patience with the longest set of complaining/stressing I've done on this board yet.

chers,
Emme


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