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Re: Rick: anxiety stuff Thrud

Posted by Rick on December 17, 2001, at 0:52:26

In reply to Rick: anxiety stuff, posted by Thrud on December 12, 2001, at 6:55:51

Thrud -

I wasn't here when you started this thread but I am now. Actually I visited Babble for the first time in awhile a couple days ago, but just ran across this today.

An anxiety "guru" I ain't, but I *have* tried a number of meds and done some research on selected aspects of anxiety and its treatment.

Klonopin remains the linchpin of my own med therapy. I did take it with selegiline for awhile. And while Klonopin in doses under 3 mg has minimal-to-no negative sexual impact, adding the selegiline resulted in a marked increase in both libido and tactile sensitivity -- TOO much, sometimes. And the selegiline defininitely improved wakefulness and cognition as well.

The downside is that the selegiline also added back some anxiety. But not enough to keep me from rating it an effective combo. Keep in mind, though, that I have SP, without DP or (either type) of PD. So I don't know how dangerous a "little" increase in anxiety (vs. solo Klonopin, anyway) would be for you.

In retrospect, I realize that a very small amount of selegiline goes a loooong way in some respects. As the combo with Klonopin stabilized, I was taking only 2.5 mg of selegiline a day, which already *seemed* awfully low. But since then I've seen people who say that, once they've reached steady state, taking as little as 2.5 mg selegiline 2-3 times a week provides plenty of ongoing stimulation. (Which is not to imply that this would be a sufficient dosage for use as a primary antidepressant or in the third PD - Parkinson's Disease.)

Re modafinil/adrafinil, I currently take Provigil (modafinil) with Klonopin, and they form an excellent combo. By no means does the Provigil detract from the effectiveness of my Klonopin -- despite what some have postulated -- as long as I stay at 100 mg/day on the Provigil. (An occasional bump to 200 mg can be useful, but after two days at this level I start to get wired.) Provigil definitely adds unique, adjunctive anti-anxiety dimensions to my treatment, but they're qualitatively different than basic "stay calm!" effects provided by Klonopin. This leads me to believe that Provigil alone would be a much less effective treatment. (Maybe the story is different for adrafinil, even though modafinil *is* its primary metabolite.)

Provigil seems pro-sexual to me, but it's nothing compared to the 2.5 mg/day of selegiline!

Rick

> Hi Rick, hope you're still out there....
>
> As an anxiety guru, I was wondering if you could help me out.
>
> I'm currently on 200mg Lamictal and 3mg Xanax per day for PD. It's strange, although the Xanax takes care of the anxiety, I need something stimulating like Lamictal to increase my "energy" levels; otherwise I feel calm but totally vegetated.
>
> The Lamictal is pooping out on me: I know the feeling. The pdoc and I are running out of ideas. I read on a search of the archives here that someone (patc?) believed Klonopin to be effective for atypical depression (which includes very strong lethargy).
>
> Is this true? If so, why haven't I heard more about it? My pdoc is quite willing to switch me over to Klonopin and see what happens. If Klonopin monotherapy doesn't work, could selegiline plus a benzo work as a way to getting a stimulant effect without sending my anxiety off and above all WITHOUT SEXUAL DYSFUNCTION?!?!?!?
>
> Even Lamictal gives me sexual dysfunction, as does Xanax somewhat. Maybe you have other ideas you could share? I've even considered ECT for relief without sexual side effects, but apparently it is not an effective treatment for PD....
>
> I'm starting to get REALLY desperate now and willing to listen to any kind of way-out suggestions!
>
> Thrud
>
>
>


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poster:Rick thread:86648
URL: http://www.dr-bob.org/babble/20011213/msgs/87164.html