Posted by Emme on January 12, 2004, at 9:57:56
In reply to Re: Can you all give me some feedback? » Emme, posted by Ame Sans Vie on January 12, 2004, at 8:19:28
> > Hello All,
>
> Hiya. :-)Hello.
> As far as benzodiazepines are concerned, many people find Xanax to be minimally sedating and more uplifting than most others in this class. You mentioned you already take it though... how does it compare with clonazepam for you?
The Xanax is fine, but I find clonazepam to be a smoother ride. I eased off the clonazepam for a while to just see if I thought it was making me more depressed. I don't think it is. I'm thinking about going back to more regular use of a low dose of clonazepam and see if the sedating effects ease up. I did okay on it for quite a while. But I'll ask my pdoc about the benzos you mention below. She's brought up Ativan but we haven't acted on it yet.
> Some other benzos that may be less zombifying are Ativan (lorazepam), Serax (oxazepam), and Paxipam (halazepam). If you're outside the U.S., Lexotan (bromazepam) may be worth a try.
> If you're just using anxiolytics on an as-needed basis, then maybe you would be better off with phenobarbital (Luminal/Solfoton -- a long-acting [about 12 hours] barbiturate that works well for anxiety and can also increase energy levels). Amobarbital (Amytal), secobarbital (Seconal), amobarbital/secobarbital (Tuinal), and pentobarbital (Nembutal) are also barbiturates and can have a phenobarbital-like effect, but they may be better if you need something shorter-acting. Equanil (meprobamate) or Soma (carisoprodol) are also good options for as-needed use. Equanil is specifically touted as an anti-anxiety medication, while Soma is a muscle-relaxant which partially metabolizes into meprobamate in your system. I've always found Soma to be wonderful at eradicating anxiety and inducing a sort of easy-going, happy-go-lucky feeling. Again though, these drugs are usually only a good idea if they're used intermittently
Good lord! I didn't know there were so many options! Hmmm...maybe some of these might be options in the case of that extra breakthrough or situational anxiety.
> I also felt quite over-stimulated with Lamictal... it felt very Paxil-like, too. I discontinued it the very day I began feeling SSRI-type side effects. The benzos, barbs, meprobamate, and carisoprodol I mentioned above are all possible candidates, I feel, to counterract the Lamictal stimulation. Depakote is another possibility.
Stimulating effects aside, I've been able to tolerate it better than many other things. Thanks for the suggestions for calming agents.
> As for your heart rate, that's something you absolutely should discuss with your doctor. Perhaps a higher dose of atenolol, a switch to another beta-blocker (i.e. propranolol), or the addition of an alpha-adrenergic agonist like clonidine or guanfacine is in order.
My pulse isn't running *dangerously* high, and I don't have palpitations, but I'd certainly like to get it a bit lower. I may try a higher dose of atenolol. I tolerate it well except that I think it makes me feel cold. Is propanolol cardio-selective? I don't know about the other two. I'll look them up.
> Of course you have to exercise extreme caution when administering stimulants to bipolars, but how about trading in the selegiline for a very low dose of methylphenidate (2.5mg prn), magnesium pemoline (56.25mg), or an amphetamine (5mg prn) to see how that fares you?I'll look those up too. It may be that whatever energizing drug I use, it'll have to be on an as-needed basis. I hate symptom-chasing, but...
> I'd probably stick with Seroquel... I may be mistaken, but I believe research shows that Risperdal and Zyprexa are more likely than other antipsychotics to cause diabetes.
That's my thinking too.
> Perhaps... Strattera and Wellbutrin are two meds I forgot earlier that may be useful for treating the benzo zombification. Again though, there is the risk of induction of mania.
Oh yeah. I forgot about the Wellbutrin. Too simulating, especially on top of the Lamictal. I'm not going there again.
> I'd put Topamax on the "should all else fail" list if I were you... the fact that it caused depression once before doesn't really work in its favor.
I was reading those posts a short while ago about topomax helping depression and was starting to wonder...
> That's true -- though, as I mentioned above, Depakote may also be a good MS to reduce stimulation caused by lamotrigine.She's held off pushing for it, but I suppose it's possible that my pdoc might bring it up. I feel nervous about it because I've read about the side effects: weight gain, hair loss... Am I being overly nervous? Maybe most people don't have these problems?
> I haven't heard personally of any cases where Tegretol worked when Trileptal did not, or vice versa -- they're basically the same drug, though Trileptal is safer.
Thanks for putting so much thought in to replying.
Emme
poster:Emme
thread:299547
URL: http://www.dr-bob.org/babble/20040109/msgs/299778.html