Posted by zeugma on October 9, 2004, at 21:43:42
In reply to Re: rip van winkle syndrome » zeugma, posted by karaS on October 9, 2004, at 20:48:42
> Hi z,
>
> Sorry it's taken me a while to answer you. I've had quite a busy week working at both a catering job and a temp job. It's so nice to have a day off finally.Yes. Tomorrow will be my day off (sort of). And the day after. But there's so much I have to do. It is almost more exhausting for me to be in my chaos of an apt. than to be in my workplace. I think I'm going to listen to music, and let my mind drift. My ADD really feels like a REM state: directionless, random processes that follow their own course. I think Strattera had such an effect on my ADD because it is such a powerful norepinephrine reuptake inhibitor, and suppressor of REM sleep. But I can't take it (see below).
>
> > It wasn't like nortriptyline suddenly got me going. But as with your experience with doxepin, it sent my panic attacks packing, and I was able to slowly get the elements in place that would lead to progress after years of being hopelessly stalled. When you mention that doxepin worked for your panic attacks, it makes me wonder whether the TCA's aren't superior to SSRI's in terms of treating panic disorder. Le Doux (author of my textbook "Synaptic Self") is director of the Center for the Study of Fear and Anxiety at NYU, and yet in the index to his book, there is shockingly no mention of a structure long associated with anxiety disorders, the locus coeruleus (seat of CNS NE production). Norepinephrine has gotten a raw deal in popular culture, but more dismayingly, from distinguished professionals. Le Doux has interesting things to say about such phenomena as long term potentiation and the role of the hippocampus in memory, but considering that he is the author of "The Emotional Brain" and that his ostensible specialization is fear and anxiety, I do not consider him a thinker worth taking seriously for a moment, and in fact his contributions have a deleterious effect on the neurosciences. I get some basic information from him, but it is writers like Gerald Edelman ("A Universe of Consciousness") and J. Allan Hobson ("Dreaming as Delirium") whose ideas will outlast our time. Anyway...
>
> I have not read any of the books you mention so I can't comment but I do think that TCAs are excellent for anxiety. The SSRIs seem to prevent anxiety attacks in me as well but the action of the TCAs (at least doxepin) felt more direct. I don't know how to explain it really but I think you're on to something there.
>I am sure that TCA's have a more direct action on panic. Don't have the energy to speculate further, but what you have said corroborates my own experience.
> > I got my script for 30 mg Ritalin LA today. Like you, I am wary of making changes during a crucial time. So you have Tuesday off? for what it's worth, I can't rely on Ritalin for energy. Strattera is actually more energizing, and hopefully it will be the case that keeping it at a low dose will avoid its pitfalls. Best of luck tomorrow!
>
> I haven't started the Cymbalta yet because I didn't want to have unexpected side effects while working. I'll start it this weekend. I hate starting new drugs. Can you tell?
>No I couldn't :)
> How are you doing balancing the Strattera and Ritalin?The Strattera is gone. it tore my stomach apart, and it seemed that I got a response only from doses that came close to 40 mg. Plus it would wear off around 1 or 2 pm necessitating bid dosing, and of course, more side effects. It did its job for a little but it is not a medicine that I can tolerate. I am now taking 30 mg ritalin LA am plus 10 mg at noon. It is not doing wonders for me, but I tolerate it better than Strattera, and I need something I can take that does not feel worse than the original condition. If I needed Strattera to work full-time, I would opt for part-time and try to scrape by. I would have no choice.
I explained to my pdoc that Ritalin simply is not as effective for my symptoms as Provigil or Strattera, but that the latter two are not tolerable. I told him that Ritalin's inefficacy in itself causes anxiety, so he let me increase my clonazepam. There is nothing more anxiogenic, for me, than to know that my focus is slipping away, and that others can see it (I have a job that calls for constant interaction, and trust me: they can). My pdoc told me also to decrease caffeine as much as possible, as they compete for the same receptors. I had much the same thought. But if Ritalin at the higher dose doesn't help, it will be caffeine all the way. I am not having serious s/e from Ritalin, so I suppose the dose could go higher. We'll see.
By the way, to answer your question in your last post: I think I have both. A fun combination :) I am also restarting buspirone, 15 mg hs, as I told him it blocked hypnagogic hallucinations when I knew I would be vulnerable to them (ie, when I am stressed or have gotten inadequate sleep previously). I took it last night without problems. I tolerate buspirone well at low dosages.
So you are starting Cymbalta today? I am getting impatient!
-z
>
> Kara
>
>
poster:zeugma
thread:397388
URL: http://www.dr-bob.org/babble/20041007/msgs/400976.html