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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 37. This is the beginning of the thread.
Posted by greenwillow on January 25, 2011, at 10:19:11
I was recently dxd with ptsd. Are there specific meds that are generally prescribed for dealing with this? Also are there any searchable websites to help me find a psychologist specifically trained in dealing with this disorder?
Thanks, Green Willow
Posted by Phillipa on January 25, 2011, at 11:03:53
In reply to ptsd meds, posted by greenwillow on January 25, 2011, at 10:19:11
Hi greenwillow my pdoc now thinks I also have this which leads to the Gad so I'd also love to know. Thanks for posting this question. Phillipa
Posted by creepy on January 25, 2011, at 11:47:25
In reply to ptsd meds, posted by greenwillow on January 25, 2011, at 10:19:11
I think this depends on what your primary symptoms are. Mine is the depression, since Ive worked through many of my triggers in therapy.
If you have physical anxiety symptoms like fast heart rate, butterflies in stomach, etc. maybe an alpha/beta blocker would be useful. Prazosin is the only one Ive taken its supposed to be good for nightmares as well.
If you have bad hyperarousal symptoms maybe a mood stabilizer would be used. Topamax is the only one Ive tried and I couldnt tolerate it.
supposedly it slows the amygdala, which is involved in the stuck fight or flight response.
If your primary symptoms are depression and anhedonia, maybe an SSRI, SNRI would be used. TCAs as a class can be fairly sedating and anxiolytic they may be helpful. The only TCA Ive tried was desipramine and it was good for fibro pain, not so much on depression or anxiety.
Lexapro might be a good one if you have rage issues. It turned mine off like a switch at higher dosages. But for me the apathy was awful.
I hope you give therapy a shot, I have found standard therapy useful, but there are several other types which can help such as CBT, EMDR and IFS.
Posted by Zyprexa on January 25, 2011, at 15:57:37
In reply to ptsd meds, posted by greenwillow on January 25, 2011, at 10:19:11
I've taken Zyprexa for the last 13 years for PTSD. I think they use antipsychotics for PTSD. It started as ptsd and evolved into many other diagnosises. I think the sedating APs help with this because the event was very activating. I also take an antidepressant for this. These are also used for ptsd, but alone are not that usefull.
Posted by floatingbridge on January 25, 2011, at 15:58:52
In reply to ptsd meds, posted by greenwillow on January 25, 2011, at 10:19:11
Hi greenwillow,
I'm sorry about your condition. It means something intolerable happened :( never a good thing.
There is a pstd forum (.org I believe) with articles and many forums. They are Australia based. If you're in the states, I don't know. Google and Google ptsd. My county has a psych counseling site to search for providers.
I'm going to try Lyrica off-label and see I'd that helps my triggers--dial them back a bit.
I haven't found any ptsd protocol. I'd love to hear about one.
Best to you on finding your way.
fb
Posted by floatingbridge on January 25, 2011, at 17:54:33
In reply to Re: ptsd meds, posted by Zyprexa on January 25, 2011, at 15:57:37
Zyprexa, Sorry. Didn't know about the ptsd. :(
Are you taking the prozac zyprexa combination?
Best,
fb
Posted by creepy on January 26, 2011, at 10:41:33
In reply to Re: ptsd meds, posted by Zyprexa on January 25, 2011, at 15:57:37
Must be some serious anxiety to need such a powerful AAP.
The biggest concern with zyprexa is the metabolic side effects. Some studies showed that metformin helps a lot with that. If your doc hasnt mentioned it you may want to bring it up. Zyprexa can raise blood sugar levels and change how the body stores and uses energy from fats. It can be a BIG weight gainer.
Are you stable now? Enough to consider therapy like EMDR? I recently started with a trauma specialist and Im working towards EMDR.
Posted by greenwillow on January 26, 2011, at 15:03:04
In reply to Re: ptsd meds, posted by creepy on January 25, 2011, at 11:47:25
Creepy (or anyone), What is IFS therapy?
> I think this depends on what your primary symptoms are. Mine is the depression, since Ive worked through many of my triggers in therapy.
> If you have physical anxiety symptoms like fast heart rate, butterflies in stomach, etc. maybe an alpha/beta blocker would be useful. Prazosin is the only one Ive taken its supposed to be good for nightmares as well.
> If you have bad hyperarousal symptoms maybe a mood stabilizer would be used. Topamax is the only one Ive tried and I couldnt tolerate it.
> supposedly it slows the amygdala, which is involved in the stuck fight or flight response.
> If your primary symptoms are depression and anhedonia, maybe an SSRI, SNRI would be used. TCAs as a class can be fairly sedating and anxiolytic they may be helpful. The only TCA Ive tried was desipramine and it was good for fibro pain, not so much on depression or anxiety.
> Lexapro might be a good one if you have rage issues. It turned mine off like a switch at higher dosages. But for me the apathy was awful.
> I hope you give therapy a shot, I have found standard therapy useful, but there are several other types which can help such as CBT, EMDR and IFS.
Posted by greenwillow on January 26, 2011, at 15:04:45
In reply to ptsd meds, posted by greenwillow on January 25, 2011, at 10:19:11
Posted by floatingbridge on January 26, 2011, at 15:06:49
In reply to Thanks for ideas (nm), posted by greenwillow on January 26, 2011, at 15:04:45
Posted by greenwillow on January 26, 2011, at 17:11:16
In reply to Re: ptsd meds, posted by creepy on January 25, 2011, at 11:47:25
My symptoms are serious depression, and now it has come to manifest itself physically with severe heart palpitations which the cardiologist says is from adrenaline. Also I have developed nausea which is as of yet undiagnosed, and have also had some nightmares. You mention alpha/beta blockers. I do have a couple of beta blockers around the house, they are propanolol and bystolic. I take it that alpha blocker something different than beta blockers???? thanks GW
> I think this depends on what your primary symptoms are. Mine is the depression, since Ive worked through many of my triggers in therapy.
> If you have physical anxiety symptoms like fast heart rate, butterflies in stomach, etc. maybe an alpha/beta blocker would be useful. Prazosin is the only one Ive taken its supposed to be good for nightmares as well.
> If you have bad hyperarousal symptoms maybe a mood stabilizer would be used. Topamax is the only one Ive tried and I couldnt tolerate it.
> supposedly it slows the amygdala, which is involved in the stuck fight or flight response.
> If your primary symptoms are depression and anhedonia, maybe an SSRI, SNRI would be used. TCAs as a class can be fairly sedating and anxiolytic they may be helpful. The only TCA Ive tried was desipramine and it was good for fibro pain, not so much on depression or anxiety.
> Lexapro might be a good one if you have rage issues. It turned mine off like a switch at higher dosages. But for me the apathy was awful.
> I hope you give therapy a shot, I have found standard therapy useful, but there are several other types which can help such as CBT, EMDR and IFS.
Posted by creepy on January 26, 2011, at 21:04:54
In reply to Re: ptsd meds » creepy, posted by greenwillow on January 26, 2011, at 15:03:04
Inter family systems therapy. It seems to be about defining various 'parts' of your psyche that do work, like dissociate, get angry, defend against feeling helplessness, etc. Id have called them 'protective mechanisms' before trying this therapy.
The therapist has you focus on the part in question and ask it to tell its story.
Eventually the defensive parts may let up enough to let you get at 'exiles' which are parts that carry repressed feelings from traumatic experiences.
So far it seems like a different spin on what Ive already done for years, but the focused association is new. and its really hard to do for me =(
Posted by creepy on January 26, 2011, at 21:12:32
In reply to Re: ptsd meds » creepy, posted by greenwillow on January 26, 2011, at 17:11:16
Heart palpitations can be due to lots of NE, sure. But they can be other things too. oddly I find that I need -more- NE. Its almost like being hyperaroused for so long with PTSD has caused all sorts of other derangements in my system. I perceive pain more strongly. MY blood pressure sometimes drops and I get migraine. my sinuses are perpetually congested and I am fatigued. Sure many of these symptoms can come from other things but its odd that adding an NRI helps them all. As if I was missing the extra NE. It pushes the anxiety a bit, which sucks. But the alternative is worse.
Alpha and beta blockers block different andrenergic receptors. Which are involved in PTSD? Not sure because I see both used. Prazosin is common for nightmares. Maybe because of its short halflife. Clonidine is often used for helping with adrenaline rush in response to triggers. all of these meds can -cause- depression because they block NE. So youd need to be careful with them.
Posted by Zyprexa on January 27, 2011, at 6:16:00
In reply to Re: ptsd meds » Zyprexa, posted by floatingbridge on January 25, 2011, at 17:54:33
I'm taking: Zyprexa, perphenazine, bupropion sr, sertraline and cogentin. Prozac didn't work for me.
Posted by Zyprexa on January 27, 2011, at 6:27:07
In reply to Re: ptsd meds, posted by creepy on January 26, 2011, at 10:41:33
I did have diabeties for a while, but has gone away. I suspect it was geodon that made me diabetic. I did take metformin for a while and it helped keep my weight down.
Its not just severe anxiety, but also I'm schitzoaffective now.
Posted by floatingbridge on January 27, 2011, at 10:35:56
In reply to Re: ptsd meds, posted by Zyprexa on January 27, 2011, at 6:27:07
Zyprexa, do you partially attribute developing schizoaffective to experiencing severe anxiety? I understand if this isn't the thread or even if you don't care to discuss any further. Peace.
(I believe I suffered anxiety for years before depression. That the anxiety wore me down....)
Greenwillow, apologies for hijacking your thread.
fb
Posted by Zyprexa on January 28, 2011, at 21:25:39
In reply to Re: ptsd meds » Zyprexa, posted by floatingbridge on January 27, 2011, at 10:35:56
Yes I do. I underwent a lot of anxiety after the accident. People blamed me for the death (which was not me), and beat me up and yelled at me. I lived in fear for many years thinking someone would be on the way to kill me. Very stressfull.
Posted by phillipa on January 28, 2011, at 21:35:58
In reply to Re: ptsd meds » floatingbridge, posted by Zyprexa on January 28, 2011, at 21:25:39
Zyprexa accident? What happened so sorry. Yes Ptsd for sure. Love Phillipa
Posted by floatingbridge on January 28, 2011, at 21:46:59
In reply to Re: ptsd meds » floatingbridge, posted by Zyprexa on January 28, 2011, at 21:25:39
Zyprexa, all I can say is I am so sorry. That sounds nightmarish. Can I send some hugs?
At the very least, some very positive thoughts...
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Posted by MissThang on January 29, 2011, at 6:18:33
In reply to ptsd meds, posted by greenwillow on January 25, 2011, at 10:19:11
Wondering if nefazodone would be good for your ptsd...I've just started taking it for axiety/depression (the anxiety component of my condition has become much worse since a trial of parnate that didn't go well at all) and I've been in need of something other than a benzo to calm me down that didn't cause weight gain or sexual dysfunction and nefazodone seems to be fitting the bill...I'm only on 50mg/day at this point (just amping up) but the anxiety is already much better.
Posted by greenwillow on January 29, 2011, at 20:18:45
In reply to Re: ptsd meds, posted by MissThang on January 29, 2011, at 6:18:33
Exactly what is nefazodone?? Green Willow
> Wondering if nefazodone would be good for your ptsd...I've just started taking it for axiety/depression (the anxiety component of my condition has become much worse since a trial of parnate that didn't go well at all) and I've been in need of something other than a benzo to calm me down that didn't cause weight gain or sexual dysfunction and nefazodone seems to be fitting the bill...I'm only on 50mg/day at this point (just amping up) but the anxiety is already much better.
Posted by phillipa on January 29, 2011, at 20:27:16
In reply to Re: ptsd meds » MissThang, posted by greenwillow on January 29, 2011, at 20:18:45
The old serzone generic. Has a lot of antihistamine properties from what I know? Phillipa
Posted by floatingbridge on January 29, 2011, at 20:45:10
In reply to Re: ptsd meds » MissThang, posted by greenwillow on January 29, 2011, at 20:18:45
Hi greenwillow,
(And fellow dealing-with-ptsd people.)
I stumbled across 'guanfacine' in Wiki. Also known as Tenex (short-acting), and Intuniv (long-acting, recently endorsed for ADHD). Both are Alpha Blockers, which I think you mentioned--I don't know what that means.Prazosin (alpha blocker) is listed in Wiki as off label treatment for ptsd.
I'm interested in Intuniv because I have add, and use a stimulant. Intuniv can be used monotherapy for ADHD, but I think I read something about using it in
conjunction to stimulants. (The last bit was off topic :- / )greenwillow, hope you're doing alright.
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Posted by MissThang on January 30, 2011, at 1:28:29
In reply to Re: ptsd meds » greenwillow, posted by phillipa on January 29, 2011, at 20:27:16
Green Willow,
Philippa is right -- nefazodone is the generic of the brand name drug serzone. What I like about it is that it's one of the few serotonin drugs that doesn't cause sexual dysfunction or weight gain. It's very good for anxiety with depression. So far, I'm on a very low dose (50mg -- just titrating up) but I can tell it's been very helpful with my anxiety already. As I continue to titrate up to the minimally effective therapeutic dose (at least 200mg/day), I anticipate greater antidepressant/anti-anxiety benefits.
Serzone came under fire a few years ago because of a few rare instances of liver damage from it -- about 1 in 250,000 - 300,000 people will get liver damage, which can be remedied if noticed early, so it's important to monitor liver function while on this drug, especially at first. Apparently, if you're one of the few who's susceptible to it, you'll have the effects within the first 6 months. On askapatient.com, there are quite a few people who've been on it a decade or more with no ill effects to their livers, so the risk isn't really all that great, but, out of an abundance of caution, I plan to get my liver tests run every month the first 6 months on the med and every 3 months thereafter.
I'm really hopeful that this med continues to work for me as it has so far, however, since in addition to helping with my anxiety (and hopefully, soon, on my depression), it also seems to be helping reduce my long term problem with nearly daily headaches, which have greatly reduced since I started on nefazodone.
I don't know if it's got many anti-histamine effects though -- so far, I haven't noticed any dry mouth, constipation or other symptoms like you would typically find with a med with strong antihistamine properties. It's considered safe to take with Zyrtec and Claritin, but must be used with caution with benedryl due to the possibility of excess sedation.
My eventual goal is to add this to wellbutrin, which gave me great AD effects but increased my anxiety level a bit too much. Stahl, the famous psychiatrist, labeled the combination of nefazodone and wellbutrin as one of 12 "heroic combinations" -- combos that are particularly effective even when other meds have failed.
Anyway -- hope I've answered all your questions -- good luck!
Posted by floatingbridge on January 30, 2011, at 3:10:46
In reply to Re: ptsd meds, posted by MissThang on January 30, 2011, at 1:28:29
MissThang, best of luck on your new med plan. I'm going to Google the 12 heroic combos. Just very curious. Thanks for that tidbit.
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