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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 33. This is the beginning of the thread.
Posted by displaced9 on August 3, 2011, at 14:41:06
I am currently taking Wellbutrin 450mg SR, Cymbalta 60mg, and BuSpar 15 mg 3x/day. I am diagnosed with dysthymia and generalized anxiety disorder w/ panic attacks.
The dysthymia is pretty much under control but nothing seems to help with my anxiety since I stopped taking Lexapro. I had to stop Lexapro because of weight gain. I also tried Seroquel but it too caused weight gain.
I take Klonopin 1mg twice daily if needed, but I build a tolerance quickly and it starts to not work unless I increase the dosage.
I am also taking L-Theanine (Theanine Serene brand), New Chapter's Perfect Calm multivitamin and have tried Natural Calm magnesium supplement as well.
Even strong Kava teas and "Relaxation" teas - Nothing works.
My anxiety mostly turns into severe muscle tension which causes a lot of pain. I also get panic/anxiety attacks occasionally, and find it difficult to fall asleep sometimes due to the anxiety / tension in my muscles.
Anyone have any other suggestions? BuSpar doesn't seem to be doing anything at all. I have been on 15mg daily, 30mg daily and now 45mg daily. Tried going up on Cymbalta to 90mg but it gave me tremors.
Thanks.
Posted by Christ_empowered on August 3, 2011, at 17:24:32
In reply to Any other recommendations for Anxiety?, posted by displaced9 on August 3, 2011, at 14:41:06
I wasn't impressed by BuSpar. 60mgs/day did nothing. I have heard that it can help depression in combo with an antidepressant, so...maybe you should keep taking it.
I take niacinamide and taurine for anxiety. 3 grams niacinamide (today I'm trying 6 grams; so far so good) in 2 equal doses, 6 grams taurine in 2 equal doses. Doesn't work immediately, but it does seem to help considerably. Niacinamide makes benzos work better (some GABA thing). When I took it with Klonopin, the Klonopin worked better and the taper went rather smoothly.
Posted by floatingbridge on August 3, 2011, at 17:28:50
In reply to Any other recommendations for Anxiety?, posted by displaced9 on August 3, 2011, at 14:41:06
Luvox? It was recently mentioned to me for anxiety. It is different from other ssri formulas. Wikipedia has a decent entry. There are some threads here recently, too. Maybe search the site/archives.
Cymbalta was not a good med for me re:anxiety and cognitive function. How is it for you? Sounds like it' has a positive effect on your dysthymia?
I wonder about a low profile muscle relaxant, too. Zanaflex
helped me with overall physical tension, therefore reducing
anxiety. It's in generic, tizanadine (sp?). It is nothing like flexeril. I would take it usually at bed, but I found it mild enough to use during the day from time to time.And massage. Actually fairly light. But I love my massage therapist. I don't get to go often. Initiating treatment wasvan ordeal in itself. Too anxious to be touched. But worth it once I got past that and found my person.
> I am currently taking Wellbutrin 450mg SR, Cymbalta 60mg, and BuSpar 15 mg 3x/day. I am diagnosed with dysthymia and generalized anxiety disorder w/ panic attacks.
>
> The dysthymia is pretty much under control but nothing seems to help with my anxiety since I stopped taking Lexapro. I had to stop Lexapro because of weight gain. I also tried Seroquel but it too caused weight gain.
>
> I take Klonopin 1mg twice daily if needed, but I build a tolerance quickly and it starts to not work unless I increase the dosage.
>
> I am also taking L-Theanine (Theanine Serene brand), New Chapter's Perfect Calm multivitamin and have tried Natural Calm magnesium supplement as well.
>
> Even strong Kava teas and "Relaxation" teas - Nothing works.
>
> My anxiety mostly turns into severe muscle tension which causes a lot of pain. I also get panic/anxiety attacks occasionally, and find it difficult to fall asleep sometimes due to the anxiety / tension in my muscles.
>
> Anyone have any other suggestions? BuSpar doesn't seem to be doing anything at all. I have been on 15mg daily, 30mg daily and now 45mg daily. Tried going up on Cymbalta to 90mg but it gave me tremors.
>
> Thanks.
Posted by floatingbridge on August 3, 2011, at 17:31:04
In reply to Re: Any other recommendations for Anxiety?, posted by Christ_empowered on August 3, 2011, at 17:24:32
Speaking of GABA, there is OTC GABA. I take it with lemon balm and some low dose magnesium.
> I wasn't impressed by BuSpar. 60mgs/day did nothing. I have heard that it can help depression in combo with an antidepressant, so...maybe you should keep taking it.
>
> I take niacinamide and taurine for anxiety. 3 grams niacinamide (today I'm trying 6 grams; so far so good) in 2 equal doses, 6 grams taurine in 2 equal doses. Doesn't work immediately, but it does seem to help considerably. Niacinamide makes benzos work better (some GABA thing). When I took it with Klonopin, the Klonopin worked better and the taper went rather smoothly.
Posted by displaced9 on August 3, 2011, at 17:46:38
In reply to Re: Any other recommendations for Anxiety?, posted by Christ_empowered on August 3, 2011, at 17:24:32
What brands of niacinamide and taurine do you take and in what dosages do you buy them in? What doses should I start at and how long to know if it's working ?
Are there any side effects? I've also been taking 3, tbsp of flax oil daily.
> I wasn't impressed by BuSpar. 60mgs/day did nothing. I have heard that it can help depression in combo with an antidepressant, so...maybe you should keep taking it.
>
> I take niacinamide and taurine for anxiety. 3 grams niacinamide (today I'm trying 6 grams; so far so good) in 2 equal doses, 6 grams taurine in 2 equal doses. Doesn't work immediately, but it does seem to help considerably. Niacinamide makes benzos work better (some GABA thing). When I took it with Klonopin, the Klonopin worked better and the taper went rather smoothly.
Posted by displaced9 on August 3, 2011, at 17:56:41
In reply to Re: Any other recommendations for Anxiety? » displaced9, posted by floatingbridge on August 3, 2011, at 17:28:50
>luvox apparently isn't very available in the US anymore.
Cynbalta is fine as far as cognitive function.
Not sure if Wellbutrin is doing much of anything.
Would a psych actually rx zanaflex ? I can ask. Can't be any worse than the benzo. Note I have taken Roboxin which is supposed to be a heavy duty muscle relaxer but it had no effect on me.
Luvox? It was recently mentioned to me for anxiety. It is different from other ssri formulas. Wikipedia has a decent entry. There are some threads here recently, too. Maybe search the site/archives.
>
> Cymbalta was not a good med for me re:anxiety and cognitive function. How is it for you? Sounds like it' has a positive effect on your dysthymia?
>
> I wonder about a low profile muscle relaxant, too. Zanaflex
> helped me with overall physical tension, therefore reducing
> anxiety. It's in generic, tizanadine (sp?). It is nothing like flexeril. I would take it usually at bed, but I found it mild enough to use during the day from time to time.
>
> And massage. Actually fairly light. But I love my massage therapist. I don't get to go often. Initiating treatment wasvan ordeal in itself. Too anxious to be touched. But worth it once I got past that and found my person.
>
> > I am currently taking Wellbutrin 450mg SR, Cymbalta 60mg, and BuSpar 15 mg 3x/day. I am diagnosed with dysthymia and generalized anxiety disorder w/ panic attacks.
> >
> > The dysthymia is pretty much under control but nothing seems to help with my anxiety since I stopped taking Lexapro. I had to stop Lexapro because of weight gain. I also tried Seroquel but it too caused weight gain.
> >
> > I take Klonopin 1mg twice daily if needed, but I build a tolerance quickly and it starts to not work unless I increase the dosage.
> >
> > I am also taking L-Theanine (Theanine Serene brand), New Chapter's Perfect Calm multivitamin and have tried Natural Calm magnesium supplement as well.
> >
> > Even strong Kava teas and "Relaxation" teas - Nothing works.
> >
> > My anxiety mostly turns into severe muscle tension which causes a lot of pain. I also get panic/anxiety attacks occasionally, and find it difficult to fall asleep sometimes due to the anxiety / tension in my muscles.
> >
> > Anyone have any other suggestions? BuSpar doesn't seem to be doing anything at all. I have been on 15mg daily, 30mg daily and now 45mg daily. Tried going up on Cymbalta to 90mg but it gave me tremors.
> >
> > Thanks.
>
>
Posted by floatingbridge on August 3, 2011, at 18:09:37
In reply to Re: Any other recommendations for Anxiety?, posted by displaced9 on August 3, 2011, at 17:56:41
Luvox is available, just overlooked.
Good luck!
Posted by Lou Pilder on August 3, 2011, at 18:15:55
In reply to Any other recommendations for Anxiety?, posted by displaced9 on August 3, 2011, at 14:41:06
> I am currently taking Wellbutrin 450mg SR, Cymbalta 60mg, and BuSpar 15 mg 3x/day. I am diagnosed with dysthymia and generalized anxiety disorder w/ panic attacks.
>
> The dysthymia is pretty much under control but nothing seems to help with my anxiety since I stopped taking Lexapro. I had to stop Lexapro because of weight gain. I also tried Seroquel but it too caused weight gain.
>
> I take Klonopin 1mg twice daily if needed, but I build a tolerance quickly and it starts to not work unless I increase the dosage.
>
> I am also taking L-Theanine (Theanine Serene brand), New Chapter's Perfect Calm multivitamin and have tried Natural Calm magnesium supplement as well.
>
> Even strong Kava teas and "Relaxation" teas - Nothing works.
>
> My anxiety mostly turns into severe muscle tension which causes a lot of pain. I also get panic/anxiety attacks occasionally, and find it difficult to fall asleep sometimes due to the anxiety / tension in my muscles.
>
> Anyone have any other suggestions? BuSpar doesn't seem to be doing anything at all. I have been on 15mg daily, 30mg daily and now 45mg daily. Tried going up on Cymbalta to 90mg but it gave me tremors.
>
> Thanks.dp9,
You wrote,[...nothing seems to help with...anyone have any other suggestions?...].
I see that you could be at a crossroad. I know of two ways, either by human achievemeent or by divine accomplishment.
There are numerous types of advice that you could get from others here to take this drug or that drug etc. And if you are looking for a drug from others, if the drug works for them, will that mean you will have the same reaction?
Then there is the possibility of death from the drug. Do you want to take that risk? Then there is the possibilty of getting a life-ruinnig condition from the drug, and the possibility of suicide. Do you want to take that risk?
Do you know that about 40,000 people died last year from psychotropic drugs as per one way or another? And how about the possibility of liver failure? Do you want to continue to roll the dice?
My friend, you have a choice now. If there was a way for you to have a new life so that all those things that you have will pass away, would you take that risk to be a new person by seeing how that could happen?
If so, accept this opportunity to become a whole new person. To do this;
A. I would like to have active dialog here with me
B. Something each day to take, will be included.
C. If you read about a Rider on a White Horse from me, the Rider is not Christiandom's Jesus.
D. This will come from a Jewish perspective from me.
E. birds
F. redacted by respondent
If you want to try to overcome your condition by human achievement only, then reject this opportunity now. But if you do want a whole new life, accept this opportunity to hear how you could become a whole new creature.
Lou
Posted by Christ_empowered on August 3, 2011, at 18:44:13
In reply to Re: Any other recommendations for Anxiety? » displaced9, posted by floatingbridge on August 3, 2011, at 18:09:37
I take 3 500mgs capsules of Vitacost brand niacinamide 2x daily. Today I'm trying 6 grams (6 caps, 2x daily). Feeling a little tranquilized, but otherwise fine.
I also take Jarrow Formulas Taurine. They come in 1,000mgs capsules. They're on perma-sale at www.vitacost.com and elsewhere. I take 3 capsules 2x daily, for a total of 6 grams.
When I started, I jumped right into the full doses of each. If you wanted to, you could try it more gradually, like taking 500mgs niacinamide plus 1 gram taurine 2x daily, and then work up as needed. 3 grams niacinamide was/is pretty standard for orthomolecular treatment of anxiety disorders. Larger amounts were/are sometimes used for schizophrenia and other more severe disorders.
I saw on vitacost.com that there's a relatively inexpensive niacinamide that comes in 1500mgs time release capsules. That might be worth trying. When I have to reorder I may just order that stuff.
Posted by jono_in_adelaide on August 3, 2011, at 19:46:15
In reply to Any other recommendations for Anxiety?, posted by displaced9 on August 3, 2011, at 14:41:06
Mirtzepine 30mg at bedtime would be worth a try, risperidone 1mg at bedtime would also be well worth trying.
Posted by displaced9 on August 3, 2011, at 19:49:05
In reply to Re: Any other recommendations for Anxiety?, posted by jono_in_adelaide on August 3, 2011, at 19:46:15
Mirtazapine is remeron right ? If so I tried that before and Gaines 5 lbs in a week. I couldn't stop eating
Does risperdone cause weight gain ?
Posted by Phillipa on August 3, 2011, at 19:53:22
In reply to Re: Any other recommendations for Anxiety?, posted by displaced9 on August 3, 2011, at 19:49:05
I think not sure the atypicals do cause weightgain. As for luvox sold as fluvoximine not to be mistaken for generic prozac. Similar spelling. Phillipa
Posted by jono_in_adelaide on August 3, 2011, at 19:53:45
In reply to Re: Any other recommendations for Anxiety?, posted by displaced9 on August 3, 2011, at 19:49:05
Risperidone can cause weight gain in the doses used for psychosis, but in the 1mg dose used for anxiety and depression, it hasnt caused any for me, infact I have managed to lose a fair swag of weight while taking it.
By taking 1mg risperidone at bedtime, you will likely get SOME releif of your anxiety, and thus be able to reduce your reliance on Klonopin, such that you wont be tolorant to it, and when you do need it, it will realy work
Taking the 1mg of Risperidone has enabled me to cut my Xanax from 1mg three times a day to 1mg twice a dat on most days, thus I have 1mg up my sleeve to take if I am having a particularly bad day.
Posted by jono_in_adelaide on August 3, 2011, at 20:02:36
In reply to Re: Any other recommendations for Anxiety?, posted by jono_in_adelaide on August 3, 2011, at 19:53:45
"A comparison of low-dose risperidone to paroxetine in the treatment of panic attacks: a randomized, single-blind study.
Prosser JM, Yard S, Steele A, Cohen LJ, Galynker II.
SourceThe Department of Psychiatry and Behavioral Sciences, Beth Israel Medical Center, Albert Einstein College of Medicine, New York, NY 10003, USA. jprosser@chpnet.orgAbstract
BACKGROUND: Because a large proportion of patients with panic attacks receiving approved pharmacotherapy do not respond or respond poorly to medication, it is important to identify additional therapeutic strategies for the management of panic symptoms. This article describes a randomized, rater-blind study comparing low-dose risperidone to standard-of-care paroxetine for the treatment of panic attacks.METHODS: Fifty six subjects with a history of panic attacks were randomized to receive either risperidone or paroxetine. The subjects were then followed for eight weeks. Outcome measures included the Panic Disorder Severity Scale (PDSS), the Hamilton Anxiety Scale (Ham-A), the Hamilton Depression Rating Scale (Ham-D), the Sheehan Panic Anxiety Scale-Patient (SPAS-P), and the Clinical Global Impression scale (CGI).
RESULTS: All subjects demonstrated a reduction in both the frequency and severity of panic attacks regardless of treatment received. Statistically significant improvements in rating scale scores for both groups were identified for the PDSS, the Ham-A, the Ham-D, and the CGI. There was no difference between treatment groups in the improvement in scores on the measures PDSS, Ham-A, Ham-D, and CGI. Post hoc tests suggest that subjects receiving risperidone may have a quicker clinical response than subjects receiving paroxetine.
CONCLUSION: We can identify no difference in the efficacy of paroxetine and low-dose risperidone in the treatment of panic attacks. Low-dose risperidone appears to be tolerated equally well as paroxetine. Low-dose risperidone may be an effective treatment for anxiety disorders in which panic attacks are a significant component."
Posted by floatingbridge on August 3, 2011, at 20:40:12
In reply to Re: Any other recommendations for Anxiety?, posted by jono_in_adelaide on August 3, 2011, at 20:02:36
Do you have an idea what is considered low dose?
Thanks, Jono
> "A comparison of low-dose risperidone to paroxetine in the
treatment of panic attacks: a randomized, single-blind study.
> Prosser JM, Yard S, Steele A, Cohen LJ, Galynker II.
> SourceThe Department of Psychiatry and Behavioral Sciences, Beth Israel Medical Center, Albert Einstein College of Medicine, New York, NY 10003, USA. jprosser@chpnet.org
>
> Abstract
> BACKGROUND: Because a large proportion of patients with panic attacks receiving approved pharmacotherapy do not respond or respond poorly to medication, it is important to identify additional therapeutic strategies for the management of panic symptoms. This article describes a randomized, rater-blind study comparing low-dose risperidone to standard-of-care paroxetine for the treatment of panic attacks.
>
> METHODS: Fifty six subjects with a history of panic attacks were randomized to receive either risperidone or paroxetine. The subjects were then followed for eight weeks. Outcome measures included the Panic Disorder Severity Scale (PDSS), the Hamilton Anxiety Scale (Ham-A), the Hamilton Depression Rating Scale (Ham-D), the Sheehan Panic Anxiety Scale-Patient (SPAS-P), and the Clinical Global Impression scale (CGI).
>
> RESULTS: All subjects demonstrated a reduction in both the frequency and severity of panic attacks regardless of treatment received. Statistically significant improvements in rating scale scores for both groups were identified for the PDSS, the Ham-A, the Ham-D, and the CGI. There was no difference between treatment groups in the improvement in scores on the measures PDSS, Ham-A, Ham-D, and CGI. Post hoc tests suggest that subjects receiving risperidone may have a quicker clinical response than subjects receiving paroxetine.
>
> CONCLUSION: We can identify no difference in the efficacy of paroxetine and low-dose risperidone in the treatment of panic attacks. Low-dose risperidone appears to be tolerated equally well as paroxetine. Low-dose risperidone may be an effective treatment for anxiety disorders in which panic attacks are a significant component."
>
>
Posted by jono_in_adelaide on August 3, 2011, at 22:18:46
In reply to Re: Any other recommendations for Anxiety?, posted by floatingbridge on August 3, 2011, at 20:40:12
I'd say 1-1.5mg per day would be considered low dose, but I stand to be corrected.
Posted by jono_in_adelaide on August 3, 2011, at 22:26:00
In reply to Re: Any other recommendations for Anxiety?, posted by floatingbridge on August 3, 2011, at 20:40:12
I have had no side effects from 1mg risperidone at night, except for a bit of drowsiness during the first 2 days.
I think the exciting thing isnt that it works about as well as paroxetine, but that it works as well through a different mechanism, so the two can be taken together for a double whamey effect, and that there is no tolorance or dependence as there is with benzos
Posted by floatingbridge on August 3, 2011, at 22:30:03
In reply to Re: Any other recommendations for Anxiety?, posted by jono_in_adelaide on August 3, 2011, at 22:26:00
> I have had no side effects from 1mg risperidone at night, except for a bit of drowsiness during the first 2 days.
>
> I think the exciting thing isnt that it works about as well as paroxetine, but that it works as well through a different mechanism, so the two can be taken together for a double whamey effect, and that there is no tolorance or dependence as there is with benzosJono, I'm not familiar with the other medication paroxetine. You have taken the risperdal and it helps with sleep and throughout the next day? I was reading the wiki entry and trying to understand how risperdal was so different.
Thanks for getting back to me with dosage.
Posted by displaced9 on August 3, 2011, at 22:34:33
In reply to Re: Any other recommendations for Anxiety?, posted by jono_in_adelaide on August 3, 2011, at 22:26:00
Just curious.. are you male or female? and age?
Paroxetine in the past caused sexual issues for me. I am 29 yo male.
But the 1mg risperidone added to current regimen (possibly replacing one of the drugs) sounds like it could work..
Posted by utopizen on August 4, 2011, at 0:31:27
In reply to Re: Any other recommendations for Anxiety?, posted by displaced9 on August 3, 2011, at 22:34:33
have you tried Neurontin? It's a great alternative to Klonopin... no absurd withdrawal if you lose it and your doc feels like taking a week's vacation, claim it was 4 days to excuse the lack of a backup, and...
yeah. anyhow, Neurontin is very, very, very soothing.
It feels like it envelopes the soul.
Posted by jono_in_adelaide on August 4, 2011, at 0:34:25
In reply to Re: Any other recommendations for Anxiety?, posted by floatingbridge on August 3, 2011, at 22:30:03
paroxetine is paxil/aropax/seroxat, an SSRI antidepressant.
Posted by jono_in_adelaide on August 4, 2011, at 0:37:16
In reply to Re: Any other recommendations for Anxiety?, posted by utopizen on August 4, 2011, at 0:31:27
Me: male, 39, Australia
I found adding 1mg risperidone at night to my other meds made a big difference in how I felt
Posted by displaced9 on August 4, 2011, at 6:06:37
In reply to Re: Any other recommendations for Anxiety?, posted by utopizen on August 4, 2011, at 0:31:27
He mentioned Neurontin last time. What dosage do you take ?
Would I take it in lieu of buspar ?
Thanks !
Posted by Shes_InItForTheMoney on August 4, 2011, at 16:19:48
In reply to niacinamide, taurine, posted by Christ_empowered on August 3, 2011, at 18:44:13
I felt absolutely horrible on niacinamide, regardless of brand and dose. This stuff also can cause massive increases in blood sugar. I would have these horrible scarry dreams, and feel like absolute crap, and my mood would be horrible. I became very grumpy, aggressive. A number of other people I have met found they are the same way when taking it.
So, I guess, YMMV, be careful, etc.
Jay
> I take 3 500mgs capsules of Vitacost brand niacinamide 2x daily. Today I'm trying 6 grams (6 caps, 2x daily). Feeling a little tranquilized, but otherwise fine.
>
> I also take Jarrow Formulas Taurine. They come in 1,000mgs capsules. They're on perma-sale at www.vitacost.com and elsewhere. I take 3 capsules 2x daily, for a total of 6 grams.
>
> When I started, I jumped right into the full doses of each. If you wanted to, you could try it more gradually, like taking 500mgs niacinamide plus 1 gram taurine 2x daily, and then work up as needed. 3 grams niacinamide was/is pretty standard for orthomolecular treatment of anxiety disorders. Larger amounts were/are sometimes used for schizophrenia and other more severe disorders.
>
> I saw on vitacost.com that there's a relatively inexpensive niacinamide that comes in 1500mgs time release capsules. That might be worth trying. When I have to reorder I may just order that stuff.
>
>
>
>
>
>
Posted by Phillipa on August 4, 2011, at 19:26:12
In reply to Re: niacinamide, taurine » Christ_empowered, posted by Shes_InItForTheMoney on August 4, 2011, at 16:19:48
Jay knew it was you as who else comes up with these long names to post with. How is life for you? Phillipa
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