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Dr. Bob is Robert Hsiung, MD,
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Posted by Alan on October 11, 2002, at 23:21:59
In reply to Re: AD's vs. Bzds for Anxiety disorders - Alan, posted by ZeeZee on October 11, 2002, at 23:05:14
Well stated and appreciated! I know of many success stories with the MAOI's in combo with xanax, etc and was on one track with the AD vs. bzd's - this probably considering all of the "face time" we are seeming to be getting free of charge via-a-vis AD's and anxiety disorders (completely unethical no matter how well intended or how one couches it - they're professional salesman after all - but that's just my opinion of course.)
MAOI's and bzd's have indeed saved one of my best friend's and colleague's career and life!
Best to you,
Alan
Posted by ZeeZee on October 12, 2002, at 9:17:32
In reply to Re: AD's vs. Bzds for Anxiety disorders - Alan » ZeeZee, posted by Alan on October 11, 2002, at 23:21:59
I totally agree with you in where you're coming from in regard to the professional salesperson. I have expressed myself before in this regard however have received no support for my position, which is in fact the same as yours. Lest we receive continuous PBC's or ban's our point unfortunately cannot be taken further.
This is LLL.
Posted by BrittPark on October 12, 2002, at 12:44:50
In reply to Re: Lexapro or eqiv. vs. Bzds for anxiety disorder » pharmrep, posted by Alan on October 11, 2002, at 22:40:56
Here, Here. Benzophobia is as common in the treatment of anxiety as Opiophobia is in treating pain. People with chronic anxiety or pain are grossly undertreated in the US.
Britt
Posted by Alan on October 12, 2002, at 13:37:42
In reply to Re: Lexapro or eqiv. vs. Bzds for anxiety disorder » Alan, posted by BrittPark on October 12, 2002, at 12:44:50
> Here, Here. Benzophobia is as common in the treatment of anxiety as Opiophobia is in treating pain. People with chronic anxiety or pain are grossly undertreated in the US.
>
> Britt
========================================
Well said Britt.
For me it is a matter of commercialism and economics trumping patients being trusted for what they have to say by their sometimes paternalistic doctors (of any stripe). This is of course not always the case - but one reads so much about this very thing on this bboard and many others.It is, I suspect also deeply rooted culturally speaking when it comes to the dreaded and misunderstood "A" word (addiction) which of course has nothing whatsoever to do with medical dependence...but the pushing of AD's for anxiety by pharmecuticals exploit those fears with the "non-habit forming" tease.
Now look at these bboards talking about withdrawing from AD's. Or the Paxil lawsuit about co.'s so emboldened to withold these symptoms because they can throw out so many test results and cherry pick the ones (after they change the testing criteria) that they send to the FDA for approval. Shame on the FDA. Ever had a doc look at you with a blank stare when you tell them about the withdrawl (sorry, "discontinuation syndrome") that you feel going off an AD simply because it's not listed on the package insert???
How many times did I personally see many top doctors who would not acknowledge what I was telling them about my anxiety (after I complied with all of their "wait the side effect out" suggestions) to have to end up firing them while at the same time having my career and relationships remain in jeopardy to fit "their" commercially and ideological agenda?
I did this for years, waiting out this and that and the other thing while not getting sufficient treatment. I can see why those that are not offered ALL of the options of treatment with REALISTIC risk-assessment just go through life thinking that this is just the best psychiatry can do for me....
I even found myself early on weighing the cost/benefits of having symptom relief at the expense of my sexual life (a side effect of AD's WAY under reported by the way)! Now how absurd is that kind of rationale to heap upon an already suffering patient? How much harm can be done by creating that kind of emotional conflict. This isn't to say that it happens to everyone....but a large population seems to be right here on the internet talking about these very same issues...in a virtual "world" group therapy.
Why did it take me and many others that I read about on this list so long to find a doctor that listened to what was being told to them?
The terrific pdoc that I eventually ended up with is well known in a large metropolitan area, heads an entire psy dept, and is highly regarded by their peers. Why did I have to wait years for someone like them to say right off the bat during the first visit, after previously reviewing unsuccessful clinical trials galore with every drug under the sun - EXCEPT those evil bzds in MONOTHERAPY), "Well, which drug do you feel better taking?"
That's all I needed to hear.
I know I share this experience with many others...if they only knew what was actually happening to them. It's all about giving or taking away a patient's right to choose their own destiny and form of treatment. Except in the most extreme of cases (institutionalisation issues and the like), the patient is the boss and the doc is the employee.
And that's a hard lesson to learn - if one is ever fortunate to be in the position to learn it at all.
Sorry for the rant.
Alan
Posted by Dinah on October 12, 2002, at 14:29:45
In reply to Re: Lexapro or eqiv. vs. Bzds for anxiety disorder » BrittPark, posted by Alan on October 12, 2002, at 13:37:42
Posted by Geezer on October 12, 2002, at 15:01:33
In reply to Re: Lexapro or eqiv. vs. Bzds for anxiety disorder » BrittPark, posted by Alan on October 12, 2002, at 13:37:42
Alan,
IMHO, no need to apologize....one of the best "rants" I have read in a long time. If we were talking Cardiac Surgery I would offer a humble bow to the surgeon for his training and experience, in Psychiatry (where nothing is known with certainty) the "consumer's" anecdotal experience seems to be most valuable. As you mention - the reasons are diverse and anything but medical.
Good cheer
Posted by GabbiX2 on October 12, 2002, at 15:15:36
In reply to Re: Amen! (nm) » Alan, posted by Dinah on October 12, 2002, at 14:29:45
I'm printing that and bringing it to my Dr.
He's refusing to re-prescribe Benzo's though they've worked for me before, and anxiety is ravaging my personal life (whats left of it)
which of course compounds the anxiety.Thank-you
Posted by Alan on October 12, 2002, at 15:45:11
In reply to Re: Amen! Alan ThankYOU, posted by GabbiX2 on October 12, 2002, at 15:15:36
> I'm printing that and bringing it to my Dr.
> He's refusing to re-prescribe Benzo's though they've worked for me before, and anxiety is ravaging my personal life (whats left of it)
> which of course compounds the anxiety.
>
> Thank-you
============================================While you're at it you may want to take this in too:
http://panicdisorder.about.com/library/weekly/aa031997.htm
Also ask them if they've taken the time to read the World Health Organisation's report on "The Rational Use of Benzodiazapines" (or at least the summary thereof) which uneqivocably states that short AND long term use of bzd monotherapy is some of the safest psychotropic medication in existence for the general population when treating symptoms of anxiety disorder.
If they look at you dead-pan or refuse to accept these basic fundamental concepts, perhaps taking control of your life and finding a doc that acknowledges these simple to understand ideas is the best route to go.
How to do that....that's a whole other thread I'm afraid. There is a catch 22 involved in "doc shopping" for these meds - totally unfair to the patient I might add.
A treasured member here at babble, Faschad, posted about this a few months back - perhaps you can find it in the archives...or I can find it later...or someone else knows where it is. "The controlled Substance Catch 22" was the title I believe although it was in another thread title...
Regards,
Alan
Posted by Micki on October 12, 2002, at 16:26:05
In reply to Re: Amen! Alan ThankYOU » GabbiX2, posted by Alan on October 12, 2002, at 15:45:11
This is my 6th day on 10 mg Lexapro and I feel just as anxious and depressed, and more lethargic than before. Could barely force myself to go to the grocery store today, and can't seem to bring myself to wash the dishes in my sink. Does this mean this is the wrong drug for me, or might this still turn around...I know 6 days isn't very long.
Picked up the second prescription my doctor called in for me--Seroquel, which is an anti-psychotic, but she said to take it in a low dose (12.5 - 25 mg) and it may help with the anxiety/ruminating. However, after reading some of the Seroquel message thread, including stuff about permanent side effects, I'm afraid to take it.
Posted by emmalie on October 12, 2002, at 16:33:04
In reply to Anyone switched to Lexapro? « ggrrl, posted by Dr. Bob on June 11, 2002, at 7:52:48
I am new to this site. I just switched to 10 mg of Lexapro from 20 mg of Celexa a few days ago. Does not seem like anyone has been posting lately about how they are doing on this drug. I'm curious how it's working for people . . .
Posted by Mr Christopher on October 12, 2002, at 17:04:18
In reply to Wish I could, posted by JaneB on June 11, 2002, at 13:12:29
Jane, it is out now.
Posted by Mr Christopher on October 12, 2002, at 17:09:01
In reply to so . . . how is everyone doing on lexapro?, posted by emmalie on October 12, 2002, at 16:33:04
Hey as far as switching is concerned, I caution anyone against switching unless they feel an adequate reason. For example, the current medication is not working any longer or the side effects continue and are unbearable. The bottom line is depression is a very ugly disease and if you are having success then why switch? Don't do it.
Posted by Mr Christopher on October 12, 2002, at 17:12:48
In reply to Day 6 on 10 mg and feeling terrible, posted by Micki on October 12, 2002, at 16:26:05
Don't give up, even though there is a ton of data to support an early on-set of action, most anti-depressants take from 4 to 6 weeks to get the full effect. Consider asking your doctor to bump you up to 20mg per day. This shouldn't increase side effects and possible assist in getting you out of bed and back to normal quicker. One more thing...The drug doesn't do it alone. Talk with friends, a therapist, whoever you feel comfortable with. You shouldn't rely on the drug alone especially now.
Posted by emmalie on October 12, 2002, at 17:17:15
In reply to Re: so . . . how is everyone doing on lexapro?, posted by Mr Christopher on October 12, 2002, at 17:09:01
I was on 20 mg of celexa for a month and it was working GREAT for me, except for the fact that i was experiencing severe jaw and head tension. So my pdoc switched me to lexapro, thinking that the side effect might go away. So far (3 days into it), i have less jaw tension, but i don't feel as happy and calm. guess i should just wait it out . . .
Posted by johnnylex on October 12, 2002, at 18:36:24
In reply to Anyone switched to Lexapro? « ggrrl, posted by Dr. Bob on June 11, 2002, at 7:52:48
For those of you wanting to know how some of us have been doing on Lexapro, here is my status at 4 weeks....
After 3 weeks at 10mg Lexapro my doctor bumped me up to 20mg this past week - today is my 5th day at 20mg. I have been pleased with Lexapro from a side-effects standpoint, but have found almost no relief for my anxiety and depression. Prior to this I was on 150mg of Effexor, which was doing an adequate job for my depression and providing some relief for my social anxieties. I needed to get off the Effexor due to unreasonable side-effects. I am hoping that the Lexapro will start to do its thing any day now, but it seems like I have given it enough time to get some amount of relief...so I am worried that Lexapro may not be the best medication for me. I'll post again with any changes.
By the way, thanks to everyone on this board for posting...it is comforting to know that I am not alone.
Posted by emmalie on October 12, 2002, at 19:23:46
In reply to Lexapro treatment status at 4 weeks...., posted by johnnylex on October 12, 2002, at 18:36:24
thanks for responding johnnylex.
That's kind of how I'm feeling after 3 days or so. Celexa definitely took away my anxiety but gave me bad jaw/head tension. Now, on lexapro, the jaw/head tension is much better but I feel more anxious. If only I could merge the two drugs into one . . .
Posted by Alan on October 12, 2002, at 22:01:56
In reply to Re: Amen! Alan ThankYOU, posted by GabbiX2 on October 12, 2002, at 15:15:36
> I'm printing that and bringing it to my Dr.
> He's refusing to re-prescribe Benzo's though they've worked for me before, and anxiety is ravaging my personal life (whats left of it)
> which of course compounds the anxiety.
>
> Thank-you
-----------------------------------------Here is the link to the posting by faschad that I mentioned in my last post.
http://www.dr-bob.org/babble/20020416/msgs/103521.html
Posted by GabbiX2 on October 12, 2002, at 22:18:31
In reply to Re: Amen! Alan ThankYOU » GabbiX2, posted by Alan on October 12, 2002, at 22:01:56
I can't thank-you enough ALAN
I can't switch Dr's (yes Accused of Dr. Shopping in Canada they can force you to go to only one dr. of their choice if they feel you've been doing that.
The fact that I've had to move 5 times in less than a year and can't afford to travel to the same Dr, Never had multiple prescriptions, and only once took more than my prescription amount of Ativan, or the fact that I voluntarily quit taking benzo's. doesn't seem to matter much.Sorry for the rant, just one more horror story..
Posted by Alan on October 13, 2002, at 1:32:14
In reply to Thanks for your trouble » Alan, posted by GabbiX2 on October 12, 2002, at 22:18:31
Posted by pharmrep on October 13, 2002, at 2:09:35
In reply to Day 6 on 10 mg and feeling terrible, posted by Micki on October 12, 2002, at 16:26:05
> This is my 6th day on 10 mg Lexapro and I feel just as anxious and depressed, and more lethargic than before. Could barely force myself to go to the grocery store today, and can't seem to bring myself to wash the dishes in my sink. Does this mean this is the wrong drug for me, or might this still turn around...I know 6 days isn't very long.
>
> Picked up the second prescription my doctor called in for me--Seroquel, which is an anti-psychotic, but she said to take it in a low dose (12.5 - 25 mg) and it may help with the anxiety/ruminating. However, after reading some of the Seroquel message thread, including stuff about permanent side effects, I'm afraid to take it.** it is too soon to decide on lexapro...if you can, give it a few more weeks...and if you can, try it without the other med...after 1 month, if you dont see what you want...then try 15mg, or add something else if you must.
Posted by Alan on October 13, 2002, at 10:29:19
In reply to Re: Day 6 on 10 mg » Micki, posted by pharmrep on October 13, 2002, at 2:09:35
YMMV but - A close relative told me about his experience with switching over to Lex. from Celexa for an anxiety disorder and it esentially went something like this:
....Been on Celexa since it came onto the market and it has helped me better than anything else I have ever taken (the list is to long to even think about). PDoc recently asked me to consider switching to Lexapro, which is similar to Celexa without the isomer that causes most of the side effects. However, the Lexapro made me extremely anxious so possibly the sleepiness side effect of Celexa was what I needed. I went back on the Celexa feel better but back to the usual sedation problem....
In response, I didn't want to say anything about the whimsical idea that all of the side effects would reside in the (removed) mirror image molecule and all the therapeutic effect would reside in the remaining molecule, but it's not surprising he discovered that on his own.
Doctors will fall for some pretty flimsy lines if delivered with a straight face and a pert attitude. Any biologist could tell them that when mirror-image isomers of molecules exist, it tends to be so that most of the biological activity resides in one isomer and the other is nearly inactive. However, the isolated-isomer version of Prozac never made it to market because it turned out to be dangerous, so the "one isomer active" rule may apply more to naturally occurring substances than it does to synthetic drugs.
Judging from the public statements I've heard, few authorities who are financially independent of Forest Pharmaceuticals expect Lexapro to be systematically better than Celexa for anything except the maker's bottom line. (There could be a few individual exceptions.) Same goes for Nexium compared to Prilosec and all these other analogous "next-generation" pills.
Interesting how the next generation always makes it to market just as the previous one's patent is expiring.
Skeptical in Seattle,
Alan
Posted by ANXIETY ANN on October 13, 2002, at 16:40:26
In reply to Re: Lexapro treatment status at 4 weeks...., posted by emmalie on October 12, 2002, at 19:23:46
> thanks for responding johnnylex.
>
> That's kind of how I'm feeling after 3 days or so. Celexa definitely took away my anxiety but gave me bad jaw/head tension. Now, on lexapro, the jaw/head tension is much better but I feel more anxious. If only I could merge the two drugs into one . . .*****
I have been taking Lexapro now for A Week. I too have terrible head /jaw tension in back of my neck, like a burning sensation. I only feel it when the lEXAPRO is wearing off. (after about 12 hours). I also have trouble sleeping and my anxiety is much worse. The reason i take it is for anxiety and panic. I,m not depressed at all. Is there anyone out there that Lexapro has helped expressly for anxiety. will the terrible neck and head pain go away? will I ever get a good nights rest? thanks for your help
Posted by Alan on October 13, 2002, at 17:17:59
In reply to Re: Lexapro treatment status at 4 weeks...., posted by ANXIETY ANN on October 13, 2002, at 16:40:26
> >
> > That's kind of how I'm feeling after 3 days or so. Celexa definitely took away my anxiety but gave me bad jaw/head tension. Now, on lexapro, the jaw/head tension is much better but I feel more anxious. If only I could merge the two drugs into one . . .
>
> *****
> I have been taking Lexapro now for A Week. I too have terrible head /jaw tension in back of my neck, like a burning sensation. I only feel it when the lEXAPRO is wearing off. (after about 12 hours). I also have trouble sleeping and my anxiety is much worse. The reason i take it is for anxiety and panic. I,m not depressed at all. Is there anyone out there that Lexapro has helped expressly for anxiety. will the terrible neck and head pain go away? will I ever get a good nights rest? thanks for your help
========================================
The reality is that for anxiety disorders, anxiolytics work at a much higher percentage of the time than do AD's (by the AD co's own stats)for the general population. There are exceptions and stastistics do not, as I suppose you know, apply to individual cases.Have you tried a benzodiazapine at all or alternatively other non AD treatments?
Please read my post directly above yours to explain why you are possibly feeling more rather than less anxiety. It is a bit technical but it speaks to your issue about anxiety related symptoms - in whatever form they appear...
Best,
Alan
Posted by emmalie on October 13, 2002, at 17:27:42
In reply to Re: Lexapro treatment status at 4 weeks...., posted by ANXIETY ANN on October 13, 2002, at 16:40:26
It's day 4 for me on Lexapro.
I was in a total zombie state for much of today (I take it in the morning when I wake up). I feel less anxious but it's at the expense of feeling TOTALLY out of it. Perhaps this will go away with time . . .
Posted by emmalie on October 13, 2002, at 19:24:08
In reply to Anyone switched to Lexapro? « ggrrl, posted by Dr. Bob on June 11, 2002, at 7:52:48
For some reason, right now I feel really sick. Kind of like I'm getting the flu. Body aches, keep getting a little hot and cold. Is this an effect of Lexapro that I should expect to feel since I am just starting it?
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