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Dr. Bob is Robert Hsiung, MD,
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Posted by JESSsMom on December 27, 2002, at 13:29:00
In reply to Re: What drug worked best for your depression/anxiety? » JESSsMom, posted by jackt on December 27, 2002, at 7:15:28
Jack, the Effexor Xr started to work in the very first week. My biggest problem is waking up in terror in the morning, then having the panic last all freaking day long until the evening. It was totally debilitating.
I started 37.5mg/day of XR on a Monday, suffered through the nasty side effects all week, woke up IN PEACE (wow) for four straight mornings, but woke up in panic that Sat. morning.
Saw pdoc, he upped my dosage to 75mg/day, nasty side effects again, spent a straight week without panic until one day it happened again.
Pdoc explained that it has to be in your system for a while to get the full benefit and for the side effects to go away. He was right.
I've been completely anxiety free now, for the first time in YEARS for two full weeks.
My depression isn't being touched though, so I asked to have my dose upped (I read you need XR at high doses for the depression to be relieved). He put me on 112.5mg/day for a few days and then gave me the option to up it to 150mg/day when I was ready.
I couldn't stand the sweating and have gone back down to my 75mg/day dosage at this point. It's working fine for the GAD.
Biggest question of all--did it cause more anxiety at first? NO WAY. I would never have lasted a day on it if it had. My GAD was so bad at that point, didn't eat a thing for a full week after Thanksgiving. Only drank liquids to keep myself hydrated. I would never have been able to tolerate more anxiety.
Hope this info helps you.
JM
Posted by utopizen on December 27, 2002, at 19:34:37
In reply to Re: What drug worked best for your depression/anxiety?, posted by Sebastian on December 26, 2002, at 14:33:20
> Zyprexa.!!
It's marketed for psychotic anxiety... I think, or assuming. Anyway, did you have non-psychotic anxiety? Don't you think it's kind of extreme? Did a benzo work, or were you trying to avoid addiction? Does it bring you into remission, and if not, how does this differ from "addiction" if Zyprexa is taken to avoid benzo?
I wonder if there's any controlled studies on APs in social anxiety patients...
Posted by Aadika on December 27, 2002, at 21:01:46
In reply to What drug worked best for your depression/anxiety?, posted by Dysfunk on December 26, 2002, at 14:16:10
I've found that relatively high-dose clonazepam (2mg bid, + 1mg hs) in addition to Provigil (200mg qd) and propranolol (10mg bid) has worked wonders for me. (I have avoidant personality disorder [basically severe social phobia] as well as dysthymia) Best of luck to you!
~ Aadika
Posted by utopizen on December 27, 2002, at 21:16:34
In reply to Re: What drug worked best for your depression/anxiety?, posted by Aadika on December 27, 2002, at 21:01:46
> I've found that relatively high-dose clonazepam (2mg bid, + 1mg hs) in addition to Provigil (200mg qd) and propranolol (10mg bid) has worked wonders for me. (I have avoidant personality disorder [basically severe social phobia] as well as dysthymia) Best of luck to you!
>
> ~ AadikaWish I had a cool doc like you do. 2mg. that must be cool. what's hs mean? I remember getting really talkative once back when I tried propananol and popped them beyond a count... I went from super-shy to super talkative, then kept talking to this class of kids I was in that time who hadn't known me before that day, and I go to this kid, "why don't you talk?" and this girl was like "hey, go easy, he's just shy!"
I was also on a hi amount of ritalin too... it was the SAT's, after all =P
I would try propananol, but the refills are expired, and asking for it again would guarantee a "well doesn't the propananol work!?" reaction from my pdoc the next time I ask for some more Klonopin prn.
Posted by Sebastian on December 27, 2002, at 21:20:36
In reply to Re: What drug worked best for your depression/anxiety?, posted by utopizen on December 27, 2002, at 19:34:37
Utopizen
Yes I am coming out of a psycosis. It is the most effective AP I have tried for anxiety. I was starting to wonder why I still used an anti-psycotic for anxiety.
Sebastian
Posted by Aadika on December 27, 2002, at 21:23:41
In reply to Re: What drug worked best for your depression/anxiety? » Aadika, posted by utopizen on December 27, 2002, at 21:16:34
"H.S." is a medical abbreviation used to mean "before bed".
~ Aadika
Posted by bookgurl99 on December 27, 2002, at 23:58:17
In reply to What drug worked best for your depression/anxiety?, posted by Dysfunk on December 26, 2002, at 14:16:10
Serzone. It took care of the anxiety and depression, and left my feelings/motivation/ability to orgasm intact.
Side effects included general drowsiness (alleviated slightly by thyroid hormones), and slight memory problems for the first few weeks.
Posted by temoigneur on December 28, 2002, at 2:34:22
In reply to What drug worked best for your depression/anxiety?, posted by Dysfunk on December 26, 2002, at 14:16:10
Hi Dysfunk, I don't know if this will be of any help to you, as I suffer from OCD, not primarily depression, but I also have severe anxiety - anyhow, my experience with prozac sounds exactly like yours, it worked brilliantly for four months, then the anxiety just came flooding back in. I haven't been stable in five years ever since. Today, I had the fortune of talking with one of the worlds leading experts in OCD, and he told me that some people are fast metabolizers of drugs, and that I may have to raise the dose up to 160mg, to reach a level, where my body can't "adjust" to the prozac, how ever that happens, and render it uneffective. He suggested going up at 20mg/week Best of luck
Ben
Posted by temoigneur on December 28, 2002, at 2:45:31
In reply to Re: What drug worked best for your depression/anxiety?, posted by temoigneur on December 28, 2002, at 2:34:22
> Hi Dysfunk, I don't know if this will be of any help to you, as I suffer from OCD, not primarily depression, but I also have severe anxiety - anyhow, my experience with prozac sounds exactly like yours, it worked brilliantly for four months, then the anxiety just came flooding back in. I haven't been stable in five years ever since. Today, I had the fortune of talking with one of the worlds leading experts in OCD, and he told me that some people are fast metabolizers of drugs, and that I may have to raise the dose up to 160mg, to reach a level, where my body can't "adjust" to the prozac, how ever that happens, and render it uneffective. He suggested going up at 20mg/week Best of luck
>
> BenNB OCD patients usually require a higher SSRI/Anafranil dosage, to begin with - just something to keep in mind. I was worked up to 80mg initially, which is not uncommon for OCD.
Posted by JohnL on December 28, 2002, at 5:09:24
In reply to What drug worked best for your depression/anxiety?, posted by Dysfunk on December 26, 2002, at 14:16:10
My favorite FDA drug...Zyprexa.
Other FDA favorites...Prozac.Favorite non-FDA drugs...Amisulpride; Adrafinil.
In my experience in observing others, if the above four drugs were the only psychiatric meds on the planet, most depressed or bipolar folks would be able to get well with one of them or any combination of them.
JohnL
Posted by cosis on December 28, 2002, at 7:22:38
In reply to What drug worked best for your depression/anxiety?, posted by Dysfunk on December 26, 2002, at 14:16:10
Nardil beats them all, or Parnate.. Try an MAOI if you don't mind the side effects.. Most of them go away with time
Posted by Aadika on December 28, 2002, at 8:29:08
In reply to Re: What drug worked best for your depression/anxiety?, posted by cosis on December 28, 2002, at 7:22:38
What with all the hype I've read about Nardil being the "gold standard" treatment for SP and AvPD, I have to say my expectations for this medication were hardly met... in fact, at a dose of 135mg / day, I had no relief of symptoms of AvPD. I believe I'm going to talk to my pdoc Monday about dropping the propranolol from my regime as it tends to make me somewhat depressed, raising my dosage of Provigil to 200mg b.i.d., and reintroducing Neurontin-- this time at a higher dosage. The last time I gave up on it at a mere 1,200mg / day. If that fails, I suppose I'll give Parnate a shot, in addition to a GABAergic drug like Riluzole, Sabril, Lamictal, or high-dose Depakote.
~ Aadika
Posted by vickisnowwhite on December 28, 2002, at 9:08:55
In reply to What drug worked best for your depression/anxiety?, posted by Dysfunk on December 26, 2002, at 14:16:10
> I have been on so many of the older anti-depressants and then Prozac. Prozac was a miracle, I never felt better, then one day just stopped working and threw me into an awful depression. Since then I have tried a couple new drugs and ended up back on low doses of Prozac.Nothing seems to give me the same feeling I once had on Prozac. I recently combined Prozac and Effexor, and I am still trying to decifer if it works. It takes so long to go up on a drug and find the correct dosages.Very frustrating process!!
>
> I am just curious, in your experience with general ongoing depression and some anxiety, what has been the best drug treatment?Prozac 40mg, perphenazine (an antipscychotic) 2mg 1-4 tablets a day, buspar 15mg bid, and welbutrin 400 q day. this works very well for me I feel fantastic about 95% of the time. (yet get very tired sometimes)
Posted by vickisnowwhite on December 28, 2002, at 9:14:15
In reply to Re: What drug worked best for your depression/anxiety?, posted by vickisnowwhite on December 28, 2002, at 9:08:55
meant to say 400mg for the welbutrin not just 400!!!
sorry
Posted by cosis on December 28, 2002, at 10:18:37
In reply to Re: What drug worked best for your depression/anxiety? » cosis, posted by Aadika on December 28, 2002, at 8:29:08
Like any drug it doesn't work for everyone, but it works for a majority. It did a number on my anxiety/depression. Thank god for Nardil
Posted by Dysfunk on December 28, 2002, at 12:38:41
In reply to Re: What drug worked best for your depression/anxiety?, posted by JESSsMom on December 27, 2002, at 5:47:25
JessMom:
Thanks for the feedback. I think I have given Effexor a fair shot. I can't seem to find a dosage that works well for me.
I tried Wellbutrin way back when and I did gain weight. UGH. I prefer a drug with a more speedy effect rather than a sedating one.
Posted by Dysfunk on December 28, 2002, at 12:40:13
In reply to Re: What drug worked best for your depression/anxiety? » jackt, posted by JESSsMom on December 27, 2002, at 13:29:00
I never had such anxiety until I started taking Effexor!
Posted by Remi on December 28, 2002, at 12:41:22
In reply to Re: What drug worked best for your depression/anxiety?, posted by cosis on December 28, 2002, at 10:18:37
Effexor 112.5mg and valium 10mg. Zyprexa while finding that combo. Have had success with SSRIs before also. If I had no concerns about weight gain or movement disorders, I would just stay on Zyprexa and probably not need any others.
Posted by Dysfunk on December 28, 2002, at 12:44:14
In reply to Re: What drug worked best for your depression/anxiety?, posted by bookgurl99 on December 27, 2002, at 23:58:17
Book Gurl, I am glad Serzone worked for you. It dropped my blood pressure so low I was surprised I could even move at all.
Posted by Dysfunk on December 28, 2002, at 12:46:07
In reply to Re: What drug worked best for your depression/anxiety?, posted by temoigneur on December 28, 2002, at 2:34:22
Ben: thanks for the info. I was on a pretty high dose of Prozac when it stopped working. Later, when I came back to it my dosage was medium. Still, I just can't seem to get the same effect I had.
Posted by Dysfunk on December 28, 2002, at 12:48:18
In reply to Re: What drug worked best for your depression/anxiety?, posted by JohnL on December 28, 2002, at 5:09:24
John L:
Sounds like the general consensus is Zyprexa. I may have to have my doc look into it. Thanks.
Posted by highanxiety on December 28, 2002, at 14:19:44
In reply to Re: What drug worked best for your depression/anxi, posted by Dysfunk on December 28, 2002, at 12:48:18
im not sure if this is a bit off the beaten path topic wise...but the most wonderful relief I ever got from anxiety was after surgery, I got an IV of Zofran...was that great. After I recovered I found some an abstract I believe on Medscape that had to do with Zofran being effective for OCD. Of course for me there is a definite link (tic disorder OCD panic disorder)...I wonder if this drug will ever be approved for ocd or anxiety disorders..from what I remember smaller doses were used in the studay and were very effective, smaller than given for PONV and chemo.
Posted by worrier on December 28, 2002, at 20:08:18
In reply to Re: What drug worked best for your depression/anxi, posted by highanxiety on December 28, 2002, at 14:19:44
>The only meds that have helped me at all are benzos. Every antidepressant I tried just made things much worse (Wellbutrin,Prozac,Paxil). I don't have a big problem with depression...mainly the anxiety, and that is almost purely physical, I don't worry about "things" I worry about feeling anxious. This never happened until I took Paxil. It seemed to completely rewire my brain in a most unacceptable way. Before the paxil my "only" problem was panic attacks. Curious to know if anyone else has this primarily physical anxiety? Who's to say what drug is best seems everyone I know takes paxil or effexor with great success. Sorry to have babbled on so long ...this can be a long frustrating journey. Everyone hang in there.
Posted by ZeeZee on December 28, 2002, at 20:45:52
In reply to Re: What drug worked best for your depression/anxi, posted by worrier on December 28, 2002, at 20:08:18
I don't know if I'd call it "physical anxiety" but my anxiety and fears are about anxiety and fear, not "things" as you say. But that's the nature of panic disorder and agoraphobia - it's the fear of the fear.
In the past, Nardil and Parnate took all of this away for me and rather quickly. I highly recommend MAOI's for panic disorder if you can tolerate the effects and the diet.
Posted by HannahBeGood on December 29, 2002, at 1:35:04
In reply to What drug worked best for your depression/anxiety?, posted by Dysfunk on December 26, 2002, at 14:16:10
> I have been on so many of the older anti-depressants and then Prozac. Prozac was a miracle, I never felt better, then one day just stopped working and threw me into an awful depression. Since then I have tried a couple new drugs and ended up back on low doses of Prozac.Nothing seems to give me the same feeling I once had on Prozac. I recently combined Prozac and Effexor, and I am still trying to decifer if it works. It takes so long to go up on a drug and find the correct dosages.Very frustrating process!!
>
> I am just curious, in your experience with general ongoing depression and some anxiety, what has been the best drug treatment?Dysfunk~
Oh lord, it's the waiting 4-6 weeks and titration and eating like a pig and then feeling like you've been doibg absolutely n/t different exceopt spending money and swallowing pills til ya gag and s/time's nothin' seems to work at all, just nothin...
I've had depressive episodes since puberty, which I tended to by either actually getting physically sick (mono-AT 14) I was quarantined in my upstairs room for 6 weeks-I loved it, just books, art, sleep and dreams-FOR DAYS AND DAYS. Couldn't climb stairs with a swollen spleen & in the 70's it was believed mononucleosis was highly contagious for much longer than they do now.
Even now, only sleep and solitude for sev'l days (plus meds) can stabilize me for at least a couple of weeks.Wellbutrin helped me keep my head barely above water off & on for a yr. and a half. I have atypical depression and ADD (have only been dx'd w/that for 'bout a yr.). Remeron gave me good sleep, no a.m. grogginess and was a terrific, fast (one week) anxiolytic. Didn,t help depression, though.
Effexor at 300 mgs. 'helped' carry me thru unmanageable grief when my parents died. But did not help w/dep, mood, excess sleeping, ADD, or general inertia.I *must* have a dopamine safety net and booster to quell any significant part of my depression, plus a benzo, or I wd. startle every time the wind blew.
After a yr, my p-doc and I are still fine-tuning, but he is on the right track, knows I see a therapist and g.p. as well.
It's not perfect, but I am up and moving most days, can enjoy the world again and am not in the dark pit I was in for 3-4 mos. of summer'01.My med schedule:
15-60mgs. Dex spansules allowed per day
Us'ly take 451-4 mgs. Klonopin (I use clonazepam) allowed daily
take2-4 daily, but lately it's usually 3-415 mgs. Lexapro per day (can't tell any dif. after
8 weeks.)IR 40 mg. propanolol up to 3 a day (migraine prevention)
350 mgs. Soma (carisoprodal-a truly effective muscle relaxant), up to 3 x's a day-depends on whether I am in a pain 'flare' or not-often skip them, but when in pain, they are a ncessity.
darvocet , forgot the mgs, 350/100 or vice-versa, up to 2 daily (has some tylenol in it)
-the soma, propanolol and darv. are all for pain relief or prevention, so I don't take them every day, the propanolol, at least 40 mgs a day as it does quiet my physical anxiety symptoms best, theKingKong is clutching my heart' feeling which can totally immobilize me. The Klonopin is hard to explain, since it gives me more of a mental /intellectual smoothness or at least leveling, so my irrational thoughts have a harder time taking over my brain and leading me to say or think things that are just plain painful and unproductive. It has good mood stabilizing properties. So, if u used the prop and the klono together carefully, w/ur doc's guidance, I believe they can combine effectively.
I really believe the dexedrine/klonopin/prop'l combo has been my only "med" that has truly relieved me of about 55% of my symptoms. The small dose of Darvocet enhances this combination. But, I cannot take pain meds constantly due to tolerance and the dreaded "slow and or no" movement effects (constipation).
Of course, I am a chronic pain patient and I need those weak little darvocets to help me simply 'move' period. My p-doc allows me to keep 5mg dex IR on hand, so I don't crash and burn before my child does at bedtime. I sometimes will take 1 in the morning w/a (slow-release) spansuleor 2, as I am very difficult to awaken before the sun rises.I aspire to greater heights, but the past 5 yrs. have been very turbulent, and I believe I am still recuperating emotionally from unavoidable life events.
I still have tremendous bouts of fatigue, I isolate and I worry. But, I do have hope for the future.I think, w/patience, I may have a decent one. Hope u do, Too!
Hannah
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