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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 34 to 58 of 58. Go back in thread:
Posted by worrier on December 30, 2002, at 22:53:36
In reply to Re: What drug worked best for your depression/anxiety? » Dysfunk, posted by HannahBeGood on December 29, 2002, at 1:35:04
>just a question about the propanalol...because your comment about the King Kong clutching my heart thing really hit home with me. That describes the feeling exactly. I brought up the beta-blocker idea to my GP who vetoed it immediately...but she vetoes anything except antidepressants which I absolutely cannot take,but haven't talked to my psychiatrist about it yet. Do you notice any side effects from it? I find that my anxiety/panic manifests itself in primarily physical ways...not so much thoughts,etc. so this sounds like it might help.
Posted by temoigneur on December 31, 2002, at 1:26:19
In reply to Re: What drug worked best for your depression/anxi, posted by Dysfunk on December 28, 2002, at 12:46:07
> 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.
Hi Dysfunk, gosh, I'm really hoping the prozac works out, do you mind if I ask how high a dose you were on when you said it stopped working initially, the doctor tried explaining to me that in quick metabolizers, he theorizes that perhaps raising the dosage to a level where your body can no longer "adjust" to it and cancel out the effects could be the answer.
He said to raise the dosage until the blood level of the metabolite (I think - you're doctor should know what they look for), was about 1000nano-grams/ml
Posted by Noa on January 1, 2003, at 13:38:24
In reply to Re: What drug worked best for your depression/anxi, posted by Dysfunk on December 29, 2002, at 13:33:51
Best combo so far, but far from perfect:
effexor xr 262.5 mg
adderall xr 30 mg
serzone 500 mg
lorazepam .25 mg
synthroid 50 mcg
cytomel 25 mcg
folic acid 400-800 mcg
chromium picolinate 400 mcg
Posted by Sswift on January 2, 2003, at 7:40:06
In reply to Re: What drug worked best for your depression/anxi, posted by worrier on December 28, 2002, at 20:08:18
Can anyone tell me of any meds for anxiety/depression that does not cause weight gain? I have been on Paxil for I think a year now and have gained about 30 pounds from it. Any suggestions??
Posted by fairnymph on January 2, 2003, at 14:08:21
In reply to What drug worked best for your depression/anxiety?, posted by Dysfunk on December 26, 2002, at 14:16:10
I suffer from obsessive compulsive disorder (a type of anxiety disorder) and depression. Prozac worked the best for me (I haven't tried any other SSRIs), even though I was only on it for 2 months, the antidepressant effects lingered for a few months after! I went off it because I couldn't stand the sexual side effects.
Effexor worked fairly well, but it stopped working (even after I maxed out the dose) after a couple months. And even when it worked best it didn't help as much as Prozac. BUT I loved the fact that on Effexor I still had a libido, even if I still couldn't orgasm. Also, Effexor gave me a lot of energy throughout the day and I lost some weight on it (appetite supressing).
Reboxetine was great for my depression, and had ZERO side effects at 8 mg a day (other than increased libido). It gave me a lot of energy and seemed to increase my intellectual abilities. It didn't help with my anxiety or ocd symptoms though . :( BUt, I recommend it highly to anyway who is suffering from straight depression.
Remeron, tianeptine, and wellbutrin did NOTHING for me at all.
Good luck, hope you find a drug that works for you again.
~fairnymph
fairnymph@ziplip.com
> 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?
Posted by HannahBeGood on January 2, 2003, at 22:03:39
In reply to Re: What drug worked best for your depression/anxiety? » HannahBeGood, posted by worrier on December 30, 2002, at 22:53:36
Hi worrier-
Sorry took so long to reply. I was first prescribed Inderal (generic = propanolol) after I had my 1st child at 40. I had taken phentermine off and on to help me lose pregnancy weight. When I quit after about a yr., I had terrible bouts of anxiety, and this was *after* I quit taking it. So, after some consideration of my B.P. checks while I was dieting, they slowly rose over time, and worried about the phen-fen situation (i only filled the fenfluramine part of my RX 2 or 3 times, then stopped, due to the sensationalistic news reports that were flying around at the time). The combo WAS an incredible anorexic and I had to force food when I took both at once. Losing weight was a snap.But, as I said a few mos. afterwards I went to my g.p., and we arranged a stress test. I did well, close to top 20% in endurance and I was slim no cholesterol problems. The cardio doc said , Well, you're probly gonna be on meds for life, cuz w/u I think it's simply genetics. I never mentioned the phentermine to either doc. Took 120 mgs SR daily of propanollol or Inderal, forget if the generic came in SR. Within one week my B.P. went from a high of around 160/105 back to my usual 110/60. I titrated off of it later, as I was having no symptoms and wanted to see how my pressure was, and it remained normal to lowish.
I was then prescribed it for chronic headaches, but have only used it 20-120 mgs. a day, as the situation merits. The past yr. has been a hard one and I average about 80 mgs. daily.It doubles as a pain preventative and as a good med for 'physical' anxiety. Performers are often prescribed it so they can control their thumping hearts and sweaty palms during stressful concerts, plays, etc.
Taking a beta-blocker can lower your blood pressure 'too' much, if u're not careful. It also can cause fatigue and depression in some patients. You're doc may have been considering these possibilities, but it wd. be nice if he/she wd. 'share' and explain, if this is the case, no? How is ur BP usually? High, low, just right?
Ask more questions about this med possibility, as I have used it off and on for 5 yrs, and only with good results. One is cautioned not to discontinue use abruptly, but, rather to titrate down slowly, with a dr's guidance. (I think this is a warning that will become ubiquitous with all drugs in the near future. With many it is certainly warranted, but I think we are reaching a kind of mass hysterical paranoia about stopping any drug these days & then suffering unbearable side-effects). I have simply 'quit' many in the past (with no problems at all, before anybody knew any better, supposedly) but, that was before some of the real ass-kickers came along (like Effexor-which I did discontinue after 9 months, but, verrrry slowly and carefully). That was one I did feel withdrawal effects from. But titrating properly and starting lexapro during the FXR drop minimalized the effects to almost nothing.
Let me know how things go for u. All the best~Hannah
Posted by Cisco on January 4, 2003, at 13:38:14
In reply to Re: What drug worked best for your depression/anxiety? » worrier, posted by HannahBeGood on January 2, 2003, at 22:03:39
I've had amazing anti-depressive results with certain non-selective serotonin sub-receptor (5-HT1A, 5-HT2A, 5-HT2C, 5-HT4, etc) agonist's, which are derived from from the indolealkylamine class of medications.
Cisco
Posted by temoigneur on January 4, 2003, at 16:57:38
In reply to Re: What drug worked best for your depression/anxiety?, posted by Cisco on January 4, 2003, at 13:38:14
> I've had amazing anti-depressive results with certain non-selective serotonin sub-receptor (5-HT1A, 5-HT2A, 5-HT2C, 5-HT4, etc) agonist's, which are derived from from the indolealkylamine class of medications.
>
> CiscoMy Gosh, I've been searching frantically, emailing doctors in europe and everwhere to get a hold of a 5-HT2A agonist, how did you get access to these drugs
Thanks a million
Posted by worrier on January 11, 2003, at 19:55:50
In reply to Re: What drug worked best for your depression/anxiety? » worrier, posted by HannahBeGood on January 2, 2003, at 22:03:39
Thanks for the info. perhaps my GP was concerned about the bp thing, but she never really seemed to listen to anything I said anyway. Before my really bad experience with paxil, my bp had been perfectly normal or even a little on the low side. While on paxil ( which caused my panic/anxiety to increase to intolerable levels) it went up to 130-135/80-85. Weird thing is that it has stayed there after 8 months of being off the paxil. I know that that is considered a normal bp, but it's not normal for me...a fact my dr. completely ignored. My sister takes a beta-blocker for migraine prevention and has had problems when trying to come off of it...she gets jittery, heart pounds,etc. So I know they should be used with caution. Need to see my pdoc sometime soon and will discuss this with him. Will let you know what happens. Worrier.
Posted by worrier on January 11, 2003, at 20:17:21
In reply to Re: What drug worked best for your depression/anxiety?, posted by Cisco on January 4, 2003, at 13:38:14
> I've had amazing anti-depressive results with certain non-selective serotonin sub-receptor (5-HT1A, 5-HT2A, 5-HT2C, 5-HT4, etc) agonist's, which are derived from from the indolealkylamine class of medications.
>
> Cisco> What about anti-anxiety effects of these meds? I'm not even familiar with this class of drugs...where can I find some info? Thanks, worrier.
Posted by Cisco on January 12, 2003, at 3:27:39
In reply to Re: What drug worked best for your depression/anxiety?, posted by temoigneur on January 4, 2003, at 16:57:38
This is a very interesting class of endogenous SSRA's (Serotonin Sub-Receptor Agonist's). Hey, I just invented a new class of AD's!
However, it would be preferable to discuss in detail over cyber coffee. If you are interested, e-mail me at cisco255@hotmail.com
Cisco
Posted by patricia22w on August 24, 2003, at 15:48:51
In reply to Re: What drug worked best for your depression/anxi, posted by highanxiety on December 28, 2002, at 14:19:44
> 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.
xxxx
I had the same experience. I was given remeron but it wasn't helping so they switched to zofran and I felt better than I ever remember in my life. I had no anxiety in talking to people where as normally am practically agoraphobic. I've asked my primary care physician if he could prescribe it for anxiety depression but he said it is only for chemo or post operative nausea. He's prescribed other antidepressants which I've tried but don't like the side effects and have heard so many negative experiences people have had taking them, that I end up going off them and not really giving them a chance. I was just wondering is there any way I could get a prescription for zofran that anyone knows of. My insurance covers it (I checked with the pharmacy)I've seen it for sale on the internet without a prescription, but can not afford to buy it right now. Is there any way that glaxo-wellcome could do a study on zofran for anxiety depression and I could volunteer? Thanks for the help.
Patricia
Posted by El on August 24, 2003, at 22:01:11
In reply to Re: What drug worked best for your depression/anxi » highanxiety, posted by patricia22w on August 24, 2003, at 15:48:51
well i can tell you this paxil had me more scared than i have ever felt in the first week and it lasted 2 full days, lexapro was taking me down the same path. i couldnt take either for more than a week. i am in the market now too and looking for suggestions! i hear the benzos are the best, but im no doctor and i havent talked to mine about them yet! and i am a physically anxiety stricken person bordering agoraphobia as well and cant deal with those side effects.
Posted by btnd on August 25, 2003, at 14:36:36
In reply to Re: What drug worked best for your depression/anxi, posted by El on August 24, 2003, at 22:01:11
Definitely Klonopin. My depression was (is?) due to problems with anxiety. Klonopin not only helps with the anxiety (both social and general), it also makes me antidepressed and pro-social.
I also used Xanax and it has even more pronounced antidepressive effect, unfortunately it has short action. I hope this problem will be fixed when I try the slow release version Xanax SR.Take care,
Brad
Posted by El on August 25, 2003, at 16:23:48
In reply to Re: What drug worked best for your depression/anxi, posted by btnd on August 25, 2003, at 14:36:36
Did klonopin (or Xanax) give you any side effects? i hate feeling spacey or lightheaded, this causes me to have anxiety attacks. so i pretty much cant take anything that alters my perception or makes me feel any different than i *normally* do. that probably rules out nearly ALL possible drugs that i can take, but i am searching and hopeful. also did you take them just when you needed them or all the time? my doc has suggested a prescript that i only take when i need it, not all the time, to alleviate those se's that freak me out.
El
Posted by Viridis on August 26, 2003, at 5:02:53
In reply to Re: What drug worked best for your depression/anxi, posted by El on August 25, 2003, at 16:23:48
Klonopin and Xanax have been very effective for me, and the good news with these (and other benzodiazepines) is that tolerance usually develops quite rapidly to the side effects, but not the anti-anxiety effects. It took me about a week or two to get over some mild sleepiness/clumsiness/brain fog with daily Klonopin use, and since then I've had no side effects at all.
One strategy might be to take it before bed at first, when these things aren't such a problem. I did this initially, but found that the anti-anxiety effect wore off by about the middle of the next day, so now I take it in the AM. However, taking it at night at least in the beginning could help you avoid feeling spacey during the day.
Of course, if you only take the meds as-needed, you may find that the side effects do occur. Why not try a very small dose, see how you feel, and work up from there if it's appropriate?
Klonopin is a great drug for me, both for anxiety and the depression that results from anxiety. As another poster mentioned, Xanax seems to have a more pronounced antidepressant effect, and with the new extended-release form (which I haven't tried) could also be a good option.
Posted by Peter on August 26, 2003, at 5:41:03
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!
>
> ~ Aadika
>>Hi:
You know, I've heard it said a lot that provigil is a really good, smooth-acting stimulant that does a great job at counteracting benzo-induced fatigue. I've been taking klonopin at differing doses for 5 or 6 years now - only in the last few weeks have I gone up as high as 3.5mg daily. My pdoc has me taking adderall to help provide 'pep,' and to help the probable adult ADHD I have. I guess provigil isn't effective for ADHD?
Adhd aside, what do you find effective about provigil in your current combo?
Also, does the provigil raise your resting heartrate? I found that other stims, like adderall or dex, raised my RHR to the point that my pdoc used to add beta-blockers, like propranolol. But I always found that beta-blockers to somehow counteract that energy-providing benefits of the stims - and I didn't like the idea of my heart going thru a kind of 'push-pull' experience - up from the stim, down from the beta-blocker. Why do you take prop. and in what way is it effective in combo w/your other meds?
thanks,
Peter
Posted by btnd on August 26, 2003, at 6:05:52
In reply to Re: What drug worked best for your depression/anxi, posted by El on August 25, 2003, at 16:23:48
> Did klonopin (or Xanax) give you any side effects? i hate feeling spacey or lightheaded, this causes me to have anxiety attacks. so i pretty much cant take anything that alters my perception or makes me feel any different than i *normally* do. that probably rules out nearly ALL possible drugs that i can take, but i am searching and hopeful. also did you take them just when you needed them or all the time? my doc has suggested a prescript that i only take when i need it, not all the time, to alleviate those se's that freak me out.
> ElI now have no side-effects whatsoever. During the 1st week I was little *slow* and had some problems with my short term memory (for example I was talking to few people and 2 hours later I didn't know what was the topic of the conversation :) but it all eventually went away.
Brad
Posted by zeugma on August 26, 2003, at 7:41:44
In reply to Re: What drug worked best for your depression/anxi, posted by btnd on August 26, 2003, at 6:05:52
I am extremely disturbed to read all this about the efficacy and safety of Klonopin for social phobia/anxiety. I am only now doing intensive research on ways to treat social phobia- which, by the way, I was diagnosed with almost a year age. Every time I have complained about experiencing severe anxiety in the presence of others, my pdoc minimized the situation, noting that SSRI's- which I cannot tolerate- were the accepted treatment for social phobia and that there wasn't really anything else to consider. I have been pursuing CBT for the past month- with his knowledge, by the way- and feeling increasing levels of agitation and anxiety. The kind of intensive analysis and anxiety-provoking my therapist has requested has precipitated something like a panic attack, and I called my pdoc yesterday to tell him what happened. He brushed it aside and asked if the drugs I was taking (nortriptyline, Strattera, Buspar) were still working. I told him yes but I was terribly anxious, just not depressed. He told me this was an issue I should work out in CBT, and told me to let him know how I was feeling at our next session (the 15th). Well, I have decided to discontinue CBT for now, and also to discontinue this pdoc. Does this sound reasonable? I have posted more detailed information about my condition and history in a thread below.
Posted by McPac on August 26, 2003, at 13:34:59
In reply to Re: What drug worked best for your depression/anxi » El, posted by Viridis on August 26, 2003, at 5:02:53
I took Xanax for years (stopped a decade ago).
It worked great but near the end I started to develop somewhat of a tolerance to it (it seemed to take more to do the same thing. However, the worst thing I remember is the god-awful terrible withdrawal (incredibly hard to get off of). That has kept me from trying Klonopin, even though I really would very much like to try Klonopin. Is Klonopin as terrible to quit as Xanax? Also, some say they become tolerant to Klonopin---is that a small % of users, in your opinion? Finally, I've read where some say it can actually cause depression---do you believe that (or is that just a small % perhaps)? Would love to hear your answers to those questions. I may very well try Klonopin down the road and just want to know some answers. It worked GREAT for my Aunt (who had VERY similar problems to me).
Posted by Viridis on August 26, 2003, at 23:29:15
In reply to extremely disturbed, posted by zeugma on August 26, 2003, at 7:41:44
Some doctors simply refuse to prescribe benzodiazepines, on the grounds that they're "addictive". This is simply not true for most anxiety patients, and benzos remain the "gold standard" for anxiety disorders. I would try other pdocs ASAP.
You do have to be a little careful about asking for benzos outright -- my pdoc says that asking for Xanax, especially, can trigger suspicion of "drug-seeking behavior". Klonopin (clonazepam) seems much less controversial, and has very little potential for abuse. It's also very effective for many anxiety sufferers.
If you can, I'd see another pdoc (it may take more than one), describe your symptoms, and if they suggest SSRIs, mention that you've heard that a drug called clonazepam works well and would prefer to try that. It may take a few tries, but chances are you will find a pdoc with common sense who isn't taken in by the pharmaceutical companies' push for their more expensive meds.
It's just a hunch, but I suspect (based on my experiences) that an older pdoc who's been around and knows the ins and outs of older and newer meds would be more likely to prescribe it.
Good luck!
Posted by zeugma on August 27, 2003, at 7:43:59
In reply to Re: extremely disturbed » zeugma, posted by Viridis on August 26, 2003, at 23:29:15
> Some doctors simply refuse to prescribe benzodiazepines, on the grounds that they're "addictive". This is simply not true for most anxiety patients, and benzos remain the "gold standard" for anxiety disorders. I would try other pdocs ASAP.
>
> You do have to be a little careful about asking for benzos outright -- my pdoc says that asking for Xanax, especially, can trigger suspicion of "drug-seeking behavior". Klonopin (clonazepam) seems much less controversial, and has very little potential for abuse. It's also very effective for many anxiety sufferers.
>
> If you can, I'd see another pdoc (it may take more than one), describe your symptoms, and if they suggest SSRIs, mention that you've heard that a drug called clonazepam works well and would prefer to try that. It may take a few tries, but chances are you will find a pdoc with common sense who isn't taken in by the pharmaceutical companies' push for their more expensive meds.
>
> It's just a hunch, but I suspect (based on my experiences) that an older pdoc who's been around and knows the ins and outs of older and newer meds would be more likely to prescribe it.
>
> Good luck!Thanks for the support. The severe anxiety and feeling of incipient panic is starting to settle down. I'm very afraid of spoiling my chances of receiving appropriate medication by exhibiting "drug-seeking behavior." It is hard when a condition is so unpleasant that when you are sitting alone thinking of a certain set of symptoms, they seem so painful that you would literally do ANYTHING to be rid of them... Last year when I first learned of the social phobia diagnosis I begged my pdoc for Paxil because I' had heard that it was approved for this disorder. This in spite of the fact that I had sworn I would never go near another SSRI. He turned this one down on the valid grounds that it could mess with the blood levels of my TCA. I was not pleased but got him to agree to a trial of the Buspar instead. So you see I was definitely seeking a drug to relieve my anxiety.
The thing is that now I am in a very different place. My depression is virtually in remission and I am able to do things I couldn't dream of this time last year: work 40 hours a week, focus on my work, sleep at night and eat three meals a day. This is really the first tome in my life thst I have been able to do this things on a regular basis for any length of time. I think my pdoc has done a GREAT job treating my depression and ADHD. I think he feels that since I'm not depressed or attentionally challenged I can solve the social anxiety through CBT. I had thought so too, until I started to break down last week. I would like nothing more than to 'stabilize' my medication and not take any more pills. But I'm also sick of suffering debilitating anxiety in the presence of others. I am going to discuss these issues with my neuropsychologist next week. She has been concerned about my anxiety for months and has heard countless stories about my social anxieties. In fact she is the one who recommended CBT. She has heard me complain many times about my pdoc's seeming disinterest in my anxiety. I will see how that goes with her and then go to my appt. with pdoc on the 15th. I feel like I can last until that point since I have put the CBT on hold. If he has nothing rational to say I will ask my CB therapist for a referral to a pdoc who specializes in anxiety issues. I can put up with this social phobia for a little while longer in the interest of maintaining my sanity, but I have no intention of putting up with it indefintely.
Posted by McPac on August 27, 2003, at 14:42:52
In reply to extremely disturbed, posted by zeugma on August 26, 2003, at 7:41:44
"noting that SSRI's- which I cannot tolerate"
>>>>>>>>> Hi zeugma, why can't you tolerate the ssri's?
I have always had trouble with the ssri's because they cause anger/agitation/irritability in me (some ssri's moreso than others).
Yet I also need something for crummy anxiety, nervousness.
Thanks!!!
Posted by zeugma on August 27, 2003, at 20:46:15
In reply to zeugma, Re: extremely disturbed, posted by McPac on August 27, 2003, at 14:42:52
Hi McPac,
SSRI's cause worsening of my sleep problems, severe appetite loss and terrible IBS flareups. They sem to affect my body like stimulants, Prozac felt very much like Ritalin but with stomach upset added on. My depression is marked by agitation, insomnia, and appetite loss to begin with so these side effects were hard to take. In the past year I have been tempted to try an SSRI (not Prozac or Zoloft) to treat my severe social phobia. I would like to hear from any social phobics/ people with avoidant personality disorder who were helped by an SSRI, since I do not feel like I can get through CBT without pharmaceutical assistance, and SSRI's are prescribed a lot more freely than some other meds.
Posted by temoigneur on August 28, 2003, at 0:21:03
In reply to Re: What drug worked best for your depression/anxiety?, posted by Cisco on January 12, 2003, at 3:27:39
In reply to Re: What drug worked best for your depression/anxiety?, posted by Cisco on January 4, 2003, at 13:38:14> I've had amazing anti-depressive results with certain non-selective serotonin sub-receptor (5-HT1A, 5-HT2A, 5-HT2C, 5-HT4, etc) agonist's, which are derived from from the indolealkylamine class of medications.
>
> CiscoMy Gosh, I've been searching frantically, emailing doctors in europe and everwhere to get a hold of a 5-HT2A agonist, how did you get access to these drugs
Thanks a million
Hi cisco, I'm extremely interestedin the compounds you found, another school year is starting and I'll have to watch it pass by if I don't find something to help with my anxiety - I tried to email you @ cisco255@hotmail.com but the hotmail msg said that address didn't exist, I'd love to know what you were referring to in the above post, my email is bentley79@hotmail.com, thanks so much
Ben
> This is a very interesting class of endogenous SSRA's (Serotonin Sub-Receptor Agonist's). Hey, I just invented a new class of AD's!
>
> However, it would be preferable to discuss in detail over cyber coffee. If you are interested, e-mail me at cisco255@hotmail.com
>
> Cisco
This is the end of the thread.
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