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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 17 of 17. This is the beginning of the thread.
Posted by phillipa on January 16, 2005, at 17:40:56
I've really gotten confused on the anti-anxiety meds and which ones work. I found in the hospital that they were using a lot of zyprexia, seroquel, lamictal, ect in addition to xanax, klonopin. Now I don't know what to think. Can anyone help? I thought I knew about these drugs and uses until now. Fondly Phillipa
Posted by ace on January 16, 2005, at 22:07:41
In reply to What Is Best Anti-Anxiety Med In Your Opinion?, posted by phillipa on January 16, 2005, at 17:40:56
> I've really gotten confused on the anti-anxiety meds and which ones work. I found in the hospital that they were using a lot of zyprexia, seroquel, lamictal, ect in addition to xanax, klonopin. Now I don't know what to think. Can anyone help? I thought I knew about these drugs and uses until now. Fondly Phillipa
I am smarter than any doctor and going to be a psychiatrist myself, so trust me!!!
Best Anxiety meds...1. Nardil
2. Xanax
3. Klonopin
4. Diazepam (relaxes muscles too)
5. Old TCA's (all have potential for anti-anxiety effects)
6. Neurontin (4 some people)
7. Seroquel/Zyprexa/Geodon/Thorazine/Mellaril (all antipsychotics)
8. Stelazine (Definately has strong anxiolytic effects)Love Ace!
Posted by zmg on January 16, 2005, at 22:19:02
In reply to Re: What Is Best Anti-Anxiety Med In Your Opinion? » phillipa, posted by ace on January 16, 2005, at 22:07:41
I'm planning to try the French AD Stablon which they compare favorably to Xanax (Alprazolam).
http://www.servier.com/pro/Neurosciences/stablon/stablon_faq.asp#1
Would be nice if it helps. Its an SSRA.
Posted by phillipa on January 16, 2005, at 22:19:34
In reply to Re: What Is Best Anti-Anxiety Med In Your Opinion? » phillipa, posted by ace on January 16, 2005, at 22:07:41
Wow! A pdoc! You will be a wonderful one since you have experienced problems of your own. When do you graduate? Can I be your first patient? A question then. It was suggested I try seroquel for sleep or zyprexa. I now take klonopin and chloral hydrate. What is your Rx. Fondly Phillipa
Posted by CareBear04 on January 18, 2005, at 13:58:55
In reply to What Is Best Anti-Anxiety Med In Your Opinion?, posted by phillipa on January 16, 2005, at 17:40:56
hi phillipa--
for me, it depends on what kind of anxiety i'm feeling. for very physical, strung-out and antsy types of feelings, nothing works as well as xanax. i take xanax regularly, but xanax prn works like a charm, too. recently, when i was in the hospital, something happened that made me hysterical crying. i knew i needed a prn to calm down and get smart, so i sucked it up and asked the nurse who gave me xanax. within minutes, i was so calm and cold that they didn't recognize me or know what to do with me. ativan is my second choice and klonopin probably third. for physical tremors and that kind of anxiety, propranolol is also great, especially if you have associated heart palpitations or panic-type symptoms. my pdocs have said that klonopin and xanax are the best benzos for panic attacks.as for things like racing thoughts and psychological angst, neuroleptics are the best for reigning my thoughts in. actually, lithium is very effective, but not as a prn, which seems to be what you're asking for, no? haldol has been the best for me, and the atypicals all work the same to a greater or lesser degree. abilify is one that i was only on for a few weeks, so i can't really comment on whether it slowed my thoughts down, but i don't think it did at 10mg/day for two weeks. seroquel was mostly a sleeping pill. now risperdal is intersting. it was my first antipsychotic, and eventually-- in teh very long-term-- it did reign in some of those racing and morbid thoughts. zyprexa was very effective, either as a prn or a standing drug, but for me it was successful only as a med of last-resort. it totally knocked me out when i was too upset to deal; it kept me safe, but it didn't help me deal with things while vertical. the anticonvulsants like depakote or neurontin were mildly helpful, though i wasn't on those long, either. i imagine tegretol or trileptal would be similar.
oh, and effexor was good for generalized anxiety, though it didn't do much for my mood.
hope this helps!
Posted by ace on January 19, 2005, at 20:30:22
In reply to Re: What Is Best Anti-Anxiety Med In Your Opinion? » phillipa » ace, posted by phillipa on January 16, 2005, at 22:19:34
> Wow! A pdoc! You will be a wonderful one since you have experienced problems of your own.
Thanks! It's true...roughly 70% of pdoc's indeed have a psychiatric past. I feel i will be able to empathise with my patients so well, because I have experiencied such a wide spectrum of affective and other disorders...
When do you graduate?
Well i'm in medicine now, but I have so many credit points which pertain to medicine, my medical degree will only be for 2 years as opposed to four...i was in medicine before but had to pull out due to illness. I'll be a clinical psychiatrist in 5-6 yrs
Can I be your first patient?Sure!! Free of charge too!
A question then. It was suggested I try seroquel for sleep or zyprexa. I now take klonopin and chloral hydrate. What is your Rx. Fondly Phillipa
Seroquel, in my opinion, and after reading a plethora of anecdotes and clinical trials, has a greater sedative quality than Zyprexa. However, unless you have other illnesses which by perforce require the use of an antipsychotic, for sleep reasons, I would use a more benign drug....
suggestions...
1. Clonidine *
2. Valium (10mg)
3. Trazodone *
4. Mogadon (10mg)
5. Clomipramine, or other TCA
Actually, what is your diagnosis? This will give me a better vantage point to reccomend a medication to help both the insomnia + mental illness...Good Luck friend!!!
Ace
Posted by CareBear04 on January 19, 2005, at 20:57:55
In reply to Re: What Is Best Anti-Anxiety Med In Your Opinion? » phillipa, posted by ace on January 19, 2005, at 20:30:22
ace-- how cool! your training sounds exciting, as does the fact that you'll be in clinical psychiatry relatively soon.
can i ask what country you're in. from what i know about the american medical system from my boyfriend or sister, it doesn't sound like you're training in the states.
i didn't know the percentage of pdocs with previous psych experience, but it makes much sense. i read in a book that "psychiatrists specialize in their own defects." that makes sense. if not their own psych problems, then maybe that of their family members or friends. my previous pdoc told me that his father was bipolar. he also told me that i'd make a hell of a psychopharmacologist, though since i've never known a good psychopharm dr, i didn't know whether to take it as a compliment. he said it was-- that i have the memory to bring to mind the details of all the meds and the experience to sift through the extraneous and pull out the info relevant to medicating. i personally hate psychiatry after many bad experiences with it, but when that pdoc told me that he wouldn't be at all surprised to see me at a conference in ten years, i couldn't really deny it. i have a tendency to root for the underdog and to fight and defend the people who seem most helpless and hopeless, and pscyhiatry certainly has a lot of people fitting that profile.
ace, i think it's great that you're going into psychiatry. i think we definitely could use some more empathy in the field. i've appreciated it when my pdoc has admitted to using some drug or another, though usually ones like propranolol that are taken for many reasons.
funny about psych residents these days. i've only come across them in the hospital, and it's surprising that over 2/3 of the ones i've seen have been women. not only are they women, but in one psychiatric residency program, especially, the women were all really good looking, which made me wonder whether the residency director is man with an eye for pretty women. also, it seems like psych residents are all really thin and fashionable, especially since they don't have to wear the white coats. this paragraph is completely unnecessary, but it's something i noticed, so i thought maybe others could relate.
Posted by phillipa on January 19, 2005, at 21:30:07
In reply to Re: What Is Best Anti-Anxiety Med In Your Opinion? » phillipa, posted by ace on January 19, 2005, at 20:30:22
Ace; It started off as anxiety disorder many years ago[probably before the PDR was revised], became depression/anxiety, new pdoc PTSD, and now I think major depession. I can't stay asleep, and it seems I need more klonopin and CH all the time. Thanks for your help Phillipa
Posted by ace on January 20, 2005, at 19:03:56
In reply to Re: What Is Best Anti-Anxiety Med In Your Opinion?, posted by phillipa on January 19, 2005, at 21:30:07
> Ace; It started off as anxiety disorder many years ago[probably before the PDR was revised], became depression/anxiety, new pdoc PTSD, and now I think major depession. I can't stay asleep, and it seems I need more klonopin and CH all the time. Thanks for your help Phillipa
In that case, I would seriously consider a sedating TCA as first line...Nardil, for some, including myself, has sedative properties. Also, Clonidine has been shown to help anxiety and depression and has unequivocal sedative properties. Also, now I know your diagnoses, I believe Seroquel would be a good choice too...in the range of 100-200mg. Zyprexa 2.5-10mg would also seem an astute decision. Wecan also try some old antipsychotics which have VERY much sedative properties, although they do not really seem to effect depressive symptoms.
But, overall, I would try something like Clomipramine, or Trazodone.
Hope this helps!!!
I wish you happiness!
Ace
Posted by University on January 20, 2005, at 23:17:59
In reply to What Is Best Anti-Anxiety Med In Your Opinion?, posted by phillipa on January 16, 2005, at 17:40:56
> I've really gotten confused on the anti-anxiety meds and which ones work. I found in the hospital that they were using a lot of zyprexia, seroquel, lamictal, ect in addition to xanax, klonopin. Now I don't know what to think. Can anyone help? I thought I knew about these drugs and uses until now. Fondly Phillipa
Klonopin--clonazepam--is, by FAR, the best anxiolytic I've ever used. It's sweet taste makes taking it sublingually easy.
Posted by ed_uk on January 22, 2005, at 10:21:59
In reply to Re: What Is Best Anti-Anxiety Med In Your Opinion, posted by University on January 20, 2005, at 23:17:59
All this talk about becoming a doctor is making me depressed. I used to want to be a doctor, in fact I was very enthusiastic about it. I eventually accepted that I couldn't do it because I have too many problems. Now I'm doing pharmacy at uni and I hate it- it's the most boring lifeless course imaginable, I think I'm going to drop out.
Posted by jujube on January 22, 2005, at 12:30:52
In reply to Re: What Is Best Anti-Anxiety Med In Your Opinion, posted by ed_uk on January 22, 2005, at 10:21:59
Please don't drop out Ed. Perhaps you can re-evaluate your choice of a major. You have so much to contribute and seem so bright and personable, I am sure that you will find a course of study about which you will be enthusiastic. Are there academic counsellors at your uni with whom you could discuss alternative programs?
Take care of you.
> All this talk about becoming a doctor is making me depressed. I used to want to be a doctor, in fact I was very enthusiastic about it. I eventually accepted that I couldn't do it because I have too many problems. Now I'm doing pharmacy at uni and I hate it- it's the most boring lifeless course imaginable, I think I'm going to drop out.
>
Posted by sabre on January 22, 2005, at 20:44:38
In reply to Re: What Is Best Anti-Anxiety Med In Your Opinion, posted by ed_uk on January 22, 2005, at 10:21:59
Hi Ed
I know how you feel. I went through the graduate medical entrance exam last year....a 5.5 hour ordeal and was offered an interview.Unfortunately my social anxiety crippled me to the point of being unable to face up to the interview. I pulled out two days before. I was also fearful of the PBL method of learning that they use now.
Now I am beginning to think there are other options. With a background in pharmacy you could launch pretty well into a masters/PhD in neuroscience. Scientific research demands creativity, logic, intelligence...you name it. I have heard that the best medical students often become bored with medicine. They eventually settle into one speciality area and it can become repetitious and dull.
If you want to help people, use that smart brain of yours for neuro/pharmo research!!!!
Can you put social anxiety on the top of your to-do list?sabre
Posted by eeyorena on January 24, 2005, at 16:51:48
In reply to What Is Best Anti-Anxiety Med In Your Opinion?, posted by phillipa on January 16, 2005, at 17:40:56
After 25 years of an anxiety disorder? And many many meds...I would have to say that my treatments of choice are:
1) Talk therapy
2) Exercise and massage
3) Decent sleep...which means at least 90 minutes of REM sleep a night
4) My dog
5) AtivanOther meds I've tried include: Xanax, Klonopin, Prozac, Elavil, Effexor...and I was mis-prescribed Lithium at one time.
Posted by ed_uk on January 25, 2005, at 9:50:11
In reply to Re: What Is Best Anti-Anxiety Med In Your Opinion?, posted by eeyorena on January 24, 2005, at 16:51:48
Hello,
Why do you prefer Ativan to Xanax and Klonopin?
Ed.
Posted by FredPotter on January 25, 2005, at 14:28:41
In reply to Re: What Is Best Anti-Anxiety Med In Your Opinion?, posted by eeyorena on January 24, 2005, at 16:51:48
I've had major anxiety problems for 41 years. It was originally described as "nameless dread" and I can't improve on that. The only drug that did anything was alcohol, but I came unstuck on that in the end. I take Xanax but it doesn't do much. Breathing in for 7 and out for 11 helps a bit. Exposure to and involvement with other people and the wider community is probably the most useful thing, as well as a lifestyle that gives stimulation and security. Not that I've achieved any of this
Posted by dancingstar on January 25, 2005, at 15:57:03
In reply to Re: What Is Best Anti-Anxiety Med In Your Opinion?, posted by eeyorena on January 24, 2005, at 16:51:48
i wanna know how you got to be so smart.
This is the end of the thread.
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