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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 18 of 18. This is the beginning of the thread.
Posted by garnet71 on April 1, 2009, at 9:52:12
Had a panic attack after dropping my son off at school this morning-I thought I was going to pass out in my car. It starts when my breathing seems to get messed up, then I see flashes of light, then my lower arms got so tingly, got dizzy-came close to passing out. So I don't know if the anxiety is causing hypoxia, or if its something else. I took 2 xanax, but I'm only allowed one a day, so I think I might need to switch to something else besides Buspirone now.
I can't say for sure if the Adderall is causing it, because the day before I started this drug, I had a panic attack. I can sit at my comptuer for hours on adderall w/no anxiety. For some reason, the anxiety is the worse in my car. I have no driving phobia, I like driving, so I don't know what's up with that. Even in my early 20s when I'd get anxiety here and there, it would start in my car. Well, I didn't even know what anxiety was back then but I remember this.
The Adderall is working so well with focus and motivation, much better than Ritalin-I don't want to quit yet.
Or could that be symptoms of high/low blood pressure?
I also wonder if Buspirone messes with my breathing. I don't feel like I have normal breathing anymre, like I have to remind myself to breath sometimes. I doubt it, but its a possibility.
I don't know what to do. I haven't tried Celexa or Lexapro for a number of years so was thinking about that. But Zoloft and Wellbutrin both took away my motivation and made me depressed and physically miserable too, and I can't take Prozac. I don't know about Effexor-it seems to be too much.
I'm not sure what to do-I really want to stay on the Adderall until I get through school. It's made a big difference so far.
Any ideas?
Thanks
Posted by garnet71 on April 1, 2009, at 10:17:44
In reply to New meds needed for anxiety - advice please, posted by garnet71 on April 1, 2009, at 9:52:12
I've never tried anticonvsulants, TCAs or MAOIs - or anything else, but don't think I want to> I don't think I can handle months or years of trials of meds right now because my whole life will fall apart.
Since SSRIs always correct my anxiety w/in a few days, I wonder if its worth trying Laxapro or Celexa again since its been so many years. I quit taking them when they made me so lethargic, I couldn't function at all. I think I waited the 4-6 weeks too, but am not sure. That was long ago.
Does Lexapro or Celexa affect different H receptors or their precursors much different than Zoloft/Prozac? I"m not sure if I want to try Paxil.
I am considering St. Johns Wort-but my PDocRN said not to take it w/o going back there first, and she doesn't really think I should try it, my next appt. is not for about another month.
Or Effexor..I don't know what to do. I hope I can sse the doctor next time I go. He works mostly out of a hospital, so he's only there once a week.
Posted by myco on April 1, 2009, at 12:21:54
In reply to New meds needed for anxiety - advice please, posted by garnet71 on April 1, 2009, at 9:52:12
> I can't say for sure if the Adderall is causing it, because the day before I started this drug, I had a panic attack. I can sit at my comptuer for hours on adderall w/no anxiety.>
***Adderall is not a good mix for panic and anxiety as it's going to have an effect on the neuros and physical issues that panic/anxiety have. Definately plays a role in bp and heart rate...common with stimulants...main reason why dr's dont like to use with maois...both mess or bp unstable potentially causing issues. I'm sure youre aware of this though.
> The Adderall is working so well with focus and motivation, much better than Ritalin-I don't want to quit yet.
***just watch the dose, listen to how your body/mind feels....also other ways of getting that stimulant effect.
> Or could that be symptoms of high/low blood pressure?
***of course possible...stimulants can mess with those issues easily and unpredictably and mixing with other meds may potentially increase it more. I dont like the idea of stimulants in combo with meds that have a significant effect on NE...but thats just me. Sometimes you need a lil boost...and I believe what I read and feel that continued use of some AD's dampen the effects of DA which makes NE...therefor a stimulant may be called for but if your med is ok and your an anxiety patient?....not the best choice hun. But if you get more benefit than bad from it then youre ahead.
> I don't know what to do. I haven't tried Celexa or Lexapro for a number of years so was thinking about that. But Zoloft and Wellbutrin both took away my motivation and made me depressed and physically miserable too, and I can't take Prozac. I don't know about Effexor-it seems to be too much.
***interesting...doesnt zoloft and wellbutrin (at least this alot) effect DA or NE...when you increase effects in this pathway the neuros readjust in the seratonin pathway (if I remember correctly)...bringing down mood potentially and energy levels....increasing seratonin often dose this...kind of why many people in ssri's find themselves lazy and sitting around with no motivation...lack of stimulation i believe...bits of stimulants to motivate/energize the lethargic depressive....get them going, off the couch etc. My mom for example...exactly whats happening with her...ssri's for to many years killed her motivation and made her lazy and tired very easily...always told her she doesnt need seratonin...finally clued in...herbal supplement for L-Dopa (i introduced her to) and bam...off the couch, mood up, energy up, concentration kicked in, she can read again...damn ya know....some people, especially anxiety patients like me and mom, benefit very very little from ssri's....dopamine/noreph/gaba is what is required for me and her anyway. Nardi gives me this but also the seratonin which i dont really need but I deal with .... doesnt seem to do much as opposed to ssris which make me miserable and increase my anxiety usually.
This follows into a recommendation for you regarding effexor....regardless of what the fda or health canada states about effexor being indicated for anxiety like GAD....it's bullocks for alot of people...once you get high in dose the anxiety skyrockets....dont avoid the med cause of what I say...just take note if you use it...keep an on anxiety levels on it.
> I'm not sure what to do-I really want to stay on the Adderall until I get through school. It's made a big difference so far.***if you can tolerate the issues then stick with it...dont interupt your schooling...changing meds can be a nightmare so stick it out as long as its benefiting you more than causing issues until school is done. I changed in school and it messed up 4th year a bit for me.
myco
---------------
Posted by desolationrower on April 1, 2009, at 20:24:09
In reply to Re: New meds needed for anxiety - advice please, posted by garnet71 on April 1, 2009, at 10:17:44
sounds like either switching to d-AMP or adding citalopram could help. either option might cause a bit less energy, but you have to find just the right amount.
or, try turning up the radio and putting down teh windows?
-d/r
Posted by Garnet71 on April 1, 2009, at 22:42:16
In reply to Re: New meds needed for anxiety - advice please » garnet71, posted by myco on April 1, 2009, at 12:21:54
No, can't take handle panic attacks like this. I was already granted a leave of absence for university (I won't be able to get a second), and allowed an exception for something last semester. I don't think I have any more chances.
Actually, I don't think I can handle all this much longer. Anxiety is torture. Today I had thoughts wishing I would die in an accident or something, so it would end. I ended up having to take 4 xanax before it stopped. I think your're right about the adderall physical effects. My chest felt tight/constricted like asthma before anxiety started. But I didn't even take the adderall today, since I don't take it unitl after 2 or 3 hours after getting up. Maybe from the day before? I woke up feeling great this morning. Adderall has that effect. I usually don't feel that good as soon as I wake. It makes me sleep really good, but only for about 5 hrs., when I think I'm the type of person that needs 8 hrs. I know lack of/ inadequate sleep can bring on anxiety to people predisposed.
I don't know Myco-I'm still very confused. Thanks for telling me the L-Dopa story and all.
Posted by Garnet71 on April 1, 2009, at 22:43:45
In reply to Re: New meds needed for anxiety - advice please, posted by desolationrower on April 1, 2009, at 20:24:09
the radio was up and the windows were down. Got any other brilliant ideas?
Posted by Phillipa on April 1, 2009, at 23:43:21
In reply to Re: New meds needed for anxiety - advice please, posted by Garnet71 on April 1, 2009, at 22:43:45
Garnet why not stick with the xanax for at least a period of a few weeks and stop the stimulant. Windows down now that's a new one. d/r you're a trip. Love Phillipa ps don't know how I missed one on anxiety. Oh also lack of sleep yes definitely as need 9-10 myself never get it though used to when in school.
Posted by myco on April 1, 2009, at 23:48:51
In reply to Re: New meds needed for anxiety - advice please » myco, posted by Garnet71 on April 1, 2009, at 22:42:16
Hun do you suffer atypical depression with anxiety like panic/gad/sad etc...? If these are serious issues for you please consider, and dont be affraid its not bad really, a maoi like nardil. I dont mean to preach about nardil (sometimes i feel like a nardil salesman here) but it is bar far the best ive taken for these issues - atyp dep with horrid anxiety issues. Nardil has a "built in benzo" - works alot of gaba for muscle relaxing effect and panic relieving effect - very good at this. plus will stimulate you providing you energy to do things you might not otherwise have the strength or drive to do. increase concentration....again feel like a salesman but consider this option. they really are effective for alot of people who havent responded (in my opinion should be considered first line in many cases) to other treatments. dont be scared of nardil serious...i admit parnate worries me because spontaneous hypertensive episodes but that wont keep me from it if i need to go there....nardil is not as unpredictable as that. really not bad...wish people wouldnt worry about maois.
chest tightening is an indication of increased anxiety and an oncoming panic attack...this is one of my personal warnings to take heed for myself...this is how they start then inability to breath properly then sweats then bam loss of reality for a second...totally out of it consciously for a moment. imagine being behind the wheel of a car when this happens and yet when i explain that to gp's they dont give a sh*t...i mean a tiny bit of ativan would do wonders for that....blah blah lol im venting grrrr had another recent argument with another bloody maoi-phobe gp lately so it's still a lil tender lol
youre gonna be ok hun....ditch the adderall seriously. you want/need stimulation?...other ways to get that more "subtly"...adding a DA med of some kind (i know that wording sounds ignorant but im not a pharmacologist or chem student) will help...bring on some NE effect more subtly. stimulants are like wham NE up the *ss hard...for me and many anxiety patients...those are a bit to much...need a lil tickle at first ya know. not so hard on the NE. lol ugh lame anyway....
*hugs
myco
------------> No, can't take handle panic attacks like this. I was already granted a leave of absence for university (I won't be able to get a second), and allowed an exception for something last semester. I don't think I have any more chances.
>
> Actually, I don't think I can handle all this much longer. Anxiety is torture. Today I had thoughts wishing I would die in an accident or something, so it would end. I ended up having to take 4 xanax before it stopped. I think your're right about the adderall physical effects. My chest felt tight/constricted like asthma before anxiety started. But I didn't even take the adderall today, since I don't take it unitl after 2 or 3 hours after getting up. Maybe from the day before? I woke up feeling great this morning. Adderall has that effect. I usually don't feel that good as soon as I wake. It makes me sleep really good, but only for about 5 hrs., when I think I'm the type of person that needs 8 hrs. I know lack of/ inadequate sleep can bring on anxiety to people predisposed.
>
> I don't know Myco-I'm still very confused. Thanks for telling me the L-Dopa story and all.
Posted by myco on April 1, 2009, at 23:53:09
In reply to Re: New meds needed for anxiety - advice please » Garnet71, posted by Phillipa on April 1, 2009, at 23:43:21
Good idea here....ditch the adderall then "stablize" yourself with a benzo for awhile ok...get rid of some of that stimulant effect and you will most likely see anxiety drop. then think about a more benign way of dealing with anxiety....believe it or not i do consider nardil benign...again lol salesman...its tough to get where you want to go on it but once there....smooth sailing very mild feeling med. i feel "normal" i dont even know im on it...just behaviours have changed. unless someone knows me they wouldnt know i was on a med. its that smooth.
but many other "safer" (to quote a typical gp) alternatives...sure. but for you stimulation?...more DA in some way.
> Garnet why not stick with the xanax for at least a period of a few weeks and stop the stimulant. Windows down now that's a new one. d/r you're a trip. Love Phillipa ps don't know how I missed one on anxiety. Oh also lack of sleep yes definitely as need 9-10 myself never get it though used to when in school.
Posted by softheprairie on April 2, 2009, at 1:11:49
In reply to New meds needed for anxiety - advice please, posted by garnet71 on April 1, 2009, at 9:52:12
I wouldn't rule out a beta blocker for anxiety if you haven't tried one yet. Historically, they've carried a risk of increasing depression for some people; the newer one I'm taking, Bystolic (the generic name is nebivolol) doesn't show that on its official information, and it hasn't increased depression for me. Bystolic makes my antidepressant desipramine at high dose (300 mg/day) tolerable, as the desipramine is great for my depression but brings on a bunch of anxiety, heart palpitations, and fast heartbeat. Perhaps a beta blocker would make your Adderall more tolerable? PRN perphenazine also helps my anxiety (yes, it's an old-school anti-psychotic, but I like it, and so far the benefits to me from it are greater than the risks and downsides).
P.S. I get the Bystolic free from the maker's patient assistance program.
> Had a panic attack after dropping my son off at school this morning-I thought I was going to pass out in my car. It starts when my breathing seems to get messed up, then I see flashes of light, then my lower arms got so tingly, got dizzy-came close to passing out. So I don't know if the anxiety is causing hypoxia, or if its something else. I took 2 xanax, but I'm only allowed one a day, so I think I might need to switch to something else besides Buspirone now.
>
> I can't say for sure if the Adderall is causing it, because the day before I started this drug, I had a panic attack. I can sit at my comptuer for hours on adderall w/no anxiety. For some reason, the anxiety is the worse in my car. I have no driving phobia, I like driving, so I don't know what's up with that. Even in my early 20s when I'd get anxiety here and there, it would start in my car. Well, I didn't even know what anxiety was back then but I remember this.
>
> The Adderall is working so well with focus and motivation, much better than Ritalin-I don't want to quit yet.
>
> Or could that be symptoms of high/low blood pressure?
>
> I also wonder if Buspirone messes with my breathing. I don't feel like I have normal breathing anymre, like I have to remind myself to breath sometimes. I doubt it, but its a possibility.
>
> I don't know what to do. I haven't tried Celexa or Lexapro for a number of years so was thinking about that. But Zoloft and Wellbutrin both took away my motivation and made me depressed and physically miserable too, and I can't take Prozac. I don't know about Effexor-it seems to be too much.
>
> I'm not sure what to do-I really want to stay on the Adderall until I get through school. It's made a big difference so far.
>
> Any ideas?
>
> Thanks
Posted by garnet71 on April 2, 2009, at 8:45:44
In reply to New meds needed for anxiety - advice please, posted by garnet71 on April 1, 2009, at 9:52:12
Thanks, you guys, for the advice-and the Nardil salespitch.
I got anxiety the second I woke up.
Phillipa, there's no way in hell I'm going to depend on Xanax to treat my anxiety. When I get it-it's too severe and it can last for days..weeks.
So I'm going to call PDocs office and see If I can get in to see the doc soon. I'll ask the nurse to replace buspirone for now; with what-i don't know yet. She didn't charge me for last appt., but maybe this time they can just bill me
Haven't taken the adderall in almost 36 hrs. Looks like I will have to put that aside.
I wonder if I treat my cortisol and thyroid issue, that the anxiety will go away? I thought the adderall somehow would fix my low thyroid issue.
No, I can't afford health care so I'm stuck treating the symptoms.
Oh, medicaid lady called me yesterday and said I waa denied for medical assistance because I'm a full time college student. I am going to appeal it basedd upon that since I receive an 'income' from teh VA for attending school, it serves as my job. It's far fetched, but I'm gong to give it a try; stranger things have happened from pulling resources out of thin air. Those benefits are derived from previous work, so maybe I have a shot. I have to pull up the state regulations to see how i can work that out. I'm dreading the paperwork though , not sure if I can handle anymore of that when there's a pile of papers here i have to deal with. I can't handle a job with panic attacks right now. At least with school, I can just not show up for class. I already have $2000 in doctors bills here.
Maybe I can get health care from college when I start the summer summester, but I don't know what my financial aid for grad school is yet to know if I can afford to deduct it out of my loans/aid.
But I can't go to school this summer if I don't get stabilized. Another catch 22.
Have a nice day everyone. It's sunny out here.
Posted by garnet71 on April 2, 2009, at 8:53:10
In reply to Re: New meds needed for anxiety - advice please » garnet71, posted by softheprairie on April 2, 2009, at 1:11:49
softprarie, never tried a betablocker, thanks for bringing that up. I don't feel I have any depression. well i got depressed yesterday from having a panic attack. I'ts depressing knowing I can't function w/this level of anxiety, but I think the anxiety has to be treated as the primary condition.
Posted by desolationrower on April 2, 2009, at 9:05:54
In reply to Re: New meds needed for anxiety - advice please » softheprairie, posted by garnet71 on April 2, 2009, at 8:53:10
if ssris have helped with anxiety before, i would do that (since your nurse seemed resistant to dexedrine). i think MAOI is a better long-term solution, but it sounds like you've got to much going right now to be trying things. or has the adderall not helped at all, putting aside the anxiety?
-d/r
Posted by garnet71 on April 2, 2009, at 9:15:37
In reply to Re: New meds needed for anxiety - advice please, posted by desolationrower on April 2, 2009, at 9:05:54
Hi, the adderall helped tremendously with focus, motivation, energy. It even seems to make my sleep better quality. I'm not saying the adderall does not facilitate anxiety, but I got a panic attack the day before I was even prescribed it. I think it makes me happy too becaues I'm so productive the way I used to be in my life-it brings me to my previous baseline. It makes me feel like my normal self. I haven't been even close to my baseline for years-it was such a great feeling to experience that again.
So I was thinking of SSRI too to avoid protracted experimentation w/other drug classes-but not sure which one to try. Not that I won't end up debilitated from them like I was before...but maybe a new one..maybe w/the adderall combo..don't know.
Posted by myco on April 2, 2009, at 15:05:34
In reply to Re: New meds needed for anxiety - advice please » garnet71, posted by softheprairie on April 2, 2009, at 1:11:49
This is a decent idea also...ive used "propanalol" in the past with good results in terms of the physical symptoms of anxiety (bp, heart rate and sweats) although it will do nothing to prevent a panic attack from occuring really...just ease the severity of it. Comes in a long lasting version aswell called "inderol". worth a look i guess if you want to stay on adderall but why "patch up" a med that causes you problems
> I wouldn't rule out a beta blocker for anxiety if you haven't tried one yet. Historically, they've carried a risk of increasing depression for some people; the newer one I'm taking, Bystolic (the generic name is nebivolol) doesn't show that on its official information, and it hasn't increased depression for me. Bystolic makes my antidepressant desipramine at high dose (300 mg/day) tolerable, as the desipramine is great for my depression but brings on a bunch of anxiety, heart palpitations, and fast heartbeat. Perhaps a beta blocker would make your Adderall more tolerable? PRN perphenazine also helps my anxiety (yes, it's an old-school anti-psychotic, but I like it, and so far the benefits to me from it are greater than the risks and downsides).
> P.S. I get the Bystolic free from the maker's patient assistance program.
>
>
> > Had a panic attack after dropping my son off at school this morning-I thought I was going to pass out in my car. It starts when my breathing seems to get messed up, then I see flashes of light, then my lower arms got so tingly, got dizzy-came close to passing out. So I don't know if the anxiety is causing hypoxia, or if its something else. I took 2 xanax, but I'm only allowed one a day, so I think I might need to switch to something else besides Buspirone now.
> >
> > I can't say for sure if the Adderall is causing it, because the day before I started this drug, I had a panic attack. I can sit at my comptuer for hours on adderall w/no anxiety. For some reason, the anxiety is the worse in my car. I have no driving phobia, I like driving, so I don't know what's up with that. Even in my early 20s when I'd get anxiety here and there, it would start in my car. Well, I didn't even know what anxiety was back then but I remember this.
> >
> > The Adderall is working so well with focus and motivation, much better than Ritalin-I don't want to quit yet.
> >
> > Or could that be symptoms of high/low blood pressure?
> >
> > I also wonder if Buspirone messes with my breathing. I don't feel like I have normal breathing anymre, like I have to remind myself to breath sometimes. I doubt it, but its a possibility.
> >
> > I don't know what to do. I haven't tried Celexa or Lexapro for a number of years so was thinking about that. But Zoloft and Wellbutrin both took away my motivation and made me depressed and physically miserable too, and I can't take Prozac. I don't know about Effexor-it seems to be too much.
> >
> > I'm not sure what to do-I really want to stay on the Adderall until I get through school. It's made a big difference so far.
> >
> > Any ideas?
> >
> > Thanks
>
>
Posted by metric on April 2, 2009, at 16:23:41
In reply to New meds needed for anxiety - advice please, posted by garnet71 on April 1, 2009, at 9:52:12
> Had a panic attack after dropping my son off at school this morning-I thought I was going to pass out in my car. It starts when my breathing seems to get messed up, then I see flashes of light, then my lower arms got so tingly, got dizzy-came close to passing out. So I don't know if the anxiety is causing hypoxia, or if its something else. I took 2 xanax, but I'm only allowed one a day, so I think I might need to switch to something else besides Buspirone now.
>
> I can't say for sure if the Adderall is causing it, because the day before I started this drug, I had a panic attack. I can sit at my comptuer for hours on adderall w/no anxiety. For some reason, the anxiety is the worse in my car. I have no driving phobia, I like driving, so I don't know what's up with that. Even in my early 20s when I'd get anxiety here and there, it would start in my car. Well, I didn't even know what anxiety was back then but I remember this.
>
> The Adderall is working so well with focus and motivation, much better than Ritalin-I don't want to quit yet.
>
> Or could that be symptoms of high/low blood pressure?
>
> I also wonder if Buspirone messes with my breathing. I don't feel like I have normal breathing anymre, like I have to remind myself to breath sometimes. I doubt it, but its a possibility.
>
> I don't know what to do. I haven't tried Celexa or Lexapro for a number of years so was thinking about that. But Zoloft and Wellbutrin both took away my motivation and made me depressed and physically miserable too, and I can't take Prozac. I don't know about Effexor-it seems to be too much.
>
> I'm not sure what to do-I really want to stay on the Adderall until I get through school. It's made a big difference so far.
>
> Any ideas?
>
> ThanksTry phenibut. You can buy it online as a "dietary supplement". It works very well at the appropriate dose -- better than Xanax IME. Don't take it everyday though, even though it might be tempting.
Also, diphenhydramine (Benadryl) has a calming effect that can be very useful when coming down from stimulants and it can potentiate the effect of other sedatives.
Posted by Garnet71 on April 2, 2009, at 18:22:59
In reply to New meds needed for anxiety - advice please, posted by garnet71 on April 1, 2009, at 9:52:12
Thanks again for all the advice. I'm going to keep it for later. i've decided to first do an experiment - exercise 3 hrs a day - to see if I can keep anxiety at bay. The thought of new meds scares me away considering all my deadlines and life dynamics at present.
If that doesn't work, I'll go from there. One and half hours down, another hour and a half to go today.
It's cheaper than health care anyway.
Posted by tensor on April 5, 2009, at 3:03:48
In reply to New meds needed for anxiety - advice please, posted by garnet71 on April 1, 2009, at 9:52:12
I have exactly the same problem with modafinil, which is a stimulant-like med. Sometimes I'm holding my breath and "forgots" to breath, weird. I've off modafinil since three weeks but still have the same problem.
/Mattias
>I also wonder if Buspirone messes with my breathing. I don't feel like I have normal breathing anymre, like I have to remind myself to breath sometimes. I doubt it, but its a possibility.
This is the end of the thread.
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