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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 5 of 5. This is the beginning of the thread.
Posted by trainspotter on August 26, 2009, at 11:37:42
By the time some people would finish thinking how to write a long insult or read this someone would have killed him/herself for reasons others would call trivia. Whether GAD, PD, OCD, PTSD, SAD or just anxious depression some people find themselves in too deep and no way out, refractory? I'm not here to lecture you on self-meds (we have docs for that) or how good ECT csn be(well I nearly died), or no coffee, no cigars no beer(only if I'm on Parnate) I'm in this to say have you missed our best meds????Here's a list of drugs that are rather superb anxiolytics
1> We all know benzos, but there are 2 types high and low potency , high potency ones are Xanax, Klonopin, Ativan and these reverse the GABA-A receptor spectrum shift that is found in PD. Low ones are Valium, Librium. SO U GET WHY XANAX IS GIVEN IN PD
2> Other GABA-A sedatives- sadly Miltown causes a hangover like whiskey.
3>TETRACYCLIC ANTIDEPS and ATYPICALS Mianserin(Bolvidon) and Remeron- Some good P.docs use these as 1st line. Hang on with Remeron LONG ENOUGH IT ALMOST IS A PANACEA. It minimizes nausea by blocking 5HT3 receptors that occurs in withdrawals. Besides they are sedative and improve sleep structure. 2 others are;
I saw this ad "Too old for Tricyclics, too anxious for SSRIs Just right for Desyrel" (Trazodone) and Serzone - Very good sedatives, superb 5HT2A and 2C antagonists, IF GIVEN WITH AN SSRI IT HELPS MINIMIZE THE INITIAL ANXIOGENIC EFFECT OF SSRI's LIKE SAY PROZAC OR THE SNRI EFFEXOR XR
4> If U TRUST EFFEXOR XR YOU HAVE TO GIVE IT TIME SAY 6 WEEKS, sorry. Are you only anxious not depressed? But then if a phone call, an email or someone calling scares you it's rather likely you have lost QUALITY OF LIFE- A RATIONALE BEHIND AD in Anxiety- So for OCD start with normal SSRI dose and increase to double that, for PD start half and increase to AD dose
5>Low dose TCA also work well- Probably you're not sleeping well? Most sedating are Amitriptyline (12.5 - 25mg) and Doxepin(10mg)
6>Augmentation of SSRI or TCA or SNRI in partial responders with an antipsychotic specially Olanzapine(Zyprexa) and Geodon or the old Fluxanol(Flupenthixol 0.5mg)
7>Gabapentin(Neurontin) and Lyrica have been found to be as anxiolytic, increasing brain levels of GABA, as panicolytic as Xanax 0.5- I used Neurontin and now am on Lyrica(WORKS WONDERS)
8>Other AED's like Valproate, Topiramate and Lamotrigine though the last IS THE PROPHYLACTIC OF BIPOLAR DEPRESSION WHEREAS ALL THE OTHERS ARE FOR BIPOLAR MANIA.
Talk to your P.doc or if you have an experienced GP. Blood work involves Thyroid Panel, Vit B12 and Folate , CBC, Dexamethasone Suppression is rarely done now.
Posted by Phillipa on August 26, 2009, at 12:51:28
In reply to Anxiety- Am I incurable or have I missed the best?, posted by trainspotter on August 26, 2009, at 11:37:42
HI trainspotter years ago in the 70's took miltown with valium l5mg divided and three beers at night and I became very functional quite quickly raising three kids, going to nursing school, running my own aerobic dance business, going through a divorce. I didn't have thyroid problems. I think took 400 of miltown for not that long six months a year? Then just stopped it as didn't need it any longer. No withdrawal no nothing was fine. So your having a hard time finding a med and have had ECT? Was that for depression or anxiety as heard not good for anxiety form an old pdoc of mine. Love Phillipa
Posted by trainspotter on August 26, 2009, at 13:52:13
In reply to Re: Anxiety- Am I incurable or have I missed the best? » trainspotter, posted by Phillipa on August 26, 2009, at 12:51:28
It's not a complete waste, I have learned that internet self help and psychiatric projects are wasting time to help some wise guys harboring dark secrets. See I've never called anyone names and insult no one. That's the paper for this mol psych. project. Btw I'm no new zealander, so lithium has some benefits, spread it on bread. Realizing that we are mortal make us fight like hens over an issue if psychiatric meds extend lifespans? I can't quit, watch me. I am quitting so that I can shave my head and join a rock 'n roll band, score heroin and/or buy crack.
Posted by Sigismund on August 26, 2009, at 14:03:43
In reply to Re:Bye to all -The Horror, the Paranoia, posted by trainspotter on August 26, 2009, at 13:52:13
>Realizing that we are mortal make us fight like hens over an issue if psychiatric meds extend lifespans?
Quite the farmyard.
>I can't quit, watch me. I am quitting so that I can shave my head and join a rock 'n roll band, score heroin and/or buy crack.Sounds like fun.
Posted by Phillipa on August 26, 2009, at 21:33:18
In reply to Re:Bye to all -The Horror, the Paranoia, posted by trainspotter on August 26, 2009, at 13:52:13
What happened? Phillipa
This is the end of the thread.
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