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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 zonked on June 9, 2010, at 14:58:50
Yikes. Meet my new permanent psychiatrist tomorrow--
I am going to at least print some abstracts, and if I can make it to the med school library and back today, perhaps some photocopies of full articles to advocate for another Marplan increase--also to determine for myself how this drug was studied and dosed in detail. Perhaps also ask for a Deplin trial (thanks Phillipa for your recent article post!)
Now, the other thing I want to strongly advocate for is replacement of my Klonopin prn with Xanax. I know anecdotally that Klonopin makes me feel more drugged and depressed; and Xanax does not (I do find myself taking it almost every day though, as the trade off makes it just barely worth it--and I have taken benzos continuously for the last 10 years.)
The only clinical evidence I could find of this was reference #20 on the alprazolam wikipedia article ("Alprazolam as an antidepressant"), and also some interesting studies which showed clonazepam slows serotonin utilization in the CNS.
Does anyone know of something more concrete I could show this doctor? I will perhaps be fighting an uphill battle--I have found that doctors in this county's public health system *loathe* xanax (or are simply told not to prescribe it to any patient under any circumstances.)
I am understandably anxious. I've gathered my medical records and they've been faxed over, I just hope this person has experience with treatment-resistance, compassion, and open-mindedness--and of course, knowledge.
-z
Posted by floatingbridge on June 9, 2010, at 20:54:27
In reply to New pdoc tomorrow! evidence of xanax superiority over klonopin?, posted by zonked on June 9, 2010, at 14:58:50
Zonked, nothing concrete, sorry. Having used both, I share your opinion. My xanax tolerance has increased only slightly over 9 years of use (with a 1.5 year use of klonopin).
I do well with xanax xr as a daily base. Xanax ir for emergency. Generic xr works as well as brand for me. I did a 'blind' test--taking either one daily w/ my eyes closed. No diff.
Hope someone posts that winning evidence for you. And good luck tomorrow--may the fit be really good.
Posted by Phillipa on June 9, 2010, at 21:41:45
In reply to Re: New pdoc tomorrow! evidence of xanax superiori » zonked, posted by floatingbridge on June 9, 2010, at 20:54:27
Zonked the very best of luck. I just know that Greenstone generic regular xanax is the best one as made by same company as the brand. Let the doc know you haven't increased doseage and that technically klonopin is stronger than xanax might do it. I also believe docs have heard the same about klonopin being a depressant as I know xanax contains a slight antidepressant effect. Phillipa
Posted by zonked on June 9, 2010, at 22:33:23
In reply to Re: New pdoc tomorrow! evidence of xanax superiori, posted by Phillipa on June 9, 2010, at 21:41:45
Phillipa, floatingbridge--
Thanks again for your continued support :-)
I didn't make it to the med school library, I will do so if necessary after tomorrow's visit.
I think my strategy wrt: Marplan will be to ask for a dose increase, and if that is denied; I will ask for a blood test measuring platelet MAO inhibition.
It is my opinion that this test must exist--by chance, I picked up a copy of "The good news about anxiety, panic, and phobias" lying around the house, and looked up MAOIs in the index; this is what Dr. Gold says: "Before administering the MAOI, I will measure blood platelet monoamine oxidase activity; then during therapy I will measure this activity again--aiming for an 80% or greater inhibition of MAO activity." (pp. 227-228).
I will be calling the lab that did my recent routine bloodwork for my physical tomorrow morning to see if I can figure out if that's something my doctor can order. I've often read that 90% inhibition should be the goal.
Once again, if anyone knows anything about this blood test do let me know!
Thanks and wish me luck!
-z
Posted by Phillipa on June 9, 2010, at 22:42:17
In reply to Re: New pdoc tomorrow! evidence of xanax superiori » Phillipa, posted by zonked on June 9, 2010, at 22:33:23
The best of luck. Seriously didn't know a blood test for MAOI's? Phillipa
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