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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 15 of 15. This is the beginning of the thread.
Posted by FrustratedMama on September 17, 2011, at 10:05:44
Hi everyone,
I am a complete wreck once again.....gained 25 pounds on a small frame, angry, and exhausted with daily anxiety attacks that feel like depersonalization and light headedness that leads to over-eating as it feels like low blood sugar attacks (ruled out).Diagnosis is generalized anxiety, adult ADHD, chronic fatigue syndrome, and atypical depression (agitated, hypersomnia, hungry type).
Current Meds:
Effexor XR 150 mg (recent switch from cymbalta due to cymbalta pooping out again)
Ambien 10 mg (cant sleep without it)
Vyvanse 50 mg (cant focus or keep impulses in control without it)
Ativan .5 mg 2x/day (was working initially at 1 mg 2x/day then quickly noticed that it was causing addiction like withdrawals and severe rebound anxiety with anxiety attacks) decreased to .5 2x/day and continuing to have significant anxiety in afternoon and even when it should be working.So...before anyone jumps on the vyvanse....Yes, i know it can cause anxiety.....but, in my case, the anxiety appears to be much greater when it is wearing off....and/or when the ativan is wearing off.
I am headed to pdoc on Monday....NEED advice...I am thinking a switch from ativan to valium to help taper? and/or a switch from vyvanse to Focalin? Please add comments and suggestions.
Posted by SLS on September 17, 2011, at 10:19:51
In reply to Anxiety and Ativan/Vyvanse...PLEASE HELP!, posted by FrustratedMama on September 17, 2011, at 10:05:44
Hi FM.
Your case is pretty complicated, and I don't think I know enough to venture an opinion. I am curious, though, if you have tried Xanax XR, doxepin, amitriptyline or Lyrica.
- Scott
Posted by FrustratedMama on September 17, 2011, at 10:29:21
In reply to Re: Anxiety and Ativan/Vyvanse...PLEASE HELP!, posted by SLS on September 17, 2011, at 10:19:51
> Hi FM.
>
> Your case is pretty complicated, and I don't think I know enough to venture an opinion. I am curious, though, if you have tried Xanax XR, doxepin, amitriptyline or Lyrica.
>
>
> - Scott
Hi Scott,
I tried Lyrica....didn't help much...too many ups and downs.Never tried amityptiline doxepin, or Xanax XR; however regular Xanax was tried once and I felt very strange...kind of paranoid and like I was really stoned or something (not in a pleasant way).
Would one of the above medications help do you think? If so, which of my med regimen would be the first to change? I am so distraught....the ativan seems to be the worst case scenario....has made my original anxiety issues seem like nothing compared to now.
Posted by Phillipa on September 17, 2011, at 10:34:57
In reply to Re: Anxiety and Ativan/Vyvanse...PLEASE HELP!, posted by FrustratedMama on September 17, 2011, at 10:29:21
FM not Scott who could be posting an answer right now. Seems you have narrowed it down to the ativan. And since meds wearing off maybe switch to valium. I once took 5mg three times a day. Very first med and at the time worked well. Sometimes I wonder if it worked well as was name brand as this was before generics? Seemed much stronger then and uplifting not high normal, relaxed. Phillipa
Posted by FrustratedMama on September 17, 2011, at 10:56:46
In reply to Re: Anxiety and Ativan/Vyvanse...PLEASE HELP! » FrustratedMama, posted by Phillipa on September 17, 2011, at 10:34:57
Thanks Phillipa!
My thought is to start with tapering ativan as this has been a nightmare...anxiety attacks are at least daily and this is the first time I have actually experienced any physical addiction.....I have gone through withdrawal effects from medications before (which are also extremely distressing) but the physical addiction to ativan is something I have never experienced....it is so bad! My poor system is so out of whack and every day is worse than before....but without the ativan I feel like I am going to die....so mad at my brain and wish I never started meds!
Posted by floatingbridge on September 17, 2011, at 13:37:26
In reply to Anxiety and Ativan/Vyvanse...PLEASE HELP!, posted by FrustratedMama on September 17, 2011, at 10:05:44
> I am headed to pdoc on Monday....NEED advice...I am thinking a switch from ativan to valium to help taper? and/or a switch from vyvanse to Focalin? Please add comments and
suggestions.
>
>Oh FM, good to see you and sorry you're back :-/
Jeez, you take a mix similar to my own or what I used to take.I'm not jumping on the vyvanse except to say it *can* cause anxiety as it wears off as you said. Do you time your Ativan to cover the crash?
I support you getting off benzos if that's your goal. The Valium might make you feel stoned a bit, maybe not, but I think it's the way to taper.
It's difficult to tell how much the meds themselves might be running your moods. I think effexor has a palpable onset lift and crash each day as well. Have you or your doctor ever considered a bipolar piece to all this? I'm not suggesting,
really just asking. The ups and downs are just exhausting, aren't they?Since you have a CFS type fatigue, I can see why the vyvanse is indicated rather than, say provigil. I have that type of fatigue, too and it really stinks. I'm sorry to hear that you do.
There has been a practice of adding tizanadine (zanaflex) in pediatric cases of stimulant therapy. It is a very very mild muscle relaxant (never ever made me loopy a bit, and I am sensitive) because it does something that helps, I think the dexie-type crash (how's that for scientific language?),
If you could find or add a middle type medication. Klonopin
(since you aren't mentioning depressive symptoms thatnhas some mood stabilization supposedly), might be better than valium, but heck, you want off the benzos. Just thinking out loud here. No recommendations.Oh wait. You mentioned atypical depression. Well poop! Still, klonopin might be better. I don't know you know.
I don't know about focaline.
Will update after your appt when you can?
Sorry things are rough right now, FM. And that I couldn't help more.
Posted by FrustratedMama on September 17, 2011, at 14:01:39
In reply to Re: Anxiety and Ativan/Vyvanse...PLEASE HELP! » FrustratedMama, posted by floatingbridge on September 17, 2011, at 13:37:26
FB, I needed this post more than ever right now...thank you! I am such an anxiety ridden mess muddled with anger and pain. gonna call pdoc now...before i end up in er with no one to watch my child. :,(
Posted by floatingbridge on September 17, 2011, at 14:33:06
In reply to Re: Anxiety and Ativan/Vyvanse...PLEASE HELP! » floatingbridge, posted by FrustratedMama on September 17, 2011, at 14:01:39
FM
You mentioned pain. I just started 300 mg gabapentin in the evening. It's too soon to tell anything. Might take it to 600mg.
Pain and anxiety. Hopefully. Mild maybe, mood stabilization. Not a daytime med for me!
Good luck. I really hope you update!
Posted by Phillipa on September 17, 2011, at 20:44:36
In reply to Re: Anxiety and Ativan/Vyvanse...PLEASE HELP! » floatingbridge, posted by FrustratedMama on September 17, 2011, at 14:01:39
How did you make out with the doc any changes? Phillipa
Posted by FrustratedMama on September 20, 2011, at 23:53:26
In reply to Re: Anxiety and Ativan/Vyvanse...PLEASE HELP! » FrustratedMama, posted by Phillipa on September 17, 2011, at 20:44:36
Changed Ativan to klonopin as needed.
Got rid of vyvanse
Adds trileptalKept Ambien!
Posted by floatingbridge on September 21, 2011, at 7:08:34
In reply to Re: Anxiety and Ativan/Vyvanse...PLEASE HELP!, posted by FrustratedMama on September 20, 2011, at 23:53:26
> Changed Ativan to klonopin as needed.
> Got rid of vyvanse
> Adds trileptal
>
> Kept Ambien!Hey, FM, I wonder how the trileptal will be. How does it start-up? It's in my short list.
How is it w/o vyvanase? For cognitive functioning. It's been difficult for me w/o dexidrine, but I think it's for the best for me. But I have been hitting the coffee :-o
Good luck! I liked klonopin more than Ativan personally.
Posted by FrustratedMama on September 21, 2011, at 7:46:14
In reply to Re: Anxiety and Ativan/Vyvanse...PLEASE HELP! » FrustratedMama, posted by floatingbridge on September 21, 2011, at 7:08:34
So far okay...will update. Been very spacy (out of it and strange feeling) but can deal with it so far. Will keep posting. Thanks for support!
Posted by Phillipa on September 21, 2011, at 19:47:04
In reply to Re: Anxiety and Ativan/Vyvanse...PLEASE HELP! » FrustratedMama, posted by floatingbridge on September 21, 2011, at 7:08:34
Took 150mg of trileptal. Didn't notice a thing good or bad. Was expensive and decided to just stop and did cold turkey. No problems at all. Phillipa
Posted by FrustratedMama on September 21, 2011, at 19:51:42
In reply to Re: Anxiety and Ativan/Vyvanse...PLEASE HELP! » floatingbridge, posted by Phillipa on September 21, 2011, at 19:47:04
I feel slightly less agitated without the vyvanse but have put my foot in my mouth several times. Worried i will lose my job. ugh. what to do?
Posted by floatingbridge on September 21, 2011, at 20:33:07
In reply to Re: Anxiety and Ativan/Vyvanse...PLEASE HELP!, posted by FrustratedMama on September 21, 2011, at 19:51:42
Hang in there. I hear you about the vyvanse :-/
This is the end of the thread.
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