Psycho-Babble Medication Thread 8121

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spasmodic dysphonia

Posted by linda on July 1, 1999, at 21:18:06

I get botox for spasmodic dysphonia. Are you aware of any medications that may be helpful in eliminating spasms when speaking. I would really like to try something different than botox. thanks for the info if any.

 

Re: spasmodic dysphonia

Posted by Rick on July 3, 1999, at 17:43:50

In reply to spasmodic dysphonia, posted by linda on July 1, 1999, at 21:18:06

If by "spasms" you mean shakiness, tremors, and weakness of the voice, that's what I'm working on now. I've sometimes wondered if I have spasmodic dysphonia, but I decided to try a pdoc first because I have social phobia and the voice problems tend to be much worse when I am anxious (they are also worse when I am tired). Pdoc started me out on Nardil (MAOI antidepressant, considered gold standard for Social Phobia), plus Xanax (fast-acting Benzo tranquilizer) on an as-needed basis.

After about a week, I found that -- perhaps 60% of the time -- the Nardil allowed me to speak in the usual anxiety-inducing situations with great confidence and almost no voice difficulty. I was amazed. Unfortunately, due to a combination of side effects (NOT including weight gain) and an apparent quick "poop-out" for me, I stopped taking the Nardil (oddly, after 10 days many of the side effects remain).

My pdoc seems to be very unorthodox with meds, and has replaced the Nardil with Selegeline, which isn't even very common as an AD, let alone for Social Phobia. (and see posts above re Selegeline's doubtful efficacy as an AD). So far, nothing. He tried "smoothing me out" by adding Lithium (also something you just don't see for SP), but after weird reactions I dropped that after one day. So now he's added a Benzo called Tranxene, once again something you never see for SP. I've only taken this a few days (with the Selegeline), but my voice is no better than when I started on this mission. Why can't he try one of the many drugs that are highly touted for SP effectiveness in some people, such as the Benzo Klonopin, or an SSRI AD such as Paxil? Maybe I need a new pdoc; this one seems to pride himself on being non-conformist when it comes to meds.

BTW, he says the hypertensive MAOI reactions with tyramine-rich foods (especially aged cheese) are seen almost exclusively in women, rarely in men.

I've always been curious about Botox treatment since "discovering" Spasmodic Dysphonia on the net. How well does the Botox work? If it works, why don't you want to stay with it?

> I get botox for spasmodic dysphonia. Are you aware of any medications that may be helpful in eliminating spasms when speaking. I would really like to try something different than botox. thanks for the info if any.

 

Re: spasmodic dysphonia

Posted by Chris A. on July 4, 1999, at 0:36:03

In reply to Re: spasmodic dysphonia, posted by Rick on July 3, 1999, at 17:43:50

I've seen research articles advocating selegiline for social phobia. Check medline for details. Some people reporting on Selegiline were on doses to small to be effective; 50 to 60 mgs. is more often that not required to treat depression. I can't remember the recommended doses for social phobia. I think when a lot of docs read about the doses for parkinson's, they are hesitant to give adequate doses for other off label conditions.

My pdoc seems to be very unorthodox with meds, and has replaced the Nardil with Selegeline, which isn't even very common as an AD, let alone for Social Phobia. (and see posts above re Selegeline's doubtful efficacy as an AD).

If you haven't taken 60 mg. of Selegiline it hasn't a fair trial - (maximizing the dose being a basic principle in psychopharmacology). So far, nothing. He tried "smoothing me out" by adding Lithium (also something you just don't see for SP), but after weird reactions I dropped that after one day. So now he's added a Benzo called Tranxene, once again something you never see for SP. I've only taken this a few days (with the Selegeline), but my voice is no better than when I started on this mission. Why can't he try one of the many drugs that are highly touted for SP effectiveness in some people, such as the Benzo Klonopin, or an SSRI AD such as Paxil? Maybe I need a new pdoc; this one seems to pride himself on being non-conformist when it comes to meds.
>

 

Re: spasmodic dysphonia

Posted by D.C on July 6, 1999, at 7:49:30

In reply to Re: spasmodic dysphonia, posted by Chris A. on July 4, 1999, at 0:36:03

I also have spasmodic dysphonia, albeit a mild case, and have tried Botox injections. After having five or six injections, I decided it wasn't worth it. Since then I've been using Nardil with good success. Yet because of the weight gain and insomnia I'm going to go off it and try paxil. Mild cases of spasmodic dysphonia also respond to voice work. You might consider working with a voice teacher in a University Theater department - these people are more helpful than speech pathologists. Good luck, I know SD isn't easy.

> I've seen research articles advocating selegiline for social phobia. Check medline for details. Some people reporting on Selegiline were on doses to small to be effective; 50 to 60 mgs. is more often that not required to treat depression. I can't remember the recommended doses for social phobia. I think when a lot of docs read about the doses for parkinson's, they are hesitant to give adequate doses for other off label conditions.
>
> My pdoc seems to be very unorthodox with meds, and has replaced the Nardil with Selegeline, which isn't even very common as an AD, let alone for Social Phobia. (and see posts above re Selegeline's doubtful efficacy as an AD).
>
> If you haven't taken 60 mg. of Selegiline it hasn't a fair trial - (maximizing the dose being a basic principle in psychopharmacology). So far, nothing. He tried "smoothing me out" by adding Lithium (also something you just don't see for SP), but after weird reactions I dropped that after one day. So now he's added a Benzo called Tranxene, once again something you never see for SP. I've only taken this a few days (with the Selegeline), but my voice is no better than when I started on this mission. Why can't he try one of the many drugs that are highly touted for SP effectiveness in some people, such as the Benzo Klonopin, or an SSRI AD such as Paxil? Maybe I need a new pdoc; this one seems to pride himself on being non-conformist when it comes to meds.
> >

 

Re: spasmodic dysphonia

Posted by DC on July 18, 1999, at 15:16:18

In reply to Re: spasmodic dysphonia, posted by D.C on July 6, 1999, at 7:49:30

Selegeline is one of those drugs that sounds good in theory, but is virtually useless in practice. Your doc is merely trying to prove his own ideas. Nardil is thousand times more effective.

> I also have spasmodic dysphonia, albeit a mild case, and have tried Botox injections. After having five or six injections, I decided it wasn't worth it. Since then I've been using Nardil with good success. Yet because of the weight gain and insomnia I'm going to go off it and try paxil. Mild cases of spasmodic dysphonia also respond to voice work. You might consider working with a voice teacher in a University Theater department - these people are more helpful than speech pathologists. Good luck, I know SD isn't easy.
>
>
>
>
>
> > I've seen research articles advocating selegiline for social phobia. Check medline for details. Some people reporting on Selegiline were on doses to small to be effective; 50 to 60 mgs. is more often that not required to treat depression. I can't remember the recommended doses for social phobia. I think when a lot of docs read about the doses for parkinson's, they are hesitant to give adequate doses for other off label conditions.
> >
> > My pdoc seems to be very unorthodox with meds, and has replaced the Nardil with Selegeline, which isn't even very common as an AD, let alone for Social Phobia. (and see posts above re Selegeline's doubtful efficacy as an AD).
> >
> > If you haven't taken 60 mg. of Selegiline it hasn't a fair trial - (maximizing the dose being a basic principle in psychopharmacology). So far, nothing. He tried "smoothing me out" by adding Lithium (also something you just don't see for SP), but after weird reactions I dropped that after one day. So now he's added a Benzo called Tranxene, once again something you never see for SP. I've only taken this a few days (with the Selegeline), but my voice is no better than when I started on this mission. Why can't he try one of the many drugs that are highly touted for SP effectiveness in some people, such as the Benzo Klonopin, or an SSRI AD such as Paxil? Maybe I need a new pdoc; this one seems to pride himself on being non-conformist when it comes to meds.
> > >

 

Re: spasmodic dysphonia

Posted by Rick on July 19, 1999, at 11:05:52

In reply to Re: spasmodic dysphonia, posted by DC on July 18, 1999, at 15:16:18

I tend to agree with you. After five weeks the Selegeline is doing absolutely nothing for my SP.
Maybe it's dosage related --I'm only up to 15mg -- but I saw the Medline title (not actual article)that Chris A. referred to, and it was a study of *low-dose* selegeline in treating SP.

My pdoc claims that selegeline has been used as an AD "for years" in Europe, with great success in some individuals. Even if that's true (and I'm skeptical), that doesn't mean it will help SP.

Please let us know how the Paxil works out, including side-effects. Thanks.

> Selegeline is one of those drugs that sounds good in theory, but is virtually useless in practice. Your doc is merely trying to prove his own ideas. Nardil is thousand times more effective.
>
>
>
> > I also have spasmodic dysphonia, albeit a mild case, and have tried Botox injections. After having five or six injections, I decided it wasn't worth it. Since then I've been using Nardil with good success. Yet because of the weight gain and insomnia I'm going to go off it and try paxil. Mild cases of spasmodic dysphonia also respond to voice work. You might consider working with a voice teacher in a University Theater department - these people are more helpful than speech pathologists. Good luck, I know SD isn't easy.
> >
> >
> >
> >
> >
> > > I've seen research articles advocating selegiline for social phobia. Check medline for details. Some people reporting on Selegiline were on doses to small to be effective; 50 to 60 mgs. is more often that not required to treat depression. I can't remember the recommended doses for social phobia. I think when a lot of docs read about the doses for parkinson's, they are hesitant to give adequate doses for other off label conditions.
> > >
> > > My pdoc seems to be very unorthodox with meds, and has replaced the Nardil with Selegeline, which isn't even very common as an AD, let alone for Social Phobia. (and see posts above re Selegeline's doubtful efficacy as an AD).
> > >
> > > If you haven't taken 60 mg. of Selegiline it hasn't a fair trial - (maximizing the dose being a basic principle in psychopharmacology). So far, nothing. He tried "smoothing me out" by adding Lithium (also something you just don't see for SP), but after weird reactions I dropped that after one day. So now he's added a Benzo called Tranxene, once again something you never see for SP. I've only taken this a few days (with the Selegeline), but my voice is no better than when I started on this mission. Why can't he try one of the many drugs that are highly touted for SP effectiveness in some people, such as the Benzo Klonopin, or an SSRI AD such as Paxil? Maybe I need a new pdoc; this one seems to pride himself on being non-conformist when it comes to meds.
> > > >

 

Re: spasmodic dysphonia

Posted by Rajeev Rajput on December 21, 1999, at 3:45:23

In reply to Re: spasmodic dysphonia, posted by DC on July 18, 1999, at 15:16:18

Sir,
I feel short of breath. My voice is very breathy, whisper like. Sometimes it is 50 % o.k. & sometimes, it is very worse. In the starting days of this problem, my voice seems to be much better in the morning. Now this is not the case. The problem started when i was disturb mentally. I am also suffering from anxiety depression from last five years. My voice problem started nine months ago. It got very worse. Now i am recovering. I have recoevered to say 25 % of my original voice. Is i am suffering from abb. type of spasmodic dysphonia. It there any cure for it & what are the chances of recovering. I have heard about botox injection. Would it help me in my case. Please let me know. Is there no new treatment invented.

I am very much depressed. If you will help me, i will be very oblige.

Thanking you

Rajeev Rajput
rajraj22@yahoo.co.uk

 

Re: spasmodic dysphonia

Posted by Noa on December 21, 1999, at 15:44:04

In reply to Re: spasmodic dysphonia, posted by Rajeev Rajput on December 21, 1999, at 3:45:23

I just read the thread leading up to your post and find it interesting. Have you heard of Diane Rehm, who is a DC based talk show host on public radio, who has this problem? She got botox treatments and is able to continue her work. She gets maintenance botox treatement every once in a while. I think she wrote a book about her story.

 

Re: spasmodic dysphonia

Posted by Rick on December 21, 1999, at 23:19:06

In reply to Re: spasmodic dysphonia, posted by Rajeev Rajput on December 21, 1999, at 3:45:23

If the problem is all or partially mental -- and particularly if it is worse around other people, Klonopin (clonazepam) may be very helpful to you. Voice problems are one of my biggest Social Anxiety symptoms, and the Klonopin helps immensely. Once in a while, even when I'm NOT feeling anxious, I have brief strange voice symptoms (e.g., tremor), which makes me wonder if I also have some degree of dysphonia -- which could in turn be adding to the Social Anxiety out of embarrassment...sort of a vicious circle.

------
> Sir,
> I feel short of breath. My voice is very
breathy, whisper like. Sometimes it is 50 % o.k. &
sometimes, it is very worse. In the starting days
of this problem, my voice seems to be much better
in the morning. Now this is not the case. The
problem started when i was disturb mentally. I am
also suffering from anxiety depression from last
five years. My voice problem started nine months
ago. It got very worse. Now i am recovering. I
have recoevered to say 25 % of my original voice.
Is i am suffering from abb. type of spasmodic
dysphonia. It there any cure for it & what are the
chances of recovering. I have heard about botox
injection. Would it help me in my case. Please let
me know. Is there no new treatment invented.
>
> I am very much depressed. If you will help me, i
will be very oblige.
>
> Thanking you
>
> Rajeev Rajput
> rajraj22@yahoo.co.uk

 

Re: spasmodic dysphonia

Posted by Noa on December 22, 1999, at 5:04:03

In reply to Re: spasmodic dysphonia, posted by Rick on December 21, 1999, at 23:19:06

Rick, that is an interesting thought--the vicious circle. I don't have dysphonia, but I know that in certain situations, like public speaking or performing, when I get anxious, my voice does start to shake. The thing is, once I NOTICE the shaking, that is when I get REALLY ANXIOUS, which, in turn, causes more shaking, etc. It would be an interesting research project to look at whether social phobia is more prevalent in people who have physiological symptoms such as shaky voice, or fair skin that blushes easily, etc.

 

Re: spasmodic dysphonia

Posted by Rick on December 22, 1999, at 10:02:51

In reply to Re: spasmodic dysphonia, posted by Noa on December 22, 1999, at 5:04:03

Noa, that actually seems to be a prevalent theory in some circles -- that physical symptoms like easy blushing and sweating can exacerbate Social Phobia or even cause it in the first place through embarrasment (leading to avoidance).

I've heard of an "ETS" (don't know what it means) surgical operation that some people have gone through which supposedly can reduce symptoms such as blushing, and ostensibly reduce Social Phobia in the process.

Rick
---
> Rick, that is an interesting thought--the vicious circle. I don't have dysphonia, but I know that in certain situations, like public speaking or performing, when I get anxious, my voice does start to shake. The thing is, once I NOTICE the shaking, that is when I get REALLY ANXIOUS, which, in turn, causes more shaking, etc. It would be an interesting research project to look at whether social phobia is more prevalent in people who have physiological symptoms such as shaky voice, or fair skin that blushes easily, etc.


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