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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 8 of 8. This is the beginning of the thread.
Posted by Circe on May 23, 2000, at 10:03:43
Hello everyone.
I'm new to the board and have been reading as much as I can on the various treatments for Generalized Anxiety Disorder (with minor depression and occasional anxiety attacks).
Here are my symptoms:
Constant worrying (especially about losing those I love) and hyper-vigilance to danger
Irritability
Innability to relax
Restless sleep
Muscle tension and severe pain
Muscle tremors
Hot flashes
Light-headedness and vertigo
I only become depressed when the worrying overwhelms me and I fear I can't handle it anymore. Suicide appeals at times like those.I'm not apathetic. I enjoy life. I guess I'm saying that I don't have depression overall, just at certain times.
In the past I had a doctor that focused on my depression and so prescribed medications that helped in some ways, but made the anxiety worse. When I was on Prozac, for example, nothing made me cry, but I still became very angry and stressed over the stupidest things. I know that the SSRI's screw with sleep cycles as well.
I have been reading on Remeron and Serzone. The side effects scare me. I've read of some here that take Klonipin (and have for years) without any problems. The more I read, the more confused I become.
I need a medication that will help me relax (including my muscles) and hopefully won't make me more tired or dizzy than I already am. I have a doctor's appointment in a few weeks.
Any suggestions?
Circe
Posted by Susan the Crone on May 23, 2000, at 14:29:08
In reply to GAD... medication recommendations, posted by Circe on May 23, 2000, at 10:03:43
> Hello everyone.
>
> I'm new to the board and have been reading as much as I can on the various treatments for Generalized Anxiety Disorder (with minor depression and occasional anxiety attacks).
>
> Here are my symptoms:
>
> Constant worrying (especially about losing those I love) and hyper-vigilance to danger
>
> Irritability
(snip)
Hi Circe -- I'm new here too, with diagnoses of (mild) clinical depression and
GAD. Many of my symptoms seem to be similar to yours.My doctor just put me on Effexor and Neurontin. The latter is to address
problems with sleep problems, migraines, chronic neck-shoulder tightness/pain, and
anxiety about some major life changes I'm facing. It seems that the Effexor is
for the depression, and the Neurontin is for the (current/short-term) stress/anxiety.I usuallly tolerate drugs well (with the exception of beta-blockers, to which I'm
allergic!) and as of *this* 24-hours I seem to be just fine:-)hope this is useful.
Susan the Crone
Posted by Alan on May 23, 2000, at 17:27:29
In reply to GAD... medication recommendations, posted by Circe on May 23, 2000, at 10:03:43
> Hello everyone.
>
> I'm new to the board and have been reading as much as I can on the various treatments for Generalized Anxiety Disorder (with minor depression and occasional anxiety attacks).
>
> Here are my symptoms:
>
> Constant worrying (especially about losing those I love) and hyper-vigilance to danger
>
> Irritability
>
> Innability to relax
>
> Restless sleep
>
> Muscle tension and severe pain
>
> Muscle tremors
>
> Hot flashes
>
> Light-headedness and vertigo
>
>
> I only become depressed when the worrying overwhelms me and I fear I can't handle it anymore. Suicide appeals at times like those.
>
> I'm not apathetic. I enjoy life. I guess I'm saying that I don't have depression overall, just at certain times.
>
> In the past I had a doctor that focused on my depression and so prescribed medications that helped in some ways, but made the anxiety worse. When I was on Prozac, for example, nothing made me cry, but I still became very angry and stressed over the stupidest things. I know that the SSRI's screw with sleep cycles as well.
>
> I have been reading on Remeron and Serzone. The side effects scare me. I've read of some here that take Klonipin (and have for years) without any problems. The more I read, the more confused I become.
>
> I need a medication that will help me relax (including my muscles) and hopefully won't make me more tired or dizzy than I already am. I have a doctor's appointment in a few weeks.
>
> Any suggestions?
>
> Circe
*******************************
Sure, for true, pure anxiety disorders such as GAD - take an anxiolytic such as Ativan or longer acting Klonopin. That's what they're developed for... the most successful anxiety combatants on the planet. Just have to pay close attention to their managemaent so as to not bring on withdrawl symptoms which usually exacerbate the symptoms that you ar trying to combat. Work closely with your pdoc on that one. Otherwise it would seem to be a no brainer unless I'm mising something.
Alan
***********************************
Posted by Gordon on May 23, 2000, at 17:44:45
In reply to GAD... medication recommendations, posted by Circe on May 23, 2000, at 10:03:43
The classic medication for GAD, which it sounds like you have, is Buspar. Check it out at www.buspar.com It can take up to a month to become fully effective and you may want to taper on it although it has few side effects. The advantage of Buspar over the benzo's the posters above advise is that you can quit Buspar without side effects, and may or may not be able to do that with the benzo's. Also, Klonopin has a little bit of a depressive side effect on some people, so if your doc suggests a benzo, I'd ask for Xanax or Ativan. Wellbutrin is another alternative. Good luck.
Posted by circe on May 23, 2000, at 21:47:37
In reply to Re: GAD... medication recommendations, posted by Alan on May 23, 2000, at 17:27:29
Alan,
No, you're not missing anything. I'm just a bit nervous about taking anything physically addicting. I have a bit of an addictive personality and want to be careful.
I've also recently gotten married and may be looking at having a child. I'm worried about the birth defects that benzodiazepines can cause.
I've tried Buspar, and it made me so dizzy I couldn't walk.
Anyone have any experience with Celexa or Serzone or Remeron? I know that Remeron is supposed to have anxiolytic effects, but am worried about the side effect of elevated liver enzymes and such.
I think I've made up my mind to try Celexa first, but still wanted to get everyone's opinions.
Thanks,
Circe
Posted by Gordon on May 24, 2000, at 18:37:45
In reply to Re: GAD... medication recommendations, posted by circe on May 23, 2000, at 21:47:37
> Anyone have any experience with Celexa or Serzone or Remeron? I know that Remeron is supposed to have anxiolytic effects, but am worried about the side effect of elevated liver enzymes and such.
>
> I think I've made up my mind to try Celexa first, but still wanted to get everyone's opinions.
>
Talk to people about it who have used it first. Some of the side effects you may like less than dizziness. Also, you can check out the official word on it at http://www.celexa.com
Posted by C.M. on May 25, 2000, at 5:28:36
In reply to GAD... medication recommendations, posted by Circe on May 23, 2000, at 10:03:43
Hi Circe,
Sounds a lot like the symptoms I have. I suffer mainly from anxiety symptoms.
I know that a number of people do well on benzodiazepines like Xanax and Klonopin, and although I'm not against the use of them, I would opt for a sedating antidepressant first that could target a number of your symptoms.
One particular antidepressant in mind is Elavil. It has antidepressant, anti-anxiety, and sedative like properties to it, and it promotes sleep. If the side effects are tolerable, and it's effective for an individual, it can be a very useful med. I will say that it can make you very tired for the first one to two weeks, but that does diminsh. Some people need to go up slow on the dose starting out with 5mg. or 10mg. at bedtime. The list of side effects for Elavil can look over wealming, but I myself have only had some constipation, and some dryness as side effects.
Another med in mind is Imipramine which is similar to the Elavil, but not as sedating.
As I said, I'm not against the use of meds such as Xanax and Klonopin, but if an antidepressant can work for a person with minimal side effects, I personally think a person can be better off in the long run. Now that's not to say that a low dose of a benzodiazepine couldn't be used with an antidepressant, because I myself have used Klonopin at a low enough dose not to produce a strong physical dependency. I have been able to stop the Klonopin almost right away even after taking it for several months. I just take 0.25mg. Klonopin every other day along with Elavil
SSRI's such as Celexa have also turned out to be effective meds against anxiety for many people. Perhaps a small dose of Elavil like 10 to 30mg. could be used with the Celexa.C.M.
Posted by z on May 25, 2000, at 15:30:20
In reply to GAD... medication recommendations, posted by Circe on May 23, 2000, at 10:03:43
hi circe,
i've been taking elavil for a couple of months and
it hasn't helped my anxiety (it does help me sleep
though). i'm taking moclobemide now. it doesn't
seem to be helping either. paxil, however, really
helped! when i took it, i didn't worry much about
anything really! i stopped taking it because
the nausea it seemed to be causing wasn't
subsiding.take care,
-z
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