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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 11 of 11. This is the beginning of the thread.
Posted by Miguy on September 27, 2000, at 15:13:04
Hello all,
I was diagnosed my an internist as having panic disorder with depression. Here's what he's tried on me:
Tofranil - Helped a little - S.E.: made me sweat a *lot* and had headaches
Celexa - Helped ok. S.E.: Anxiety, jaw soreness & headache.
Paxil - Helped ok. S.E.: Anxiety, jaw soreness & headache.
Zoloft - Helped ok. S.E.: Anxiety, jaw soreness, headache and bad insomnia.
Serzone - Helped ok. S.E.: Lethargy, extreme drowsiness, felt hung-over tired and hard to get out of bed in a.m.
Effexor XR - Helps a little. S.E.: Disoriented, sleepy, jaw soreness, moderate insomnia.
What do I do? I've got enough left over samples to start a drug store! I've tried each of these meds for 1-4 weeks each before switching due to side effects. I was *way* below normal dose on each. (For example, I'm currently on Effexor w/ side effects at only 75 mg.)
I'm reading about serotonin syndrome and starting to get concerned. Only other drugs I'm on are: multi-vitamin, B6, claritin & naprosyn - all prescribed by the same doc.
I've had moderate help from the drugs; just barely enough to weather the side-effects. Anyone out there have any tips or first-hand experience?
Thanks,
Scott
Posted by Miguy on September 27, 2000, at 20:33:10
In reply to Panic attacks depression - Searching for drug, posted by Miguy on September 27, 2000, at 15:13:04
In my searching thru past posts, I see a lot of benzos used for panic, but very little SSRI. Is my doc on the wrong track? Do benzos help with depression also? I don't know whether the panic caused depression or vice versa or if they're independent. Who knows?
Miguy
Posted by Greg on September 27, 2000, at 21:56:02
In reply to Re: Panic attacks - Follow up - PLEASE HELP!, posted by Miguy on September 27, 2000, at 20:33:10
I use Xanax for my anxiety and panic and it works great for me. It has a high potential for addiction so I have to watch my intake very closely. I've tried Paxil, which I think is useless and still use Atirax with some moderate success for less intense symptoms. I've also heard that many have had good results with Klonopin. The Xanax does nothing for my depression, if anything it can make it worse. But I guess depending on the severity of the anxiety or panic, it can be a worthwhile trade off.
I hope this helps a little.
Peace,
Greg> In my searching thru past posts, I see a lot of benzos used for panic, but very little SSRI. Is my doc on the wrong track? Do benzos help with depression also? I don't know whether the panic caused depression or vice versa or if they're independent. Who knows?
>
> Miguy
Posted by Aylese on September 27, 2000, at 23:10:45
In reply to Panic attacks depression - Searching for drug, posted by Miguy on September 27, 2000, at 15:13:04
I would think it is time to consult a good psychiatrist. This is obviously not something that your Internist is handling so well. You just can't beat a decent psychiatrist. Good Luck!
Posted by curran on September 28, 2000, at 21:45:39
In reply to Panic attacks depression - Searching for drug, posted by Miguy on September 27, 2000, at 15:13:04
hey scott. i've tried most of those, also with no success. Recently i went back to parnate, which, while not perfect, has worked for me for years. though an moa inhibitor, with some dangers, it really has almost no side effects for me (tho makes it hard to sleep, for which you can take a touch of deseryl (trazadone) And basically, you can eat most anything. a few things might avoid or not eat much of, but if you want something that works, try parnate. >
Hello all,
>
> I was diagnosed my an internist as having panic disorder with depression. Here's what he's tried on me:
>
> Tofranil - Helped a little - S.E.: made me sweat a *lot* and had headaches
>
> Celexa - Helped ok. S.E.: Anxiety, jaw soreness & headache.
>
> Paxil - Helped ok. S.E.: Anxiety, jaw soreness & headache.
>
> Zoloft - Helped ok. S.E.: Anxiety, jaw soreness, headache and bad insomnia.
>
> Serzone - Helped ok. S.E.: Lethargy, extreme drowsiness, felt hung-over tired and hard to get out of bed in a.m.
>
> Effexor XR - Helps a little. S.E.: Disoriented, sleepy, jaw soreness, moderate insomnia.
>
> What do I do? I've got enough left over samples to start a drug store! I've tried each of these meds for 1-4 weeks each before switching due to side effects. I was *way* below normal dose on each. (For example, I'm currently on Effexor w/ side effects at only 75 mg.)
>
> I'm reading about serotonin syndrome and starting to get concerned. Only other drugs I'm on are: multi-vitamin, B6, claritin & naprosyn - all prescribed by the same doc.
>
> I've had moderate help from the drugs; just barely enough to weather the side-effects. Anyone out there have any tips or first-hand experience?
>
> Thanks,
>
> Scott
Posted by Michael K on September 29, 2000, at 21:34:53
In reply to Re: Panic attacks depression - Searching for drug, posted by curran on September 28, 2000, at 21:45:39
> hey scott. i've tried most of those, also with no success. Recently i went back to parnate, which, while not perfect, has worked for me for years. though an moa inhibitor, with some dangers, it really has almost no side effects for me (tho makes it hard to sleep, for which you can take a touch of deseryl (trazadone) And basically, you can eat most anything. a few things might avoid or not eat much of, but if you want something that works, try parnate. >
Scott,
I agree with Curran. Based on your lack of success with those other meds, I think Parnate may help you. The Trazodone is also an effective treatment for insomnia. Good luck.
Mike
>
>
>
> Hello all,
> >
> > I was diagnosed my an internist as having panic disorder with depression. Here's what he's tried on me:
> >
> > Tofranil - Helped a little - S.E.: made me sweat a *lot* and had headaches
> >
> > Celexa - Helped ok. S.E.: Anxiety, jaw soreness & headache.
> >
> > Paxil - Helped ok. S.E.: Anxiety, jaw soreness & headache.
> >
> > Zoloft - Helped ok. S.E.: Anxiety, jaw soreness, headache and bad insomnia.
> >
> > Serzone - Helped ok. S.E.: Lethargy, extreme drowsiness, felt hung-over tired and hard to get out of bed in a.m.
> >
> > Effexor XR - Helps a little. S.E.: Disoriented, sleepy, jaw soreness, moderate insomnia.
> >
> > What do I do? I've got enough left over samples to start a drug store! I've tried each of these meds for 1-4 weeks each before switching due to side effects. I was *way* below normal dose on each. (For example, I'm currently on Effexor w/ side effects at only 75 mg.)
> >
> > I'm reading about serotonin syndrome and starting to get concerned. Only other drugs I'm on are: multi-vitamin, B6, claritin & naprosyn - all prescribed by the same doc.
> >
> > I've had moderate help from the drugs; just barely enough to weather the side-effects. Anyone out there have any tips or first-hand experience?
> >
> > Thanks,
> >
> > Scott
Posted by tjweeks on September 29, 2000, at 23:12:09
In reply to Re: Panic attacks depression - Searching for drug, posted by curran on September 28, 2000, at 21:45:39
> hey scott. i've tried most of those, also with no success. Recently i went back to parnate, which, while not perfect, has worked for me for years. though an moa inhibitor, with some dangers, it really has almost no side effects for me (tho makes it hard to sleep, for which you can take a touch of deseryl (trazadone) And basically, you can eat most anything. a few things might avoid or not eat much of, but if you want something that works, try parnate. >
>
>
>
> Hello all,
> >
> > I was diagnosed my an internist as having panic disorder with depression. Here's what he's tried on me:
> >
> > Tofranil - Helped a little - S.E.: made me sweat a *lot* and had headaches
> >
> > Celexa - Helped ok. S.E.: Anxiety, jaw soreness & headache.
> >
> > Paxil - Helped ok. S.E.: Anxiety, jaw soreness & headache.
> >
> > Zoloft - Helped ok. S.E.: Anxiety, jaw soreness, headache and bad insomnia.
> >
> > Serzone - Helped ok. S.E.: Lethargy, extreme drowsiness, felt hung-over tired and hard to get out of bed in a.m.
> >
> > Effexor XR - Helps a little. S.E.: Disoriented, sleepy, jaw soreness, moderate insomnia.
> >
> > What do I do? I've got enough left over samples to start a drug store! I've tried each of these meds for 1-4 weeks each before switching due to side effects. I was *way* below normal dose on each. (For example, I'm currently on Effexor w/ side effects at only 75 mg.)
> >
> > I'm reading about serotonin syndrome and starting to get concerned. Only other drugs I'm on are: multi-vitamin, B6, claritin & naprosyn - all prescribed by the same doc.
> >
> > I've had moderate help from the drugs; just barely enough to weather the side-effects. Anyone out there have any tips or first-hand experience?
> >
> > Thanks,
> >
> > Scott
----------------------------------------------------------------------------------------------------------Scott, I had depression with frequent panic attacks when I was younger. This was before the advent of the SSRI drugs. Before that they used trycilic compounds, which are still in use today. The one that really snapped me out of both the depression and stopped the panic was triavil(it is a combo. of Elavil and a Tranquilizer).. There are a few side effects with trycilics such as: dry mouth, sweating, dizziness; but most of these subside as time goes on. These medications are older, but they are tried and true. I tried Prozac once at the urging of my MD. After about three days my depression and panic started coming back in full swing. I went off it and back to what I knew worked. You might want to give it a try--all you have to lose is the depression and panic--good luck
Posted by Cherrie on October 2, 2000, at 4:52:07
In reply to Re: Panic attacks depression - Searching for drug, posted by tjweeks on September 29, 2000, at 23:12:09
I also suffered from debilitating panic attacks and the only thing that seems to work for me is Buspar. Xanax gave me depression, Paxil worked brilliantly on the panic but I hated the side effects (fat and so tired I could hardly function) I was on Paxil for about 3 years and most of the other side effects that you talk about do disappear after about 6 weeks. Maybe you should give the SSRI's a better chance to work, as they generally take 6-8 weeks to get full effect, otherwise try Buspar I have had no trouble with it.
Cherrie
Posted by Virgil on October 2, 2000, at 15:29:40
In reply to Panic attacks depression - Searching for drug, posted by Miguy on September 27, 2000, at 15:13:04
> Hello all,
>
> I was diagnosed my an internist as having panic disorder with depression. Here's what he's tried on me:
>
> Tofranil - Helped a little - S.E.: made me sweat a *lot* and had headaches
>
> Celexa - Helped ok. S.E.: Anxiety, jaw soreness & headache.
>
> Paxil - Helped ok. S.E.: Anxiety, jaw soreness & headache.
>
> Zoloft - Helped ok. S.E.: Anxiety, jaw soreness, headache and bad insomnia.
>
> Serzone - Helped ok. S.E.: Lethargy, extreme drowsiness, felt hung-over tired and hard to get out of bed in a.m.
>
> Effexor XR - Helps a little. S.E.: Disoriented, sleepy, jaw soreness, moderate insomnia.
>
> What do I do? I've got enough left over samples to start a drug store! I've tried each of these meds for 1-4 weeks each before switching due to side effects. I was *way* below normal dose on each. (For example, I'm currently on Effexor w/ side effects at only 75 mg.)
>
> I'm reading about serotonin syndrome and starting to get concerned. Only other drugs I'm on are: multi-vitamin, B6, claritin & naprosyn - all prescribed by the same doc.
>
> I've had moderate help from the drugs; just barely enough to weather the side-effects. Anyone out there have any tips or first-hand experience?
>
> Thanks,
>
> Scott
Scott,1-4 weeks isn't enough I think for SSRIs to begin to work. It took about 6 weeks for the Celexa to kick in for me. One month is nothing. I think you have really shortchanged yourself in a big way by going off them so early. I would give SSRIs another try for the standard 4-6 weeks before switching. Just my 2 cents.
Posted by JohnL on October 6, 2000, at 1:36:01
In reply to Panic attacks depression - Searching for drug, posted by Miguy on September 27, 2000, at 15:13:04
> Hello all,
>
> I was diagnosed my an internist as having panic disorder with depression. Here's what he's tried on me:
>
> Tofranil - Helped a little - S.E.: made me sweat a *lot* and had headaches
>
> Celexa - Helped ok. S.E.: Anxiety, jaw soreness & headache.
>
> Paxil - Helped ok. S.E.: Anxiety, jaw soreness & headache.
>
> Zoloft - Helped ok. S.E.: Anxiety, jaw soreness, headache and bad insomnia.
>
> Serzone - Helped ok. S.E.: Lethargy, extreme drowsiness, felt hung-over tired and hard to get out of bed in a.m.
>
> Effexor XR - Helps a little. S.E.: Disoriented, sleepy, jaw soreness, moderate insomnia.
>
> What do I do? I've got enough left over samples to start a drug store! I've tried each of these meds for 1-4 weeks each before switching due to side effects. I was *way* below normal dose on each. (For example, I'm currently on Effexor w/ side effects at only 75 mg.)
>
> I'm reading about serotonin syndrome and starting to get concerned. Only other drugs I'm on are: multi-vitamin, B6, claritin & naprosyn - all prescribed by the same doc.
>
> I've had moderate help from the drugs; just barely enough to weather the side-effects. Anyone out there have any tips or first-hand experience?
>
> Thanks,
>
> ScottScott,
It would appear that your doctor seems preoccupied with serotonin medications. Why, I'm not sure. I think these may not be right for you. They could work if given more time. But due to your difficulty with the side effects and the fact that they work just 'OK', that tells me the meds are not targeting the underlying cause very closely.There are other chemistries that could cause your symptoms. Elevated dopamine for example can cause panic, anxiety, and depression. A small dose antipsychotic can fix that. Something like Zyprexa, maybe Risperdal.
A deficient GABA system could too. That would be treated with a benzodiazapine like Xanax or Klonopin. These are the same class as Valium.
I have heard of people getting completely well from their depression+panic by trying Lithium. Also Depakote. Sometimes Tegretol. If someone gets better with one of these, that indicates they had a chemical or electrical instability as the cause. A little smoothing is all that was needed.
And believe it or not, I've heard of panic and anxiety being cured by taking a psychostimulant. Really! In that case, it would have indicated the chemistry of dopamine/norepinephrine failure, or low brain blood flow.
I know you don't want to add to your drug collection. But I really think you should nudge your doctor to get off the serotonin band wagon and explore some different chemistries and different meds. Your treatment has completely missed a lot of possible causes.
Oh, and one more. Beta blockers like Inderal or Pindolol. They are used on an as-needed basis to treat the panic attackes. Might not help much with the depression part of it though. Anyway, there are plenty of options. Hope something here helps.
John
Posted by coral on October 8, 2000, at 11:58:04
In reply to Re: Panic attacks depression - Searching for drug, posted by JohnL on October 6, 2000, at 1:36:01
I agree that you haven't given the SSRI's long enough to work - I suffered severe depression with panic/anxiety attacks. Tricyclics were useless and even harmful - Elavil made me enraged! The combo that finally worked for me was Zoloft at 150 mgs (took 4 months to get to that dosage), Librium (10 mgs) as needed for panic/anxiety, and Ambien (5 or 10 mgs) as needed for the nights I couldn't sleep. However, crucial to my recovery was an outstanding psychologist.
This is the end of the thread.
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