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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 Jackster on December 29, 2002, at 3:03:42
Anyone here tried depakote for panic? If so - what dose, did it work, what were the side effects?
Thanks
Jackie
Posted by Ritch on December 29, 2002, at 10:37:32
In reply to Depakote for refractory panic?, posted by Jackster on December 29, 2002, at 3:03:42
> Anyone here tried depakote for panic? If so - what dose, did it work, what were the side effects?
>
> Thanks
> JackieHi Jackie, it *does* reduce panic anxiety, but not as effectively as Klonopin. Suggest a combo of Depakote+Neurontin to your pdoc. That worked quite nicely for me in the past. Did the Tegretol poop out on you?
Posted by Jackster on December 29, 2002, at 15:22:19
In reply to Re: Depakote for refractory panic? » Jackster, posted by Ritch on December 29, 2002, at 10:37:32
Hi Mitch
Wow you have a good memory! (or you did a search ;)
yeah - the tegretol worked a bit - but not enough. Am now on Paxil 60mg and 15mg buspar. Have only been on the buspar 2 weeks - so it might be enough to kick start the paxil. Otherwise the doc has suggested depakote to augment. (Have read horror stories about hair falling out etc though) I have tried klonopin and it does work well - but in the complete opposite to everyone here - my doc wants me to take it but I don't want to be reliant on benzos. I feel like referring all the people on this board with benzophobe docs to my doc - but NZ might be a little to far to travel even for a good doc. ; )
cheers
Jackie
>
> Hi Jackie, it *does* reduce panic anxiety, but not as effectively as Klonopin. Suggest a combo of Depakote+Neurontin to your pdoc. That worked quite nicely for me in the past. Did the Tegretol poop out on you?
Posted by Ritch on December 29, 2002, at 16:47:47
In reply to Re: Depakote for refractory panic? » Ritch, posted by Jackster on December 29, 2002, at 15:22:19
Hi, I actually remembered. I have had strings of panic attacks in the past and any posts about panic catches my eye and it gets burned into my memory easily. I found Buspar to work well with SSRI's. I hope it helps with your panic probs. Depakote and the hairloss thing.. Well, I've never noticed any taking between 125mg-500mg/day. I noticed quite a bit of weight gain however at 500mg. I like clonazepam mainly because it is cheap! My pdoc was wanting to substitite Gabitril for clonazepam but at a lower dose than what I have tried in the past, but that stuff is expensive. Hey, there's another idea for you (Gabitril). You might get a lot of cognitive dysfunction with it however (but it is dose related).
good luck,
Mitch
> Hi Mitch
>
> Wow you have a good memory! (or you did a search ;)
>
> yeah - the tegretol worked a bit - but not enough. Am now on Paxil 60mg and 15mg buspar. Have only been on the buspar 2 weeks - so it might be enough to kick start the paxil. Otherwise the doc has suggested depakote to augment. (Have read horror stories about hair falling out etc though) I have tried klonopin and it does work well - but in the complete opposite to everyone here - my doc wants me to take it but I don't want to be reliant on benzos. I feel like referring all the people on this board with benzophobe docs to my doc - but NZ might be a little to far to travel even for a good doc. ; )
>
> cheers
> Jackie
Posted by ZeeZee on December 29, 2002, at 19:22:08
In reply to Re: Depakote for refractory panic? » Jackster, posted by Ritch on December 29, 2002, at 16:47:47
Mitch, You stated that Buspar has helped you in the past with panic? I'm starting it tomorrow, adding it to St.John's Wort. Can you provide any further details about your experience with it?
Thanks
Posted by Ritch on December 29, 2002, at 22:39:48
In reply to Re: Depakote for refractory panic? » Ritch, posted by ZeeZee on December 29, 2002, at 19:22:08
> Mitch, You stated that Buspar has helped you in the past with panic? I'm starting it tomorrow, adding it to St.John's Wort. Can you provide any further details about your experience with it?
> ThanksHi, The Buspar was *added* to Celexa in an attempt to snap me out of a bipolar depressive episode. It *did* reduce generalized anxiety along with the depression, but panic attacks weren't the reason for the Buspar addition. I remember I was at this place where I was taking Depakote+Klonopin+Celexa+Buspar and had absolutely ZERO anxiety, but.. I couldn't think at work! It (buspar) boosted the Celexa to pull me out of the depression, but with that particular combo/dosages I was fairly zombified as far as work-related tasks went. However the "ZERO" anxiety effect of that combo might be helpful for someone who needs their panic attacks to get under control (who knows?). All I can say for sure is that there is a direct correlation with Klonopin and not having panic attacks. Everything else helped, augmented, etc., but the K. is what dominates the absence of the panic.---Mitch
Posted by Jackster on December 30, 2002, at 1:49:56
In reply to Re: Depakote for refractory panic? » Jackster, posted by Ritch on December 29, 2002, at 16:47:47
Thanks for the advice. What dose of Buspar were you on? I'm on 15mg and am wondering if I should up the dose.
I looked up Gabitril - and as usual - we don't have it here. We don't even have Effexor which seems to be pretty common in the US. Did you get much of the cognitive disfunction with the depakote? I was on Xanax a couple of years ago and the memory loss was awful. I would forget the names of friends I'd had for years.
I hope you're doing OK - you've been giving good advice here for a while.
Cheers
Jackie> Hi, I actually remembered. I have had strings of panic attacks in the past and any posts about panic catches my eye and it gets burned into my memory easily. I found Buspar to work well with SSRI's. I hope it helps with your panic probs. Depakote and the hairloss thing.. Well, I've never noticed any taking between 125mg-500mg/day. I noticed quite a bit of weight gain however at 500mg. I like clonazepam mainly because it is cheap! My pdoc was wanting to substitite Gabitril for clonazepam but at a lower dose than what I have tried in the past, but that stuff is expensive. Hey, there's another idea for you (Gabitril). You might get a lot of cognitive dysfunction with it however (but it is dose related).
>
> good luck,
>
> Mitch
>
Posted by Ritch on December 30, 2002, at 9:48:10
In reply to Re: Depakote for refractory panic? » Ritch, posted by Jackster on December 30, 2002, at 1:49:56
Hi, I started out with 5mg twice daily of Buspar and stayed on that for two-three weeks. I felt improvement and then we upped it to 7.5mg twice daily. I never went any higher than that. I was only taking about 5 mg of Celexa with it and I didn't want to push the Buspar up any higher because it has a tendency to make me hostile (if I get the ratio of Buspar/SSRI too high). It was like I lost all fear of everything, but it was converted to anger instead. I would wait 2 weeks and see how you are doing before you increase it any more IMO. It really took 7-10 days or so to kickin. Depakote cognitive dysfunction... well all I can say is that when I am depressed it can be particularly bad (forgetfullness esp.), however when my moods are high/normal it doesn't bother me that much. What I notice is this "delay effect" when I am trying to remember something. Someone will start talking to me about some issue at work (that I should be on the same page with already), and then they will finish and I will just sit there with wheels slowly turning for a few seconds and then "OH yeah!" and then get it. It reminds me of my grandpa grabbing a hot biscuit too quickly from the pan right out of the oven and taking several seconds for the "OUCH that's HOT!" response to make the connection and then he drops the biscuit. :) I'm doing fairly well, I think I have found a workable combination of meds that might actually last a few months!---Mitch
> Thanks for the advice. What dose of Buspar were you on? I'm on 15mg and am wondering if I should up the dose.
>
> I looked up Gabitril - and as usual - we don't have it here. We don't even have Effexor which seems to be pretty common in the US. Did you get much of the cognitive disfunction with the depakote? I was on Xanax a couple of years ago and the memory loss was awful. I would forget the names of friends I'd had for years.
>
> I hope you're doing OK - you've been giving good advice here for a while.
>
> Cheers
> Jackie
>
> > Hi, I actually remembered. I have had strings of panic attacks in the past and any posts about panic catches my eye and it gets burned into my memory easily. I found Buspar to work well with SSRI's. I hope it helps with your panic probs. Depakote and the hairloss thing.. Well, I've never noticed any taking between 125mg-500mg/day. I noticed quite a bit of weight gain however at 500mg. I like clonazepam mainly because it is cheap! My pdoc was wanting to substitite Gabitril for clonazepam but at a lower dose than what I have tried in the past, but that stuff is expensive. Hey, there's another idea for you (Gabitril). You might get a lot of cognitive dysfunction with it however (but it is dose related).
> >
> > good luck,
> >
> > Mitch
> >
>
>
Posted by judy1 on December 30, 2002, at 21:26:23
In reply to Depakote for refractory panic?, posted by Jackster on December 29, 2002, at 3:03:42
Absolutely- my shrink prescribes it all the time for his patients that don't respond well to benzos, which doesn't sound like you (you have a problem with taking them? too bad, because they work really well). Anyway he feels that seizures-panic-bipolar are related and that's why depakote as an AED works well just like the benzo klonopin, also an AED. I take in the >1000mg range so lots of side-effects on depakote but I have the manic/panic thing going on. best of luck- judy
Posted by Jackster on January 3, 2003, at 3:04:03
In reply to Re: Depakote for refractory panic? » Jackster, posted by judy1 on December 30, 2002, at 21:26:23
Hi Judy
Do you know why benzos would be tried before depakote? I occasionally take klonopin - but I really don't want to go the benzo route. I would like to go travelling one day - and don't want to go through the experience of it wearing off in the middle of nowhere. I also don't know how other countries are about prescribing them (would like to live in the UK again someday).
Thanks
Jackie> Absolutely- my shrink prescribes it all the time for his patients that don't respond well to benzos, which doesn't sound like you (you have a problem with taking them? too bad, because they work really well). Anyway he feels that seizures-panic-bipolar are related and that's why depakote as an AED works well just like the benzo klonopin, also an AED. I take in the >1000mg range so lots of side-effects on depakote but I have the manic/panic thing going on. best of luck- judy
Posted by judy1 on January 4, 2003, at 20:25:22
In reply to Re: Depakote for refractory panic?, posted by Jackster on January 3, 2003, at 3:04:03
Do you know why benzos would be tried before depakote?
yep, because benzos are the first-line treatment in panic disorder and have worked well for anxiety for 40 years. We get into lots of discussions why pdocs and GPs prescribe SSRIs for panic- essentially because the pharmaceutical industry pushes them to make money- benzos are off patent and there is no money in them. (* Although Xanax XR is coming out and I guarantee will be pushed). I've been fortunate in finding docs that are not benzophobic, but I know from this forum that is not the norm. Technically in the U.S., drs. can't terminate benzo therapy w/o weaning first, and I read they must give a one month supply. So if I was travelling I would make sure that I had enough to cover myself for the entire trip- just as I would with any psychotropic drug (including AEDs, ADs, etc.) so I wouldn't go through withdrawal. take care, judy
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