Psycho-Babble Medication Thread 101723

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TO 3 Beers or social phobia help

Posted by geno on April 3, 2002, at 17:27:06

3beers,
Ok my pdoc switched me to zoloft 25mg to start am. he dropped the paxil. I didnt get a chance to mention dexadrine, because he said when i titrate up to high dose of zoloft, he wants to drop the desipramine. I guess high doses of zoloft kick in more dopamine. On the QT, i have 30 days of 1mg klonopin. He also wants to get rid of my xanax which i didnt say anything, i figure, once he cuts my xanax off, ill call him and complain of panic attacks from zoloft. (if such happens) . He keps the remeron for sleep.

Now what do i do. Hopefully the zoloft will be sorta activating for me. The remeron is good for sleep, and daytime anxity ill use klonopin. He said from m history of ghb and alcohol addiction, he wants me of benzos. BULL> i dont abuse them at all. the most i use is 1mg, 1.5 at most.

Ill see how zoloft works for a while. Then maybe even upp desipramine which in a way works as a stimulant such as dexadrine, but in softer way. I dont or cant handle dopamine meds. period.

thanks
geno

 

Re: TO 3 Beers or social phobia help » geno

Posted by TSA West on April 3, 2002, at 20:36:38

In reply to TO 3 Beers or social phobia help, posted by geno on April 3, 2002, at 17:27:06

Bonjour Geno,

There is a study which mentions how desipramine counteracts the anti-panic properties of imipramine. The clinical relevance of this needs to be proven again to have some semblance of truth:

McLeod, Daniel R. PhD *. "Therapeutic Effects of Imipramine Are Counteracted by Its Metabolite, Desipramine, in Patients With Generalized Anxiety Disorder." Journal of Clinical Psychopharmacology, Dec 2000.

Dropping the desipramine if necessary would not mean that the antidepressant effect of desipramine would be lost forever:

"Eleven (91.7%) of the 12 relapsed patients achieved full remission after an average of 4.7 weeks (range=2-8 weeks, median=4 weeks) of desipramine retreatment, a significant response rate. Conclusions: Positive response to desipramine strongly predicts favorable response to retreatment for depressive relapse following desipramine discontinuation. (Am J Psychiatry 1995; 152:926-928)"

Either Zoloft or Remeron should have anti-panic prinicples, assuming you reach a therapeutic range such that the serotonin reuptake/norepinephrine pumps are inhibited more than 80%. For Sertaline, this dose is I believe 100 mg:

http://www.preskorn.com/cgi-bin/sp.pl?words=inhibition&wt=be&bl=an&IMAGE1.x=0&IMAGE1.y=0&d=/books/ssri_s8.html

Good to see you posting,
TSA West :)

 

re: Zoloft for Social Phobia

Posted by 3 Beer Effect on April 4, 2002, at 2:34:48

In reply to TO 3 Beers or social phobia help, posted by geno on April 3, 2002, at 17:27:06

Although Zoloft 25 mg is a low starting dose, by titrating it up by 25 mg a month it may help prevent the insomnia or nervousness common with the first month of Zoloft. It probably won't be activating until 75 mgs- 50 mg made me sleepy.

I found Zoloft 100 mg each morning to work wonderfully- the best anti-depressant & social phobia med i've ever taken. But eventually it gave me insomnia, & after a week of not sleeping, I began to have "drug induced mania" & lapses in judgement. (Looking back, my psychiatrist should have either prescribed 75 mg or prescribed 100 mg with a benzo or a sub-therapeutic dose of Remeron for sleep- that guy is no longer my doctor.) With the Remeron your taking you probably won't have any sleep problems/insomnia at the effective dosages of either 75 or 100 mgs.

My 30 yr old sister did well on Zoloft 75 mg with only minor sleep disturbance, but they don't make Zoloft in 75 mg pills so you have to get 45 50 mg pills per month and cut the extra 15 in half, which could be expensive if you don't have insurance & could be a pain.

 

re: Zoloft for Social Phobia

Posted by geno on April 4, 2002, at 15:34:46

In reply to re: Zoloft for Social Phobia, posted by 3 Beer Effect on April 4, 2002, at 2:34:48

3 beers, ya i stopped paxil last night and could feel more anxious and moody today. ZOloft starting tommorrow. although ill still be on my am xanax.5mg so if its activating at this dose, i should be fine. If its sedative, maybe i could cut the am xanax back to .25 like you said.

when i get up around 100mg zoloft, ill see how i feel. Ya, i have no problem at all sleeping on remeron. it knocks me out and sleep 8 hrs. But if i dont take my am xanax, i get anxious and panicy. So hopefully the zoloft taking at breakfast is sedating for now, if he backs me off on xanax to .25. If not, im not backing off xanax. Plus i have the klonopin to take maybe when i get up to 100mg when it becomes activating.

I think my pdoc thinks that the zoloft will sedate me, so he could then lower my am xanax dose. i still at least want .25mg am. no matter what. Having benzos at my side make me feel alot better in case of panic or anxiety.

he also told me desipramine helps with sleep and anxiety, taken at night, i then asked him why does my heart rate go up if its good for sleep and anxiety. He told me because its an older tryc drug and thats a main side effect. If i go up to 50mg of desip, it does have activating properties and anxiety. So i keep it at 25mg. gives me a nice tingly sensation, esp when working out, unlike ephedrine or caffiene which make me crazy jumping out of my skin.

thank alot!
geno

 

I would just take Klonopin instead of Xanax

Posted by 3 Beer Effect on April 4, 2002, at 22:31:55

In reply to re: Zoloft for Social Phobia, posted by geno on April 4, 2002, at 15:34:46

The Klonopin lasts about 12 hours while the Xanax lasts only a few hours. Unlike Xanax, their is no euphoria with Klonopin, if you take too many you just feel really drowsy. But it still is good for preventing anxiety, & since its less addictive your doctor will probably give you more Klonopin than the teensy dose of Xanax he's giving you. Klonopin is arguably supposed to be the strongest benzo, but I think Xanax, Ativan, & Klonopin are pretty similar strength wise but with different durations of action, but Xanax & Ativan have more addictive potential.

Your doctor seems on a mission to get rid of the Xanax, so you might just let him but tell him to replace it with an adequate dose of Klonopin for daytime anxiety & tell him that unlike Xanax, with Klonopin there is no "instant gratification", it takes an hour to start working, & it has a long duration of action & half life so it results it much less addiction/abuse that the other benzodiazepines.

Short half-lives, rapid onset of action, and short duration are the hallmarks of abusable/addictive drugs.

I've heard of people seeking out Xanax at college or going to mexico to buy it & also there was negative press recently with the President's dumb niece calling in a fake Xanax prescription, but I've never heard anyone say anything about Klonopin ever.

I don't think you are supposed to mix 3 different anti-depressants at the same time- Remeron at night with Zoloft in the morning is a tried & true combination, but mixing a tricyclic in their seems risky, & tricyclics are for the most part old toxic drugs with lots of side effects. You might want to ask him if that is a good idea & if it will cause problems when your Zoloft dose gets higher (like serotonin syndrome) or too much serotonin apathy. If it was me, I would eventually ditch the tricyclic desipramine, especially if it is making your heart beat faster & you are working out, when the Zoloft got up to an effective dose.

3 Beers

 

Re: I would just take Klonopin instead of Xanax

Posted by JohnX2 on April 4, 2002, at 22:41:26

In reply to I would just take Klonopin instead of Xanax, posted by 3 Beer Effect on April 4, 2002, at 22:31:55

> The Klonopin lasts about 12 hours while the Xanax lasts only a few hours. Unlike Xanax, their is no euphoria with Klonopin, if you take too many you just feel really drowsy. But it still is good for preventing anxiety, & since its less addictive your doctor will probably give you more Klonopin than the teensy dose of Xanax he's giving you. Klonopin is arguably supposed to be the strongest benzo, but I think Xanax, Ativan, & Klonopin are pretty similar strength wise but with different durations of action, but Xanax & Ativan have more addictive potential.
>
> Your doctor seems on a mission to get rid of the Xanax, so you might just let him but tell him to replace it with an adequate dose of Klonopin for daytime anxiety & tell him that unlike Xanax, with Klonopin there is no "instant gratification", it takes an hour to start working, & it has a long duration of action & half life so it results it much less addiction/abuse that the other benzodiazepines.
>
> Short half-lives, rapid onset of action, and short duration are the hallmarks of abusable/addictive drugs.
>
> I've heard of people seeking out Xanax at college or going to mexico to buy it & also there was negative press recently with the President's dumb niece calling in a fake Xanax prescription, but I've never heard anyone say anything about Klonopin ever.
>
> I don't think you are supposed to mix 3 different anti-depressants at the same time- Remeron at night with Zoloft in the morning is a tried & true combination, but mixing a tricyclic in their seems risky, & tricyclics are for the most part old toxic drugs with lots of side effects. You might want to ask him if that is a good idea & if it will cause problems when your Zoloft dose gets higher (like serotonin syndrome) or too much serotonin apathy. If it was me, I would eventually ditch the tricyclic desipramine, especially if it is making your heart beat faster & you are working out, when the Zoloft got up to an effective dose.
>
> 3 Beers

I had a similar thought.

I would think given how stimulating Zoloft can be that the Desipramine may be redundant, right?

John

 

15mg dexetrine klonopin 8mg need opinions » JohnX2

Posted by AJ and VJ on January 15, 2003, at 20:59:20

In reply to Re: I would just take Klonopin instead of Xanax, posted by JohnX2 on April 4, 2002, at 22:41:26

My husband is adhd and he takes 15 mg of dexetrine spansuals,8 mg of klonopin and 15 mg of prozac everyday,i been reading the posts and i haven't read of anyone taking this mamy miligrams of klonopin i just would like some advice on how he can take this medications he's been on dex and prozac for 7 years and klonopin for 3 years on 4mg and then he wanted to increased to 4 more mgs because he takes klonopin before his worksouts and if he doesn't take it before a workout he gets heart palpitations which they were caused by anxiety when he was 16 to 26 and he was never really taking care of the hospitalonly gave him xanax but it didn't work out for him at all but at 26 we finally found a clinic for him which helped him so much till last week (thats another story i'll poste later) klonopin doesn't make him sleepy at all and there's nothing wrong with his heart either,my question is what do you guys think about taking this much klonopin and suggestions on how he can take it with the other medications for all of them to work with no problems,and also when he was taking dexetrine,prozac and klonpin 4mg like i said at the begining he lost over 60 pounds and now that his taking more klonopin since 4/6months ago his gainged alot now he's 198 which he was 160 so klonopin its done a lot for him in that side of the coin but i am concern whats on the other side?dex and prozac have always worked great they changed his life and our life as a married couple so much. please any suggestions, advice will be very helpfull and very apreciated, thank you and good luck to all!


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