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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 14 of 14. This is the beginning of the thread.
Posted by jay on January 29, 2003, at 23:07:10
(Wouldn't that subject line make a good book title..:-)Well, I've got a new Dx folks...Major Anxiety Disorder.(Considering I haven't gone out to do anything social in about, umm, a year and a half...and have *no* friends also) I am scared sh*tless, period!..ha. When I asked the doc about my depression..he said that of course anyone would be somewhat depressed if they where as anxious and afraid as I am. It gave me a whole new perspective. But, he did say that there is likely a small but strong component of depression to this, as I have been crushed by anxiety since I was very young.
So..with some Effexor, sedating imipramine, and benzos, anybody with anxiety as your Major disorder have luck adding to the above drug regiment:(All of them if I don't o.d. on them..lol!)
-Buspar (tried it on it's own...not fond of it..and ya I know about the "if you been on benzos it won't work" thingy...but I want to try it in a cocktail.
-Beta Blocker like Pindolol
....anything else?????Jay
Posted by Alan on January 30, 2003, at 0:35:27
In reply to Scared to Hell! Dealing with Anxiety Disorders..., posted by jay on January 29, 2003, at 23:07:10
Have you tried either AD in monotherapy OR bzd in monotherapy to see what the seperate results are? And I'm not just talking a little of one or the other. AD's besides effexor and imipramine. Bzds in normal theraputic doses including xanax, ativan, klonopin, or valium?
I found cocktails to cloud the picture.
Posted by Ritch on January 30, 2003, at 0:49:02
In reply to Scared to Hell! Dealing with Anxiety Disorders..., posted by jay on January 29, 2003, at 23:07:10
>
> (Wouldn't that subject line make a good book title..:-)
>
> Well, I've got a new Dx folks...Major Anxiety Disorder.(Considering I haven't gone out to do anything social in about, umm, a year and a half...and have *no* friends also) I am scared sh*tless, period!..ha. When I asked the doc about my depression..he said that of course anyone would be somewhat depressed if they where as anxious and afraid as I am. It gave me a whole new perspective. But, he did say that there is likely a small but strong component of depression to this, as I have been crushed by anxiety since I was very young.
>
> So..with some Effexor, sedating imipramine, and benzos, anybody with anxiety as your Major disorder have luck adding to the above drug regiment:(All of them if I don't o.d. on them..lol!)
>
> -Buspar (tried it on it's own...not fond of it..and ya I know about the "if you been on benzos it won't work" thingy...but I want to try it in a cocktail.
> -Beta Blocker like Pindolol
> ....anything else?????
>
> Jay
Jay, is this the result of your outpatient experience with that hospital you talked about earlier up in Ottawa? Just curious. So, you are on imipramine, Effexor, and a benzo?
Posted by ZeeZee on January 30, 2003, at 16:26:54
In reply to Scared to Hell! Dealing with Anxiety Disorders..., posted by jay on January 29, 2003, at 23:07:10
I highly recommend MAOI's. You'll feel as if you've been given a new brain.
Posted by JonW on January 30, 2003, at 21:38:21
In reply to Scared to Hell! Dealing with Anxiety Disorders..., posted by jay on January 29, 2003, at 23:07:10
In most cases the best treatment for a severe anxiety disorder is combining an AD with CBT. Paxil is the most established SSRI and Nardil can be a miracle drug if you can tolerate it and are willing to live with the restrictions. I don't know which benzo you take but Klonopin seems to have the reputation as being the best. You may want to try an atypical anti-psychotic. Regardless, don't sell yourself short. If you're not already, get involved with CBT.
Jon
Posted by jay on January 31, 2003, at 0:13:05
In reply to Re: Scared to Hell! Dealing with Anxiety Disorders... » jay, posted by Alan on January 30, 2003, at 0:35:27
> Have you tried either AD in monotherapy OR bzd in monotherapy to see what the seperate results are? And I'm not just talking a little of one or the other. AD's besides effexor and imipramine. Bzds in normal theraputic doses including xanax, ativan, klonopin, or valium?
>
> I found cocktails to cloud the picture.Oh yep...been through them all. I noticed at my last doc visit, he is getting a bit benzophobic at a time when I *don't* need...which is a time of crisis, while I am waiting to get into a large medical/research centre. I've put up with meds and more meds over a decade...and he knows this, so I don't know why he just doesn't let me get relief by giving me a good whack of a strong benzo, with maybe a small bit of an a.d. Oh well...we shall see what happens in the next week or so. I do know at this place I am getting into, and some possible new pdocs, who prescribe benzos at proper doses no problem. Thanks very much for your post...
Best wishes,
Jay
Posted by jay on January 31, 2003, at 0:16:06
In reply to Re: Scared to Hell! Dealing with Anxiety Disorders... » jay, posted by Ritch on January 30, 2003, at 0:49:02
No..actually I am still waiting on that. I don't know if you are in Canada or not..but this is in Hamilton, and it's one of the best research places in the world...so I *may* get lucky...but we will see. And yep..I am on the three meds you mention, but far too small a dose of a benzo. Thanks...will keep you posted..Jay
Posted by jay on January 31, 2003, at 0:21:37
In reply to Re: Scared to Hell! Dealing with Anxiety Disorders... » jay, posted by ZeeZee on January 30, 2003, at 16:26:54
> I highly recommend MAOI's. You'll feel as if >you've been given a new brain.
Ahhh...I could *really* use that..:-) The thing is I have serious blood pressure problems as it is, and I myself don't want to take the risk, because a normal bp crises for someone on an MAOI would very likely be disaster for me. I even have to take my bp every day while on Effexor. On top of that, I could *never* follow the diet...and that is even more risk with such sensitive blood pressure problems.
Thanks for the suggestion..
Jay
Posted by jay on January 31, 2003, at 0:40:19
In reply to Re: Scared to Hell! Dealing with Anxiety Disorders... » jay, posted by JonW on January 30, 2003, at 21:38:21
> In most cases the best treatment for a severe anxiety disorder is combining an AD with CBT. Paxil is the most established SSRI and Nardil can be a miracle drug if you can tolerate it and are willing to live with the restrictions. I don't know which benzo you take but Klonopin seems to have the reputation as being the best. You may want to try an atypical anti-psychotic. Regardless, don't sell yourself short. If you're not already, get involved with CBT.
>
> JonJon...thanks...and yes, when I get into this outpatient program I am waiting for, both CBT and Interpersonal therapy will be offered for me. I know a fair bit about both, and know they will help big time. I also have some worksheets and charts for my moods I have copied from books which I think are going to be helpful.
I had one little combo once that seemed to help in all ways. It was 150mg of Effexor, 5mg of Zyprexa, and 50mg (2x a day) of Serzone. But, with the 'kiss of death'(for the Serzone) liver-damage warning, I doubt many docs will prescribe Serzone anymore. I am no chemist or biologist...but I think it was the combo of the reuptake blocking action of Effexor, PLUS, all of the other agonist/antagonist action on the many, many receptors that both Zyprexa (especially) and Serzone work on. Weight gain was the only problem, but both sex drive and excellent mood improvement where there. It seems the more receptor types and sub-types we muck around with, the better tailored results we can get. The drug companies still seem to be in the mood to want to soak every dime they can out of the silly "Serotonin Imbalance" 'theory', though. (Which is mostly goobly-gock of course..heh!)
Risperdal is o.k. as a 'dire emergency' med, but the effect dosen't seem to sustain itself. I thought maybe Zyprexa and Buspar may be worth a shot..but the dual dopamine blocking sounds a bit scary. (As weak as Buspar is). I'd maybe even like to try a high dose (say 50-60 mg's) of Buspar, with a benzo and an a.d...but..will have to wait and see. You are right, though, none of us should sell ourselves short...and we should ALWAYS aim for the absolute BEST results..not just 'sorta o.k.' results, as I have in the past, and those type tend to be weak, and break under the smallest bit of pressure.
Anyhow...thanks Jon! I will keep updated on the situation. :-)
Best wishes,
Jay
Posted by missinglynxx on January 31, 2003, at 7:56:45
In reply to Re: Scared to Hell! Dealing with Anxiety Disorders... » JonW, posted by jay on January 31, 2003, at 0:40:19
Jay ,IT sounds like you are on the right track. Consider Abilify in the choice category. I think 60 mgs of Buspar would make you jump across the room, its HIGHLY enervating. GOOD luck,!
Posted by Jack Smith on January 31, 2003, at 12:12:11
In reply to Re: Scared to Hell! Dealing with Anxiety Disorders... » jay, posted by JonW on January 30, 2003, at 21:38:21
> Nardil can be a miracle drug if you can tolerate it and are willing to live with the restrictions.
JonW,
I think I read in the archives a message from you where you were just starting out Nardil. . . . Are you still on it? Could you tolerate it? live with the restrictions?
Jack
Posted by ZeeZee on January 31, 2003, at 15:08:57
In reply to Re: Scared to Hell! Dealing with Anxiety Disorders... » ZeeZee, posted by jay on January 31, 2003, at 0:21:37
You will find that you no longer need your blood pressure medication because the MAOI will reduce it to normal to below normal levels. Inexperienced doc's don't seem to understand this. Thus you won't be at any more risk than the rest of us. Parnate is a greater offender of b/p spikes than is Nardil or Marplan.
Good Luck
Posted by JonW on February 2, 2003, at 16:41:07
In reply to Nardil--JonW, posted by Jack Smith on January 31, 2003, at 12:12:11
> JonW,
>
> I think I read in the archives a message from you where you were just starting out Nardil. . . . Are you still on it? Could you tolerate it? live with the restrictions?Hi Jack,
It was the most impressive drug I've been on for SP, but I couldn't tolerate the side-effects and stopped after 8 weeks at 75mg. As impressive as it was, it wasn't enough better than other drugs I've been on to justify the side-effects and restrictions. Possibly a higher dose for another 12 weeks would be a different story, but that wasn't in the cards for me. My current med cocktail + CBT has proven more effective than Nardil alone ever was. Good Luck!
Jon
Posted by Jack Smith on February 2, 2003, at 21:37:10
In reply to Re: Nardil--JonW » Jack Smith, posted by JonW on February 2, 2003, at 16:41:07
Which side effects could you not tolerate?
This is the end of the thread.
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