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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 5 of 5. This is the beginning of the thread.
Posted by worrier on March 26, 2003, at 17:53:22
>Have a couple of questions that I'm hoping someone out there mightbe able to help me with. Brief summary to avoid taking up to much time...Major problem has been panic disorder. Horrible experiences with SSRIs, especially paxil (ER visit, serotonin reaction, really bad). Since that episode I've been on xanax for both the old panic thing and now generalized anxiety that I never had before the paxil ordeal. The xanax helps, but I still have lots of physical symptoms of anxiety daily...panic attacks have decreased. Anyway, yesterday my pdoc suggested that I might want to consider remeron or straterra. I'm really gun-shy about new meds given what some have done in the past. The other option is to wait for extended release xanax. We're not going to change anything until after a visit to an endocrinologist next month, as recent blood work and 24 hr urine tests showed my cortisol levels to be pretty elevated (over twice normal). Well, anyway, guess this wasn't too brief after all...sorry. My actual question is has anyone tried either of these drugs in relation to panic/anxiety and if so what happened? Don't want to make things worse again. Thanks, worrier.
Posted by Ame Sans Vie on March 26, 2003, at 18:20:49
In reply to questions about remeron and straterra, posted by worrier on March 26, 2003, at 17:53:22
I have social anxiety, agoraphobia, and occasional panic attacks. I took Remeron for several months, the highest dose being 45-60mg... can't remember for sure. Anyway, I found it to be remarkably similar to Benadryl. Gave me an antihistamine-type drowsiness and never any antidepressant or anxiolytic effects. The only thing that made it any different than an antihistamine to me was its tendency to cause me to hallucinate before I'd fall asleep. No experience with Strattera, but I wouldn't think an NRI would be much help for anxiety.
What about Serzone?
Posted by jrbecker on March 27, 2003, at 19:21:55
In reply to Re: questions about remeron and straterra » worrier, posted by Ame Sans Vie on March 26, 2003, at 18:20:49
many people find remeron to be terrific for anxiety. most veer away from it due to the incidence of weight gain and somnolescence, yet for the most part, these effects are transient, waning in the first couple of weeks. there is a dosage window of effectiveness where the somnolescence of the antihistamine effect is balanced out by andrenergic activity. Usually people find that range within 30-45 mg. If you suffer from increased agitation on SSRIs, this might be the med to try. Or to a lesser extent, Serzone might also be an option. You mights also considering augmenting a low dose of an SSRI with either of these as well.
Just from my own experience, I did not find Strattera to be a great AD or anxiolytic. It only gave me a very negligble mood lift, but far too much physical overstimulation (e.g. increased heartrate). Frankly, I don't believe it has that much effectiveness for ADD either. Just my own opinion though. If you search through the threads, you'll find a variety of opinions on the topic.
JB
Posted by disney4 on March 28, 2003, at 11:18:34
In reply to Re: questions about remeron and straterra, posted by jrbecker on March 27, 2003, at 19:21:55
You seem to know your Remeron facts pretty well. Do you have a lot of medication knowledge? My pdoc has told me the same thing in the past when I stopped the Remeron due to fear of weight gain. Right now I have been trying to manage with Neurontin and Klonopin, and a high dose of fish oil, but I am having a difficult stretch. On Monday I plan on going back to 30 mg Remeron nightly plus 25 mg of Topamax daily, which I have taken in the past for binge eating, but I have never taken them together, and this seems like a dynamic duo for someone like me. I am diagnosed with Bipolar Disorder and OCD. I can't tolerate SSRI's or Wellbutrin and Neurontin and Topamax are the only mood stabilizers I can handle. Would you happen to know if Neurontin 400 mg, and Klonopin 1/4 mg is compatible with Remeron and Topamax?
Posted by Ame Sans Vie on March 28, 2003, at 11:39:37
In reply to Remeron and Topamax for me? Ame Sans Vie , posted by disney4 on March 28, 2003, at 11:18:34
Adding Remeron and Topamax to Neurontin and Klonopin should be just fine. In fact, I think my new med regimen is going to be Parnate, Neurontin, Topamax, and Klonopin, so just off by one :-) I've heard quite a bit about Topamax being useful for weight loss, so I take it it must be true. How's it working out for you, and what are the other effects like? Thanks!
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