![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 9 of 9. This is the beginning of the thread.
Posted by Viridis on June 17, 2003, at 6:09:21
I saw my pdoc today, we chatted about various things and verified that my Klonopin/Xanax (occasionally)/Adderall/Neurontin combo is working pretty well for depression, anxiety, and ADD, but I'm still prone to the effects of stress. He gave me a sample pack of Gabitril (tiagabine, 2 mg pills) and suggested I try it out -- apparently some of his colleagues have had good success with it, and he's thinking of trying it himself (interesting...a pdoc who actually takes these meds).
He asked that I use it cautiously and let him know what I think. I've seen mixed reports here -- any suggestions/experiences?
Posted by mattdds on June 17, 2003, at 6:58:40
In reply to Gabitril?, posted by Viridis on June 17, 2003, at 6:09:21
Hey Viridis,
I'm curious to see how it goes. I think Gabitril is a GABA reuptake inhibitor, or somehow otherwise increases available GABA. So, pharmacologically, one would think that it'd have promise for anxiety.
That's cool that your pdoc may try it himself.
Keep us posted, I'm interested!
Take care,
Matt
Posted by Ritch on June 17, 2003, at 10:13:07
In reply to Gabitril?, posted by Viridis on June 17, 2003, at 6:09:21
> I saw my pdoc today, we chatted about various things and verified that my Klonopin/Xanax (occasionally)/Adderall/Neurontin combo is working pretty well for depression, anxiety, and ADD, but I'm still prone to the effects of stress. He gave me a sample pack of Gabitril (tiagabine, 2 mg pills) and suggested I try it out -- apparently some of his colleagues have had good success with it, and he's thinking of trying it himself (interesting...a pdoc who actually takes these meds).
>
> He asked that I use it cautiously and let him know what I think. I've seen mixed reports here -- any suggestions/experiences?Hi Viridis,
The last two or three visits my pdoc has brought Gabitril up. I wonder what is going on (recent article)? I *think* it is in phase II or III trials for GAD. I'm sure I saw that someplace. I've tried the stuff before (previous pdoc). I got switched from Depakote to Gabitril and started on a long and slow titration with it. At the time it came out the smallest tabs were 4mg, so I took 4mg hs, and then added 4mg in the day after one week. Continued to add 4mg/day/week, until I got to 12mg hs, and 8mg midday. Then when I went to 12mg bid, I got some pretty bad facial numbness and derealization and freaked out-stopped it. The things that were good about it---it definitely seemed to have a mild antidepressant effect---I didn't get angry or hostile or manic on it---I *seemed* to sleep better on it (although not as good as Neurontin). The BAD part (with any daytime dose), was a Topamax-like DAH, cognitive dulling, that was very disruptive at work. Even a single 4mg dose taken just before going to work would make me quite stupid. I might re-consider it, but only as an experiment at a low-dose at bedtime to see if it improves my sleeping.
Posted by renhnt on June 17, 2003, at 12:18:32
In reply to Re: Gabitril? » Viridis, posted by Ritch on June 17, 2003, at 10:13:07
> >I was just prescribed Gabitril this AM. I am still researching it before I take it. I was just diagnosed with bipolar spectrum along with OCD, PTSD, Panic Disorder, GAD, and an eating disorder. I was also prescribed Zoloft. I am so scared of side effects especially weight gain and lethargy. I would appreciate any information anyone could give me about these drugs. Thank you in advance.
I saw my pdoc today, we chatted about various things and verified that my Klonopin/Xanax (occasionally)/Adderall/Neurontin combo is working pretty well for depression, anxiety, and ADD, but I'm still prone to the effects of stress. He gave me a sample pack of Gabitril (tiagabine, 2 mg pills) and suggested I try it out -- apparently some of his colleagues have had good success with it, and he's thinking of trying it himself (interesting...a pdoc who actually takes these meds).
> >
> > He asked that I use it cautiously and let him know what I think. I've seen mixed reports here -- any suggestions/experiences?
>
> Hi Viridis,
>
> The last two or three visits my pdoc has brought Gabitril up. I wonder what is going on (recent article)? I *think* it is in phase II or III trials for GAD. I'm sure I saw that someplace. I've tried the stuff before (previous pdoc). I got switched from Depakote to Gabitril and started on a long and slow titration with it. At the time it came out the smallest tabs were 4mg, so I took 4mg hs, and then added 4mg in the day after one week. Continued to add 4mg/day/week, until I got to 12mg hs, and 8mg midday. Then when I went to 12mg bid, I got some pretty bad facial numbness and derealization and freaked out-stopped it. The things that were good about it---it definitely seemed to have a mild antidepressant effect---I didn't get angry or hostile or manic on it---I *seemed* to sleep better on it (although not as good as Neurontin). The BAD part (with any daytime dose), was a Topamax-like DAH, cognitive dulling, that was very disruptive at work. Even a single 4mg dose taken just before going to work would make me quite stupid. I might re-consider it, but only as an experiment at a low-dose at bedtime to see if it improves my sleeping.
>
Posted by Viridis on June 17, 2003, at 20:42:24
In reply to Re: Gabitril?, posted by renhnt on June 17, 2003, at 12:18:32
Thanks for the feedback! I'm going to hold off on the Gabitril for now (although I will try it) because my pdoc also gave me a bunch of Strattera (atomoxetine) to try for ADD, and I want to add one med at a time.
I was a little apprehensive, since I had a very bad reaction to Wellbutrin, another selective norepinephrine reuptake inhibitor. My pdoc said he had a "feeling" I'd react differently to Strattera, more along the lines of Adderall, which makes me calm and focused. His intuition is generally on target, so I tried the starting dose of 25 mg today, along with my usual meds (Klonopin, Adderall, and Neurontin).
It may just be my imagination, or a startup effect, but all day I've felt very mellow, yet accomplished a lot without stressing over things like I usually do. I'm very encouraged and am eager to pursue this med. It's much too soon to tell, but I have a good feeling about it. I'll let you know how it turns out. And, I will try the Gabitril, once I settle into (or stop?) Strattera.
Posted by Caleb462 on June 17, 2003, at 22:31:48
In reply to Re: Gabitril?, posted by Viridis on June 17, 2003, at 20:42:24
> I was a little apprehensive, since I had a very bad reaction to Wellbutrin, another selective norepinephrine reuptake inhibitor.Actually, although Wellbutrin does have a strong effect on norepinephrine, it is anything but an SNRI. It has fairly strong effect on dopamine, and possibly serotonin, as well. This is due to the many, many active metabolites of bupropion, as well as bupropion itself.
Posted by Caleb462 on June 17, 2003, at 22:39:19
In reply to Re: Gabitril?, posted by Caleb462 on June 17, 2003, at 22:31:48
>
> > I was a little apprehensive, since I had a very bad reaction to Wellbutrin, another selective norepinephrine reuptake inhibitor.
>
> Actually, although Wellbutrin does have a strong effect on norepinephrine, it is anything but an SNRI. It has fairly strong effect on dopamine, and possibly serotonin, as well. This is due to the many, many active metabolites of bupropion, as well as bupropion itself.Oh yeah, I forgot to mention, Wellbutrin is also a nicotinic chollinergic antagonist.
Posted by Viridis on June 17, 2003, at 23:12:43
In reply to Re: Gabitril?, posted by Caleb462 on June 17, 2003, at 22:31:48
Yes, that's true -- I was oversimplifying based on the "official" mechanism of action. I tolerate most meds pretty well, just seem to get into trouble when serotonin is heavily involved. SSRIs put me right over the edge, so if WB has a serotinergic effect, that might explain my reaction. And, there are all those mysterious secondary metabolites that you mentioned. All I know is that WB is bad news for me, but I have hope for Strattera.
Posted by Viridis on June 17, 2003, at 23:18:43
In reply to Re: Gabitril?, posted by Caleb462 on June 17, 2003, at 22:31:48
It was interesting, though, that WB provoked classic "fight-or-flight" responses usually associated with norepinephrine overload -- e.g., avoidance of eye contact, hypervigilance, cold hands, light sensitivity, anger, etc. But I realize that these drugs have complex effects, and may not act at the same receptors, or in the same areas of the brain, even if the purported mechanism of action is the same.
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.