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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 partlycloudy on June 24, 2005, at 6:03:19
Hello babblers. Since quitting my job I've had my medications adjusted again - I had been unable to stop crying for several months. I am feeling more stable within the past few days and I'm cautiously optimistic that this regime will work for a long time:
p.s. for mild bipolar2, GAD, and panic attacks:Cymbalta 60mg
Topamax 30mg
Xanax .25mg - .5mg as needed
Ambien 5mg as neededI consume no alcohol or caffeine as neither do me any good these days. As the depression wanes, I find that I'm able to exercise more frequently, which helps in turn. The anxiety is my biggest challenge. The xanax works, but I'm wary of dosage creep. I've tried Klonopin, Trazodone, and Vistaril, all of which either didn't work or worked into making me a viable couch potato. It still feels like something is "broken" with my fight-or-flight instincts. They are definitely overly sensitive.
pc
Posted by linkadge on June 24, 2005, at 6:27:37
In reply to Meds Update, posted by partlycloudy on June 24, 2005, at 6:03:19
"It still feels like something is "broken" with my fight-or-flight instincts. They are definitely overly sensitive."
I know exactly what you are saying. My body is full of adrenaline 24/7 and it just leads to burnout. I have this problem where a thought pops into my head, and it *immediately* provokes an intense surge of stomach acid, racing heart etc.
It's like my brain is too dumb to push the pause button for 2 seconds to assess weather an extra shot of adrenaline is really going to solve anything.
Linkadge
Posted by linkadge on June 24, 2005, at 6:29:13
In reply to Re: Meds Update, posted by linkadge on June 24, 2005, at 6:27:37
I'd like to cut that part of my brain out completely. Have an adrenalectomy or something.
It serves me no good. I'd like to take my adrenaline in pill form, (on an as needed basis), thank-you very much.
Linkadge
Posted by Sonya on June 24, 2005, at 6:50:13
In reply to Meds Update, posted by partlycloudy on June 24, 2005, at 6:03:19
> Hello babblers. Since quitting my job I've had my medications adjusted again - I had been unable to stop crying for several months. I am feeling more stable within the past few days and I'm cautiously optimistic that this regime will work for a long time:
> p.s. for mild bipolar2, GAD, and panic attacks:
>
> Cymbalta 60mg
> Topamax 30mg
> Xanax .25mg - .5mg as needed
> Ambien 5mg as needed
>
> I consume no alcohol or caffeine as neither do me any good these days. As the depression wanes, I find that I'm able to exercise more frequently, which helps in turn. The anxiety is my biggest challenge. The xanax works, but I'm wary of dosage creep. I've tried Klonopin, Trazodone, and Vistaril, all of which either didn't work or worked into making me a viable couch potato. It still feels like something is "broken" with my fight-or-flight instincts. They are definitely overly sensitive.
> pcI took benzos (all kinds) for a number of years and never felt sane on them. Like you, I thought something was "broken" with my fight-or-flight instincts. I'd jump at my own shadow. I practically became agoraphobic. I know for certain now that they only made my anxiety worse. Since I've been on depakote and seroquel, I no longer need benzos. BTW, my anxiety was so bad, I used to abuse benzos because I kept building up tolerance to "keep up" with the anxiety. Maybe with your pdoc and you can come up with an alternative?
Posted by SLS on June 24, 2005, at 7:27:22
In reply to Meds Update, posted by partlycloudy on June 24, 2005, at 6:03:19
I think Sonya might be on to something.
- Scott
Posted by partlycloudy on June 24, 2005, at 7:47:31
In reply to Re: Meds Update » partlycloudy, posted by Sonya on June 24, 2005, at 6:50:13
Hmm. The most Xanax I take in a day is between .5mg and .75mg. Could I get the heeby jeebies from a low dose like that? And caffeine completely wacks me out! It takes 4 hours to come down from a single cup of coffee.
I have tapered off of Xanax completely before - the withdrawls were not fun, but not severe - but completely a separate set of physical symptoms from the anxiety. Also, the anxiety comes at random times during the day and is rarely situational. (The panic attacks are definitely situational, and I'm much better at identifying my triggers.)Any ideas for me to present to my p-doc?
Posted by partlycloudy on June 24, 2005, at 7:53:19
In reply to Re: Meds Update » partlycloudy, posted by SLS on June 24, 2005, at 7:27:22
Effexor - high blood pressure at dosage effective on anxiety, then pooped out anyway.
Zyprexa - slept for 3 days and ate like a starving dog
Buspar - no effect whateverpc
Posted by Sonya on June 24, 2005, at 9:35:20
In reply to Re: Meds Update » Sonya, posted by partlycloudy on June 24, 2005, at 7:47:31
> Hmm. The most Xanax I take in a day is between .5mg and .75mg. Could I get the heeby jeebies from a low dose like that?
You bet! It doesn't take much. Xanax is the most addicting of all the benzos.
And caffeine completely wacks me out! It takes 4 hours to come down from a single cup of coffee.
I'm the same with coffee. I can't handle any caffeine at all.
> I have tapered off of Xanax completely before - the withdrawls were not fun, but not severe - but completely a separate set of physical symptoms from the anxiety. Also, the anxiety comes at random times during the day and is rarely situational. (The panic attacks are definitely situational, and I'm much better at identifying my triggers.)
>
> Any ideas for me to present to my p-doc?Seroquel at 25mg has helped me where everything else has failed including all SSRI's. But I dislike taking an antipsychotic for anxiety. You might also suggest a betablocker like Propranalol which I took for a period of time and it did help. If you or your pdoc thinks the anxiety is caused by depression, maybe Elavil (a old tricyclic)with Propranolol would work.
Hope everything works out alright. Anxiety is awful.
Posted by partlycloudy on June 24, 2005, at 10:01:16
In reply to Re: Meds Update » partlycloudy, posted by Sonya on June 24, 2005, at 9:35:20
Oops. Have also tried Propanolol, with no positive effect on anxiety.
My last therapist did not address my anxiety at all - I think this is partly why it has crept back so insidiously. I've made it a priority in my search for a new T. It's not like I 'came down with anxiety out of the blue; it definitely developed over a long period of time.
I have talked to my p-doc before about my concerns regarding benzo dependency, and she seems to think we've got it under control since my dosage has not increased in a year and a half, and the anxiety has waxed and waned during that time. When I was working it was particularly bad - no surprise there.
I really appreciate your thoughts and suggestions and will take them with me to my next appointment!
pc
Posted by Jazzed on June 24, 2005, at 10:06:29
In reply to Re: Meds Update » partlycloudy, posted by Sonya on June 24, 2005, at 9:35:20
> > Hmm. The most Xanax I take in a day is between .5mg and .75mg. Could I get the heeby jeebies from a low dose like that?
>
> You bet! It doesn't take much. Xanax is the most addicting of all the benzos.
>
> And caffeine completely wacks me out! It takes 4 hours to come down from a single cup of coffee.So weird how the different drugs work on ppl. I take my Adderall with coffee (very weak), and I get sleepy.
The Xanax (.25 mg - .5 mg) does nothing for me except help a bit with muscle tension, but it gives me terrible headaches.
I have nothing to offer on other drugs because I'm just not familiar with them.
Jazzy
Posted by partlycloudy on June 24, 2005, at 11:11:17
In reply to Re: Meds Update » Sonya, posted by Jazzed on June 24, 2005, at 10:06:29
It's really no wonder that it takes trying many different combinations and strengths to find what works for each of us.
I could do with some instant gratification, though. Trying a medication and waiting for a couple of weeks to confirm that it's NOT the right thing is frustrating, eh?
pc
Posted by sleepygirl on June 24, 2005, at 17:06:09
In reply to Meds Update, posted by partlycloudy on June 24, 2005, at 6:03:19
I'd like to give an AMEN!! to the anxiety being your biggest challenge. Me too, my flight or flight is on serious overdrive. I wish you good mental health.
:-)sleepy
Posted by Phillipa on June 24, 2005, at 18:47:09
In reply to Re: Meds Update, posted by sleepygirl on June 24, 2005, at 17:06:09
You know pc, maybe it just looks different in writing. But whenever I went into a store or anywhere alone I would have an anxiety attack. Panic attack. I also took xanax at the time and didn't increase the dose. A bit of klonopin too. And the pdoc kept trying different SSRI's at low doses. They sent me through the roof! Even managed to stay on effexor for a week at 37.5mg and then had to quit. Always felt like a space cadet on SSRI's. What a relief when they were dc'd and only had to use benzos with l0mg paxil. But since Menopause nothing seems to touch me. I even took 60mg of cymbalta when it came out. Of course my husband is home but if he starts to work again everything may start over. The constant phonecalls pleading with him to come home. Maybe menopause changes chemistry. Fondly, Phillipa
Posted by partlycloudy on June 25, 2005, at 7:10:41
In reply to Re: Meds Update, posted by Phillipa on June 24, 2005, at 18:47:09
Starting menopause definitely made my anxiety worse! And increased my migraines. Actually, the topamax is helping with that, too.
I'm glad that xanax still works for me, at any dosage. A staggered dose of .25mg seems to deal a bad case of anxiety pretty well: one at the onset of anxiety, and another .25mg about a hour later. if I take .5mg at once, then I fall alseep!
What is it about grocery shopping, anyway? It freaks me out bigtime.
p.s. Are you all healed from your surgery? Pleased with your results?
partlycloudy
This is the end of the thread.
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