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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 20 of 20. This is the beginning of the thread.
Posted by KaraS on July 23, 2005, at 15:49:40
Or did you still feel you needed a benzo or an SSRI to help control your anxiety?
Posted by dick hunt on July 23, 2005, at 21:49:42
In reply to Have U controlled anxiety w/ just mood stabilizer?, posted by KaraS on July 23, 2005, at 15:49:40
Hey :)
In my experience... (major GAD and Social Anxiety + panic attacks) I only responded well to benzos, paxil, Nardil (very good, but BADDDD side defects). Anyway, the effects of Paxil and all the benzos wore off after a short (2 months) period, and Nardil was too much to handle as far as side effects go... Right now I still take Klonopin, but I'm completely acclimated to it and I only take it because if I don't, I get rebound anxiety which really sux... Right now Trileptal + Gabitril seems to be working quite well, but I feel pretty stupid most of the time... Oh well, better than living off of ramen cuz I can't tolerate going out in publc to buy more food :) -Jonathan-
Posted by ed_uk on July 24, 2005, at 5:33:34
In reply to Re: Have U controlled anxiety w/ just mood stabilizer?, posted by dick hunt on July 23, 2005, at 21:49:42
Hi Jonathan,
What side effects did Nardil cause?
~Ed
Posted by SLS on July 24, 2005, at 6:22:49
In reply to Have U controlled anxiety w/ just mood stabilizer?, posted by KaraS on July 23, 2005, at 15:49:40
Depakote and Neurontin have some anxiolytic effects. Lyrica too.
What is the nature of the anxiety you are experiencing?
- Scott
Posted by ravenstorm on July 24, 2005, at 11:05:52
In reply to Re: Have U controlled anxiety w/ just mood stabilizer? » KaraS, posted by SLS on July 24, 2005, at 6:22:49
Are you bipolar? Do you only have anxiety or depression and anxiety? How much trileptal are you taking?
Posted by med_empowered on July 24, 2005, at 14:05:06
In reply to Re: dick hunt trileptal question, posted by ravenstorm on July 24, 2005, at 11:05:52
When I took trileptal, it helped some. 600mgs calmed things down a little; 900mgs really "evened things out"...but, it wasn't until I hit 1,200mgs that I found major anti-anxiety effects. Unfortunately, I still needed Klonopin and propranolol. According to some, Depakote has pretty pronounced anxiolytic effects, but I think the research is kinda sketchy and it focuses mainly on those with bipolar who also have problems with anxiety and/or panic disorders. (This is pretty common in bipolar disorder). Personally, given the cognitive dulling from higher-end doses of Trileptal and the blood tests and hormonal weirdness that goes with Depakote, I'd seriously recommend as-need benzos, buspar, SSRIs, TCAs, etc. before using a conventional mood-stabilizer or atypical antipsychotic for anxiety control. Various kinds of therapy help as well. Gabitril was OK for me, but stopped working very quickly, even after a dose a adjustment...not worth it. Neurontin flat out didn't do jack. You may recall that Parke-Davis, the Neurontin people, had to pay a $400million+ settlement in a lawsuit regarding unethical and unlawful marketing practices in pushing neurontin for things like anxiety and bipolar disorder. Before you go that route, it might be best to use some more tried and true medications.
Posted by KaraS on July 24, 2005, at 14:33:14
In reply to Re: Have U controlled anxiety w/ just mood stabilizer? » KaraS, posted by SLS on July 24, 2005, at 6:22:49
> Depakote and Neurontin have some anxiolytic effects. Lyrica too.
>
> What is the nature of the anxiety you are experiencing?
>
>
> - Scott
I'm not experiencing it at this moment but I will be soon if I don't substitute something effective for the small amount of doxepin I've recently discontinued. When I'm not on any medication, I stop being able to sleep, lose all appetite, get extremely anxious, develop panic attacks and agoraphobia. I continue to spiral downward without medication.
My doctor wants me to start taking Klonopin instead of the doxepin because it's anxiolytic as well as having some mood stabilizing properties and because he wants me to start taking dexedrine. He also mentioned the possibility of Neurontin, Lamictal or Topomax. I was just wondering if a mood stabilzer taken alone would be enough to handle the anxiety or would I also need to take a benzo. Judging from your answer above, I'm guessing that Lamictal alone would not be sufficient.K
Posted by KaraS on July 24, 2005, at 14:47:27
In reply to Re: dick hunt trileptal question, posted by med_empowered on July 24, 2005, at 14:05:06
> When I took trileptal, it helped some. 600mgs calmed things down a little; 900mgs really "evened things out"...but, it wasn't until I hit 1,200mgs that I found major anti-anxiety effects. Unfortunately, I still needed Klonopin and propranolol. According to some, Depakote has pretty pronounced anxiolytic effects, but I think the research is kinda sketchy and it focuses mainly on those with bipolar who also have problems with anxiety and/or panic disorders. (This is pretty common in bipolar disorder). Personally, given the cognitive dulling from higher-end doses of Trileptal and the blood tests and hormonal weirdness that goes with Depakote, I'd seriously recommend as-need benzos, buspar, SSRIs, TCAs, etc. before using a conventional mood-stabilizer or atypical antipsychotic for anxiety control. Various kinds of therapy help as well. Gabitril was OK for me, but stopped working very quickly, even after a dose a adjustment...not worth it. Neurontin flat out didn't do jack. You may recall that Parke-Davis, the Neurontin people, had to pay a $400million+ settlement in a lawsuit regarding unethical and unlawful marketing practices in pushing neurontin for things like anxiety and bipolar disorder. Before you go that route, it might be best to use some more tried and true medications.
I think this message was meant for me even though it had the previous poster's title on it (because it seemed to be answering my original post). If not, forgive me for responding to it.Thanks for your information. I probably have a "soft bipolar" condition based on the episodes of anxiety that I suffer with when unmedicated. I am starting on Klonopin soon but I was wondering if that didn't work out, whether a mood stabilizer alone would work but I don't think so now. I bet that if Klonopin isn't good for me for some reason, then my pdoc would probably recommend I take another benzo for the anxeity plus a mood stabilizer. He'd probably want the mood stabilizer to help with depression as well.
K
Posted by med_empowered on July 24, 2005, at 15:43:43
In reply to Re: mood stabilizers for anxiety » med_empowered, posted by KaraS on July 24, 2005, at 14:47:27
hi! I just wanted to make sure that I didn't come off as saying that a mood-stabilizer wouldn't help. If you have mood-disorder that responds well to a mood-stabilizer, and the side-effects are nill or minimal, then you probably will get some anxiolytic effects from the mood-stabilizer along with a much-needed help in overall functioning. My point is that mood-stabilizers really are for MOOD REGULATION. If you have bad anxiety they might help, but they should probably only be used for an underlying mood-disorder and not to smooth out anxiety...the resulting side-effects just wouldn't be worth it in terms of risk-benefits breakdown. BTW...if you opt for a mood-stabilizer, I'd seriously recommend low-dose Trileptal or Lamictal. Trileptal, at lower doses, is pretty easy on the patient and reasonably effective. Lamictal is nifty because it is the only mood-stabilizer that seems to have a marked, robust effect on bipolar *depression* and really functions more as a mood-brightener than simply an anti-manic agent, which is how most other mood-stabilizers work. (Atypical antipsychotics are an exception, but I seriously think they should be avoided whenever possible). In people with bipolar, there is a problem of sometimes getting some hypomanic symptoms from lamictal, which may or may not be a bad thing (hypomania really isn't nearly as problematic as depression or mania, so given the choice..I'd personaly opt for hypomania). My guess would be that combining a mood-stabilizing, long-acting benzo like Klonopin with the lamictal would boost your mood, while kind of smoothing off the rougher edges of hypomania. Good luck!
Posted by linkadge on July 24, 2005, at 17:00:44
In reply to hi!, posted by med_empowered on July 24, 2005, at 15:43:43
Clonazepam was good, but it totally stopped working for me after a short while. Then I had to go through withdrawl.
Some people don't develop tollerance, but have to share my account.
Linkadge
Posted by KaraS on July 24, 2005, at 22:50:41
In reply to hi!, posted by med_empowered on July 24, 2005, at 15:43:43
> hi! I just wanted to make sure that I didn't come off as saying that a mood-stabilizer wouldn't help. If you have mood-disorder that responds well to a mood-stabilizer, and the side-effects are nill or minimal, then you probably will get some anxiolytic effects from the mood-stabilizer along with a much-needed help in overall functioning. My point is that mood-stabilizers really are for MOOD REGULATION. If you have bad anxiety they might help, but they should probably only be used for an underlying mood-disorder and not to smooth out anxiety...the resulting side-effects just wouldn't be worth it in terms of risk-benefits breakdown. BTW...if you opt for a mood-stabilizer, I'd seriously recommend low-dose Trileptal or Lamictal. Trileptal, at lower doses, is pretty easy on the patient and reasonably effective. Lamictal is nifty because it is the only mood-stabilizer that seems to have a marked, robust effect on bipolar *depression* and really functions more as a mood-brightener than simply an anti-manic agent, which is how most other mood-stabilizers work. (Atypical antipsychotics are an exception, but I seriously think they should be avoided whenever possible). In people with bipolar, there is a problem of sometimes getting some hypomanic symptoms from lamictal, which may or may not be a bad thing (hypomania really isn't nearly as problematic as depression or mania, so given the choice..I'd personaly opt for hypomania). My guess would be that combining a mood-stabilizing, long-acting benzo like Klonopin with the lamictal would boost your mood, while kind of smoothing off the rougher edges of hypomania. Good luck!
Thanks for the clarification. My only possible bipolar presentation is the anxiety. I've never experienced mania or hypomania. It's too bad that Trileptal isn't as good as Lamictal for mood brightening since I'm less afraid of Trileptal.
Oh well, thanks again.k
Posted by KaraS on July 24, 2005, at 22:53:53
In reply to Re: hi!, posted by linkadge on July 24, 2005, at 17:00:44
> Clonazepam was good, but it totally stopped working for me after a short while. Then I had to go through withdrawl.
>
> Some people don't develop tollerance, but have to share my account.
>
>
> Linkadge
Hi,
It's so strange how some people can take something for many years while others develop tolerance so quickly. Wish I could predict which one I'd be!Do you mind if I ask you how much you were taking and how long the withdrawal lasted?
K
Posted by Phillipa on July 24, 2005, at 23:49:32
In reply to Re: hi! » linkadge, posted by KaraS on July 24, 2005, at 22:53:53
I took l50mg of trileptal with xanax and chloral hydrate last summer. It helped my anxiety. But I also think it numbed me. It's funny because now I am only taking l5mg of valium and a little of luvox. I wonder since I'm getting older if anxiety won't be as big a problem for me. Fondly, Phillipa
Posted by KaraS on July 25, 2005, at 0:43:23
In reply to Re: hi! » KaraS, posted by Phillipa on July 24, 2005, at 23:49:32
> I took l50mg of trileptal with xanax and chloral hydrate last summer. It helped my anxiety. But I also think it numbed me. It's funny because now I am only taking l5mg of valium and a little of luvox. I wonder since I'm getting older if anxiety won't be as big a problem for me. Fondly, Phillipa
It would be nice if at least one thing got better with age!
Posted by linkadge on July 25, 2005, at 15:23:41
In reply to Re: hi! » Phillipa, posted by KaraS on July 25, 2005, at 0:43:23
I was taking 3 mg. The withdrawl lasted about 2 months.
Linkadge
Posted by KaraS on July 25, 2005, at 18:06:07
In reply to Re: hi!, posted by linkadge on July 25, 2005, at 15:23:41
> I was taking 3 mg. The withdrawl lasted about 2 months.
>
>
> Linkadge
So the Klonopin never made you more depressed, it just stopped working fairly quickly? Was the withdrawal that awful? What did you take to cover your anxiety during the process?k
Posted by dick hunt on July 25, 2005, at 20:16:44
In reply to Re: Have U controlled anxiety w/ just mood stabilizer? » dick hunt, posted by ed_uk on July 24, 2005, at 5:33:34
> Hi Jonathan,
>
> What side effects did Nardil cause?
>
> ~EdMany many...
Anorgasmia for a solid 4 months at my dose of 75 mg... severe constipation (I could only go after taking a laxative)... Severe sugar cravings and 50 lbs weight gain in 5 months... Horrible postural hypotention (when I stood up I would almost faint) Severe weakness... I'm an avid mountain biker, and I went from riding 30+ miles on rough trails, to barely making it around my neighborhood... Mania... I would steal (shoplift) on a daily basis... Severe bouts of rage (punched my brother in the face for slamming a door, and routinely yelled and cussed at my boss) Went on days long road trips to nowhere (I live in the armpit/*ss of america AKA Alabama) Severe overconsumption of caffeine which i could not even tolerate before I took Nardil... Complete absence of any kind of fear, so I did a lot of very dangerous things... Rock climbing with no safety equipment including a rope! Going down class 5 rapids on a cheap innertube with no lifejacket or helmet in the middle of East Bumfu*k Alabama... Breaking into abandoned buildings to "find ghosts" (actually did find some!) Lots of weird sh*t in this state! Prophetic nightmares?! Very strange, but I knew a week before my partner died through my dreams... ETC, ETC
Posted by dick hunt on July 25, 2005, at 20:19:29
In reply to Re: dick hunt trileptal question, posted by ravenstorm on July 24, 2005, at 11:05:52
> Are you bipolar? Do you only have anxiety or depression and anxiety? How much trileptal are you taking?
I am bipolar, but my cycles are very slow (2 years severe depression, 6 months "normal" 1 year mania....etc...) I only take right now, 600mg/day... I also have severe anxiety+panic attacks (runs in the family) also, my grandfather was Schizophrenic...
Posted by ed_uk on July 26, 2005, at 14:12:42
In reply to Re: Have U controlled anxiety w/ just mood stabilizer?, posted by dick hunt on July 25, 2005, at 20:16:44
Hi!
>75 mg Nardil
....but how did you react to lower doses? It sounds like 75mg was far too much!
~Ed
Posted by dick hunt on July 27, 2005, at 11:17:21
In reply to Re: Have U controlled anxiety w/ just mood stabilizer? » dick hunt, posted by ed_uk on July 26, 2005, at 14:12:42
> Hi!
>
> >75 mg Nardil
>
> ....but how did you react to lower doses? It sounds like 75mg was far too much!
>
> ~EdHey ed :)
Any dose that was low enough to avoid certain side effects was also too low to be effective...Kinda sux
This is the end of the thread.
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