Psycho-Babble Medication Thread 573903

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Re: Lexapro: 10mg vs 20mg. Any more beneficial?? » qbsbrown

Posted by ed_uk on November 7, 2005, at 14:28:48

In reply to Re: Lexapro: 10mg vs 20mg. Any more beneficial??, posted by qbsbrown on November 6, 2005, at 16:42:09

Hi Brian :-)

>I think i just realized that i went up way too fast.

I agree. You can decrease the dose if necessary, and increase it more gradually next time.

Kind regards

Ed

 

Re: Lexapro: 10mg vs 20mg. Any more beneficial??

Posted by qbsbrown on November 9, 2005, at 14:08:52

In reply to Re: Lexapro: 10mg vs 20mg. Any more beneficial?? » qbsbrown, posted by ed_uk on November 7, 2005, at 14:28:48

Well Ed, the original "better" feeling i was getting on 40mgs has dissappated. Albeit i never felt anything on 20mgs of lexapro (which i took for months).
Think it is time to move on to 50, then perhaps 60? Chase the dragon.

Typically w/ me, i react to ADs quickly or not at all. Paxil, 9 years ago, panic disorder ended from day one i took it. It is now ineffective for me.
Lamictal, i took, felt amazing after one week, only for it to go away, and chase the dosage up, never to reach that feeling again.

So i was enthused that after a couple days at 40mgs, that i felt a difference. Lexapro just felt like a placebo. Or perhaps i have a correlation w/ side effects, and medications working.

Any offers?

I know you take 80mgs. Everywhere i read says that it's never been found that 60mg is any more beneficial that 40mg (which im sure is a bunch of crap in individual cases).

Regards,

Brain

 

Re: Lexapro: 10mg vs 20mg. Any more beneficial?? » qbsbrown

Posted by ed_uk on November 9, 2005, at 16:30:31

In reply to Re: Lexapro: 10mg vs 20mg. Any more beneficial??, posted by qbsbrown on November 9, 2005, at 14:08:52

Hi Brian,

>Everywhere i read says that it's never been found that 60mg is any more beneficial that 40mg (which im sure is a bunch of crap in individual cases).

Exactly. Individual differences and all that. Are you currently having any side effects on 40mg?

Ed

 

Re: Lexapro: 10mg vs 20mg. Any more beneficial??

Posted by qbsbrown on November 9, 2005, at 17:57:10

In reply to Re: Lexapro: 10mg vs 20mg. Any more beneficial?? » qbsbrown, posted by ed_uk on November 9, 2005, at 16:30:31

No side effects. Perhaps loss of hunger still, but it's regaining. If you've heard of derealization, that is probably my worst and most prominent symptom. Usually SSRis seem to aggrivate it, although i typically don't give them enough of a chance or time.

 

Re: Lexapro: 10mg vs 20mg. Any more beneficial??

Posted by qbsbrown on November 9, 2005, at 18:14:39

In reply to Re: Lexapro: 10mg vs 20mg. Any more beneficial??, posted by qbsbrown on November 9, 2005, at 17:57:10

the main thing that i am worried about celexa, is that 20mg of lexapro did nothing for me. What in your estimate is dosage of celexa equal to 20 mg of lexapro? Most would say 80, but i know you disagree.

 

Re: Lexapro: 10mg vs 20mg. Any more beneficial?? » qbsbrown

Posted by ed_uk on November 10, 2005, at 13:41:26

In reply to Re: Lexapro: 10mg vs 20mg. Any more beneficial??, posted by qbsbrown on November 9, 2005, at 18:14:39

Hi Brian,

>If you've heard of derealization, that is probably my worst and most prominent symptom. Usually SSRis seem to aggrivate it, although i typically don't give them enough of a chance or time.

Does anything help? Perhaps surprisingly, some people find stimulants helpful.

>What in your estimate is dosage of celexa equal to 20 mg of lexapro?

40mg. 40mg Celexa *contains* 20mg escitalopram (Lexapro) and 20mg R-citalopram.

Kind regards

Ed

 

Re: Lexapro: 10mg vs 20mg. Any more beneficial??

Posted by qbsbrown on November 10, 2005, at 13:44:29

In reply to Re: Lexapro: 10mg vs 20mg. Any more beneficial?? » qbsbrown, posted by ed_uk on November 10, 2005, at 13:41:26

What type of stimulants? There is no current treatment for Derealization/depersonalization disorder. I believe that mine is completely anxiety based, so i still have hopes for an ssri to assist me in changing back my paradigms and perceptions.

Regards,

Brian

 

Re: Lexapro: 10mg vs 20mg. Any more beneficial?? » qbsbrown

Posted by ed_uk on November 12, 2005, at 12:10:20

In reply to Re: Lexapro: 10mg vs 20mg. Any more beneficial??, posted by qbsbrown on November 10, 2005, at 13:44:29

Hi Brian

Some people on p-babble (such as Zeugma) have reported that psycho-stimulants such as Ritalin and Dexedrine/Adderall have relieved DP/DP. Zeugma does find that Ritalin aggravates his anxiety though, even though it relieves his DP/DP. Not everyone suffers increased anxiety on stimulants though, a few people even find them anxiolytic, especially Dexedrine.

Kind regards

Ed

 

Re: Lexapro: 10mg vs 20mg. Any more beneficial?? » ed_uk

Posted by zeugma on November 12, 2005, at 12:56:00

In reply to Re: Lexapro: 10mg vs 20mg. Any more beneficial?? » qbsbrown, posted by ed_uk on November 12, 2005, at 12:10:20

> Hi Brian
>
> Some people on p-babble (such as Zeugma) have reported that psycho-stimulants such as Ritalin and Dexedrine/Adderall have relieved DP/DP. Zeugma does find that Ritalin aggravates his anxiety though, even though it relieves his DP/DP. Not everyone suffers increased anxiety on stimulants though, a few people even find them anxiolytic, especially Dexedrine.

Hi Ed (and Brian),

Yes, Ritalin definitely relieves DP/DR even as it makes me tremble uncontrollably with anxiety. My DP is definitely a perceptual deficit of some kind. The locus of self-perception is in the temporo-parietal junction and Ritalin stimulates that region, while benzodiazepines, antidepressants, and miscellaneous drugs do nothing there. I know my DP is not produced by anxiety as I experience it on its own, just as I know my anxiety is not caused by depression, as I have experienced anxious states in the absence of depression. But I don't doubt you when you say your DP is anxiety-related. I have to say that the DP is at a lower level when my anxiety is controlled. It is more a feeling of bodily numbing and not being completely 'there' which persists, not the full-fledged feeling of 'nothingness' that severe DP produces.

-z
>
> Kind regards
>
> Ed

 

Re: Lexapro: 10mg vs 20mg. Any more beneficial?? » zeugma

Posted by ed_uk on November 12, 2005, at 13:41:20

In reply to Re: Lexapro: 10mg vs 20mg. Any more beneficial?? » ed_uk, posted by zeugma on November 12, 2005, at 12:56:00

Hi Z

I'm still wondering whether you'd be better served by Dexedrine than Ritalin!

Kind regards

Ed

 

Re: Lexapro: 10mg vs 20mg. Any more beneficial?? » ed_uk

Posted by zeugma on November 12, 2005, at 18:23:38

In reply to Re: Lexapro: 10mg vs 20mg. Any more beneficial?? » zeugma, posted by ed_uk on November 12, 2005, at 13:41:20

Hi again Ed,

I think DP/DR is somewhere in that vague spectrum of 'negative symptoms' which are common (more or less) to schizophrenia and severe depression, and which are known to be (in the case of schizophrenia) responsive to stimulants but at the cost of exacerbating positive symptoms. I experienced some relief, much more mild than I received from Ritalin, when i increased the Provigil dose to 300 mg. Unfortunately, my insurance will only cover 200 mg, so that experiment has come to an end.

I did feel more social on 300 mg, and also less socially anxious. But that could be because I felt more awake at 6 pm, and less in a stumbling haze. The DP is really a physical feeling of not being there at all, unsettling like a dream from which you're completely absent.

I think my best hope os when Sparlon comes out early next year. It's just Provigil but in higher doses. Hopefully I can get my insurance to cover it.

-z

 

Re: Lexapro: 10mg vs 20mg. Any more beneficial?? » zeugma

Posted by ed_uk on November 13, 2005, at 10:38:36

In reply to Re: Lexapro: 10mg vs 20mg. Any more beneficial?? » ed_uk, posted by zeugma on November 12, 2005, at 18:23:38

Hi Z

>I think DP/DR is somewhere in that vague spectrum of 'negative symptoms' which are common (more or less) to schizophrenia and severe depression, and which are known to be (in the case of schizophrenia) responsive to stimulants but at the cost of exacerbating positive symptoms.

How did perphenazine affect your DP/DR? Did it make it worse? I wonder what a dopamine agonist would do..... (unfortunately, dopamine agonists sometimes cause 'sleep attacks' - notably ropinirole and pramipexole)

>Unfortunately, my insurance will only cover 200 mg, so that experiment has come to an end.

We have generic modafinil in the UK now, 100mg and 200mg tablets. Do you have the generic in the US yet? It might be a lot cheaper.

>I think my best hope os when Sparlon comes out early next year. It's just Provigil but in higher doses.

What strengths of tablet will Sparlon come as?

Kind regards

Ed

 

Re: Lexapro: 10mg vs 20mg. Any more beneficial?? » ed_uk

Posted by zeugma on November 13, 2005, at 12:06:25

In reply to Re: Lexapro: 10mg vs 20mg. Any more beneficial?? » zeugma, posted by ed_uk on November 13, 2005, at 10:38:36

Hi Ed
>
> >I think DP/DR is somewhere in that vague spectrum of 'negative symptoms' which are common (more or less) to schizophrenia and severe depression, and which are known to be (in the case of schizophrenia) responsive to stimulants but at the cost of exacerbating positive symptoms.
>
> How did perphenazine affect your DP/DR? Did it make it worse? I wonder what a dopamine agonist would do..... (unfortunately, dopamine agonists sometimes cause 'sleep attacks' - notably ropinirole and pramipexole)

It's very hard to say how perphenazine affected DP/DR. First, the dose of perphenazine was way too high -mean dose around 32 mg, with 48 mg reached at one point. At these doses it caused incredible fatigue. However, I think perphenazine had an anxiolytic effect that lessened the manifestations. It didm't affect the core symptom of feeling detached from my body. I do remember perphenazine being anxiolytic- until it made me so sleepy that anxiolysis was beside the point. FWIW, I tolerated perphenazine better than molindone, spoken highly of by some here. That's not to say I cared for either. I also required a lot of Cogentin to manage the EPS, which set in immediately. perphenazine did have one favorable property- it was antipanic by lessening sensations of nausea, which tended to trigger panic attacks reliably.(That is why I had panic attacks when taking SSRI's.)

> >Unfortunately, my insurance will only cover 200 mg, so that experiment has come to an end.
>
> We have generic modafinil in the UK now, 100mg and 200mg tablets. Do you have the generic in the US yet? It might be a lot cheaper.
>

I don't think modafinil is available in the U.S. as generic yet. From what I have heard Cephalon has it on patent in the U.S. until next year (very convenient since Sparlon is coming out). .

> >I think my best hope os when Sparlon comes out early next year. It's just Provigil but in higher doses.
>
> What strengths of tablet will Sparlon come as?
>

It will come at a starting dose of 85 mg, with target doses of 340 and 425 mg. (Can't remember the intermediate dosages offhand.)From my experience, 340 mg would be about right.

BTW, I took 30 mg Ritalin instead of Provigil today. Less DP :-)

-z
> Kind regards
>
> Ed

 

Re: Lexapro: 10mg vs 20mg. Any more beneficial??

Posted by qbsbrown on November 13, 2005, at 17:04:26

In reply to Re: Lexapro: 10mg vs 20mg. Any more beneficial?? » ed_uk, posted by zeugma on November 13, 2005, at 12:06:25

Well Ed, after further consideration w/ my doc, im going back to ole trusty paxil for me. It has worked great in the past. There goes my sex life. Does welbutrin help counter the sexual side effects? Although it is terrible for people w/ anxiety i hear. Might have to do the viagra thing, sigh, im only 28.

As far as DP/DR is concerned, i am a frequent visitor of dpselfhelp.com, the biggest community around.

There currently is no treatment for the disorder. Some have had sucess w/ ssri + lamictal, and klonopin helps many.

There is currently a big investigation going on right now, and i know from an inside source that the intention of the surveys, is to get permission to try OPIATE ANTAGONISTS (namely naltrexone)in studies.

I know that mine is anxeity based, as are most. Seems that 50 percent got it after a big panic attack, and the other 50 from drugs. So obviously the brain is dissasociating from the extreme stress. It is on self defense 24/7, everything become a threat. For me w/ DR, the environment feels and seems extremely odd. Huge perceptual shifts.

So although it was anxeity based, doesn't mean that my chemistry hasn't changed in other parts of the brain that ssris can't touch.
So tryin to hang in there til there is an effective treatment out.

Regards,

Brain

 

Re: Lexapro: 10mg vs 20mg. Any more beneficial?? » zeugma

Posted by ed_uk on November 14, 2005, at 12:50:06

In reply to Re: Lexapro: 10mg vs 20mg. Any more beneficial?? » ed_uk, posted by zeugma on November 13, 2005, at 12:06:25

Hi Z :-)

>the dose of perphenazine was way too high

Understatement of the year ;-)

>FWIW, I tolerated perphenazine better than molindone, spoken highly of by some here.

How did you find molindone? Btw, who speaks highly of it? I've never known anyone on babble to take molindone.

What was the lowest dose of perphenazine you ever took? How did you find it?

Kind regards

Ed

 

Re: Lexapro: 10mg vs 20mg. Any more beneficial?? » qbsbrown

Posted by ed_uk on November 14, 2005, at 12:54:05

In reply to Re: Lexapro: 10mg vs 20mg. Any more beneficial??, posted by qbsbrown on November 13, 2005, at 17:04:26

Hi Brian

>Well Ed, after further consideration w/ my doc, im going back to ole trusty paxil for me. It has worked great in the past. There goes my sex life.

I took paroxetine 40mg for a few years. I find 80mg citalopram produces similar benefit to 40mg paroxetine. I do find citalopram somewhat 'milder' though.

>naltrexone

Are you interested in trying naltrexone?

Kind regards

Ed

 

Re: Lexapro: 10mg vs 20mg. Any more beneficial?? » ed_uk

Posted by zeugma on November 16, 2005, at 17:45:15

In reply to Re: Lexapro: 10mg vs 20mg. Any more beneficial?? » zeugma, posted by ed_uk on November 14, 2005, at 12:50:06

> Hi Z :-)


Hi Ed :-)

>
> >the dose of perphenazine was way too high
>
> Understatement of the year ;-)
>
> >FWIW, I tolerated perphenazine better than molindone, spoken highly of by some here.
>
> How did you find molindone? Btw, who speaks highly of it? I've never known anyone on babble to take molindone.
>
Chairman MAO has spoken highly of it. I apparently didn't tolerate molindone at all, as I think I only took a pill or two in the hospital before I was switched to perphenazine. A low dose of perphanazine no doubt is good for my panic attacks, many of which are triggered by severe nausea. Nortriptyline has the same steadying effect on my upper GI system without the EPS or extreme sedation (there's another understatement for you).

> What was the lowest dose of perphenazine you ever took? How did you find it?
>

As implied above, I found an extremely low dose helpful in quelling nausea and panic attacks caused by that. I don't know exactly what the starting dose was.

-z
> Kind regards
>
> Ed

 

Re: Lexapro: 10mg vs 20mg. Any more beneficial?? » zeugma

Posted by ed_uk on November 17, 2005, at 13:26:52

In reply to Re: Lexapro: 10mg vs 20mg. Any more beneficial?? » ed_uk, posted by zeugma on November 16, 2005, at 17:45:15

Hi Z :-)

>Chairman MAO has spoken highly of it.

I don't think he's tried it though has he?

>As implied above, I found an extremely low dose helpful in quelling nausea and panic attacks caused by that.

I think you'd find haloperidol (Haldol) similar but less sedating. You might benefit from taking 0.5mg haloperidol on as 'as required' basis for nausea and panic.

Kind regards

Ed

 

Re: Lexapro: 10mg vs 20mg. Any more beneficial?????? » qbsbrown

Posted by bigcat on November 19, 2005, at 13:57:07

In reply to Lexapro: 10mg vs 20mg. Any more beneficial??????, posted by qbsbrown on October 31, 2005, at 19:15:35

>I have GAD/Depression/PD, but the worst is the racing thoughts, obsessive thoughts, self monitoring, not being able to get out of head.

Would these be considered "classic" OCD symptoms? They seem to strike at the heart of my problems- totally consumed with monitoring the Self. Racing thoughts of negativity, dispair, dread, and self-loathing. Are there meds that are more apt to specifically target these types of symptoms (I would imagine my lethargy and failure of acting/responding "in the moment"
result from these exhausting/all-consuming symptoms. Would you recommend Anafranil, Luvox, a cocktail, anything else? I basically, word for word, have the same symptoms you describe.

 

Re: Lexapro: 10mg vs 20mg. Any more beneficial?????? » bigcat

Posted by ed_uk on November 19, 2005, at 14:09:31

In reply to Re: Lexapro: 10mg vs 20mg. Any more beneficial?????? » qbsbrown, posted by bigcat on November 19, 2005, at 13:57:07

Hi Matt

Is there any chance that you might be suffering from bipolar disorder? Has your pdoc discussed this?

Ed

PS. I'm not suggesting that you're bipolar - I'm just wondering whether your pdoc has 'ruled it out'.

 

Re: Lexapro: 10mg vs 20mg. Any more beneficial??????

Posted by bigcat on November 19, 2005, at 19:51:34

In reply to Re: Lexapro: 10mg vs 20mg. Any more beneficial?????? » bigcat, posted by ed_uk on November 19, 2005, at 14:09:31

> Hi Matt
>
> Is there any chance that you might be suffering from bipolar disorder? Has your pdoc discussed this?
>
> Ed

Hey Ed,

No, bipolar hasn't been ruled out. In fact, I've had hypomanic reactions upon starting a few meds. When Marplan worked (briefly) after four failed trials, I was definately hypomanic for a couple weeks. A high dose of Dexedrine and VERY potent marijuana mixture made me manic undoubtedly. Upon initializing a new med, I sometimes have a fleeting period of being particularly "up".

But I've never had a spontaneous manic episode (they have all been med-induced), and my mood never changes. I'm always down. Different meds just highlight different aspects of my depression, or help me see it in a different, equally painful and frustrating, light. I'm weary of all the psychiatric diagnosis, and am doubtful that "categorizing" my depression would shed much light on how to relieve it. Lithium, Lamictal, Neurontin, and other mood-stabilizers have never brought any anti-depressant effect. (I'm on Lamictal now). I feel the same one day to the next, never "cycle", and don't have "periods" when my mood brightens or I gain energy or anything like that. I almost wish there were some bipolar in me, so at least I'd be taken out of this abyss once in a while. (I'm sure I'd have a whole heap of other, probably worse problems, though).

I'd welcome and be interested in your input. Do you ask because I have "racing thoughts" of negativity? That would be an interesting perspective. I know OCD was the first manifestation of my psych illness (the depression followed a few years later). I have had clairvoyant moments (usually after smoking a bowl), where it seems that obsessing is at the heart of all my suffering. Like qbsbrown phrased so perfectly, "I can't get out of my head." A loud and cluttered head clouds my thinking and doesn't allow me to live "in the moment". I always watch myself vigilantly like I'm on a stage (what qbsbrown referred to as self-monitoring), and can't have an original thought or insight free from this entrapping obsessive cycle. This endless cycle may therefore contribute to my fatigue and anxiety I suppose???

Thanks Bud,
-matt-

 

Re: Lexapro: 10mg vs 20mg. Any more beneficial?????? » bigcat

Posted by Phillipa on November 19, 2005, at 21:03:54

In reply to Re: Lexapro: 10mg vs 20mg. Any more beneficial??????, posted by bigcat on November 19, 2005, at 19:51:34

Matt, are you rj? Did you change your name? Fondly, Phillipa

 

Re: Lexapro: 10mg vs 20mg. Any more beneficial?????? » bigcat

Posted by ed_uk on November 19, 2005, at 22:09:17

In reply to Re: Lexapro: 10mg vs 20mg. Any more beneficial??????, posted by bigcat on November 19, 2005, at 19:51:34

Hi Matt

>No, bipolar hasn't been ruled out. In fact, I've had hypomanic reactions upon starting a few meds. When Marplan worked (briefly) after four failed trials, I was definately hypomanic for a couple weeks.

Certain forms of chronic/recurrent unipolar depression may be 'related' to bipolar disorder.

Have any of your family members been diagnosed with a psych disorder?

>Lithium, Lamictal, Neurontin, and other mood-stabilizers have never brought any anti-depressant effect.

Ever taken Depakote, Tegretol or Trileptal?

>Do you ask because I have "racing thoughts" of negativity?

I was wondering whether your depression could be viewed as a depressive mixed state. Probably not. Just an idea.

>"racing thoughts" of negativity....

Many *different* negative thoughts or *repetitive* negative thoughts on the same theme? What do you mean when you say that your thoughts are 'racing'? The negative thoughts which characterise OCD are intensely repetitive. The racing thoughts which characterise bipolar disorder are much less repetitive ie. the 'flight of ideas'.

Are you physically very agitated?

>I know OCD

What sort of OCD did you suffer from? Were you actually diagnosed with OCD?

>I'm weary of all the psychiatric diagnosis....

It's all very confusing. Diagnosis is sometimes a help, sometimes a hinderance.

Regards

Ed

 

Re: Lexapro: 10mg vs 20mg. Any more beneficial?????? » Phillipa

Posted by ed_uk on November 19, 2005, at 22:10:20

In reply to Re: Lexapro: 10mg vs 20mg. Any more beneficial?????? » bigcat, posted by Phillipa on November 19, 2005, at 21:03:54

>Matt, are you rj? Did you change your name?

No - completely different Matt. There's a lot of Matt's on p-babble :-)

Ed xxxx

 

Re: Lexapro: 10mg vs 20mg. Any more beneficial?????? » ed_uk

Posted by Phillipa on November 19, 2005, at 23:11:53

In reply to Re: Lexapro: 10mg vs 20mg. Any more beneficial?????? » Phillipa, posted by ed_uk on November 19, 2005, at 22:10:20

Ed what are you doing up so late? Love PJ O


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