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Dr. Bob is Robert Hsiung, MD,
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Posted by Ljoltof on February 20, 2006, at 14:06:33
In reply to Re: best med for GAD? » Ljoltof, posted by ed_uk on February 20, 2006, at 12:25:50
Hey, thanks for the kind words and I do believe you are correct about the V being better suited to me. I will be here to report on the experiment/experience!
L.
> Hi
>
> I hope you can get off the K altogether. It sounds like the V is a better med for you :)
>
> Ed
Posted by ed_uk on February 20, 2006, at 14:14:22
In reply to Re: best med for GAD? » ed_uk, posted by Ljoltof on February 20, 2006, at 14:06:33
Please do :)
Ed
Posted by corafree on February 20, 2006, at 14:22:38
In reply to Re: best med for GAD? » corafree, posted by ed_uk on February 20, 2006, at 12:28:09
I believe amitriptyline maybe 15-20yrs back for "depression" (hate the word), before accidents. Don't think Pamelor. cf
Posted by ed_uk on February 20, 2006, at 15:31:07
In reply to Re: best med for GAD? » ed_uk, posted by corafree on February 20, 2006, at 14:22:38
Hi Cf
Perhaps you should try it again for your pain.
Ed
Posted by Ljoltof on February 20, 2006, at 22:36:50
In reply to Re: best med for GAD? » Greif, posted by corafree on February 20, 2006, at 4:22:13
Corafree - I have been following your posts on this thread and it hits me hard because I can relate to so much of what you are going through. Here I will inject my thoughts below your quotes.
*these are my ideas / opinions and I am not a healthcare professional of any sort*
>Unfortunately, narcotics work too well for anxiety. That, and >having some extra val so can take 1-1/2 or 2, deviating from >my regimen due to unbearable anxiety, is what is getting me >through this paradox.I agree that narcotics work very well for anxiety. From what I have gathered, a large amount of people with constant/chronic anxiety (aka GAD) also have chronic pain symptoms. Physical pain has been linked to depression and vice versa. I will not ever believe that GAD can exist in a person without depression. It took me a while to face the depression as it's own entity, but looking back and adding it all up leads me to insist that I would not have gotten to the levels of depression I have seen without the GAD causing so much difficulty. Now add in some physical injuries (either before or after GAD/dep. onset) and the chronic pain becomes a major obstacle to everyday life as you very well know.
> I've c-spine and t-spine extruded discs. No meds either than >aforementioned, not PT or epidurals, have helped. Surgery for >a person w/ chronic pain (someone who didn't just get flown in >from a car accident) takes the back seat. Trigger point >injections are helpful; doc's hold those back .. maybe 3x a yr.
Exactly, if an injury isn't a huge event of some sort, that injury is treated as minor - put on the back burner - not followed up on until you call the doctor the point where it looks like you're on a rabid drug hunt. I'm sort of outlining my pain situation here which is delivered via at least 3 head injuries. When these injuries are presented to my gen. physician as the major causes for my chronic back, neck and head pain (numbness in the legs etc etc) there is nothing on file to back these incidents up. That is where it's my fault..in my 2 worst injuries (14yrs old head over handlebars on a bmx bike flying down a hill, entire right side of my face was basically ripped apart, and at 18yrs old victim of a drunken 21yr old jock just out of bootcamp - the tough guy ran up from behind on a side walk punched me across the face knocking me out ..) 1st injury I picked my bike back up after regaining consciousness and somehow rode it back home. I did see my pediatrican a few days later and his first remark is something I'll never forget: "Wow. You are extremely luckily to not have suffered a brain injury." 2nd time I jumped up after being knocked out, for what I'm guessing was about 5secs., and ran towards the guy with blood flowing out of my mouth and nose as my brother was beating the sh1t out of him in the middle of the street - 2 cops grab me just before I get in range to put my boot straight down onto his already bashed in face. Cops ask me if I want the ambulance - everyone I'm with is saying lets get out of here and with my GAD in the picture I could not disagree. Filthy 'marine' got arrested while me and my brother walked away. Most important thing is that both of these injuries involve major force trauma to the head and neck simultaneously.
I have received 0 rx pain pills to this point (mid 20's now) but I have had far too many psychiatric drugs thrown my way to start counting as I write this. Is it just me or is something wrong with that picture?
> Pain & Anxiety .. re: Neurontin and Topomax. I've been on >both and had 'irritating side effects (more w/ Topomax I think)' >so prob' couldn't get to high enough dosage; noted no real >relief. Butttttt, was on Prozac or Eff-XR alongside, and so may >not have been in touch w/ myself.No experience with Neurontin or Topomax. Prozac stole my ability to feel anything at all for almost two years - when I quit it myself. Effexor XR just had me feeling irritated and I got the electricity effect....not a good time.
> I'd like to see read more discussion about Neur and Topo tho', >for anxiety (as well as pain), and the new one, 'supposed to be >better!' ... Lyrica.Lyrica looks to be just the latest cash cow to me. My suggestion for the anxiety and the pain is to add in another 10mg of Valium daily and switch from percocet to an equivalent dose of a slightly different narcotic pain killer?
> Is Ljoltof here, or anyone interested in to follow:
>
> Did you ever have have paradoxical effect (or is it affect?)>w/ .Valium? If yes, was it dc'd or increased?I'm here :) ..and I'll say flat out that I have had a paradoxical effect from Klonopin and every other benzo I've ever tried. I'd wager that effect is the appropriate form in the topic at hand because it is indeed a consequence/result of taking the med. It comes down to how long the effect lasts, the frequency, and the turbulance it causes you. I suspect the narcotic (especially percocet with that very short half life) is aiding in making this harder for you.
> Has anyone had a scrip of 10mg 3x a day increased because >anxiety was heightening? Did the increase help, on its own, >standing alone from any other benzo, for at least couple yrs?I could be taking my 10mg tabs 3x, but I have been only taking 2 a day - as I've been fairly comfortable with my anxiety.
> *** I think someone here is on val and klon? I'm wondering if >the klon protects one from a paradoxical reaction to val; like a >safety valve to catch anxiety overflow?! ***I understand what you're getting at and yes I am on both but it is only as a vehicle to say 'goodbye' to klonopin. Having 2 benzo's going simultaneously is not viewed as a permanent option for me.
> I definitely vote benzos best medicinal relief
> for anxiety. For me .. Ativan not strong enough .. Xanax >quickly here and gone .. Klonopin is a snake in the grass, but >became obvious was very effective .. Valium saved my life.In the short term, or for 'as needed' I'd be voting for benzo's right with you. However, I have found normal doses of narcotic pain pills to be the ultimate GAD/Social Anx. destroyer. Some of the finest days of my life were provided by vicodin, which were rx'd due to an infection in my throat.
> Now I'm in 'paradox' and trying to get an idea of a >hypothetical med plan that I can present to a P in a way that >feels as if I just 'reminded them of an idea they'd not yet >brought to the table'. I need to get another P soon, like >Tuesday.
I'm in a similar situation as my chronic pain gets harder to manage almost every day...I mean should someone who has been taking benzo's and amphetamines for *years* with no substance abuse history and no criminal record really be denied at least a small script of pain pills?
> Out of space and time .. sooo exhausted. Hope some of >above helps one, some, or I, isn't written carelessly. Dropping >off ... bw, cfWell there's my attempt at a decent but not too long of post..haha. Sorry if it's hard to read, I usually do proof-read but I'm spent right now!
All of this is so complicated, but just hold on and reach out...myself and plenty of others are right there with you.
Peace and best wishes for all.
-Ljoltof
Posted by corafree on February 21, 2006, at 4:11:01
In reply to Re: best med for GAD? » corafree, posted by ed_uk on February 20, 2006, at 15:31:07
Ed ... think Elavil or Pamelor? Or does anyone else have experience w/ either? bestwishes, cf
Posted by corafree on February 21, 2006, at 4:43:11
In reply to Re: best med for GAD? » corafree, posted by Ljoltof on February 20, 2006, at 22:36:50
L -
I had police records of spouse tossing me about like a ragdoll, but PCP just ordered MRIs for a definite dx after I told him of the horrible pain.
When the injuries occurred, I didn't feel the 'real bad' pain right away, .. ya' know just sore a few days.
As aged, those injuries became more prominent, and left untreated, nerve rubbing against bone, pretty soon more damage done, and then it hit me hard approx 10yrs later. I recall when just wore warm wraps around my neck and took Excedrin. Forgive me if sharing this may scare you; may not happen w/ you. Also docs may be withholding re: your age, possibility pain temporary, or thinking 'let's wait until it gets worse .. he's young, strong, too early to start narcotics'.
I had no idea it would help anxiety until I first took one (duh), and don't think my psych dx was GAD then.
Darovocet became ineffective. Morphine yuch! I think Vicodin should be provided for break-though. Regimen w/ break-through is continue reg med as prescribed and another on top of it until it subsides.
So good to hear that the paradox can come and go; believe that's what you meant. I was hoping so, ... like break-through pain! Too bad my doc didn't help me or at least tell me this.
Your post was good and I printed it. I will look at again tomorrow sometime for reference and 'get back to ya' if I've missed something.
Some heart meds can lessen anxiety greatly also.
Tks for taking time and thought to help me.
bestwishes, cf
Posted by corafree on February 21, 2006, at 10:29:48
In reply to Re: best med for GAD? » corafree, posted by Ljoltof on February 20, 2006, at 22:36:50
L
My understanding that paradox can come and go; correct?
Would you pls explain/dispute the following re: your following statements?
>In my case, physical I will not ever believe that GAD can exist in a person without depression. It took me a while to face the depression as it's own entity, but looking back and adding it all up leads me to insist that I would not have gotten to the levels of depression I have seen without the GAD causing so much difficulty. Now add in some physical injuries (either before or after GAD/dep. onset) and the chronic pain becomes a major obstacle to everyday life as you very well know.<
Have you ever had 'a wonderful thing' occur in your life, alongside successful GAD treatment, and felt lifting of your depression? I have experienced the aforementioned. Does that mean I do not have GAD? I'd think that would disprove that depression always co-exists alongside GAD.
>I have received 0 rx pain pills to this point (mid 20's now) but I have had far too many psychiatric drugs thrown my way to start counting as I write this. Is it just me or is something wrong with that picture?<Are you saying docs don't validate physical pain because you are on psych meds, or (You can yell @ me if wrong!:) are you invalidating your pain for the same reason?
I'm slow on the uptake - overwhelmed right now'! Just called re: counseling, heard back; short staffed, so no! Ohhh, I'm feeling so tiny!! Need to talk very badly.
bestwishes, cf
Posted by ed_uk on February 21, 2006, at 14:19:59
In reply to Re: best med for GAD? » ed_uk, posted by corafree on February 21, 2006, at 4:11:01
Hi CF
Yes, both Elavil and Pamelor can be effective for chronic pain. Amitriptyline (Elavil) is normally taken as a single dose in the evening.
Ed x
Posted by corafree on February 21, 2006, at 14:39:53
In reply to Re: best med for GAD? » corafree, posted by ed_uk on February 21, 2006, at 14:19:59
Hi Ed! Are they both SSRIs? I do have IBS and am lactose intolerant.
tks and bw, cf
Posted by ed_uk on February 21, 2006, at 14:43:34
In reply to Re: best med for GAD? » ed_uk, posted by corafree on February 21, 2006, at 14:39:53
Hi CF
No, they are not SSRIs, they are tricyclic antidepressants. Amitriptyline (Elavil) and nortriptyline (Pamelor) can relieve the pain and diarrhea of IBS, but they do tend to cause constipation at high doses.
Ed
Posted by corafree on February 21, 2006, at 14:48:00
In reply to Re: best med for GAD? » corafree, posted by Phillipa on February 17, 2006, at 22:41:38
Me too 'my very good friend'!
I am seeing my new case manager today. I'll await excusing myself from P assigned to, until after visit with her and filling my Valium prescription.
!!! QUESTION FOR ALL !!!
Has anyone been on a dosage of Valium 10mg 3x a day and ever had to have it increased or replaced by something stronger? I would greatly appreciate anyone who is able to share, if they have done the above.
bestwishesPhillipa&All, cf
Posted by Ljoltof on February 22, 2006, at 12:20:59
In reply to Re: best med for GAD? » Phillipa, posted by corafree on February 21, 2006, at 14:48:00
Corafree! I had typed out a long and thought out response yesterday to the questions you had asked and somehow when I went to post everything was gone....grrrr! It was probably due to me using Safari (apple user here) ..I will try to re-do the post, except this time writing down on paper then typing. I can type very fast but over the years my ability to compose a message on the fly without getting too lengthy has diminished. See what I mean? Hah.
I'm glad you're getting some fresh help, I knew it'd happen. I have been on 10mg x 3/day Valium. My current script is written this way. However I take 10mg x 2/day right now because I'm doing the Klonopin taper. I will in less than a week be cutting another .5mg Klonopin down and taking probably 30-40mg V daily. My suggestion is to try for an increase in your Valium script. I really think Valium is a strong benzo, it's just that it's not as "compressed" as the other benzo's in it's composition. Plenty of people take between 2-4mg Klonopin daily. Using the common equivalency chart, 4mg K = 80mg Valium. I, for one am not afraid of big numbers in this case!
-Lj
> Me too 'my very good friend'!
>
> I am seeing my new case manager today. I'll await excusing myself from P assigned to, until after visit with her and filling my Valium prescription.
>
> !!! QUESTION FOR ALL !!!
>
> Has anyone been on a dosage of Valium 10mg 3x a day and ever had to have it increased or replaced by something stronger? I would greatly appreciate anyone who is able to share, if they have done the above.
>
> bestwishesPhillipa&All, cf
Posted by linkadge on February 22, 2006, at 13:31:43
In reply to Re: best med for GAD? » corafree, posted by Ljoltof on February 20, 2006, at 22:36:50
"I will not ever believe that GAD can exist in a person without depression. "
Based on my own life experiences, I think GAD can happen completely independantly of depression.
Right now, I still have some bad GAD, but my depressive symtpoms left me a long while back.
Linkadge
Posted by corafree on February 24, 2006, at 11:27:06
In reply to Re: best med for GAD? » corafree, posted by Ljoltof on February 22, 2006, at 12:20:59
L ..
I've had that happen too! I feel like, "I waste too much time on my own! Now my 'supposed to be devoted to me computer' is wasting more of it! (Makes ya' wanna take something out on something! Need a 'blow up hit me' stress gadget!)
Good to know that 40mg a day of Val is not out in left field; can be an acceptable dosage in strong anxiety. That's what I'm understanding.
Why did you and P decide to pull out the Klonopin? Oh, and can you explain the following in a bit more 'layman language' pls L?
I really think Valium is a strong benzo, it's just that it's not as "compressed" as the other benzo's in it's composition. Plenty of people take between 2-4mg Klonopin daily. Using the common equivalency chart, 4mg K = 80mg Valium. I, for one am not afraid of big numbers in this case!
tkssomuchbestwishes,cf Ha!
Posted by corafree on February 24, 2006, at 11:30:53
In reply to Re: best med for GAD? » corafree, posted by Ljoltof on February 22, 2006, at 12:20:59
Apologize for not copying and pasting your para' in proper < > or > <. cf
Posted by corafree on February 24, 2006, at 11:42:29
In reply to Re: best med for GAD? » corafree, posted by ed_uk on February 21, 2006, at 14:19:59
Ed - Haven't seen a P yet. I was asked what pdrugs I would or would not prefer to try or take again? I put Elavil and Pamelor on 'maybe try' list (tks to you). Are these drugs in the original class .. SSRIs? No .. what class? A P told me once that they don't prescribe much re: dietary restrictions. (Dejavu?) I also put 'Abilify' and 'Lyrica' on the 'maybe try' list. Pls respond if can. Got to get a new P now. Will begin work on that tomorrow. tkscf
Posted by Phillipa on February 24, 2006, at 19:04:39
In reply to Re: best med for GAD? » ed_uk, posted by corafree on February 24, 2006, at 11:42:29
Elavil and Pamelor are TCA's tricyclics. Pamelor definitely put me out one night and I felt like I was melted in the bed. Last and first time I ever took it and it was only l0mg. Fondly, Phillipa
Posted by corafree on February 27, 2006, at 9:08:03
In reply to Re: best med for GAD? » corafree, posted by Phillipa on February 24, 2006, at 19:04:39
I had a similar reaction to Elavil, but thought maybe 'brain chemistry' changed since then, approx. 15yrs back maybe. Never on Pamelor as far as can recall. Just thought 'worth a shot'. I wasn't sure what all to say when asked which meds I would take! I'd never had that question put to me before!? I'd, of course, d.c. anything that disagreed me w/ too rapidly.
tksforsharing, bestwishes cf
Posted by corafree on February 27, 2006, at 9:25:17
In reply to Re: best med for GAD? » Phillipa, posted by corafree on February 27, 2006, at 9:08:03
I've had bad break-through pain .. my back injuries. Been on med on-top-of-regular med.
After meeting w/ new case manager here in particular county system, I'm anxiously awaiting some HELP! Feel like I'm 'knocking on heaven's door' (don't want to go though tho') and having thoughts re: my own mortality.
They seem to be 'putting me' in the 'personality disorder' slot out here, whereas when left past REBA, they had me in the 'GAD' slot. (I'm in a large manilla envelope .. ha!)
Don't know why posting this for sure; think maybe just need know friends here 'have my back', so to speak.
These pain meds complicate my clarity, and hence my capability of being pro-active.
bw, cf
Posted by ed_uk on February 27, 2006, at 13:23:34
In reply to Re: best med for GAD? » ed_uk, posted by corafree on February 24, 2006, at 11:42:29
Hi CF
Elavil and Pamelor are not SSRIs, they belong to a group of meds called the tricyclics.
>A P told me once that they don't prescribe much re: dietary restrictions.
There are no dietary restritions with Elavil or Pamelor, you're thinking of a different class of drugs called the MAOIs.
What dose of Percocet are you taking at the moment?
Ed
Posted by corafree on February 27, 2006, at 14:53:41
In reply to Re: best med for GAD? » corafree, posted by ed_uk on February 27, 2006, at 13:23:34
Perc 10/650 3x a day, and when have break-through pain .. Vicodin 10mg on top. The BT pain usually lasts only a couple days, but this is a longer stint.
Am fine on the Perc 10/650 3x a day, but when take the Vicodin, my behavior is off .. get a "slam door kind of feeling, or an 'angry sort of feeling', not dangerous or anything, just can be short' w/ objects, people, i.e., "Didn't you get it the first time I said it?" Don't care for the Vicodin, but don't want to take morphine.
My anxiety 'stills' beneath the narcotics. Well, you know that, I think.
Awaiting too many, 'Can't the government get anything straight?', phone calls. This MOVE has turned my 'usage of every assistance program out there' upside down. I lost a telephone assistance program and learned I can never apply again in my lifetime! Crazy!
Tks for any input if wish, cf
Posted by ed_uk on February 27, 2006, at 17:23:16
In reply to Re: best med for GAD? » ed_uk, posted by corafree on February 27, 2006, at 14:53:41
Hi CF
Taking Vicodin on top of Percocet probably isn't a good idea, you'd be better off taking a higher dose of Percocet eg. 10/650 four times a day instead of three times a day.
Remember not to exceed the maximum dose of acetaminophen, since both Percocet and Vicodin contain acetaminophen.
Ed
Posted by corafree on February 27, 2006, at 18:48:12
In reply to Re: best med for GAD? » corafree, posted by ed_uk on February 27, 2006, at 17:23:16
Ed -
Yes you're right. But .. my PCP won't allow me to take 4x Perc.
I just awakened from nap and it is gone .. now if I'm really careful the rest of the eve', it should stay away.
I have gone to quite a few pain docs that say they'll not prescribe. That's an alley I'm not finished going down tho'. My prob is again $.
Awaited to hear from DES all day and no response from a supervisor that said she would check to see if I was entitled to a 'spin down'; med $ by way of food stamps for those in 'catch-22' area of our wonderful 'system'.
(I just went to kitchen .. couldn't remember the two words - spin down - .. recall easier if take mind off a minute. There I spilled ice cubes and chased them all over the room .. they're shaped aerodynamically, and when you try to grab one they fly away .. off to a great start!) bw, cf
Posted by chess on February 27, 2006, at 18:54:32
In reply to Re: best med for GAD? » ed_uk, posted by corafree on February 27, 2006, at 18:48:12
anyone ever try xanax-xr compared to regular xanax?
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