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Dr. Bob is Robert Hsiung, MD,
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Posted by sdb on February 20, 2006, at 15:44:36
In reply to Confused regarding choice of med presecribed, posted by Op27Nr2 on February 18, 2006, at 12:20:09
Hi Op27Nr2,
ssris are a treatment for GAD but even these drugs don't work for everybody or the sideeffects are not tolerable. I personally know a case of severe mania (closed department of psy-hospital, hereditary illness in family) completely cured with abilify. She's travelling around with her son now. Abilify against anxiety I dont know examples.
Buspirone, mirtazapine or even a benzo (prazepam, ketazolam) are other options. If the anxiety is more "social" related clonazepam is one of the most effective substance.
Choosing a substance needs good anamnesis and exact diagnosis when possible e.g. which subtype of anxiety you have, maybe underlying depression or bad life experiences.~sdb
p.s. Op27Nr2 from which composer possibly from yourself (?) :-)
Posted by Op27Nr2 on February 21, 2006, at 0:06:28
In reply to Re: Confused regarding choice of med presecribed, posted by sdb on February 20, 2006, at 15:44:36
sdb,
Us musicians - we're a weird, errrrr ummmm eccentric bunch. I played the third movement to Beethoven's Op27, #2 Sonata (among other pieces) for my senior recital in high school. It was a very special performance for me, as it was the last time my mother attended my performances while she was still alive.
The anxiety I experience is not socially-related. It's really hard to explain what I feel. Sometimes I wish I could meet someone that can understand this anxiety I feel. Basically I have relatively benign everyday life occurrances or thoughts that, for whatever reason, trigger an anxious response. Going to traffic court? I'm going to end up with a felony on my record for the rest of my life. Stopping for gas on my way to work? I'm going to get fired for being late. Eating that last morsel of food on my plate? I'm going to end up morbidly obese for the rest of my life.
Do you see how irrational my thought process is? And that was just a VERY small sample of what goes on in my head during the course of my everyday life. There's so much more to this than I can articulate in words on here.
My worrying about everything totally consumes me to the point where I avoid doing the things I need to do on a daily basis. Perhaps this, in fact, *IS* a form of social phobia. I don't know. Whatever it is, I wish I could just get over it.
Posted by Greif on February 21, 2006, at 13:10:07
In reply to Re: Confused regarding choice of med presecribed, posted by Op27Nr2 on February 21, 2006, at 0:06:28
Have you tried beta blocker proprananol...good for performance anxiety. I ahve GAD and the AP I have tried either turn me into zombie (zyprexa) or send me into orbit. I would see a pshchologist and get evaluation (MMPI etc) and get advice. Psychologists have abandonded the behavioral model and most agree with medical model along with psychotherapy. Otherwise prepare yourself for testing many meds until you find the right one.
Posted by sdb on February 22, 2006, at 17:59:29
In reply to Re: Confused regarding choice of med presecribed, posted by Op27Nr2 on February 21, 2006, at 0:06:28
Hi op27Nr2,
I think it's pretty nice you're playing the op27Nr2 Sonata. Not everybody is able to do that :-)
I can understand your problems. I personally think that it can be difficult to recommend a drug or something else through the forum. If you read other posts you will find probably an option which could be appropriate and you can discuss about with a therapist.
What I can recommend is finding an understandable psychiatrist you can talk with about everything eg. your problem now but also about your past, childhood, youth and so on.
Your therapist need to have a "wave frequency" you can understand, interpret.
For me, such a short talking therapy was pretty good. Maybe I will resume this therapy soon. I stopped because of lack of time. I've found out that there were some things in my life which probably have some influence just until now but I was not aware first (I could not walk 3 years during my childhood). It can be very difficult to analyze yourself without a help from somebody else. This is only my opinion maybe there will be others sharing their experiences with you.Good luck
sdb
Posted by Op27Nr2 on February 24, 2006, at 12:58:06
In reply to Abilify for Anxiety?, posted by Op27Nr2 on February 18, 2006, at 16:40:50
Thanks so much for all of those who took the time to respond to my post. I wish the people I encounter on a daily basis were as compassionate as you all are.
I went to the health food store and got myself an amino supplement.
I called my very first doctor back (the temporary one), and he was more than willing to draw up a script for Clonazepam 1MG. I'll try this out until I see my second opinion specialist next month.
Has Welbutrin (sp?) ever been prescribed to treat anxiety? I am interested in it because of the desirable side effects people report experiencing on it.
Posted by Phillipa on February 24, 2006, at 19:06:29
In reply to Re: Confused regarding choice - op27Nr2, posted by sdb on February 22, 2006, at 17:59:29
Wellbutrin is stimulating. Fondly, Phillipa
Posted by Op27Nr2 on February 24, 2006, at 19:46:32
In reply to Re: Confused regarding choice - op27Nr2 » sdb, posted by Phillipa on February 24, 2006, at 19:06:29
Posted by linkadge on February 26, 2006, at 9:53:28
In reply to stimulating = bad for anxiety? (nm), posted by Op27Nr2 on February 24, 2006, at 19:46:32
Wellbutrin is generally NOT good for anxiety. Of all the antidepressants sometimes prescribed in mood disorders, Wellbutrin is not among them. Its profile is similar to that of a stimulant. So if coffee affects your anxiety negatively then, wellbutrin would prob be a bad choice.
Hey, I play the piano too. If you're really intensly into piano, you may want to avoid the antipsychotics alltogether. Both risperdal and zyrpexa made it difficult for me to move my fingers. The whole class can cause muscle stiffness and rigidity. (Thats sure going to be problematic when you get to the Third movement bar 76.)
You may want to try SJW if you have not already. It helped my anxiety and actually had a positive impact on my playing.
There are so many different supplements available to help anxiety, literally dozens, some better than others. The pharmacudicals may be worth a try, (I've certainly been on them all), but their side effects can be burdonsome.
Linkadge
Posted by sdb on February 26, 2006, at 19:57:27
In reply to Re: stimulating = bad for anxiety?, posted by linkadge on February 26, 2006, at 9:53:28
Hi altogether,
Wellbutrin is more against depression. It activates, perhaps agitates you thus having unpleasant effects similar to coffein being more nervous. Trazodone, Wellbutrin (bupropion), Remeron (mirtazapine) and Buspar (buspirone) are the meds without or even with pro influence relating to sexual performance (libido, arousal);
common SSRIS will cause problems.Klonopin (clonazepam) actually a antiseizure med is one of the strongest antipanic med often used for social phobia and sometimes in bipolar disorder. Sometimes clonazepam can cause sx sideffects too. Xanax XR is an antipanic med, some people have only sedating effects other people even antidepressant effects.
link: >>SJW-It helped my anxiety and actually had a positive impact on my playingThats interesting (!). How do you mean positive impact? SJW good for piano skills but weak antidepressant?
I like Richter and Gould interpretations. Bye the way, Gould had a unbelievable drug record from allopurinol and so on to propranolol, diazepam. He took many meds available that time starting very young. Richter was said to drink too much alcohol sometimes but understandable what things happened during his life. Some docs attributed to Gould hypochondria, avoidance personality, obsessive disorder and to Richter bipolar disorder.
Posted by ed_uk on February 27, 2006, at 13:27:37
In reply to Re: stimulating = bad for anxiety? to-Op27Nr2-link, posted by sdb on February 26, 2006, at 19:57:27
Hi S
When I used to play in school concerts, I always needed 10mg diazepam (Valium) an hour before. It wasn't enough though, 20mg might have been better. I did try 15mg for one concert but that wasn't enough either. Propranolol (Inderal) was useless on its own but it did relieve tremor when I took it in combination with diazepam.
Ed
Posted by linkadge on February 27, 2006, at 15:25:38
In reply to Re: stimulating = bad for anxiety? to-Op27Nr2-link, posted by sdb on February 26, 2006, at 19:57:27
I read somewhere that hypercin (or maybe it was hyperforin) was a better antidementia agent than antidepressant.
But for me, SJW had a slight motor activating effect. I felt like my movement was a little more limber, as I tend to get stiff very easily.
Linkadge
Posted by platinumbride on February 27, 2006, at 15:46:59
In reply to stimulating = bad for anxiety? (nm), posted by Op27Nr2 on February 24, 2006, at 19:46:32
fwiw:
My sister's doc upped her abilify when she found that she was very anxious recently.
It helped her immensely to have those extra 5 mgs. She is Bipolar I.
I take abilify for bipolarII. It has been great for depression.
I have anxiety as it is. Today my doc gave me cogentin for agitation that the abilify is causing - well, really akithisia.I bet that, inn general, abilify can be helpful as long as there is a willingness to try other agents for agitation/akithisia.
Diane
Posted by sdb on February 27, 2006, at 16:26:27
In reply to Re: stimulating = bad for anxiety? to-Op27Nr2-link, posted by linkadge on February 27, 2006, at 15:25:38
Link, did the SJW help for you a little and for what?-The effectiveness of SJW is still in question. There are some controversial german studies with superior results for SJW compared to SSRIS especially in the aspect of anxiety.
ed, I did not know that you play the piano. You should send me a studio record :-) I dont know if Gould took drugs for a performance. Actually unbelievable after hearing his many studio- or rare life records. But its well known that he always had a glass of pills in his handbag or many glasses in the washing room in the hotel chamber. Somebody asked him: "Do you really take this?"-answer: Not all at once. Gould was a single child isolated from school and society from his mum and he was of course genius in a way; "genius" an attribute which is controversial, relative.
Posted by ed_uk on February 27, 2006, at 17:25:37
In reply to stimulating = bad for anxiety? to-Op27Nr2-link-ed, posted by sdb on February 27, 2006, at 16:26:27
Hi S
I don't play the piano - well I can play an easy tune! I only ever played woodwind instruments in school concerts, I was never a good musician!
Ed
Posted by sdb on February 27, 2006, at 17:48:56
In reply to Re: stimulating = bad for anxiety? to-Op27Nr2-link-ed » sdb, posted by ed_uk on February 27, 2006, at 17:25:37
>>- well I can play an easy tune!
nice playing music isn't it?- it does not matter if its difficult or not.
>>I only ever played woodwind instruments
I like woodwind. There is many beautiful woodwind music of Venetian composers. When I was a child I took a woodwind with me while wandering in nature.
>>I was never a good musician
Maybe yes or maybe you are wrong. "good" isn't a precise measure of value.s
Posted by linkadge on February 28, 2006, at 9:04:51
In reply to stimulating = bad for anxiety? to-Op27Nr2-link-ed, posted by sdb on February 27, 2006, at 16:26:27
This is it. SJW has been undervalued in my oppinion. It can be a usefull herb.
There are more than just German studies. Pfizer did a study that found their Kira extract of SJW better than Zoloft.
I was using SJW mainly for anxiety. It was a good anxiolitic, and as far as work/shool impairment went, it was much better than a benzo or an SSRI.
LinkadgeLinkadge
Posted by sdb on February 28, 2006, at 11:54:31
In reply to Re: stimulating = bad for anxiety? to-Op27Nr2-link-ed, posted by linkadge on February 28, 2006, at 9:04:51
Link,
It's good you had some success with SJW even better than some SSRIS.
How much was your dosage daily? When did it "kick in" - normally it is said to be a long time. I personally remain to be sceptic concerning SJW.
There are too many variables left open. For example: When do I plant the SJW, when do I pick the SJW, the weather is changing every year and the ground and its concentration of nutrients too. It's a mix of different substances which only works together.
~sdb
Posted by sdb on February 28, 2006, at 18:06:25
In reply to Re: stimulating = bad for anxiety? to-Op27Nr2-link-ed, posted by sdb on February 28, 2006, at 11:54:31
link,
After experiments with a standardized extract by a pharmacology institute it was a fact that sjw increases serotonin very effectively in synaptic clefts. As efficient compared with ssris. I think that sjw can help after reading some studies but I am worried about consistency. Do you really wean off sjw only because of the sideeffects you mentioned?
~sdb
Posted by sdb on February 28, 2006, at 18:15:08
In reply to Re: sjw compared to ssris }} link, posted by sdb on February 28, 2006, at 18:06:25
PMID: 11518078
Posted by linkadge on March 1, 2006, at 16:05:05
In reply to Re: stimulating = bad for anxiety? to-Op27Nr2-link-ed, posted by sdb on February 28, 2006, at 11:54:31
If you take it as a treatment for depression, you need to buy a standardized extract.
Linkadge
Posted by linkadge on March 1, 2006, at 16:06:50
In reply to Re: sjw compared to ssris }} link, posted by sdb on February 28, 2006, at 18:06:25
Both hyperforin and hypercin have effects on monoamine uptake. I think that hyperforin inhibits NE,SE,DE to similar extends.
I felt at effect at 600mg of a standardized extract per day.
Linkadge
Posted by sdb on March 1, 2006, at 16:29:09
In reply to Re: sjw compared to ssris }} link, posted by linkadge on March 1, 2006, at 16:06:50
Thanks for your info, linkadge.
Was 600mg the same dosage when the serotonin syndrome occurred? -600mg isn't that much.
There are SJW tablets up to 900mg sold.
Its quite interesting you had the serotonin syndrome because other people can easily tolerate some thousand mg of SJW - actually a big therapeutical width.http://www.dr-bob.org/babble/alter/20060130/msgs/614708.html
~sdb
Posted by linkadge on March 1, 2006, at 19:54:45
In reply to Re: sjw compared to ssris }} link, posted by linkadge on March 1, 2006, at 16:06:50
The general recomended dose for depression is 900mg x 3 times per day. I felt an antidepressant effect at 600mg but didn't start to have adverse effects till many months on somewhere between 900-1200mg.
Linkadge
Posted by Op27Nr2 on April 2, 2006, at 16:15:54
In reply to Confused regarding choice of med presecribed, posted by Op27Nr2 on February 18, 2006, at 12:20:09
Hello All,
Came back from a new doctor yesterday, whom I explained everything I've posted originally. She was a bit confused as the the reasoning behind Md#2 starting me on Abilify.
After explaining to my newest doctor (Md#3) that I have been unable to tolerate SSRIs I've been prescribed before, she went ahead and is starting me on Lexapro. I am very prone to nausea, concerned about sexual side effects and am adamant about avoiding medication that will cause weight gain. I'm not sure how much of an incentive she had to "push" Lexapro as much as she did, but she was very confident this will help me more than anything I've tried before.
So my Xanax and Abilify will go in the trash. I'm hoping that Lexapro will be my saving grace. I will post more about my experience with this medication.
Again, I thank everyone who gave such wonderful input and all of your kind words of encouragement.
Posted by Op27Nr2 on April 2, 2006, at 16:19:57
In reply to Re: Confused regarding choice of med presecribed, posted by Op27Nr2 on April 2, 2006, at 16:15:54
Oh one more thing - I do understand that Lexapro is an SSRI. Md#3 said it was the "most advanced" and the "most selective" of any medication in the SSRI family. She believes that those reasons (among others probably too technical for the average person) will contribute to my success on the drug and decrease the chances of the side effects affecting me.
This is the end of the thread.
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