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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 12 of 12. This is the beginning of the thread.
Posted by Michael Bell on May 1, 2006, at 10:57:23
Although Klonopin and Nardil have been very good for my social anxiety, they don't seem to help with the constant ruminating thoughts and thought patterns. I don't have compulsions, but the ruminations have an obsessive quality. Is there a non-SSRI med or supplement that is known to be effective for reducing ruminating/obsessive thoughts?
Thanks
Posted by ed_uk on May 1, 2006, at 11:33:09
In reply to Is there a non-SSRI that works for ruminations?, posted by Michael Bell on May 1, 2006, at 10:57:23
Can you describe your ruminating thoughts in more detail?
Ed
Posted by Phillipa on May 1, 2006, at 12:50:30
In reply to Re: Is there a non-SSRI that works for ruminations? » Michael Bell, posted by ed_uk on May 1, 2006, at 11:33:09
Are they OCD? Anafranil? Luvox is an SSRI so that's out. Love Phillipa
Posted by Racer on May 1, 2006, at 13:43:19
In reply to Is there a non-SSRI that works for ruminations?, posted by Michael Bell on May 1, 2006, at 10:57:23
Honestly? Maybe not. CBT could be helpful, or any other good psychotherapy, because that is a behavior issue.
BUT
It's also cognitive hyperactivity. So, anything that is prescribed for ADD or ADHD is likely to help. Ritalin helped me ENORMOUSLY for that, although I stopped taking it for adverse effects. Dexedrine is second place, so far. Strattera helped me with depression and Monkey Brain. (Hey, no reason not to make up my own diagnosis, right?)
Hope that helps...
Posted by yxibow on May 1, 2006, at 14:44:29
In reply to Is there a non-SSRI that works for ruminations?, posted by Michael Bell on May 1, 2006, at 10:57:23
> Although Klonopin and Nardil have been very good for my social anxiety, they don't seem to help with the constant ruminating thoughts and thought patterns. I don't have compulsions, but the ruminations have an obsessive quality. Is there a non-SSRI med or supplement that is known to be effective for reducing ruminating/obsessive thoughts?
>
> ThanksCBT would be one answer actually -- learning to cope with what (I have annoying ruminations and thoughts that are antithetical [not part of] my personality, especially when I excercise -- its just part of my OCD) is a lifetime illness, namely OCD. OCD can be overcome, learned to conquer, but it is always with you, save for cingulotomy surgery which could leave you brain deficient.
Sometimes antipsychotics are added ajunctively with SSRIs to improve chances of success in severe OCD cases. Today, that would be small doses of things like Zyprexa or Seroquel. Orap (pimozide), an older antipsychotic, has been an older line treatment for "tics" (Tourette's and other parts of the OC Spectrum complex.)
As for the aforementioned, Strattera would be least anxiety provoking probably to your system than any other stimulant which just might bring it roaring to the forefront.
I assume you've been through the gamut of SSRIs -- Luvox had helped for such things more than any other SSRI I had tried in the past. But it really has to be dosed up beyond its normal dose to like 400 or 450. Of course this depends on the person, Luvox has a wide range of dosing.
But I just realized that you had noted you were talking Nardil so I see why the SSRI category would be contraindicated. Have you thought about other drugs other than MAOIs for social anxiety or did you go through medications short of them for it, because they're sort of the last stage one would pick. I will just assume you have.
I can't say that Anafranil, which is an SRI, would cause a hypertensive crisis or not -- that would then be your only non SSRI drug which had been for a long time a gold standard for OCD.
Other than that, GABA-nergic drugs I guess would be your only bet other than antipsychotic adjunctive to your therapy -- though you are already on Klonopin -- there is the range of AEDs though I dont know of any particularly good for OCD. Neurontin is fairly harmless I guess.
Hope that helps
-- Jay
Posted by Declan on May 1, 2006, at 17:53:30
In reply to Is there a non-SSRI that works for ruminations?, posted by Michael Bell on May 1, 2006, at 10:57:23
As a life long ruminator I have thought it's just something that's part of the human condition and that we have to put up with unless we become enlightened. Of course our brains could be out of whack. It's not that I love my ruminations or anything, but I wouldn't dream of taking an SSRI for mine. Unless they were driving me nuts.
Declan
Posted by linkadge on May 1, 2006, at 21:13:24
In reply to So full of scorpions is my mind, posted by Declan on May 1, 2006, at 17:53:30
Rumination can be bad. It can literally make you feel trapped in your own mind. Rumination can be like a smouldering fire that is never extinguished.
When I am ruminating too much I literally can't hear anything or see anything outside my mind.
Rumination can be positive or negative. I suppose if its constructive thought that gets somewhere its positive.
Anticholinergic medication seem to help my ruminations the most. TCA's would be good for this.
Linkadge
Posted by Michael Bell on May 3, 2006, at 6:39:40
In reply to Re: So full of scorpions is my mind, posted by linkadge on May 1, 2006, at 21:13:24
I'm not sure what the difference, if any, there is between obsessions and ruminations. What I do know is that I ruminate about social phobia and social situations even though I have no anticipatory, or any other type of anxiety in the physical sense. It's the circular thought process that I'm stuck with. I would like to break this cycle, and I'm strongly considering starting CBT along with the appropriate meds. Thanks for the input.
Posted by ed_uk on May 3, 2006, at 10:39:22
In reply to Thanks for the replies... btw, I ruminate about SP, posted by Michael Bell on May 3, 2006, at 6:39:40
Hi M
Doesn't sound OCD-like. You could try an atypical AP but I wouldn't recommend it - too many side effects. The CBT sounds like a good idea.
Ed
Posted by Tony P on May 3, 2006, at 17:27:21
In reply to Is there a non-SSRI that works for ruminations?, posted by Michael Bell on May 1, 2006, at 10:57:23
Serzone (nefazodone) worked well for me for years. It's an SRI but not in the SSRI family. No longer available in Canada but I believe generic may be available in US & elsewhere.
Soma seems to help me. It's prescribed as a muscle relaxant but is closely related to the anxiolytic meprobamate (see some recent posts). It's actually metabolized to meprobamate -- you might call it Meprobamate XR <g>
Tony
Posted by yxibow on May 3, 2006, at 23:06:22
In reply to Re: Is there a non-SSRI that works for ruminations?, posted by Tony P on May 3, 2006, at 17:27:21
> Serzone (nefazodone) worked well for me for years. It's an SRI but not in the SSRI family. No longer available in Canada but I believe generic may be available in US & elsewhere.
Have to be cautious about liver tests with Serzone -- it has a non zero risk of liver disease. Good thing with such is that jaundice usually is well observed before any real harm happens.
> Soma seems to help me. It's prescribed as a muscle relaxant but is closely related to the anxiolytic meprobamate (see some recent posts). It's actually metabolized to meprobamate -- you might call it Meprobamate XR <g>
Soma -- sigh, the medication I cant mix with my mixture. It has additive CNS depression and for some can be as habituating as Miltown (meprobamate).
Posted by addinbc on May 3, 2006, at 23:59:35
In reply to Is there a non-SSRI that works for ruminations?, posted by Michael Bell on May 1, 2006, at 10:57:23
Hi there;
I'm not sure if this has been mentioned yet, but I have depression/anxiety/A.D.D. and I have constant ruminating thoughts too. I found Strattera IMMENSELY helpful for the rumination as it 'quieted' my mind so I could think straight. It might be worth a try. If you do try it, it is a good idea to "start low and go slow" with this med. By the way, it is an SNRI (norepinephrine reuptake inhibitor).
Best wishes.
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