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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 4 of 4. This is the beginning of the thread.
Posted by alwaysthinking on August 25, 2007, at 22:39:14
I've been on various TCAS/SSRIs for years for OCD and panic.. after 80 lbs of weight gain, apathy, no sex life, and just getting sick and tired of the whole debacle, I safely tapered of zoloft (slowly and steadily.) I've been taking 15 MG of Valium a day, and now that I don't have the SSRI "cushion" so to speak, the anxiety monster has been creeping back into my life slowly but surely (sorry... trying to interject a little humor there...) My concerns are the dose. Is 15 MG daily a high dose? Should I talk to my pdoc about going up to 20 MG instead, or trying a different? Yes, I admit that i AM afraid of benozs (how can one not be with all the horror stories out there??) but I've exhausted most other options. I have to be a functional human being. I have obligations to meet (work, grad school, bills to be paid...) I just can't be a non-functional person because of anxiety/OCD. I know that within the next few years they are going to be exploring glutatmate modulators for OCD... Do I just try to rough it out for a while and see what happens? I'd ask to try something experimental or off-label, but I'm uninsured right now... I'm just not sure what to do. The SSRIs are not an option for me. I was pre-diabetic towards the end, and my body is now riddled with stretch marks and scars from the rapid weight gain. I started off at a healthy 145 when beginning the WHOLE gamut of SSRIs (you name it I've tried it) and ended up over 200 lbs. I'm sorry, but that is UNACCEPTABLE. Any suggestions would be greatly appreciated.
Posted by Phillipa on August 25, 2007, at 23:22:11
In reply to The right benzo/dosage?, posted by alwaysthinking on August 25, 2007, at 22:39:14
I understand your concern seems there are horror stories on all meds. I can only speak for myself but it's almost 40 years a long time and still at the same dose of valium. Over the years maybe for a few years ativan when new, the xanax when new, klonopin depressed me greately, back on valium well it's 20mg going down to l5 mg no problem gave up xanax in one day only .5 but no problem for me. I'd try one and make sure your dose doesn't escalate never made me "high". Now that's just me. Good luck in whatever you decide. Phillipa
Posted by Fivefires on August 27, 2007, at 12:32:04
In reply to The right benzo/dosage?, posted by alwaysthinking on August 25, 2007, at 22:39:14
> I've been on various TCAS/SSRIs for years for OCD and panic.. after 80 lbs of weight gain, apathy, no sex life, and just getting sick and tired of the whole debacle, I safely tapered of zoloft (slowly and steadily.)>
Ya' know, for me, anxiety preceded depression in my life. I don't hear a lot of people say this. Can you say which came first for you? Think I just started saying I was depressed because that's the pdoc said was the reason for my anxiety.(?) But, truly, the cart was put before the horse, the depression was put before the anxiety, and it wasn't depression which caused my anxiety. It was fear. It wasn't depression.
Until a week ago, I've been on a benzo and levothyroxine only. I've been alright, but big life issues have saddened me. The first SSRI ever took 'increased my anxiety'! That's when I began Xanax. It was the same w/ all SSRIs. I was on an TCA and a benzo for a short stint a year or so ago and didn't feel it was helpful for either depression or anxiety. Something was missing I think or something was being missed.
> I've been taking 15 MG of Valium a day, and now that I don't have the SSRI "cushion" so to speak, the anxiety monster has been creeping back into my life slowly but surely (sorry... trying to interject a little humor there...) My concerns are the dose. Is 15 MG daily a high dose?>
A lot of people will tell you yes, but my anxiety nearly killed me. For me, it is now a very fearful monster. I had a central nervous system breakdown, NOT a nervous breakdown. It followed the cold turkey (I didn't object as Klonopin felt like it was doing nothing. I was akin to Xanax.) of Klonopin. I don't know how else to put it, other than central nervous system, w/o giving the impression 'I just went crazy'. It was very physical and the only crazy thing that happened was hyperventilating left untreated causing pressure in my head. It began w/ a long loud crying jag. Then hyperventilating set in. I made my way into a hospital as my body just collapsed from beneath me. Someone else who went through this described difficulty just bringing food to their mouth w/ a utensil, and so did I. My body was shutting down as if I were 100y/o. I was on a psych ward w/ all suicide attempts, and nurses weren't even monitoring my BP. I almost fell due to 'I think it's called hypotension', saw the floor begin to go out from under me, screamed for help, as if had fallen could have hit my head on the grey cement floor beneath me and maybe ended up spending the rest of my life shuffling on grey cement floor!
Anyway, the two pdocs gave me Valium and I did a 180. And there was no problem w/ my cognitive thinking. Whatever bit of it was slipping away w/ the untreated hyperventilating, was back!!!
>Should I talk to my pdoc about going up to 20 MG instead, or trying a different? >
If you're unable to take care of your normal daily activities, or are having to ask someone else to do everything for you, I'd do so. After being on Valium for a year, I switched to Xanax. My thinking was Xanax was more activating. But, at this point, I'm on the fence a bit re: this. It's hard for me to differentiate here due to some significant life changes at the times on one or the other.
>Yes, I admit that i AM afraid of benozs (how can one not be with all the horror stories out there??) but I've exhausted most other options.>
What horror stories? Maybe horror stories like Effexor-XR? It was the best AD I ever took. Maybe you have considered the SNRIs.
There's been nothing horrific occur in my life due to benzos, but there has been, due to the lack of them.
>I have to be a functional human being. I have obligations to meet (work, grad school, bills to be paid...) I just can't be a non-functional person because of anxiety/OCD. I know that within the next few years they are going to be exploring glutatmate modulators for OCD>
Very interesting. I'll have to write this one down.
>Do I just try to rough it out for a while and see what happens?>
Do you have someone to help you in your life, i.e. take you to the doc when needed?
>I'd ask to try something experimental or off-label, but I'm uninsured right now... I'm just not sure what to do.>
Hmmm. Wouldn't think you'd have to be insured to try something experimental. Sounds scary, but there are a lot of 'trials' where I live. So sorry about uninsured. Can you get samples?
>The SSRIs are not an option for me.>
I hear ya'!
>I was pre-diabetic towards the end, and my body is now riddled with stretch marks and scars from the rapid weight gain. I started off at a healthy 145 when beginning the WHOLE gamut of SSRIs (you name it I've tried it) and ended up over 200 lbs. I'm sorry, but that is UNACCEPTABLE.>
I'm so sorry! I appreciate your bravery in being your best advocate.
>Any suggestions would be greatly appreciated.
I'm always thinkin' 2, but too much I think.(?) (It's been brought to my attn in my life.)
Will be thinking of you.
StillDoingIt, 5f
Posted by med_empowered on August 28, 2007, at 13:47:45
In reply to Re: The right benzo/dosage?, posted by Fivefires on August 27, 2007, at 12:32:04
Dosages vary. 15mgs/day valium isn't really a lot--in the 70s, 40mgs/day was standard, and lots of people took more (or less)..its variable. Just try to avoid sedation, noticeable cognitive impairment, and disinhibition (all of these are more likely at higher doses). Docs have been weird about valium, at least in the US; they'll rx 2, 3, 4+ mgs klonopin and xanax, but with valium they're like "whooa, that's addictive." Its the whole "Mother's Little Helpers" thing, giving valium a bad rap.
I think you might want to think about serax, though; its supposedly really clean with a mild antidepressant effect.
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