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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 20 of 20. This is the beginning of the thread.
Posted by sukarno on August 17, 2008, at 3:00:10
I've been on Valium for 18 years and Stablon for the past three for treatment of panic disorder with agoraphobia and major depression.
My depression was getting steadily worse over the past few years, along with irritability, frustration and increasingly frequent rage reactions in addition to feeling heavily sedated even on a low dose of 12mg/day in divided doses.
I decided to stop Valium abruptly and ask my psychiatrist for Xanax (alprazolam) as I remember that Xanax is much less sedating. Thankfully he prescribed it!
Within five days my depression was completely gone! It is now day 18 of alprazolam therapy and my depression is still in remission. I am totally shocked by this, but very pleased too. I feel little or no sedation along with good anxiolytic activity (zero panic attacks!).
I have been able to reduce my Stablon dosage from 4 tablets a day to only three and I even stopped using my lightbox and yet my depression is still in remission.
I had read that alprazolam has an antidepressant effect by increasing norepinephrine and by increasing 5-HT (serotonin) in the hippocampus. It also has action on beta-adrenergic receptors, whereas conventional benzodiazepines don't.
I have some theories as to why Xanax seems to have worked for me (please feel free to critique and give me advice about this):
1. Valium exacerbates or causes depression?
2. Valium somehow interferes with Stablon (tianeptine) metabolism?
3. Xanax (alprazolam) is less likely to exacerbate depression than is Valium?
4. Xanax boosts the effects of Stablon?
5. Xanax is an antidepressant in its own right?I'm not sure which one it is.
After dumping Valium and being on Xanax, I report now that I have no aggression or hostility and my head feels so "clear" and peaceful. Things don't make me angry anymore. Little things used to send me over the edge, but not anymore. I feel like my old self decades ago.. _normal_.. finally.
I no longer feel paranoid or frustrated. This has been consistent for the past two weeks.
This is really a miracle. I am on 1mg 3x/day along with Stablon 3x/day (every 8 hours).I hope this keeps up.
Has anyone else found that Xanax is good for depression?
Has anyone found that Valium caused them to be depressed or worsened their existing depression?
Thanks! :-)
I really thought my life was over because I've tried so many medications in the past. I really hope this new feeling of peace and normal mood keeps up.
Posted by sukarno on August 17, 2008, at 3:05:32
In reply to Xanax (alprazolam) as an antidepressant. Miracle!, posted by sukarno on August 17, 2008, at 3:00:10
The Effect of Sympathetic Antagonists on the Antidepressant Action of Alprazolam
Libyan J Med, AOP: 080101
The Effect of Sympathetic Antagonists on the Antidepressant Action of Alprazolam
Al-Tubuly RA1, Aburawi SM1, Alghzewi EA1, Gorash ZM1, Errwami S2(1) Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Al-Fateh University, Tripoli, Libya.
(2) Diabetic Center, Tripoli, LibyaReceived for publication on 17 February 2007. Accepted in revised form 09 December 2007
Key words: Alprazolam; imipramine; swimming maze; atenolol; prazocin; propranolol
Abstract
Alprazolam is an anti-anxiety drug shown to be effective in the treatment of depression. In this study, the effect of sympathetic receptor antagonists on alprazolaminduced antidepressant action was studied using a mouse model of forced swimming behavioral despair. The interaction of three sympathetic receptor antagonists with benzodiazepines, which may impact the clinical use of alprazolam, was also studied. Behavioral despair was examined in six groups of albino mice. Drugs were administered intraperitoneally. The control group received only a single dose of 1% Tween 80. The second group received a single dose of alprazolam, and the third group received an antagonist followed by alprazolam. The fourth group was treated with imipramine, and the fifth group received an antagonist followed by imipramine. The sixth group was treated with a single dose of an antagonist alone (atenolol, a β1-selective adrenoceptor antagonist; propranolol, a non selective β-adrenoceptor antagonist; and prazocin, an α1-adrenoceptor antagonist). Results confirmed the antidepressant action of alprazolam and imipramine. Prazocin treatment alone produced depression, but it significantly potentiated the antidepressant actions of imipramine and alprazolam. Atenolol alone produced an antidepressant effect and potentiated the antidepressant action of alprazolam. Propranolol treatment alone produced depression, and antagonized the effects of alprazolam and imipramine, even producing depression in combined treatments.
In conclusion, our results reveal that alprazolam may produce antidepressant effects through the release of noradrenaline, which stimulates β2 receptors to produce an antidepressant action. Imipramine may act by activating β2 receptors by blocking or down-regulating β1 receptors.
http://www.ljm.org.ly/modules.php?name=News&file=article&sid=1309
Posted by dbc on August 17, 2008, at 7:05:04
In reply to Abstract, posted by sukarno on August 17, 2008, at 3:05:32
Its quite the amazing drug until you go through its withdrawal. Thats not an anti-benzo statement, thats from personal experience. The withdrawal is soul crushing.
Posted by sukarno on August 17, 2008, at 8:56:05
In reply to Re: Abstract, posted by dbc on August 17, 2008, at 7:05:04
"Its quite the amazing drug until you go through its withdrawal. Thats not an anti-benzo statement, thats from personal experience. The withdrawal is soul crushing."
Indeed, but that shouldn't happen if one tapers off very slowly and over a long period of time. My psychiatrist said that if I should want to taper off, I should do it over an 18 month period and no faster than that and I'll be okay with little or no discomfort. Pharmacies can compound it for even smaller dosage reductions.
Most people try to quit abruptly (i.e. "cold turkey") or taper far too rapidly.
There are unfortunate souls though who do lose their medication or end up incarcerated and the prison/jail physician won't prescribe them their medication. There is also the case where their prescribing physician relocates or retires and is replaced by a "benzo-bigot". Surgery is also another example.
In these cases, withdrawal is abrupt and can be life-threatening, especially in the case of alprazolam and panic disorder, since doses used in the treatment of panic disorder are often higher and on a more long term basis as prophylaxis.
I personally don't think anyone should ever attempt the "cold turkey" method or a rapid taper (i.e. over a few days or weeks). A lot of doctors without proper knowledge of benzodiazepines will attempt too rapid a taper and will not individualize it.
For the most part, panic disorder is a chronic and disabling illness which is primarily biochemical with a link to genetic predisposition that waxes and wanes over time and requires long term and often lifelong pharmacotherapy with a benzodiazepine. Alprazolam is perhaps the most efficacious agent besides imipramine, with the former having a more favorable and benign side effect profile.
I don't wish panic attacks on my worst enemy and I wish there was some sort of surgery available that would stop panic attacks for good. I don't know why there hasn't been any progress made in the realm of psychosurgery. I'd rather have that if it was safe rather than having to take pills everyday. Pills remind me that I have an illness and that makes me feel like a weak or "defective" person. I shouldn't think like that, but can't help it every time I have to take my medication.
I remember before I had panic disorder I used to be so full of energy and had no problems with psychosomatic complaints. After having my first panic attacks I felt fatigued all the time, even when I wasn't nervous. It seems like more of a physical disease than anything mental.
Posted by dbc on August 17, 2008, at 9:20:12
In reply to Panic Disorder, posted by sukarno on August 17, 2008, at 8:56:05
One of my DXs is panic disorder and has been for the last 5 years. I've been admitted into the ER over 15 times and threatened with being sent to a mental ward.
My xanax taper was a 2 month ordeal which eventually ended in valium bridging. There is no other benzo that requires a massive long term withdrawal aside from xanax (belive me i've withdrawan from valium, ativan, klonopin, etc). Its not at all the same thing. If the taper you're speaking of is the Ashton method the only thing she's been correct about is the valium bridging.
Why? The triazolo-ring thats responsible for xanax's ability to quickly pass through the BBB. It probably also accounts for the minor AD effect. Think of xanax as a sort of benzo hybrid because while it shares similar qualities as the rest of the benzo family it also has methods of action that are unique.
Posted by Jeroen on August 17, 2008, at 10:11:17
In reply to Xanax (alprazolam) as an antidepressant. Miracle!, posted by sukarno on August 17, 2008, at 3:00:10
blood test to identify schizophrenia and other
some companies are working on a blood test to know if you have schizophrenia
if thats its true all blood test are totall scam
Posted by Phillipa on August 17, 2008, at 10:58:09
In reply to Re: Panic Disorder, posted by dbc on August 17, 2008, at 9:20:12
I was always told a benzo is a benzo when going from one to the other the pdocs just changed them. I think I'm immune to them now as don't feel a thing from them and just recently my pdoc gave me xanax to switch for valium take some .5xanax and l5 of valium. Nothing different. I used to do really well on 2 me of xanax a day and even less or none years ago menopause and related medical condions changed that unfortunately. And yes my pdoc's always said that xanax had a slight antidepressant effect. How does it relate to desipramine? Phillipa
Posted by theo on August 17, 2008, at 11:41:26
In reply to Xanax (alprazolam) as an antidepressant. Miracle!, posted by sukarno on August 17, 2008, at 3:00:10
How much and when do you take your Xanax? Are you taking generic?
Posted by sukarno on August 17, 2008, at 11:43:34
In reply to Re: Panic Disorder » dbc, posted by Phillipa on August 17, 2008, at 10:58:09
I found that Klonopin/Rivotril (clonazepam) made me the most depressed, even though it was anxiolytic. The first few pills I took gave me a distinct feeling of dysphoria.
I tried desipramine (Norpramin) years ago and what I didn't like about it was that it made me somewhat nervous, at least in the beginning of treatment. It didn't have the sedative effects that other tricyclic antidepressants had. I felt quite faint the first day on it.. it was very uncomfortable, but after a few days I thought I felt some improvement in mood and possible reduction in panic attacks.
Did you try desipramine too? Have you tried Stablon (tianeptine)?
I have found that a gluten-free/casein-free diet has helped reduce my anxiety by about half. I've been on that diet since January 2007. When I used to eat wheat and other sources of gluten, I would feel like a nervous wreck and have lots of palpitations. My psychiatrist said gluten is bad for anxiety, even in patients without Celiac Disease.
Posted by sukarno on August 17, 2008, at 11:49:24
In reply to Re: Xanax (alprazolam) as an antidepressant. Miracle! » sukarno, posted by theo on August 17, 2008, at 11:41:26
"How much and when do you take your Xanax? Are you taking generic?"
I take the generic, 1mg three times a day (4am, noon, and 8pm). I set my alarm on my cellphone to go off every 8 hours to remind me to take it, even if I'm sleeping. That way I can be assured of a more constant level in my bloodstream as it is rather short-acting. So far, everything is going smoothly.
Posted by dbc on August 17, 2008, at 11:59:43
In reply to Re: Xanax (alprazolam) as an antidepressant. Miracle!, posted by sukarno on August 17, 2008, at 11:49:24
Thats an old psych board joke.
Q. whats the quickest way to find out what time it is?
A. Ask a xanax user
I took 3mg a day also and i had it timed within 5 minutes without any sort of reminder.
Posted by med_empowered on August 17, 2008, at 13:57:34
In reply to Xanax (alprazolam) as an antidepressant. Miracle!, posted by sukarno on August 17, 2008, at 3:00:10
OK, so xanax has a bad rep..its kind of regarded as the crack cocaine of the benzo world. I think only Halcion causes more problems.
THAT SAID, the stuff can be amazing and very effective. Have you given the XR version a go? I think its in generic now, so I would imagine that might be worth considering. Have you tried Serax? Its not nearly as potent as xanax, but it lasts longer and has some mild antidepressant properties.
Anyway, I'm glad you found relief. It sounds like your doc is smart about using xanax, which is why I'm a little surprised you're not on the xr (then again...I'm not a doc). I've had family members who were on xanax basically from the day it hit the market and, except for occasional dosage increases, they never had any major probs with it.
Posted by emme on August 17, 2008, at 14:48:58
In reply to Re: Abstract, posted by dbc on August 17, 2008, at 7:05:04
> Its quite the amazing drug until you go through its withdrawal. Thats not an anti-benzo statement, thats from personal experience. The withdrawal is soul crushing.
Unless you are fortunate enough to not get withdrawal at all. I can go from using it every day (when needed) to not taking it at all with absolutely no ill effects. Perhaps that is because I generally need a low dose and never seem to develop tolerance. I suspect individuals vary in how susceptible they are to suffering a bad withdrawal.
Posted by Phillipa on August 17, 2008, at 20:18:03
In reply to good for you!, posted by med_empowered on August 17, 2008, at 13:57:34
Med tried the extended version namebrand and generic didn't release properly I guess as it kept me awake for almost two weeks. I know my Dauther-in-law had to supplement with regular xanax also. But is a great med. Phillipa
Posted by TexasRVer on August 17, 2008, at 22:59:06
In reply to Re: Abstract, posted by dbc on August 17, 2008, at 7:05:04
> Its quite the amazing drug until you go through its withdrawal. Thats not an anti-benzo statement, thats from personal experience. The withdrawal is soul crushing.
I agree. Withdrawal is difficult. Several years ago I was taking Xanex regularly---Don't remember how much 1 MG QID or more. I decided to taper off. Every time I reduced the dosage, I could not sleep, but kept working on it. After a year or so, I was down to 1 at bedtime. No pill--no sleep. I kept cutting the dosage, finally down to 1/2 mg at bedtime---then just QUIT---I did it at a time that I really did not have anything that I had to do. Had a couple of nights without sleep---then was okay. The doc laughed at me when I listed my medications. I put down 1/2 of a 1/4 mg. Xanex if needed. Would you believe that sometimes that leaves me with a "hangover"? Last time I could not sleep, I broke the tablet into 1/8th of a tablet. But, that is all I needed. It still amazes me after having such a difficult time getting off of them. I am so grateful!!!!!
After getting off the Xanex and high dosage of Effexor, I became very sensitive to these medicatons. Effexor was great for me--but now, I cannot take even a small amount.
Posted by sukarno on August 18, 2008, at 2:38:31
In reply to good for you!, posted by med_empowered on August 17, 2008, at 13:57:34
"Have you given the XR version a go? I think its in generic now, so I would imagine that might be worth considering. Have you tried Serax? Its not nearly as potent as xanax, but it lasts longer and has some mild antidepressant properties."
I don't live in the US, but recently Xanax XR was introduced here and there's no generic for that.
How did you like it? :-)I was given a Serax capsule in the emergency room when I was having panic attacks. It took a long time to take effect. I remember walking home from the ER and it didn't take effect until 45 minutes later and it took effect very slowly, but also lasted a long time. The walk home was about 45 minutes to an hour.
Psychiatrists over here don't seem to be as forceful regarding medications although they will try to get you on the SSRI bandwagon. When I was still living in the West they would threaten to cut off my benzodiazepines (Valium) unless I was willing to try more SSRIs, despite the fact that I'm allergic to Prozac (rashes on arms and legs and itching in the throat along with upper GI bleeding that landed me in the hospital). Paxil/Seroxat gave me horrible panic attacks and I ended up in the ER with out of body experiences and a few electric shock sensations that were terrifying. Zoloft made me feel a tingling, prickling sensation all over. Effexor, even in a tiny dose (1/4 of 25mg tablet) gave me tachycardia at first, followed by a severe and tense headache. My blood pressure was high, so I quit it and then my BP was back to normal.
I thought that was unethical for them to try to force SSRIs on me by threats of taking me cold turkey off Valium. I had already taken the tricyclic antidepressants, tried BuSpar and trazodone. So many meds... I think I've calculated that I've been on 20 different medications.
A pdoc here once tried to give me a strange combination drug product specially made by the hospital containing Zoloft, BuSpar, Xanax and something else (I think it was Frisium/clobazam), so I "fired" him and went for a second opinion. Remember, the doctor isn't your boss, but you pay his/her salary. I encourage people to be more proactive.
Dr. Stuart Shipko M.D., a famous psychiatrist and neurologist practicing in Pasadena, CA says not to take any psychiatric drug that has been on the market for less than 10 years as there's too much pressure on (and perks for) physicians from drug reps when the drug is under patent, so results from clinical trials are skewed, sometimes deliberately, and the worst reactions show up in postmarketing reports. He even attended "Effexor dinners" paid for by the drug reps who knew his prescribing history, almost chiding him for prescribing Xanax for panic disorder and offering all kinds of perks and misinformation so that he's prescribe Effexor instead.
No one should have to take a medication they don't feel comfortable with. I don't know how things are in the US and Canada these days, but the last time I was there (1990s) they were pushing SSRIs as being a panacea without any withdrawal symptoms or significant side effects (conveniently called "discontinuation syndrome" now, which is the same as "withdrawal syndrome", but with less stigma because of the way it sounds).
Posted by sukarno on August 18, 2008, at 3:30:08
In reply to Re: good for you!, posted by sukarno on August 18, 2008, at 2:38:31
I forgot to mention that SSRIs destroyed my libido when I was on them. I think this is because of the increase in serotonin or dopamine antagonism (or perhaps both).
I had no interest in the opposite sex whatsoever and at first I didn't attribute that to the medication because the doctor didn't tell me that could happen so I thought instead that something was wrong with me until I found others with the same problem who were also taking SSRIs. I don't want to be graphic, but it was almost as if I was "numb down there".
The emotional blunting wasn't all that bad since that was better than being depressed, but being in my 20s at the time, I couldn't imagine life without marriage (or sex). A marriage isn't only about sex, but if things are very wrong in that department it could put the marriage on the rocks or end up in divorce and that will cause plenty of depression.
I was told that Serzone (nefazodone) was good for depression and didn't cause sexual dysfunction, but I later heard it was pulled off the market in the US due to hepatotoxicity (liver damage). Is it still available there? I can't find it here either.
Stablon doesn't affect my libido one way or the other. I think it gave it a mild boost in the beginning, but it hasn't lowered it any.
Posted by NegCreep on August 18, 2008, at 15:56:22
In reply to SSRI sexual dysfunction, posted by sukarno on August 18, 2008, at 3:30:08
I know your pain....
You might be interested in this up and coming drug , Agomelatine.
Its not out yet but might be within a year or so. It's supposed to be an effective antidepressant with absolutely no Sexual dysfunction.Theres a thread with some reports on use of it in clinical trials here:
http://www.dr-bob.org/babble/20080814/msgs/846351.html
some other info here:
http://en.wikipedia.org/wiki/AgomelatineThis is my best hope at the moment. Never tried stablon as its not available here in the UK.
Posted by dcruik518 on August 18, 2008, at 16:21:53
In reply to Re: Xanax (alprazolam) as an antidepressant. Mira, posted by dbc on August 17, 2008, at 11:59:43
> Thats an old psych board joke.
>
> Q. whats the quickest way to find out what time it is?
>
> A. Ask a xanax user
>
> I took 3mg a day also and i had it timed within 5 minutes without any sort of reminder.That's why Xanax XR is a much better choice. you don't get that crash so it ends up being more like clonazepam, less addictive.
Posted by Phillipa on August 18, 2008, at 19:57:42
In reply to SSRI sexual dysfunction, posted by sukarno on August 18, 2008, at 3:30:08
Nefazadone is available here was presciribed didn't take it do to the liver scare. Did you do well on it? Phillipa
This is the end of the thread.
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