Psycho-Babble Medication Thread 914717

Shown: posts 1 to 10 of 10. This is the beginning of the thread.

 

Should I really bother with an anticonvulsant.....

Posted by jms600 on August 29, 2009, at 16:39:25

My anxiety is going from bad to worse. Benzos aren't touching it. I'm taking 150mg Effexor, 600mg Lithium, 40mg Buspirone and 10mg Zyprexa but still I get severe panic disorder. It's getting so I can't do a thing because of immense panic.

I've tried all the SSRIs/SNRIs, most atypical/typical antipsychotics, amitriptyline and benzos - all with little success of treating my panic disorder.

I know my psychiatrist will be unhappy about prescribing Nardil and so may consider an anticonvulsant instead. I have already tried Sodium valproate about five years back and it's results weren't that noticeable (but there again my anxiety wasn't as bad then).

So, as I've grown tolerant to benzos, is my psychiatrist right in trying an anticonvulsant for severe panic disorder and, if so, which drug should I steer him towards as a long term treatment?

Any advice would be much appreciated.

 

Re: Should I really bother with an anticonvulsant.....

Posted by SLS on August 29, 2009, at 16:44:22

In reply to Should I really bother with an anticonvulsant....., posted by jms600 on August 29, 2009, at 16:39:25

> My anxiety is going from bad to worse. Benzos aren't touching it. I'm taking 150mg Effexor, 600mg Lithium, 40mg Buspirone and 10mg Zyprexa but still I get severe panic disorder. It's getting so I can't do a thing because of immense panic.
>
> I've tried all the SSRIs/SNRIs, most atypical/typical antipsychotics, amitriptyline and benzos - all with little success of treating my panic disorder.
>
> I know my psychiatrist will be unhappy about prescribing Nardil and so may consider an anticonvulsant instead. I have already tried Sodium valproate about five years back and it's results weren't that noticeable (but there again my anxiety wasn't as bad then).
>
> So, as I've grown tolerant to benzos, is my psychiatrist right in trying an anticonvulsant for severe panic disorder and, if so, which drug should I steer him towards as a long term treatment?
>
> Any advice would be much appreciated.


Has your doctor ever mentioned Lyrica (pregabalin)?


- Scott

 

Re: Should I really bother with an anticonvulsant.....

Posted by jms600 on August 29, 2009, at 16:50:33

In reply to Re: Should I really bother with an anticonvulsant....., posted by SLS on August 29, 2009, at 16:44:22

> > My anxiety is going from bad to worse. Benzos aren't touching it. I'm taking 150mg Effexor, 600mg Lithium, 40mg Buspirone and 10mg Zyprexa but still I get severe panic disorder. It's getting so I can't do a thing because of immense panic.
> >
> > I've tried all the SSRIs/SNRIs, most atypical/typical antipsychotics, amitriptyline and benzos - all with little success of treating my panic disorder.
> >
> > I know my psychiatrist will be unhappy about prescribing Nardil and so may consider an anticonvulsant instead. I have already tried Sodium valproate about five years back and it's results weren't that noticeable (but there again my anxiety wasn't as bad then).
> >
> > So, as I've grown tolerant to benzos, is my psychiatrist right in trying an anticonvulsant for severe panic disorder and, if so, which drug should I steer him towards as a long term treatment?
> >
> > Any advice would be much appreciated.
>
>
> Has your doctor ever mentioned Lyrica (pregabalin)?
>
>
> - Scott


No. I know that's an option - but from what people have told me on here, tolerance develops to the drug after about a week. Do you know if this is true?

jms

 

Re: Should I really bother with an anticonvulsant..... jms600

Posted by Phillipa on August 29, 2009, at 17:19:48

In reply to Re: Should I really bother with an anticonvulsant....., posted by jms600 on August 29, 2009, at 16:50:33

From what I know lasts a lot longer than a week might want to try it? Phillipa

 

Re: Should I really bother with an anticonvulsant..... jms600

Posted by yxibow on August 30, 2009, at 0:13:12

In reply to Re: Should I really bother with an anticonvulsant....., posted by jms600 on August 29, 2009, at 16:50:33


> No. I know that's an option - but from what people have told me on here, tolerance develops to the drug after about a week. Do you know if this is true?


I couldn't take it because it changed my vision a bit, but this is equally possible with Neurontin. Its supposedly more powerful than Neurontin.


What people probably are commenting is that the lethargy, slurred speech, and other such things that I got on Neurontin first and likely Lyrica has some similar effects probably wear off so that for most people, especially those who have already taken benzodiazepines may not find it particularly useful for sleep.


But if your biochemical makeup needs a change at GABA in the certain ways that these two agents do, its always worth a try. It may be very subtle and not like a benzodiazepine but it could help. There arent a lot of side effects other than the startup ones and possible blurred vision (not sure if that goes away long term) with either one.


-- Jay

 

Re: Should I really bother with an anticonvulsant..... yxibow

Posted by SLS on August 30, 2009, at 0:33:30

In reply to Re: Should I really bother with an anticonvulsant..... jms600, posted by yxibow on August 30, 2009, at 0:13:12

What do you think of the idea of using propranalol for panic attack episodes?


- Scott

 

Re: Should I really bother with an anticonvulsant..... jms600

Posted by SLS on August 30, 2009, at 0:45:45

In reply to Re: Should I really bother with an anticonvulsant....., posted by jms600 on August 29, 2009, at 16:50:33

I think some people report that they lose the "high" that sometimes occurs when treatment is initiated or upon dosage increases. I am not so sure about there being a loss of anxiolytic effect.

That gabapentin (Neurontin) has been reported to be useful in treating anxiety disorders, including panic disorder, is not news. However, I just thought that pregabalin (Lyrica) might have been a more potent analogue of gabapentin.


http://www.ncbi.nlm.nih.gov/pubmed/12665421?ordinalpos=6&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DefaultReportPanel.Pubmed_RVDocSum

http://www.ncbi.nlm.nih.gov/pubmed/17502773?ordinalpos=2&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DefaultReportPanel.Pubmed_RVDocSum

http://www.ncbi.nlm.nih.gov/pubmed/17444287?ordinalpos=3&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DefaultReportPanel.Pubmed_RVDocSum

http://www.ncbi.nlm.nih.gov/pubmed/16699602?ordinalpos=5&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DefaultReportPanel.Pubmed_RVDocSum


- Scott

 

Thanks guys (nm)

Posted by jms600 on August 30, 2009, at 11:15:44

In reply to Should I really bother with an anticonvulsant....., posted by jms600 on August 29, 2009, at 16:39:25

 

Re: Thanks guys

Posted by Phillipa on August 30, 2009, at 18:43:58

In reply to Thanks guys (nm), posted by jms600 on August 30, 2009, at 11:15:44

Interesting history per Wiki. Phillipa

http://en.wikipedia.org/wiki/Gabapentin

 

Re: Should I really bother with an anticonvulsant..... SLS

Posted by yxibow on August 30, 2009, at 19:08:58

In reply to Re: Should I really bother with an anticonvulsant..... yxibow, posted by SLS on August 30, 2009, at 0:33:30

> What do you think of the idea of using propranalol for panic attack episodes?
>
>
> - Scott

If the individual doesn't already have low blood pressure, and fairly strong depression. Not sure of long term use but PRN could take the edge off the symptoms (of course not the origin, per se)

-- Jay


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