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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 16 of 16. This is the beginning of the thread.
Posted by Vincent_QC on December 13, 2009, at 13:55:00
HI Everyone!
I was put back on the Paxil for the second time this year for extreme panic disorder and general anxiety.This summer, I had NO problem starting it at 10mg at bedtime...I increase it fast to 20mg and my panic attack was under control... but I had daytime sedation and no energy...that why I was taking it at bedtime.
Now, I can't take more than 2,5 mg... I start it again the 9 december...now I have opposite side-effects... 3-4 hours after I take the 2,5mg, I start feeling more anxious, I can sit for more than 5 minutes, I sweat a lot from the hands and foots, my anxiety symptoms (migraine, disconnected feeling, high blood pressure and varialbe pulse rate, pain in the head and eyes pain as well as jaw pain) increase by 10 fold and I do more panic attacks, trigger or not...
So I wondering if I should call the PDoc again tomorrow and ask to be switch to another one SSRI, one who will not increase too much at first my anxiety level... even if I know that almost all the SSRI'S increase the anxiety for 1 until 4 weeks after starting the treatment...
Because if I can't increase to 20mg at least the Paxil, it will not work on the panic attack and disorder for sure... I don't want to be on the increase process for 4 months before I reach that dosage...since the amount of anxiety I live everyday destroy completly my life for now... I can't even drive the car to go see a friend or go buy a pack of cigarettes alone... I always feel like I will die...
I also remark that when I expose myself to a public place under the Paxil med, I feel more irritated, can't tolerate the noise, i'm sensible to the light and the migraine start hurting more and more... I never react like that on the Paxil before...
Any idea for a good SSRI who will less increase the anxiety at the begining of the treatment? Lexapro (Cipralex), Celexa, Zoloft, Remeron... or adding remeron to the Paxil???
Also, i'm already on 8mg of Clonazepam who not work anymore... but addiction made the decrease of the dosage impossible... I try to change to the Ativan at 12mg day, the same day I start the Paxil, so the 9 december, but that's not enought to = the same amount of Rivotril... since I had withdraws effects of benzos meds on the Ativan, compare with the Rivotril...
Another fast question here...
For the headpain and the eyes pain as well as the jaw pain, can I take some Neurontin? Someone had good results with the Neurontin in the decrease of their migraine intensity or others pain related to the head???
Thanks for your answers!!!
Bye!
Vincent ;-)
Posted by Phillipa on December 13, 2009, at 13:59:29
In reply to SSRI with the less anxiety increase at first???, posted by Vincent_QC on December 13, 2009, at 13:55:00
Just a thought could you have akathesia or a paradoxical reaction to the benzos? I remember a poster here who couldn't take valium cause of that. Also seriously luvox was sedating moreso than the others. Love Phillipa
Posted by Vincent_QC on December 13, 2009, at 14:25:55
In reply to Re: SSRI with the less anxiety increase at first??? » Vincent_QC, posted by Phillipa on December 13, 2009, at 13:59:29
> Just a thought could you have akathesia or a paradoxical reaction to the benzos? I remember a poster here who couldn't take valium cause of that. Also seriously luvox was sedating moreso than the others. Love Phillipa
Hi Phillipa!
well... too bad that for the akathesia, one of the med use to reduce it is the Rivotril!!!I think that I reach a too high dose of Rivotril... who make all the others Benzos meds not working anymore...
I can still remember that not a long time ago, I was only on 8-12mg of Valium and was finding it to help a lot with the anxiety!!! That's so strange...
For the Luvox i'm really not sure... since it's among the worse SSRI's... because of it's severals interractions with other meds...
Thats why I think about something like Zoloft, even if it's hitting the dopamine, more than the others SSRI's..., Lexapro take a long time before working...but it's working for sure, I find it more sedating than the other ones, Celexa have more side-effects at first... Prozac can give SURPRISE after 1-2 months... you increase the dosage and feel the side-effects only 3-4 weeks after!!!
That's why I talk also about Remeron... since it's lacking the side-effects of the SSRI's... more easy to start... but I don't know if it's good for panic disorder and GAD... since I was on it for 6 months at 45 mg and didn't notice a lot of improve for the anxiety... maybe a combo like Remeron and Zoloft will help more? Low dose of Remeron like 15mg and low dose of Zoloft to beging?
Also, for the pain in the head, eyes and jaw... somethings like Neurontin can help? I remember then when I was on it a long time ago, I had pins and needles effect and was free of migraine at least... but i'm not sure if I can blend it with a SSRI???
Anyway... any good suggestion will be appreciate!
Thanks ;-)
Posted by janejane on December 13, 2009, at 16:28:06
In reply to SSRI with the less anxiety increase at first???, posted by Vincent_QC on December 13, 2009, at 13:55:00
Just wanted to add a recent experience... tried a small start-up dose of zoloft for a few days and had to stop due to anxiety. I'm not sure how common a response I had, but it was pretty uncomfortable. A friend of mine who is prone to anxiety was pretty happy with it until it pooped out, though.
Posted by Phillipa on December 13, 2009, at 20:22:25
In reply to Re: SSRI with the less anxiety increase at first?? » Vincent_QC, posted by janejane on December 13, 2009, at 16:28:06
I really think it's individual we're all so different. Zoloft first time wired me second time didn't feel it at all? Phillipa
Posted by Reggie BoStar on December 13, 2009, at 23:54:43
In reply to SSRI with the less anxiety increase at first???, posted by Vincent_QC on December 13, 2009, at 13:55:00
Vincent,
Per Phillipa's suggestion, everyone seems to have unique experiences with the brain juices.Benzos are not an option for me because I'm an alcoholic. However, years ago I was put on Buspar (Buspiron) for anxiety following ECT treatments. Not only did it fix the anxiety without sedating me - it also marked the end of any anxiety-type reactions at any time while taking SSRIs and other AD's. For me Buspar has been the non-benzo solution for anxiety and remains one of the few meds I've ever taken that does what it's supposed to do with no side effects that I'm aware of.
A word about Neurontin though: up until last summer I had been taking 2400 mg/day. I was taking it to reduce the number of migraines I was having and their severity, which worked very well; and also to lower the risk of seizures caused by the Wellbutrin I was taking.
I had been complaining about constant fatigue for years. At least once or twice a month I would have 4-5 day sleeping marathons wherein I got out of bed only to go to the john, feed the cats, and drink a bottle of Ensure. Eventually another patient in a therapy meeting pointed out that Neurontin ran a pretty high risk of causing the fatigue I was experiencing.
I talked it over with my Neurologist and we began a closely supervised reduction in Neurontin, gradually getting it down to the 1200mg/day dose I'm on now. It worked really well at reducing fatigue and lowering the number of sleep marathons I seem to need. Unfortunately I've found that I can't go much lower without bringing on terrible migraines. So that's where I'm sitting for now. My Neurologist suggested that maybe we can try reducing it slowly again after I've been on 1200mg for a longer time.
I chimed in there for two reasons: to let you know that for me, Buspar fixed the kinds of anxiety problems you're describing; and that Neurontin, while it does work at reducing the frequency of my migraines and as a general pain killer for neuralgia-type problems, causes a huge amount of fatigue and sedation.
That's my story at any rate. To repeat Phillipa yet again, everyone is different. It's taken many years of discouraging experimentation to get where I am, which is somewhat in control of my symptoms but not completely by a long shot. I still have a long ways to go and probably less time than I've already spent working on everything.
You're sure to have better luck, because mine stinks in any kind of comparison test you could imagine.
Have a good one,
Reggie BoStar
Posted by Reggie BoStar on December 14, 2009, at 0:21:40
In reply to Re: SSRI with the less anxiety increase at first??, posted by Phillipa on December 13, 2009, at 20:22:25
Hi Phillipa,
I still live! I came here to wish you the best in this holiday season. Along the way I butted in with some opinions, of course!Take care,
Reggie
Posted by Leo BoStar on December 14, 2009, at 0:24:00
In reply to Re: SSRI with the less anxiety increase at first??, posted by Phillipa on December 13, 2009, at 20:22:25
He never did learn to mind his own business.
Neither did I. Happy Holidays!
Leo BoStar
Posted by Vincent_QC on December 14, 2009, at 12:01:58
In reply to Re: SSRI with the less anxiety increase at first??? » Vincent_QC, posted by Reggie BoStar on December 13, 2009, at 23:54:43
> Vincent,
> Per Phillipa's suggestion, everyone seems to have unique experiences with the brain juices.
>
> Benzos are not an option for me because I'm an alcoholic. However, years ago I was put on Buspar (Buspiron) for anxiety following ECT treatments. Not only did it fix the anxiety without sedating me - it also marked the end of any anxiety-type reactions at any time while taking SSRIs and other AD's. For me Buspar has been the non-benzo solution for anxiety and remains one of the few meds I've ever taken that does what it's supposed to do with no side effects that I'm aware of.
>
> A word about Neurontin though: up until last summer I had been taking 2400 mg/day. I was taking it to reduce the number of migraines I was having and their severity, which worked very well; and also to lower the risk of seizures caused by the Wellbutrin I was taking.
>
> I had been complaining about constant fatigue for years. At least once or twice a month I would have 4-5 day sleeping marathons wherein I got out of bed only to go to the john, feed the cats, and drink a bottle of Ensure. Eventually another patient in a therapy meeting pointed out that Neurontin ran a pretty high risk of causing the fatigue I was experiencing.
>
> I talked it over with my Neurologist and we began a closely supervised reduction in Neurontin, gradually getting it down to the 1200mg/day dose I'm on now. It worked really well at reducing fatigue and lowering the number of sleep marathons I seem to need. Unfortunately I've found that I can't go much lower without bringing on terrible migraines. So that's where I'm sitting for now. My Neurologist suggested that maybe we can try reducing it slowly again after I've been on 1200mg for a longer time.
>
> I chimed in there for two reasons: to let you know that for me, Buspar fixed the kinds of anxiety problems you're describing; and that Neurontin, while it does work at reducing the frequency of my migraines and as a general pain killer for neuralgia-type problems, causes a huge amount of fatigue and sedation.
>
> That's my story at any rate. To repeat Phillipa yet again, everyone is different. It's taken many years of discouraging experimentation to get where I am, which is somewhat in control of my symptoms but not completely by a long shot. I still have a long ways to go and probably less time than I've already spent working on everything.
>
> You're sure to have better luck, because mine stinks in any kind of comparison test you could imagine.
>
> Have a good one,
> Reggie BoStar
Hi Reggie!
Hummm interresting... Buspar was the first med I was put on when I was 19yo... not only I had more panic attacks under it, but it was causing a lot of migraines on me so I was switched to the Paxil... who worked just by blocking the panic attack... not remove all the anxiety inside me... I remember that the agoraphobia was still there under the Paxil... but at the time, I didn't had GAD or SAD... those 2 DX started many years later...By the way, I was an alcoholic also and drug addict ... but it's now over... I don't feel the need or the craving for drugs or alcohol... since they trigger panic attacks on me!!! hehe I remember the last time I took a E pill... I thikn I had waves of extreme panic attacks for almost 8 hours in a row... after that experience I say : never again!!!
Another thing, for the Buspar, when you entering into the Benzoes meds addiction, I read a lot of studies about the fact that the chance to benefit from positive effects of the Buspar are lower...and one of is side-effect is the constant headache and migraine as well... so maybe your migraine is comming from the Buspar?
Anyway, for the Neurontin, I will not be sedated by it since I can take 4mg of Rivotril at the same time and don't feel any sedation from it! My brains are used to meds who slow down the neurons...
I was using Seroquel at bedtime to help me to sleep but I had to increase the dosage always and always... so I think my body develop a tolerance into the sedative effect of meds... whatever the process (Gaba or H1)...
I have an appointment with my Family Doctor today, I succeed to have one since someone cancel his appointment.
I will ask for the Zoloft... or the Effexor-xr... and the Neurontin for the pain in the head...
I was thinking at first about something like a beta blocker (Inderal) to lower my level of adrenaline... but I know it will make me depress overall... also, headache and migraine are side-effects of the beta blockers as well... since I remember very well the 3 months I was under the Inderal med... I had strong headache all the time and I was tired... not tired to sleep but tired physically... I was not able to do something physically...
So the goal is to find the good AD with the minimum increasement of anxiety at first, who will work on the panic disorder and the GAD... and find something to stop the constant migraine...
Did you see a difference in the frequency of your migraine from the decrease of 2400 mg of Neurontin to 1200 mg??? I know you wrote that under 1200mg you will have migraine... but at 1200mg is it ok for the migraine?
I think the lower dose will fit perfectly to me, since I already take benzos meds and don't want to add more cognitive problems on me... don't want to end my life in a car crash or something like that, just because I lack of attention... lol
Well thanks for your help !!! I appreciate it a lot!
Vincent ;-)
Posted by Phillipa on December 14, 2009, at 18:40:02
In reply to Re: SSRI with the less anxiety increase at first?? » Phillipa, posted by Leo BoStar on December 14, 2009, at 0:24:00
Wow wait a minute Reggie and Leo BoStar you guys brothers? I never noticed this before. And the buspar is he for real seriously as also thought it would not work after benzos thanks. And Please let me know about the names. Love Phillipa
Posted by Reggie BoStar on December 14, 2009, at 19:21:25
In reply to Re:Huh??????, posted by Phillipa on December 14, 2009, at 18:40:02
Hi Phillipa,
Leo is my uncle. I think we may have joked around a bit about it many threads ago, but I'm not sure.RE Buspar, what do you mean "it would not work after benzos"? The only time I ever had benzos was when I was being detoxed from alcohol, and then for 3 or 4 days max. And although I clearly needed them to help with the detox process, I actually didn't like them very much because they made me act like a fool in all the worst ways. Ativan was the worse of all. It gave me wobbly knees, so much so that I fell down wrapped around an IV stand and hurt myself pretty badly. After that I was under "bed arrest" until I was discharged.
They won't give the benzos to me outside of the detox wards because of the alcoholism.
Regardless of when and how many benzos I've had, Buspar does the job for me. Maybe it's one of those individual cases again, where someone who's had both meds gets better results with Buspar, and someone else gets the opposite. I honestly don't know.
The mechanism of how Buspar operates compared to that of the benzos is completely different. It's not a tranq at all, does not sedate, is not habit forming. It seems to suppress anxiety somehow, without any kind of euphoria, high, etc. When it's stopped it has to be done gradually, just like any other brain juice. But I've never heard anyone in therapy groups complain about withdrawal symptoms of any kind - aside from a return of the anxiety that was being treated, that is.
The onset was very subtle. First I noticed that I got over the usual upsets a lot faster and didn't dwell on them as much as I used to. At the right dose, I eventually stopped getting upset in the first place.
I'm sure someone else will have different experiences with it. All I know is, it works for me.
So whatcha gonna do??
Reggie BoStar
Posted by Phillipa on December 14, 2009, at 21:33:03
In reply to Re:Huh?????? » Phillipa, posted by Reggie BoStar on December 14, 2009, at 19:21:25
A family affair? Well I will goggle buspar. See I've been on benzos not increasing doses actually going down as now they make me tired . Was on them wow 40 years. That's so awesome your Uncle. The BoStars and Company!!!! Love to you both Phillipa
Posted by Leo BoStar on December 14, 2009, at 22:07:40
In reply to Re:Huh?????? » Reggie BoStar, posted by Phillipa on December 14, 2009, at 21:33:03
Try the Wikipedia article:
http://en.wikipedia.org/wiki/Buspar
Like all Wikipedia articles its sources should be checked. It's an easy enough job to verify information when all the sources and links to related topics are in one place. The criticisms of Wikipedia are overblown.
Returns on the love. He feels it but can't say it.
Here he comes. Click.
Enjoy,
Leo BoStar
Posted by Phillipa on December 15, 2009, at 19:57:06
In reply to Re:Huh?????? » Phillipa, posted by Leo BoStar on December 14, 2009, at 22:07:40
Thanks Leo I took it a long time ago and doses were 5mg so didn't do a thing. If it restores taste and smell as mine are gone last six years Maybe that would Help? Phillipa
Posted by Leo BoStar on December 15, 2009, at 22:33:17
In reply to Re:Huh?????? » Leo BoStar, posted by Phillipa on December 15, 2009, at 19:57:06
There's a possibility that only your sense of smell is gone, because the sense of smell constitutes almost every sensation we qualify as taste. There are really only 4 categories of taste identified these days: bitterness, saltiness, sourness, sweetness. Some lists include a 5th taste, "savoriness."
In other words, if you can identify these tastes in common foods like tonic water (bitterness), table salt (saltiness), sugar (sweetness), lemon juice (sourness), it may be that just your sense of smell is lacking. If that's the case, then all sorts of other possibilities besides side effects come into play. For example, there could be an obstruction, a deviated septum, or some other physical disorder in the sinuses.
I'm not a doctor by any means so take all of this with a grain of salt - if you'll pardon the expression. This is all sheer speculation by an old guy who reads too much. One of the things he read on this topic is another Wikipedia article, this one on the sense of taste:
http://en.wikipedia.org/wiki/Sense_of_taste
By the way, the tonic water used in the example above is the old fashioned quinine solution used in Gin and Tonic drinks. It's far from being the same as club soda, which is merely carbonated water. The flavor of tonic water is a perfect example of bitterness. It's also good for treating malaria. Note the reference to tonic water in this article:
http://en.wikipedia.org/wiki/Quinine
I'm guessing too much. The articles are interesting, so it's not a total loss.
Here he comes again. Click.
Leo BoStar
Posted by Phillipa on December 16, 2009, at 20:43:56
In reply to Re:Huh?????? » Phillipa, posted by Leo BoStar on December 15, 2009, at 22:33:17
Leo thanks. I attended two taste and smell centers one at Wake Forrest Hospital, and One in DC. Both did the taste testing and smell testing. Both also said try prednisone for two weeks and then theophylline. I did the prednisone not the theophylline as a med for breathing and I breath fine. MRI of brain and sinuses okay. I've recently seen the doc for osteoporosis and he said see a neurologist this doc is very good and I'd been thinking same thing. I figured it was the first cranial nerve though? I've always wondered if the eye prk lasix surgery could have somehow damaged a nerve? As it started fading right after that. Hence I suck on dark chocolate truffles at night. No pleasure in food. This started at age 56 so that's not old to me so I rule that one out. Inherited so many autoimmune wierd things. Well you like to google see what else you can come up with? I need a neurologist in Charlotte NC. Thanks sweetie. Love Phillipa
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