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Dr. Bob is Robert Hsiung, MD,
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Posted by g_g_g_unit on October 15, 2010, at 6:40:03
In reply to Re: why no relief from anxiety with clomipramine? » g_g_g_unit, posted by SLS on October 15, 2010, at 6:21:22
what I'm experiencing isn't true mania, as far as I'm aware, and my psychologist hasn't expressed any concern that I might be manic. it's more the byproduct of constant sleep disruption induced by the drug, and closer to ADHD-like hyperactivity (I have inattentive ADD).
in fact, Nardil had the exact same effect, and I gave up after 12 weeks of tattered sleep. Seroquel offers me no relief from insomnia - I experience restless legs and akathisia.
My Dx is inattentive ADD, OCD and major depression, with the ADD only diagnosed recently.
I've tried various SSRI's which relieve the OCD, but exacerbate the ADD.
Neurontin and Memantine which significantly helped my anxiety but not my attention.
Dexamphetamine which profoundly improves my attention.
Parnate which improved my attention, but made me feel really flat, and caused a lot of insomnia.
Nardil which improved my depression, but caused a lot of insomnia and didn't do a lot for my anxiety.
> Imipramine had been the drug of choice for panic disorder until more recently. I have seen Nardil work well for the symptoms you describe. However, you might think about using a mood stabilizer given your history of mania. I would think about trying Trileptal.
>
> What drugs have you tried so far, and what were your reactions to them?
>
>
> - Scott
>
>
Posted by Brainbeard on October 15, 2010, at 6:54:45
In reply to why no relief from anxiety with clomipramine?, posted by g_g_g_unit on October 15, 2010, at 6:06:05
That's why my doc adds fluvoxamine: to reverse the SRI/NRI ratio. Normally, blood levels of the NRI metabolite dominate over blood levels of the SRI motherdrug. When fluvoxamine is added, the mother drug is boosted while the metabolite is suppressed. He finds this an excellent combo for OCD.
Posted by SLS on October 15, 2010, at 7:07:34
In reply to Re: why no relief from anxiety with clomipramine?, posted by g_g_g_unit on October 15, 2010, at 6:40:03
Strattera would be an interesting drug to work with, perhaps in combination Effexor.
- Scott
Posted by floatingbridge on October 24, 2010, at 16:24:38
In reply to Re: why no relief from anxiety with clomipramine?, posted by g_g_g_unit on October 15, 2010, at 6:40:03
Hi g_g_g,
Sounds like you are having ongoing frustrations with meds. I know you have a complex illness. I don't post you often because I don't have anything helpful to add.
In addition, this post is off-topic, but you mention add-inattentive which I deal
with, too. I found zanaflex is used in conjunction with stimulant therapy. It is a milder muscle relaxant AND it helps with my occasional RLS.Google add + zanaflex (tizanidine).
Best to you :)
Posted by Brainbeard on October 25, 2010, at 9:51:55
In reply to Re: why no relief from anxiety with clomipramine?, posted by g_g_g_unit on October 15, 2010, at 6:40:03
Maybe, and I know this may sound harsh - MAYBE you are not worth the drug.
Posted by Brainbeard on October 25, 2010, at 9:52:58
In reply to Re: why no relief from anxiety with clomipramine? » g_g_g_unit, posted by Brainbeard on October 25, 2010, at 9:51:55
Posted by g_g_g_unit on October 26, 2010, at 6:13:48
In reply to Re: why no relief from anxiety with clomipramine? » g_g_g_unit, posted by floatingbridge on October 24, 2010, at 16:24:38
Hey, thanks for your concern. I'll definitely look into zanaflex . . I'm not officially 'on' stims yet, but I know that during the few times I've sampled them they've exacerbated my neck and shoulder tension.
Take care.
> Hi g_g_g,
>
> Sounds like you are having ongoing frustrations with meds. I know you have a complex illness. I don't post you often because I don't have anything helpful to add.
>
> In addition, this post is off-topic, but you mention add-inattentive which I deal
> with, too. I found zanaflex is used in conjunction with stimulant therapy. It is a milder muscle relaxant AND it helps with my occasional RLS.
>
> Google add + zanaflex (tizanidine).
>
> Best to you :)
Posted by Brainbeard on October 28, 2010, at 3:17:02
In reply to Re: why no relief from anxiety with clomipramine? » g_g_g_unit, posted by floatingbridge on October 24, 2010, at 16:24:38
Triple G, sorry for my hideous joke.
I think you could have given clomipramine a little bit longer. On 225mg for more than a month now, I'm beginning to feel more and more stable (as long as I don't do my wicked med and drug experiments). The side-effects can feel very acute and nasty, but in the end, they would be worth the trade if my brain gets tweaked long enough to relief me from a chunk of anxiety and depression.
Posted by g_g_g_unit on October 28, 2010, at 4:04:27
In reply to Re: why no relief from anxiety with clomipramine?, posted by Brainbeard on October 28, 2010, at 3:17:02
Hey, that's cool. I'm really glad you're seeing the results. The problem is that, when I began clomipramine, I was experiencing a severe, adrenaline-like onslaught of anxiety, which was literally lasting 24/7. After 6 or so weeks on the drug, I have not seen my anxiety (physical or mental) alter *at all*; even SSRIs provide some relief after 2-3 weeks, whereas here, I am just as anxious and fearful as ever. The only positive I have seen is an easing of my depression but I just can't live with anxiety like this. Factor in the sleep deprivation and I am very close to lopping off someone's head. There just haven't been enough gains to justify continuing at this point :(
> Triple G, sorry for my hideous joke.
>
> I think you could have given clomipramine a little bit longer. On 225mg for more than a month now, I'm beginning to feel more and more stable (as long as I don't do my wicked med and drug experiments). The side-effects can feel very acute and nasty, but in the end, they would be worth the trade if my brain gets tweaked long enough to relief me from a chunk of anxiety and depression.
Posted by Brainbeard on October 28, 2010, at 15:13:15
In reply to Re: why no relief from anxiety with clomipramine? » Brainbeard, posted by g_g_g_unit on October 28, 2010, at 4:04:27
I am really sorry to hear that. I wonder if there were any other factors working towards your noradrenergic fear trip.
However, the quest for a mind more sane continues. Meanwhile, responsible insanity provides a welcome break every now and then. Personally, I detest depression more than fear.
My fears, after all, have gotten me as far as I've got now - if Paxil hadn't killed my compulsions, I might have been a lot closer to realizing my dreams. Compulsions show at least an endeavour to recollect the pieces of the perfect object and put them back together. Having had my brain soaked in paroxetine for a couple of years has done severe damage to both compulsions and ambitions, both of which are, let's not forget it, dopamine driven.
Serotonergic obsessions alone lead nowhere. It's better to do insane things than to merely be insane, which will only lead to paralysis.Please let us know all about your upcoming experiences with stimulants!
Posted by g_g_g_unit on October 28, 2010, at 19:09:56
In reply to A Mind More Sane » g_g_g_unit, posted by Brainbeard on October 28, 2010, at 15:13:15
Sure, I'm in a similar boat to you. I used to be highly ambitious and driven by my compulsions, though I think that continuing in that fashion was completely untenable. I fought to stay off meds as long as humanly possible, but in the end, it just wans't worth it anymore. I'm thankful I accomplished *some* of what I set out to before this point, so it's difficult to completely drown myself in regret.
Anyway, I'm not averse to the experience of fear/anxiety, but as long as it's combined with positive affect (which leads to intermittent bursts of pleasure, excitement, etc.). What I was experiencing was more in the realm of unrelenting panic, and was lasting for weeks at a time. I think it was triggered by immigration, but I'm not sure. So you believe it's NE-related? Neurontin helped, but caused too much sedation.
If I ever get my hands on stimulants, I'll let you know. Meanwhile, in a fit of desperation, my (ex?)therapist and (ex)psychiatrist have diagnosed me as schizophrenic! They claim my body dysmorphic symptoms count as (positive) delusions, and that my lack of motivation and concentration difficulties are negative symptoms! My depression-related fatigue is actually schizophrenic catatonia! I also touch my face when I'm anxious while being stared at during conversation, and this is again supposedly a schizophrenic trait!!
My GP think it's a joke, and is referring me to a neurodevelopmental psych for a second opinion on ADHD.
> I am really sorry to hear that. I wonder if there were any other factors working towards your noradrenergic fear trip.
>
> However, the quest for a mind more sane continues. Meanwhile, responsible insanity provides a welcome break every now and then. Personally, I detest depression more than fear.
>
> My fears, after all, have gotten me as far as I've got now - if Paxil hadn't killed my compulsions, I might have been a lot closer to realizing my dreams. Compulsions show at least an endeavour to recollect the pieces of the perfect object and put them back together. Having had my brain soaked in paroxetine for a couple of years has done severe damage to both compulsions and ambitions, both of which are, let's not forget it, dopamine driven.
> Serotonergic obsessions alone lead nowhere. It's better to do insane things than to merely be insane, which will only lead to paralysis.
>
> Please let us know all about your upcoming experiences with stimulants!
Posted by Phillipa on October 28, 2010, at 19:48:22
In reply to Re: A Mind More Sane » Brainbeard, posted by g_g_g_unit on October 28, 2010, at 19:09:56
I touch my face all the time and I'm not schizophrenic. Never heard that before? Phillipa
Posted by Brainbeard on October 29, 2010, at 3:29:41
In reply to Re: A Mind More Sane » Brainbeard, posted by g_g_g_unit on October 28, 2010, at 19:09:56
> Meanwhile, in a fit of desperation, my (ex?)therapist and (ex)psychiatrist have diagnosed me as schizophrenic!
That's hilarious, although not really funny. How long till you'll be forcefully hospitalized?? It's remarkable how many doctors will never say: 'I don't have a clue about the cause of your symptoms' but instead will come up with a strained left-over diagnosis.
Posted by maxime on October 29, 2010, at 16:30:54
In reply to Re: A Mind More Sane » g_g_g_unit, posted by Phillipa on October 28, 2010, at 19:48:22
> I touch my face all the time and I'm not schizophrenic. Never heard that before? Phillipa
Phillipa, a lot of people touch their faces and they are not shizophrenic.
Posted by floatingbridge on October 29, 2010, at 18:25:47
In reply to Re: A Mind More Sane » Brainbeard, posted by g_g_g_unit on October 28, 2010, at 19:09:56
Hi g_g_g,
Well your gp thinks it's a joke, and I'm so glad he does, but really--it's a joke with you as the punchline. Not very funny to me. I'm glad your gp is on your side and making him or herself useful.
I know I've missed lots of your story, but why no stimulants, even milder ones?Last I checked I thought you did well with them.
Posted by maxime on October 29, 2010, at 21:58:36
In reply to Re: A Mind More Sane » Phillipa, posted by maxime on October 29, 2010, at 16:30:54
> > I touch my face all the time and I'm not schizophrenic. Never heard that before? Phillipa
>
> Phillipa, a lot of people touch their faces and they are not shizophrenic.Maybe they touch their face a lot because they feel like something is on it???
Posted by floatingbridge on October 29, 2010, at 22:35:44
In reply to Re: A Mind More Sane » maxime, posted by maxime on October 29, 2010, at 21:58:36
When I'm tired, stressed, or upset, I think I touch my face quite a bit....
Posted by g_g_g_unit on October 29, 2010, at 23:07:52
In reply to Left-Over Diagnoses, posted by Brainbeard on October 29, 2010, at 3:29:41
> That's hilarious, although not really funny. How long till you'll be forcefully hospitalized??thankfully, they can't do jack, because I saw the psych and psychologist privately.
Posted by g_g_g_unit on October 30, 2010, at 2:23:18
In reply to Re: A Mind More Sane, posted by floatingbridge on October 29, 2010, at 18:25:47
> Hi g_g_g,
>
> Well your gp thinks it's a joke, and I'm so glad he does, but really--it's a joke with you as the punchline. Not very funny to me. I'm glad your gp is on your side and making him or herself useful.
>
> I know I've missed lots of your story, but why no stimulants, even milder ones?Last I checked I thought you did well with them.Well, the psychiatrist I saw completely disregarded my early history (including my ADHD symptoms), which discounts her diagnosis in my GP's eyes. Her argument is that Schizophrenia is the only possible explanation for my present decline (as opposed to ADHD, which my mom and two brothers have, and which would be the far more logical answer). She was far more interested in my anxiety/depression symptoms, which is the general trend I find.
My GP's referred me to a neurodevelopmental psych, who he said should have no qualms in diagnosing ADHD.
As for stims, I've only experimented with them a couple of times and found they helped. My GP has said that since my anxiety/OCD symptoms are so prominent, I should probably get those under control first, which I'm okay with.
Posted by Brainbeard on October 30, 2010, at 7:39:40
In reply to Re: A Mind More Sane » floatingbridge, posted by g_g_g_unit on October 30, 2010, at 2:23:18
>My GP has said that since my anxiety/OCD symptoms are so prominent, I should probably get those under control first, which I'm okay with.
>I back that up. My selegiline induced hyperneurosis has made the need for addressing OCD adequately *before* addressing executive functions painfully clear.
Posted by g_g_g_unit on October 30, 2010, at 22:33:25
In reply to Re: A Mind More Sane, posted by Brainbeard on October 30, 2010, at 7:39:40
It's weird - in retrospect, clomipramine was definitely helping my obsessions, but causing a tonne of physical anxiety/tension, which masked the effect. Now that I'm nearly off it, I'm a lot more physically at ease, but more mentally anxious.
Posted by g_g_g_unit on October 30, 2010, at 22:57:52
In reply to Re: A Mind More Sane » Brainbeard, posted by g_g_g_unit on October 30, 2010, at 22:33:25
did stablon have any effect (positive/negative) on your OCD brainbeard?
Posted by Conundrum on October 31, 2010, at 13:52:38
In reply to Re: A Mind More Sane » Brainbeard, posted by g_g_g_unit on October 30, 2010, at 22:33:25
> It's weird - in retrospect, clomipramine was definitely helping my obsessions, but causing a tonne of physical anxiety/tension, which masked the effect. Now that I'm nearly off it, I'm a lot more physically at ease, but more mentally anxious.
Which SSRIs have you tried? Maybe the adrenergic effects of clomipramines metabolite are too much?
Have you ever tried Celexa or Luvox? They seem to be tamer SSRIs.
Posted by Phillipa on October 31, 2010, at 21:17:26
In reply to Re: A Mind More Sane, posted by Conundrum on October 31, 2010, at 13:52:38
Luvox was the only SSRI I never even felt the first dose and kept waiting for something to happen but nothing but I was on ativan at the same time the doc raised the dose by 50mg each day til I got to 250mg. Phillipa
Posted by Brainbeard on November 1, 2010, at 14:40:42
In reply to stablOCDn » g_g_g_unit, posted by g_g_g_unit on October 30, 2010, at 22:57:52
Tianeptine and OCD... No, my OCD was too sturdy for Stablon. It's a very mild med anyway, although I give it thumbs up for likeability.
This is the end of the thread.
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