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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 9 of 9. This is the beginning of the thread.
Posted by CaffeinePoet on May 14, 2011, at 23:43:40
I have Generalized Anxiety Disorder pretty badly.
When I go on an SSRI or a benzo, even at low doses, I find that my functioning in life is negatively affected by a lack of drive and fatigue.
Is there a class of medication that helps GAD, that DOESN'T slow you down, make you feel demotivated? I typically have only been on one med at a time, as little as possible, but am open to trying combos.
Posted by SLS on May 15, 2011, at 8:45:43
In reply to AD's that are not demotivating?, posted by CaffeinePoet on May 14, 2011, at 23:43:40
> I have Generalized Anxiety Disorder pretty badly.
>
> When I go on an SSRI or a benzo, even at low doses, I find that my functioning in life is negatively affected by a lack of drive and fatigue.
>
> Is there a class of medication that helps GAD, that DOESN'T slow you down, make you feel demotivated? I typically have only been on one med at a time, as little as possible, but am open to trying combos.MAOI: Nardil, Parnate, Marplan
SNRI: Effexor, Cymbalta, Pristiq, Savella *SSRI/5-HT1a agonist: Viibrd (vilazodone) **
* Not all SNRIs will affect an individual the same way. I don't think one can generalize upon this class of drug therapeutic utility or side effects. It is worth trying more than one.
** I think Viibrd is worth a try, even though it is not yet approved for GAD.
Best in my opinion: Nardil
- Scott
Posted by Phillipa on May 15, 2011, at 10:51:38
In reply to AD's that are not demotivating?, posted by CaffeinePoet on May 14, 2011, at 23:43:40
Benzos were fine for me at low doses. No benefits from SSRI's or SNRI's and can't gain weight as diabetes in my family so rather stuck. Phillipa
Posted by CaffeinePoet on May 15, 2011, at 13:04:19
In reply to Re: AD's that are not demotivating? » CaffeinePoet, posted by Phillipa on May 15, 2011, at 10:51:38
> Benzos were fine for me at low doses. No benefits from SSRI's or SNRI's and can't gain weight as diabetes in my family so rather stuck. Phillipa
Thanks! I am taking a low dose benzo (clonopin, .50 divided into 2 doses). This is a reduction from .75, also divided into 2 doses, and I am feeling some motivation return.
I realize that perhaps I am unrealistic in expecting to feel virtually NO side effects.
I once took Serzone, and that made me feel utterly Normal with no side effects, but the liver-failure risk is too high.
Posted by jms600 on May 15, 2011, at 16:04:39
In reply to Re: AD's that are not demotivating? » Phillipa, posted by CaffeinePoet on May 15, 2011, at 13:04:19
> > Benzos were fine for me at low doses. No benefits from SSRI's or SNRI's and can't gain weight as diabetes in my family so rather stuck. Phillipa
>
> Thanks! I am taking a low dose benzo (clonopin, .50 divided into 2 doses). This is a reduction from .75, also divided into 2 doses, and I am feeling some motivation return.
>
> I realize that perhaps I am unrealistic in expecting to feel virtually NO side effects.
>
> I once took Serzone, and that made me feel utterly Normal with no side effects, but the liver-failure risk is too high.
I'm going through something similar to you. Have terrible motivation along with severe GAD. I'm on 225mg of Effexor which has helped a little without increasing my anxiety. I may ask my doctor if I can go up to 300mg.I agree with SLS - Nardil seems to be the best choice but the downside is the dietary restrictions.
Posted by SLS on May 15, 2011, at 19:03:54
In reply to Re: AD's that are not demotivating?, posted by jms600 on May 15, 2011, at 16:04:39
Hi.
> I'm going through something similar to you. Have terrible motivation along with severe GAD. I'm on 225mg of Effexor which has helped a little without increasing my anxiety. I may ask my doctor if I can go up to 300mg.That's a good move. You could then add Wellbutrin or nortriptyline if necessary.
Good luck.
- Scott
Posted by floatingbridge on May 16, 2011, at 8:33:17
In reply to AD's that are not demotivating?, posted by CaffeinePoet on May 14, 2011, at 23:43:40
CP, I have anxiety (plus ADD) but not gad--so this may not fly, but ten days in, emsam reduces my anxiety.
It's still the honeymoon. I am thinking about cutting back on my xanax. However, until I get something else it's benzos for sleep.
I'm surprised by the stress reducing properties for me. Pleased might be a better word. Good luck.
Posted by CaffeinePoet on May 16, 2011, at 13:53:34
In reply to Re: AD's that are not demotivating? » CaffeinePoet, posted by floatingbridge on May 16, 2011, at 8:33:17
> CP, I have anxiety (plus ADD) but not gad--so this may not fly, but ten days in, emsam reduces my anxiety.
>
> It's still the honeymoon. I am thinking about cutting back on my xanax. However, until I get something else it's benzos for sleep.
>
> I'm surprised by the stress reducing properties for me. Pleased might be a better word. Good luck.What is emsam? I haven't heard of it before. Does it go by another name in the U.S./Europe, or by a brand name?
Posted by floatingbridge on May 16, 2011, at 14:30:53
In reply to Re: AD's that are not demotivating?, posted by CaffeinePoet on May 16, 2011, at 13:53:34
Emsam is a transdermal preparation of
segeline. It's a brand name patch. An maoi. At lower doses (like 6mg transdermal) there are no dietary restrictions.Then there's something about maoi a or b inhibition at different doses, but I don't seem to get that straight. Sorry.
Google segeline or emsam. This is in the US. In Europe, I don't know.
This is the end of the thread.
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