![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 10 to 34 of 46. Go back in thread:
Posted by jono_in_adelaide on September 30, 2012, at 0:18:23
In reply to Re: I'm done with benzos. What else can I use? » phidippus, posted by SLS on September 29, 2012, at 23:08:05
Geodon works by blocking the 5HT2 receptors which paly a significant role in anxiety and agitation.
I'd try Atarax first (say 50mg three times a day prn) and if that doesnt prove adequate, I'd try Geodon 20mg twice a day prn
Taking Buspar 15-30mg twice a day continuously might also be helpful.
I was under the impression that gabapentin and pregabalin took several days to achive their effect?
Posted by jono_in_adelaide on September 30, 2012, at 0:31:13
In reply to Re: I'm done with benzos. What else can I use? » phidippus, posted by SLS on September 29, 2012, at 23:08:05
"I can't see Geodon as being used as a PRN for anxiety, especially when lower dosages can be anxiogenic and produce insomnia. Is it worth a try? I guess so."
http://www.ncbi.nlm.nih.gov/pubmed/11910268
The novel atypical antipsychotic ziprasidone has a pharmacologic profile notable for potent agonism of serotonin (5-HT)1A receptors, antagonism at 5-HT1D receptors, and reuptake inhibition of norepinephrine. 5-HT1A receptor agonism, in particular, suggests anxiolytic activity, and ziprasidone has shown preliminary efficacy in treating the symptoms of anxiety associated with psychotic disorders. In this study, the anxiolytic efficacy of ziprasidone was evaluated in nonpsychotic subjects who were anxious before undergoing minor dental surgery. We compared a single oral dose of 20 mg ziprasidone (N = 30) with that of 10 mg diazepam (N = 30) and placebo (N = 30) in a randomized, parallel-group, double-blind study. The peak anxiolytic effect of ziprasidone compared with that of placebo was similar to that of diazepam but had a later onset. At 3 hours postdose, the anxiolytic effect of ziprasidone was significantly greater than that of placebo (p < 0.05) and somewhat greater than that of diazepam. Diazepam showed a significantly greater anxiolytic effect than placebo at 1 hour (p < 0.05) but not at 3 hours. The sedative effect of ziprasidone was never greater than that of placebo, whereas that of diazepam was significantly greater than that of placebo 1 to 1.5 hours postdose. Ziprasidone was generally well tolerated. Only one patient reported treatment-related adverse events (nausea and vomiting) and, unlike diazepam, ziprasidone did not cause reductions in blood pressure. Dystonia, extrapyramidal syndrome, akathisia, and postural hypotension were not seen with ziprasidone. Thus, ziprasidone may possess anxiolytic effects in addition to its antipsychotic properties.
I would definatly try Atarax first ( the drowsiness passes off within a week) but if you have failed both atarax and benzos, then I would think a theraputic trial of Geodon in a low dose would be indicated
Posted by vbs on September 30, 2012, at 0:57:39
In reply to Re: I'm done with benzos. What else can I use?, posted by jono_in_adelaide on September 30, 2012, at 0:31:13
Ask your pdoc about Buspar and hydroxyzine. Either of these would be good alternatives to benzos.
Posted by SLS on September 30, 2012, at 3:18:11
In reply to Re: I'm done with benzos. What else can I use?, posted by jono_in_adelaide on September 30, 2012, at 0:31:13
Hi Jono.
I am surprised by the study you provided. Geodon (ziprasidone) is somewhat weird. At low dosages, Geodon blocks 5-HT2c receptors to a greater extent than the 5-HT2a or DA receptors, and is an inhibitor of NET and SERT. It is described as being be activating, and even agitating at low dosages by Stephen Stahl. He explains the pharmacology underlying the clinical observation, and he recommends using higher dosages. In my opinion, Geodon is just an unpredictable drug. I guess there is nothing to lose by trying it, though. For all I know, Stahl is completely wrong. There is the possibility, though, that his observations are limited to people suffering from schizophrenia, and that they do not extrapolate well to other disorders. Interestingly, it is the blockade of 5-HT2c receptors by Prozac that might explain why some people experience anxiety and agitation when they first begin taking that drug.
http://www.medscape.org/viewarticle/484929
"Here's a very interesting thing about ziprasidone. Have you ever given ziprasidone at 20 mg and had a patient become activated and agitated? If you have, the reason is that the dosing is too low. Because this is such a powerful 5HT2C antagonist, at low doses, that's all it does. It doesn't have any dopamine antagonism, so it's potentially activating, at least for those people whose genes don't want to have their 5HT2C receptors blocked...
To prevent this, you've got to do a counterintuitive thing, which is to stop using 20 mg, because you're going to make patients "go bonkers." You've got to use probably 60 mg to have enough robust D2 on board so that the patient doesn't get activated. This is an art. Some patients tolerate different doses than others; but the counterintuitive thing is that you raise the dose, you get less activation. If you've had bad experience with this particular drug, that might help you understand how to dose"
I was impressed with Phenergan (promethazine) for anxiety. I've seen it work well enough such that it was an effective replacement for Zyprexa in a male schizophrenic, but without the metabolic side effects.
Agitation is listed as a frequent side effect of Geodon in the package label.
http://www.rxlist.com/geodon-drug/side-effects-interactions.htm
- Scott> "I can't see Geodon as being used as a PRN for anxiety, especially when lower dosages can be anxiogenic and produce insomnia. Is it worth a try? I guess so."
>
> http://www.ncbi.nlm.nih.gov/pubmed/11910268
>
> The novel atypical antipsychotic ziprasidone has a pharmacologic profile notable for potent agonism of serotonin (5-HT)1A receptors, antagonism at 5-HT1D receptors, and reuptake inhibition of norepinephrine. 5-HT1A receptor agonism, in particular, suggests anxiolytic activity, and ziprasidone has shown preliminary efficacy in treating the symptoms of anxiety associated with psychotic disorders. In this study, the anxiolytic efficacy of ziprasidone was evaluated in nonpsychotic subjects who were anxious before undergoing minor dental surgery. We compared a single oral dose of 20 mg ziprasidone (N = 30) with that of 10 mg diazepam (N = 30) and placebo (N = 30) in a randomized, parallel-group, double-blind study. The peak anxiolytic effect of ziprasidone compared with that of placebo was similar to that of diazepam but had a later onset. At 3 hours postdose, the anxiolytic effect of ziprasidone was significantly greater than that of placebo (p < 0.05) and somewhat greater than that of diazepam. Diazepam showed a significantly greater anxiolytic effect than placebo at 1 hour (p < 0.05) but not at 3 hours. The sedative effect of ziprasidone was never greater than that of placebo, whereas that of diazepam was significantly greater than that of placebo 1 to 1.5 hours postdose. Ziprasidone was generally well tolerated. Only one patient reported treatment-related adverse events (nausea and vomiting) and, unlike diazepam, ziprasidone did not cause reductions in blood pressure. Dystonia, extrapyramidal syndrome, akathisia, and postural hypotension were not seen with ziprasidone. Thus, ziprasidone may possess anxiolytic effects in addition to its antipsychotic properties.
>
>
> I would definatly try Atarax first ( the drowsiness passes off within a week) but if you have failed both atarax and benzos, then I would think a theraputic trial of Geodon in a low dose would be indicated
Posted by jono_in_adelaide on September 30, 2012, at 5:45:03
In reply to Re: I'm done with benzos. What else can I use? » jono_in_adelaide, posted by SLS on September 30, 2012, at 3:18:11
You may well be right scott, but given that he has failed on numerous benzos, his options seem to be hydroxyzine, buspar, or failing that, one of the atypicals..... and I thought of geodon because it has less sedative and metabolic effects than the others, and (as per that study) has some evidence base for PRN use in anxiety.
I think his first option should be Atarax or Buspar, and his second option should be Atarax + Buspar, with an atypical comming a distant third'
For what its worth, Melleril would have been good in this situation, but unfortunatly it is no more
Posted by SLS on September 30, 2012, at 8:14:52
In reply to Re: I'm done with benzos. What else can I use?, posted by jono_in_adelaide on September 30, 2012, at 5:45:03
> You may well be right scott, but given that he has failed on numerous benzos, his options seem to be hydroxyzine, buspar, or failing that, one of the atypicals..... and I thought of geodon because it has less sedative and metabolic effects than the others, and (as per that study) has some evidence base for PRN use in anxiety.
>
> I think his first option should be Atarax or Buspar, and his second option should be Atarax + Buspar, with an atypical comming a distant third'
>
> For what its worth, Melleril would have been good in this situation, but unfortunatly it is no more
I think your reasons for choosing Geodon are good ones.Do you think Buspar can be used as a PRN? I thought that it takes a few weeks to begin working.
- Scott
Posted by Lou Pilder on September 30, 2012, at 8:46:24
In reply to Re: I'm done with benzos. What else can I use? » jono_in_adelaide, posted by SLS on September 30, 2012, at 3:18:11
> Hi Jono.
>
> I am surprised by the study you provided. Geodon (ziprasidone) is somewhat weird. At low dosages, Geodon blocks 5-HT2c receptors to a greater extent than the 5-HT2a or DA receptors, and is an inhibitor of NET and SERT. It is described as being be activating, and even agitating at low dosages by Stephen Stahl. He explains the pharmacology underlying the clinical observation, and he recommends using higher dosages. In my opinion, Geodon is just an unpredictable drug. I guess there is nothing to lose by trying it, though. For all I know, Stahl is completely wrong. There is the possibility, though, that his observations are limited to people suffering from schizophrenia, and that they do not extrapolate well to other disorders. Interestingly, it is the blockade of 5-HT2c receptors by Prozac that might explain why some people experience anxiety and agitation when they first begin taking that drug.
>
> http://www.medscape.org/viewarticle/484929
>
> "Here's a very interesting thing about ziprasidone. Have you ever given ziprasidone at 20 mg and had a patient become activated and agitated? If you have, the reason is that the dosing is too low. Because this is such a powerful 5HT2C antagonist, at low doses, that's all it does. It doesn't have any dopamine antagonism, so it's potentially activating, at least for those people whose genes don't want to have their 5HT2C receptors blocked...
>
> To prevent this, you've got to do a counterintuitive thing, which is to stop using 20 mg, because you're going to make patients "go bonkers." You've got to use probably 60 mg to have enough robust D2 on board so that the patient doesn't get activated. This is an art. Some patients tolerate different doses than others; but the counterintuitive thing is that you raise the dose, you get less activation. If you've had bad experience with this particular drug, that might help you understand how to dose"
>
> I was impressed with Phenergan (promethazine) for anxiety. I've seen it work well enough such that it was an effective replacement for Zyprexa in a male schizophrenic, but without the metabolic side effects.
>
> Agitation is listed as a frequent side effect of Geodon in the package label.
>
> http://www.rxlist.com/geodon-drug/side-effects-interactions.htm
>
>
> - Scott
>
>
>
> > "I can't see Geodon as being used as a PRN for anxiety, especially when lower dosages can be anxiogenic and produce insomnia. Is it worth a try? I guess so."
> >
> > http://www.ncbi.nlm.nih.gov/pubmed/11910268
> >
> > The novel atypical antipsychotic ziprasidone has a pharmacologic profile notable for potent agonism of serotonin (5-HT)1A receptors, antagonism at 5-HT1D receptors, and reuptake inhibition of norepinephrine. 5-HT1A receptor agonism, in particular, suggests anxiolytic activity, and ziprasidone has shown preliminary efficacy in treating the symptoms of anxiety associated with psychotic disorders. In this study, the anxiolytic efficacy of ziprasidone was evaluated in nonpsychotic subjects who were anxious before undergoing minor dental surgery. We compared a single oral dose of 20 mg ziprasidone (N = 30) with that of 10 mg diazepam (N = 30) and placebo (N = 30) in a randomized, parallel-group, double-blind study. The peak anxiolytic effect of ziprasidone compared with that of placebo was similar to that of diazepam but had a later onset. At 3 hours postdose, the anxiolytic effect of ziprasidone was significantly greater than that of placebo (p < 0.05) and somewhat greater than that of diazepam. Diazepam showed a significantly greater anxiolytic effect than placebo at 1 hour (p < 0.05) but not at 3 hours. The sedative effect of ziprasidone was never greater than that of placebo, whereas that of diazepam was significantly greater than that of placebo 1 to 1.5 hours postdose. Ziprasidone was generally well tolerated. Only one patient reported treatment-related adverse events (nausea and vomiting) and, unlike diazepam, ziprasidone did not cause reductions in blood pressure. Dystonia, extrapyramidal syndrome, akathisia, and postural hypotension were not seen with ziprasidone. Thus, ziprasidone may possess anxiolytic effects in addition to its antipsychotic properties.
> >
> >
> > I would definatly try Atarax first ( the drowsiness passes off within a week) but if you have failed both atarax and benzos, then I would think a theraputic trial of Geodon in a low dose would be indicatedFriends,
It is written here that one has {nothing to loose} by trying Geodon.
You may be a parent or caretaker and trying to make a more-informed decision as to drug your child or parent or not, or even yourself to be drugged.
Be advised, that the drug {Geodon}, has in it chemical constituants that I am not permitted here by the nature of prohibitions posted to me here by Mr Hsiung, to fully reveal the historical development of psychotropic drugs, their uses as for what, and who devised the drugs durring a particular time period.
So let it be with Mr Hsiung. I come to save people, not to (redacted by respondent). The drug, Geodon, can induce life-ruining conditions, addiction and death. And more than that, the drug can induce agreession that could lead to the murder of others and the killing of one's self. The withdrawal can be horrific and there is no proven treatment that I know of by {humnan achievemnt} to alleviate the withdrawal. But I know of a way for people to get through withdrawal from these drugs and there is a prohibition to me here by Mr Hsiung that prevents me from posting that here.
Here are some statistics that could open your eyes to a situaton that may not be acknowledged that could have the potential for you to make a more informed decision as to put the chemicals of this drug into your body or not.
Lou
http://www.ehealthme.com/ds/geodon/tardive+dyskinesia
Now you see that the stats show over 5%. Now those of you that are sceptics concerning this site, ehealthme, can contact the site to understand more as to what these stats mean and how they were gathered. And the Mayo Clinic endorses the site. If you doubt the sit's credibility by someone making claims against the site here, you could contact the Mayo clinic ad ask them.
And now the drug could kill you.
http://www.ehealthme.com/ds/geodon/death
And then there is aggresion.
http://www.ehealthme.com/ds/geodon/aggression
Nothing to loose?
Posted by Lou Pilder on September 30, 2012, at 9:32:04
In reply to I'm done with benzos. What else can I use?, posted by phidippus on September 29, 2012, at 17:48:43
> Benzos just make me depressed. I just came off 2mg of Klonopin and felt much brighter. What else can I use PRN for anxiety?
>
> EricFriends,
It is written here, [...what else can I use?...].
Be advised, those that want the poster to continue to go down the road of {human achievement} to overcome depression and/or addiction by taking mind-altering drugs, that the road thearof is a very broad road, wider than a mile. But those of you that advocate one to go down that road, do you tell them where that road leads them to what's waiting 'round the bend? Does it lead to tardive dyskinesia, heart failure, death, addiction, induce a mind-altered state to cause one to kill themselves or commit mass-murder and a host of other life-ruining conditions?
Now I prohibited here by the nature of the prohibitions posted to me here by Mr Hsiung from revealing a lot about these drugs, that IMHHHO could mark the difference between you being a live person or a corpse. And the party-line here involves Mr Hsiung citing Jean Jacques Rousseau's fascism by him posting a table of contents of one of Rousseau's writings that others that followed his thinking based thier justification for mass-murder and state-sponsored antisemitism on. After all, Mr Hsiung states that he does what will be good for this community as a whole. As a whole? Do you have any idea who also said that? Can you not all see where this wide road leads to? could it lead to death? Would that be good for this community as a whole? If so, is this not then a community of (redacted by respondent)?
Lou
Posted by Lou Pilder on September 30, 2012, at 10:13:42
In reply to Lou's response-wheytngrowndhaben, posted by Lou Pilder on September 30, 2012, at 9:32:04
> > Benzos just make me depressed. I just came off 2mg of Klonopin and felt much brighter. What else can I use PRN for anxiety?
> >
> > Eric
>
> Friends,
> It is written here, [...what else can I use?...].
> Be advised, those that want the poster to continue to go down the road of {human achievement} to overcome depression and/or addiction by taking mind-altering drugs, that the road thearof is a very broad road, wider than a mile. But those of you that advocate one to go down that road, do you tell them where that road leads them to what's waiting 'round the bend? Does it lead to tardive dyskinesia, heart failure, death, addiction, induce a mind-altered state to cause one to kill themselves or commit mass-murder and a host of other life-ruining conditions?
> Now I prohibited here by the nature of the prohibitions posted to me here by Mr Hsiung from revealing a lot about these drugs, that IMHHHO could mark the difference between you being a live person or a corpse. And the party-line here involves Mr Hsiung citing Jean Jacques Rousseau's fascism by him posting a table of contents of one of Rousseau's writings that others that followed his thinking based thier justification for mass-murder and state-sponsored antisemitism on. After all, Mr Hsiung states that he does what will be good for this community as a whole. As a whole? Do you have any idea who also said that? Can you not all see where this wide road leads to? could it lead to death? Would that be good for this community as a whole? If so, is this not then a community of (redacted by respondent)?
> LouFriewnds,
If you are considering understanding more of what's goin' on here, I am requesting that you read the following.
Lou
To see up Google
B. Type in:
[Rousseau and the parenthood of the state part 2] and part 1
Posted by ChicagoKat on September 30, 2012, at 10:57:34
In reply to Re: I'm done with benzos. What else can I use? » jono_in_adelaide, posted by SLS on September 30, 2012, at 8:14:52
> > You may well be right scott, but given that he has failed on numerous benzos, his options seem to be hydroxyzine, buspar, or failing that, one of the atypicals..... and I thought of geodon because it has less sedative and metabolic effects than the others, and (as per that study) has some evidence base for PRN use in anxiety.
> >
> > I think his first option should be Atarax or Buspar, and his second option should be Atarax + Buspar, with an atypical comming a distant third'
> >
> > For what its worth, Melleril would have been good in this situation, but unfortunatly it is no more
>
>
> I think your reasons for choosing Geodon are good ones.
>
> Do you think Buspar can be used as a PRN? I thought that it takes a few weeks to begin working.
>
>
> - ScottFor some reason my posts have not shown up. So if they eventually do and I am repeating myself, I apologize. I have 3 things to say.
1. For the most part you are all avoiding my suggestion of gabapentin. Yes, it does cause some some unwanted side effects, but for others it works VERY well, with minimal to no side effects. I can say that it has been a Godsend to me.
2. As far as "atypicals" go, I don't believe they are really so atypical. I don't believe they really cause that much less EPS. I know I had akathisia while on Zyprexa, and I've heard horror stories from many other people too. I've often wondered if it was just a marketing ploy by the manufacturers of antipsychotics to sell more drugs. I really believe, except for the people who really need them, that they are a dangerous class of drugs and not to be messed around with.
3. Buspar does indeed take weeks, if not months to work. I tried it and it did squat for me. I believe it is simply a hyped-up SSRI.
That's my 3 cents.
Kat
Posted by gadchik on September 30, 2012, at 12:38:54
In reply to Re: I'm done with benzos. What else can I use? » SLS, posted by ChicagoKat on September 30, 2012, at 10:57:34
Why not a low dose of Klonopin? Maybe you have tried it and its not for you? Ive used low dose remeron for anxiety. But I have read that anything over 1mg a day klonopin is less effective for anxiety and causes more side effects.
Posted by phidippus on September 30, 2012, at 14:44:15
In reply to Re: I'm done with benzos. What else can I use?, posted by gadchik on September 30, 2012, at 12:38:54
I have tried low dose Klonopin. I felt no effect on my anxiety.
Eric
Posted by phidippus on September 30, 2012, at 14:45:43
In reply to Re: I'm done with benzos. What else can I use? » SLS, posted by ChicagoKat on September 30, 2012, at 10:57:34
I get a drug rash from Gabapentin, however I do fine on Lyrica. Maybe I should try it again.
Eric
Posted by phidippus on September 30, 2012, at 14:48:43
In reply to Re: I'm done with benzos. What else can I use? » jono_in_adelaide, posted by SLS on September 30, 2012, at 8:14:52
I use Hydroxyzine as a sleep aid, but nothing more. I don't find its anxiolytic effect strong enough.
I've been on Buspar. It did nothing for me.
Eric
Posted by phidippus on September 30, 2012, at 14:51:57
In reply to Re: I'm done with benzos. What else can I use?, posted by jono_in_adelaide on September 30, 2012, at 5:45:03
I use hydroxyzine to help me sleep. Its isn't strong enough to use PRN for anxiety.
Buspar did nothing for me.
I was on Melleril as a kid.
Eric
Posted by phidippus on September 30, 2012, at 14:52:51
In reply to Re: I'm done with benzos. What else can I use?, posted by vbs on September 30, 2012, at 0:57:39
Thanks
Eric
Posted by phidippus on September 30, 2012, at 14:59:15
In reply to Re: I'm done with benzos. What else can I use?, posted by jono_in_adelaide on September 30, 2012, at 0:18:23
Gabapentin and Pregablin take effect right away. I've been on Lyrica before. It worked alright for anxiety. Just wish I could take it PRN.
Eric
Posted by phidippus on September 30, 2012, at 15:09:10
In reply to Re: I'm done with benzos. What else can I use? » phidippus, posted by SLS on September 29, 2012, at 23:08:05
about Promethazine:
"Also used to potentiate any opiates. Commonly combined with pethidine (AKA, meperidine, or Demerol) in a brand called Mepergan, a meperidine/promethazine combination. Also frequently used in conjunction with codeine, in a syrup form. The combination leads to more powerful euphoric effects than with codeine alone"-wikipedia.
I take 50 mg of Oxycodone almost every day. How would Promethazine affect me?
I have taken Gabapentin before-I got a drug rash. Lyrica I had no problems with.
Seroquel just makes me sleepy.
I'm curious to see if Geodon works. I've never found an atypical antipsychotic to be anxiolitic.
Eric
Posted by phidippus on September 30, 2012, at 15:12:01
In reply to Re: I'm done with benzos. What else can I use?, posted by Beckett on September 29, 2012, at 22:36:26
May I ask how you managed to kick the klonopin so quickly?
It took me a couple weeks to get down to 1 mg, then I just stopped it. No tricks.
Eric
Posted by SLS on September 30, 2012, at 15:12:11
In reply to Re: I'm done with benzos. What else can I use? » SLS, posted by ChicagoKat on September 30, 2012, at 10:57:34
Hi Kat.
> 1. For the most part you are all avoiding my suggestion of gabapentin.
Actually, I think several posts (including one of mine) are in agreement with your suggestion.
> 2. As far as "atypicals" go, I don't believe they are really so atypical. I don't believe they really cause that much less EPS.
You might be right. However, what I have encountered in the medical literature suggests that the differences in the occurrence of EPS - especially TD - are rather large; with SGAs being far less liable to produce these effects than the FGAs.
> I know I had akathisia while on Zyprexa, and I've heard horror stories from many other people too.
It seems to me that EPS is an infrequent occurrence on Psycho-Babble; this, despite the observation that EPS is more common among people with bipolar disorder than those with schizophrenia. I don't think most unaffected people will go out of their way to spontaneously post on Internet forums that they are not experiencing EPS.
> I really believe, except for the people who really need them, that they are a dangerous class of drugs and not to be messed around with.
I used to think that any AP was devilishly dangerous.
When should an AP not be used, in your opinion?
> 3. Buspar does indeed take weeks, if not months to work. I tried it and it did squat for me. I believe it is simply a hyped-up SSRI.
Like most other psychotropics, individual reactions to Buspar can be highly variable. Some people have reported here that Buspar has been the best anxiolytic that they had ever taken. I never tried it. For quite some time, it was thought that prior exposure to a BZD rendered Buspar less effective. I don't think this notion has been substantiated scientifically. I'm not sure, though.
- Scott
Posted by phidippus on September 30, 2012, at 15:14:19
In reply to Re: I'm done with benzos. What else can I use? » phidippus, posted by phillipa on September 29, 2012, at 21:28:31
Klonopin was making me depressed. It seems every benzo I try I just get paradoxical reactions. I'm sick of it. I need something else.
Eric
Posted by phidippus on September 30, 2012, at 15:16:42
In reply to Re: I'm done with benzos. What else can I use?, posted by jono_in_adelaide on September 30, 2012, at 0:31:13
Interesting, I might try this.
Eric
Posted by ChicagoKat on September 30, 2012, at 16:09:52
In reply to Re: I'm done with benzos. What else can I use? » jono_in_adelaide, posted by phidippus on September 30, 2012, at 14:59:15
> Gabapentin and Pregablin take effect right away. I've been on Lyrica before. It worked alright for anxiety. Just wish I could take it PRN.
>
> EricJust FYI Eric, I took Lyrica, and it worked, but not as well as Neurontin (for me, anyway), and it seemed to make my depression worse. but again, that's just for me, you may have a different experience. And I surely didn't take it prn, I had no idea I couldn't, even though the pdoc did write for an interval....I never pay attention to those. bad me....ha ha. but anyways, I never had any trouble taking it prn, just so you know. Good luck.
Kat
p.s. I do take things at interval that I KNOW should be taken at whatever interval they are written for. But I know which drugs I can just ignore that interval with....I AM a pharmacist, after all :)
Posted by ChicagoKat on September 30, 2012, at 16:14:28
In reply to Re: I'm done with benzos. What else can I use?, posted by phidippus on September 30, 2012, at 15:09:10
> about Promethazine:
>
> "Also used to potentiate any opiates. Commonly combined with pethidine (AKA, meperidine, or Demerol) in a brand called Mepergan, a meperidine/promethazine combination. Also frequently used in conjunction with codeine, in a syrup form. The combination leads to more powerful euphoric effects than with codeine alone"-wikipedia.
>
> I take 50 mg of Oxycodone almost every day. How would Promethazine affect me?
>
> I have taken Gabapentin before-I got a drug rash. Lyrica I had no problems with.
>
> Seroquel just makes me sleepy.
>
> I'm curious to see if Geodon works. I've never found an atypical antipsychotic to be anxiolitic.
>
> Eric
>
>
>
Eric, just another FYI, I'd warn you to stay away from Phergan...it can have some pretty nasty side effects, especially when mixed with the drugs you are taking. And again, I'd warn you against the Geodon, b/c I think antipsychotics, be they "atiypical" or not can have some really nasty side effects and be downright dangerous in certain conditions. The drugs you are on makes me urge this warning to you even more strongly.
Kat
Posted by ChicagoKat on September 30, 2012, at 16:43:55
In reply to Re: I'm done with benzos. What else can I use?, posted by SLS on September 30, 2012, at 15:12:11
> Hi Kat.
>
> > 1. For the most part you are all avoiding my suggestion of gabapentin.
>
> Actually, I think several posts (including one of mine) are in agreement with your suggestion.
>
> > 2. As far as "atypicals" go, I don't believe they are really so atypical. I don't believe they really cause that much less EPS.
>
> You might be right. However, what I have encountered in the medical literature suggests that the differences in the occurrence of EPS - especially TD - are rather large; with SGAs being far less liable to produce these effects than the FGAs.
>
> > I know I had akathisia while on Zyprexa, and I've heard horror stories from many other people too.
>
> It seems to me that EPS is an infrequent occurrence on Psycho-Babble; this, despite the observation that EPS is more common among people with bipolar disorder than those with schizophrenia. I don't think most unaffected people will go out of their way to spontaneously post on Internet forums that they are not experiencing EPS.
>
> > I really believe, except for the people who really need them, that they are a dangerous class of drugs and not to be messed around with.
>
> I used to think that any AP was devilishly dangerous.
>
> When should an AP not be used, in your opinion?Oh, I believe antipsychotics should be used for certain, but only in people in whom I believe the benefit outweighs the risk. I'm talking of people with schizophrenia or bipolar individuals who experience psyshotic episodes. I think the antipsychotics are very useful in those incidences. But using them for other purposes..to augment depression treatment, to help with sleep I see as using a cannon when a simple gun will suffice. Let's face it..all antipsychotics carry the risk of EPS, including the atypicals, and as you well know, some of those effects, especially TD, is irreversible. So why expose people to such a very real and very bad risk when it's not necessary? Of course, I may be biased b/c of my experience with akathisia which went on for an entire hellish summer. At the time I just thought it was worsening of my condition, that my anxiety was getting worse. Then I noticed how much pacing I was/had been doing and got to thinking about it. The minute I stopped Zyprexa is when that HELL went away. And, let's face too, that a LOT of people may experience akathisia from antipsychotics, atypical or not, and will do the same thing I did: think it's just a worsening of their anxiety and will never imagine it's actually akathisia caused by the AP they are taking. I was lucky I knew more about the subject, but it took even me months to pick up on it, and my pdoc at the time (a different one than I have now..my current one would have picked it up in an instant)..anyways even my super-highly trained, supposedly incredibly knowledgeable pdoc never even suspected it.
Anyways that is a long post ( as usual, from me!) to let you know why I don't think APs should be used so casually, even if they are atypical, b/c I experienced a nightmare from one, I expect many innocent people are experiencing the same nightmare right now b/c of them, and I have heard lots of other horror stories, and I think more will come out. I just don't believe the atypicals are as free from EPS as the manufacturers have led us to believe. But, of course, I believe 100% in their use in those who truly need them, be they atypicals or not.
Oh - and I certainly believe in the use of chlorpromazine in the treatment of SS.OK, end of rant. Guess that's why there's a forum; it provides info, but it also gives us space to disagree in a (hopefully) respectful way. b/c I truly do respect your knowledge and opinions on this board. Just not when it comes to this topic. Hope you are feeling better!
Kat
>
> > 3. Buspar does indeed take weeks, if not months to work. I tried it and it did squat for me. I believe it is simply a hyped-up SSRI.
>
> Like most other psychotropics, individual reactions to Buspar can be highly variable. Some people have reported here that Buspar has been the best anxiolytic that they had ever taken. I never tried it. For quite some time, it was thought that prior exposure to a BZD rendered Buspar less effective. I don't think this notion has been substantiated scientifically. I'm not sure, though.I concede your points on Buspar. I guess I tend to get negative on things that didn't work for me, but that is very wrong of me b/c the brain is so not understood, it is like the universe in the way we don't understand it, and everyone reacts differently to different psyhotropics. So I concede your point that Buspar may indeed be very effective for some, even though it is certainly true it takes weeks to work.
>
>
> - Scott
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