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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 paulb on November 20, 2015, at 20:47:09
HI
I have anxiety disorder mainly social but general and a bit of panic. Interested in and have tried topiramate, gabapentin, pregabalin, clonazepam(benzo/anticonvulsant, but not vigabatrin or tiagabine. had good results with pregabalin and gabapentin but my pdoc wouldnt let me stay on the dose needed for relief as was slightly above the RDA. Clonazepam was far too strong. i am now on lorazepam which i know is not an anticonvulsant but tolerate much better than clonazepam. have got 50% remission after being on it for a long time. I would like to ask is topiramate consistent in its effect or does it not provide a smooth ride for people with anxiety as i was not on it that long . vigabatrin sounds scary because of the vision problems and im not sure about tiagabine. i like the souynd of topiramate because it works on gaba a and would work syngernistically with lorazepam but what could be its pitfalls. at the end of the day i just have to try it but for whatever reason its not effective enough i dont think vigabatrin is available to people with mood disorders because of the severe side effect mentioned and more info is needed for me on tiagabine. if you respond ill keep trying to run this thread because theres so much i want to ask. thanks paulb
Posted by rjlockhart37 on November 21, 2015, at 0:39:50
In reply to please help me on anticonvulsants for anxiety, posted by paulb on November 20, 2015, at 20:47:09
Lyrica and Nuerontin are vary good off label use for anxiety. I've been on both of them. But Lyrica in the US is a C-V substance, it has antianxiety effects without much of the addiction potential of benzos. It's a step below the benzo's
Depakote is a good agitation and some anxiety but it has some cognitive blunting effects, it can slow down some thinking and make you feel off.
Gabiril (tiagabine) i've never taken but i have read it increaes levels of GABA, but mainly the choice would be depakote by doctors, it's a widely used for siezures and some mood disorders
Posted by paulb on November 21, 2015, at 4:00:29
In reply to Re: please help me on anticonvulsants for anxiety, posted by rjlockhart37 on November 21, 2015, at 0:39:50
> Lyrica and Nuerontin are vary good off label use for anxiety. I've been on both of them. But Lyrica in the US is a C-V substance, it has antianxiety effects without much of the addiction potential of benzos. It's a step below the benzo's
>
> Depakote is a good agitation and some anxiety but it has some cognitive blunting effects, it can slow down some thinking and make you feel off.
>
> Gabiril (tiagabine) i've never taken but i have read it increaes levels of GABA, but mainly the choice would be depakote by doctors, it's a widely used for siezures and some mood disorders
>
>Yes, i agree lyrica is good stuff for anxiety. curiously it worked better for me with lamotrigine but i had to increase the lyrica dose. I have not had much experience with depakote i guess its kind of an older medication but still good. What is your view on topiramate in terms of consisitency of effect, how well it works with other medications and in general for anxiety.
Posted by linkadge on November 21, 2015, at 14:19:32
In reply to Re: please help me on anticonvulsants for anxiety, posted by paulb on November 21, 2015, at 4:00:29
If you did well or lorazepam and / or lyrica, you may ask to combine them? I.e. a lower dose of lyrica and some lorazepam.
Linkadge
Posted by rjlockhart37 on November 21, 2015, at 21:58:27
In reply to Re: please help me on anticonvulsants for anxiety, posted by paulb on November 21, 2015, at 4:00:29
i've never taken topamax but topamax has a clicq name for being called "dopamax" because of it's clouding in some thinking, but thats praobly at higer doses, i don't think topamax has a sedating but it could have some stablization with nuero's, it's a good mood stabilzer off label use.....
lithium is always been known a golden treatment mood stabilizer but in the US, sometimes you have check your lithium levels with blood tests, and i hate needles
maybe ask about trileptal or tegetrol those are known to have calming properties without "real" sedation
Posted by herpills on November 22, 2015, at 11:19:17
In reply to please help me on anticonvulsants for anxiety, posted by paulb on November 20, 2015, at 20:47:09
I don't know of any anticonvulsant that would help anxiety any better than pregabalin would. What dose did you need to find it effective? I know the max fda dose is 600mg, but maybe you could find a doctor that would be willing to go higher? I had a pain doctor once tell me they would go as high as 900mg.
Posted by Christ_empowered on November 22, 2015, at 11:30:05
In reply to please help me on anticonvulsants for anxiety, posted by paulb on November 20, 2015, at 20:47:09
I think a lyrica+benzo mix sounds good. Have you ever tried supplements? I do old school Orthomolecular, the core of which is: b-100 complex, high dose vitamin c, and high dose either niacin or niacinamide (I've opted for niacinamide).
In high doses, B3 acts kinda sorta like a benzo in the brain. It can potentiate some anticonvulsants and benzos, too. Its also a potent antioxidant. It also...cheap. I now take 6 grams/day, using 1.5 gram sustained release tablets (2 in the AM, 2 in the PM), plus everything else.
I was just thinking...you could do a basic Orthomolecular protocol w/ lyrica, a benzo, or whatever med(s) you end up on, and then maybe you'll get more mileage out of the Rx pills.
Posted by Christ_empowered on November 22, 2015, at 11:45:01
In reply to please help me on anticonvulsants for anxiety, posted by paulb on November 20, 2015, at 20:47:09
Taurine is sometimes used in high(ish) doses as a calmative. I take both taurine and niacinamide (I'm just that anxious, lol), and I think it works well for me.
Maybe a couple grams daily? (Preferably on an empty stomach).
Again, just a thought.
Posted by SLS on November 22, 2015, at 14:46:35
In reply to please help me on anticonvulsants for anxiety, posted by paulb on November 20, 2015, at 20:47:09
Tiagabine (Gabitril) can be effective for anxiety disorders and insomnia. However, it is rather unpredictable. It can produce agitation, anger, irritability, anxiety, and dysphoria in a minority of people. However, because it can work so well, it wouldn't hurt to try. These adverse effects would show up rather quickly. If they do, just stop taking the drug. I don't think they disappear with continued treatment.
Check out Google.
https://www.google.com/?gws_rd=ssl#q=tiagabine+anxiety+disorders
Good luck.
- Scott
Posted by rjlockhart37 on November 22, 2015, at 21:49:44
In reply to Re: please help me on anticonvulsants for anxiety » paulb, posted by SLS on November 22, 2015, at 14:46:35
yea it has cognitive side effects, i read that when i researched about gabirtil few years ago......it can cause serious side effects with people who never taken it before espcially without siezures
vaporate is more predictable than tiagabine
Posted by SLS on November 23, 2015, at 8:42:52
In reply to Re: please help me on anticonvulsants for anxiety » SLS, posted by rjlockhart37 on November 22, 2015, at 21:49:44
> yea it has cognitive side effects, i read that when i researched about gabirtil few years ago......it can cause serious side effects with people who never taken it before espcially without siezures
>
> vaporate is more predictable than tiagabineThe problem with valproate is that it often leaves people feeling somewhat depressed and has the potential for producing liver and platelet abnormalities.
Phidippus reports seeing good results with tiagabine (Gabitril) for anxiety. I think the key is to start with a much lower dosage than what is used for seizure disorders, and titrate gradually. To my knowledge, it is the only GABA reuptake inhibitor available.
- Scott
Posted by Phillipa on November 23, 2015, at 12:05:42
In reply to Re: please help me on anticonvulsants for anxiety, posted by SLS on November 23, 2015, at 8:42:52
Scott is that gabapentin? Thanks Phillipa
Posted by paulb on November 23, 2015, at 15:52:50
In reply to Re: please help me on anticonvulsants for anxiety, posted by linkadge on November 21, 2015, at 14:19:32
The combination of lorazepam and a lower dose of pregabalin is a great idea i will suggest to my physician. thankyou for your advice
Posted by paulb on November 23, 2015, at 15:57:57
In reply to Re: please help me on anticonvulsants for anxiety » paulb, posted by herpills on November 22, 2015, at 11:19:17
It was 750mg that did the trick for me. 600mg which is the RDA wasnt enough but when it was increased to 750 it worked wonders. I have heard tale of a physician in a city near where i live prescribe up to 900mg of pregabalin. A fellow patient told me about that when i was in hospital.
Posted by SLS on November 23, 2015, at 19:37:18
In reply to Re: please help me on anticonvulsants for anxiety, posted by paulb on November 23, 2015, at 15:52:50
> The combination of lorazepam and a lower dose of pregabalin is a great idea i will suggest to my physician. thankyou for your advice
My apologies. I misread your first post. I thought you had already tried combining lorazepam with pregabalin. Linkadge's idea is indeed an excellent one. I hope it works for you.
I did some of my own investigation into the utility of using tiagabine (Gabitril) to treat GAD. Several articles suggest that it is not effective.
I found this review of strategies to treat GAD:
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3184575/
- Scott
Posted by phidippus on December 4, 2015, at 0:11:14
In reply to please help me on anticonvulsants for anxiety, posted by paulb on November 20, 2015, at 20:47:09
lorazepam is an anticonvulsant. tiagabine is a selective gaba reuptake inhibitor. and has some data supporting it as an effective anxiolytic. topomax has no indications for anxiety and in fact can worsen it.
Eric
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