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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 utopizen on August 24, 2002, at 22:04:01
I'm pretty much treatment resistant, GAD.
I use to think I wasn't GAD, because I was "only" anxious in social situtations. Turns out from reading a medical doc that GAD just means my anxiety is existing in more than two parameters- for example, public speaking, talking to new people, "mating" (as psychiatrists romantically say).
Ok, so my social anxiety/social phobia/GAD/whatever you want to call it has seen and fought off Celexa, Paxil, beta blockers, and even made me too chill to talk on Klonopin.
And Wellbutrin was causing me such dry throat I was consistently waking up at 3 in the morning with a painful dryness feeling.Neurontin works, but with too much cognitive disturbance/brain fog. It works if other people were to rate how I spoke to them with ease, and I've (gasp) even introduced myself to a celebrity on it. But it requires 1600mg (high dose) and takes 3 hrs. to kick in, and impairs my concentration too much to bother using in school.
So I want to go on something serious, 3rd line. I want an MAOI, I think. I've heard the trend in resistant anxiety patients is to use new antipsychotics. That freaks me out, but let me know your experience with it if you've gotten it for that purpose.
I'm vegan, thank god, so cheese isn't a problem. And I hate alcohol, so I should be able to avoid it even in my very alcohol-centric campus....
but I really want to know, what do socially anxious people taking MAOIs feel on one?
Can you "mate" at ease?Why is Parnate and Nardil carrying different supporters, while only Nardil is ever considered the "gold standard"? I have ADD, and a claim on the 'net I heard was that Parnate is activating- which is attracting to an ADDer, since activiating drugs tend to also help us focus.
And what are those weird drugs no one ever lists as a good drug for anxiety because it's only for "treatment resistant" patients? I've got all the markings of a soon-to-be early onset alcoholic if I don't race myself into treatment soon! =)
thanks for your help, fellow treatment resistment patients!
Posted by cybercafe on August 25, 2002, at 0:51:45
In reply to Give me your antipsychotics, your benzos, MAOIs..., posted by utopizen on August 24, 2002, at 22:04:01
> I use to think I wasn't GAD, because I was "only" anxious in social situtations. Turns out from reading a medical doc that GAD just means my anxiety is existing in more than two parameters- for example, public speaking, talking to new people, "mating" (as psychiatrists romantically say).
really?? hmmm.... i thought it included the words "persistent"
> Ok, so my social anxiety/social phobia/GAD/whatever you want to call it has seen and fought off Celexa, Paxil, beta blockers, and even made me too chill to talk on Klonopin.
> And Wellbutrin was causing me such dry throat I was consistently waking up at 3 in the morning with a painful dryness feeling.you're saying wellbutrin cured you but klonopin did not?
> Neurontin works, but with too much cognitive disturbance/brain fog. It works if other people were to rate how I spoke to them with ease, and I've (gasp) even introduced myself to a celebrity on it. But it requires 1600mg (high dose) and takes 3 hrs. to kick in, and impairs my concentration too much to bother using in school.... i was taking 2700 mg neurontin before with no drowsiness ... how long have you been on it for?
did you find neurontin more sedating than klonopin?> So I want to go on something serious, 3rd line. I want an MAOI, I think. I've heard the trend in resistant anxiety patients is to use new antipsychotics. That freaks me out, but let me know your experience with it if you've gotten it for that purpose.
yeah the atypicals seem okay... kind of overkill perhaps ... i'd rather go for an anticonvulsant (gabatril? or the other one... ) if possible
> I'm vegan, thank god, so cheese isn't a problem. And I hate alcohol, so I should be able to avoid it even in my very alcohol-centric campus....
well i think alcohol is okay except for tap beer and red wine, but not sure... i wouldn't touch alcohol on any AD myself cuz it won't get metabolized for 56+ hours .. so you may as well just stop taking your meds!
> but I really want to know, what do socially anxious people taking MAOIs feel on one?
> Can you "mate" at ease?.. nope! but i'm taking the lowest dose, and it sure helps
> Why is Parnate and Nardil carrying different supporters, while only Nardil is ever considered the "gold standard"? I have ADD, and a claim on the 'net I heard was that Parnate is activating- which is attracting to an ADDer, since activiating drugs tend to also help us focus.
i'm guessing that nardil would be better, but parnate has a nice side effect profile -- in general though, YMMV
> And what are those weird drugs no one ever lists as a good drug for anxiety because it's only for "treatment resistant" patients? I've got all the markings of a soon-to-be early onset alcoholic if I don't race myself into treatment soon! =)
you mean MAOIs? ... or are you talking about something else ? .. i am wondering how serzone would do
> thanks for your help, fellow treatment resistment patients!
heh heh
Posted by alan on August 25, 2002, at 2:10:09
In reply to Give me your antipsychotics, your benzos, MAOIs..., posted by utopizen on August 24, 2002, at 22:04:01
> I'm pretty much treatment resistant, GAD.
>
> I use to think I wasn't GAD, because I was "only" anxious in social situtations. Turns out from reading a medical doc that GAD just means my anxiety is existing in more than two parameters- for example, public speaking, talking to new people, "mating" (as psychiatrists romantically say).
>
> Ok, so my social anxiety/social phobia/GAD/whatever you want to call it has seen and fought off Celexa, Paxil, beta blockers, and even made me too chill to talk on Klonopin.
------------------------------------------You've only tried klonopin for GAD? What happened to valium, tranxene, ativan or xanax in monotherapy or in combination with each other? Many get startlingly different results with each.
Alan
Posted by utopizen on August 25, 2002, at 7:31:32
In reply to Re: Give me your antipsychotics, your benzos, MAOIs..., posted by cybercafe on August 25, 2002, at 0:51:45
Wellbutrin was only in my system for a week. The dry throat caused me to wake up consistently each morning at 3 AM with a painfully dry feeling, which is too much on my sleep schedule to take- so I don't know how it would do.
I've been taking Neurontin as needed for about 6 months. I decided it might not be best for mono therapy when after experiencing great results the first day, I had left the pills in my bag in someone's car and ended up acting noticably anxious around a potential "mate". I'd prefer something, at least to add, that didn't leave after 6 hours.
Klonopin and Neurontin don't seem too sedating. I've nodded on Neurontin a few times, but it only exaggerates sedation when I'm already fatigued. Yeah, nodding's annoying, but most times I don't because I get enough sleep. Klonopin scares me because I have a "reduced drive to talk," so I don't know how I'd respond in public speaking.
And I've read all the docs about second and third-line therapies on the web for doctors, and one a few even mention xanax as an effective treatment, and some even point to studies showing it was ineffective. It's really strange that the one benzo considered as gold standard for SP makes one not talk, since that appears to be one of the problems for us...
Posted by alan on August 25, 2002, at 12:28:34
In reply to Re: Give me your antipsychotics, your benzos, MAOI, posted by utopizen on August 25, 2002, at 7:31:32
> Wellbutrin was only in my system for a week. The dry throat caused me to wake up consistently each morning at 3 AM with a painfully dry feeling, which is too much on my sleep schedule to take- so I don't know how it would do.
>
> I've been taking Neurontin as needed for about 6 months. I decided it might not be best for mono therapy when after experiencing great results the first day, I had left the pills in my bag in someone's car and ended up acting noticably anxious around a potential "mate". I'd prefer something, at least to add, that didn't leave after 6 hours.
>
> Klonopin and Neurontin don't seem too sedating. I've nodded on Neurontin a few times, but it only exaggerates sedation when I'm already fatigued. Yeah, nodding's annoying, but most times I don't because I get enough sleep. Klonopin scares me because I have a "reduced drive to talk," so I don't know how I'd respond in public speaking.
>
> And I've read all the docs about second and third-line therapies on the web for doctors, and one a few even mention xanax as an effective treatment, and some even point to studies showing it was ineffective. It's really strange that the one benzo considered as gold standard for SP makes one not talk, since that appears to be one of the problems for us...
------------------------------------------
My diagnosis is strikingly similar to yours (GAD and SP) and in the correct dosages, these have been the most successful combos for me - after much experimentation! Remember, it takes a couple of weeks for the side effects to wear off. One can't realistically make long term decisions with one arbitrarily set dose of any bzd.Start low and add on until you reach a theraputic dose. That way you won't feel cognitively impaired at first.
1)Klonopin maint. .5mg 2X's a day, ativan PRN - usually anywhere between 2-4mg's spread out over the day depending if I have public speaking to do.
Inderal 10mg 1&1/2 hr before speaking. (Klonopin steady state in this dosage or perhaps half of this eliminates the effect of fluctuating levels of ativan PRN).2)Ativan 2-4 mg daily and neurontin 300mg 3X daily. Inderal as above. Neurontin had some effect on the ativan fluctuating slightly in my system as I dosed PRN.
One could switch out xanax for the ativan or valium for the klonopin in the above scenarios if you responded better to any of them.
alan
Posted by wcfrench on August 25, 2002, at 16:52:11
In reply to Re: Give me your antipsychotics, your benzos, MAOI » utopizen, posted by alan on August 25, 2002, at 12:28:34
I don't mean to rain on your parade, but...
Everyone has different reactions to these medicines. I'm not saying that something that helps one person won't help another, but you have to keep in mind that it's a good possibility. I took, at one time, 3600 mg of Neurontin a day with no drowsiness, whereas a friend of mine took 300 and fell asleep at her desk. Everyone reacts differently to these medicines, especially with Neurontin and Benzos. Some get more sleepy than others, some get "brain fog," some have trouble concentrating, some get this, some get that. If you have found a successful cocktail for yourself, it might completely ruin another person's days. It's good to share these things so that we can support eachother, but to pass off my treatment as a sure-fire cure to another forum poster would be ignorant and dangerous. Everyone is going to get a different reaction.. it's a mixed bag. In general, anti-depressants make people feel less depressed, anti-anxiety agents make people feel less anxious, and anti-psychotics make people feel less psychotic. Combining medications beyond that to achieve success is completely dependent on your personal body chemistry. What turns out to be a great combination for one person might cause many problems in another person.
I hope you guys understand that I am not trying to be an antagonist of good-hearted support, but I am just urging you to err on the side of caution when sharing medication combinations. We've all got different chemistry.
Utop, my heart goes out to you because I know how difficult and frustrating it is to go through school with problems with anxiety. My junior and senior years in college were plagued by social anxiety and bouts of depression. It's quite frustrating around people of the opposite sex when you're trying to think and speak clearly but you can't calm down enough to think regular thoughts. Thankfully, some of that has come and gone, but it's still something I deal with. Well, good luck to you.
-Charlie
Posted by utopizen on August 25, 2002, at 18:05:14
In reply to Re: Give me your antipsychotics, your benzos, MAOI, posted by wcfrench on August 25, 2002, at 16:52:11
I actually posted a very similar response a few days ago to someone else asking about celexa's workings.
I think we, hopefully, realize this board is therapeutic as much as it is communicative or informational. We really just throw ideas out there, experiment with these ideas, and tell others how our experiments worked. Our doctors really can't predict much in the realm of anxiety, as one medical association pointed out and hoped for progress in this area.
I'm pretty good on Neurontin, but I haven't tried it in classes yet, and fear I'll have to get off it to concentrate better.
I'm taking a public speaking course this semester, I determined that today. I am determined to prove to myself that with enough work on meds and general "happy thoughts" to myself I can prove that I can actually speak in public smoothly.
If I can speak in public without anxiety, I can really prove to myself I haven't let this thing knock me down completely.
Neurontin does that, for sure- I just want something that doesn't go away so quickly... although in the case of N, I sort of appreciate "sobering up" to it so I can think clearly when I don't need it... in the same way I (and I'm sure everyone else) wants to sober up to think straight after drinking... it's the same reason I switched back to old man ritalin... it turns off when I'm done using it, basically.
Posted by cybercafe on August 25, 2002, at 21:29:04
In reply to Re: Give me your antipsychotics, your benzos, MAOI, posted by utopizen on August 25, 2002, at 7:31:32
> I've been taking Neurontin as needed for about 6 months. I decided it might not be best for mono therapy when after experiencing great results the first day, I had left the pills in my bag in someone's car and ended up acting noticably anxious around a potential "mate". I'd prefer something, at least to add, that didn't leave after 6 hours.
hmmm.. you know what though? with neurontin .. and social situations... the first few minutes, hours.. of meeting people is the worst if i can get through that and really come across as a cool guy... for a whole 6 hours! ... then going back to my car or disappearing to the washroom aint that bad... (i always stash some neurontin in my wallet just in case... as well as my backpack... i mean you have to stash condoms and ear plugs in your wallet anyways right??) so it's really not that bad :) plus if i am socializing with someone really important to me i will probably err on the side of caution and take more neurontin than usual ... so it will take longer to wear off than usual ....
though on the other hand... opportunities with "mates" tend to come out of nowhere (talking to someone at a bus stop, restaurant, whatever) ... so it just might happen a mere 1 hour before your next dose is due! .. so yeah, if there was a longer acting anxiolytic, "hook me up with some o' dat shit" :) :)
Posted by utopizen on August 25, 2002, at 23:48:12
In reply to Re: Give me your antipsychotics, your benzos, MAOI, posted by cybercafe on August 25, 2002, at 21:29:04
>>>>. so yeah, if there was a longer acting anxiolytic, "hook me up with some o' dat shit" :) :)
lol- I'll see what my doc says this wed, maybe he has an idea for some special drug or something. I'm thinking no matter what it is, I'm going to try to eventually get a high dose on it. I've read several reports, especially one on a reversible MAOI, that often SP requires more dosing than what the drug is regularly indicated for in other disorders.
The movie Awakenings comes to mind... wasn't that like a million mg of Vitamin C? Or maybe something else, I was like 7 when I watched it...
Hey, maybe you should up your dose of MAO, why not? it's all good, you're already restricting your diet anyway... I just learned raspberries made the list... arrg. my favorite fruit.
It's funny, I use to think I was too good for drugs, and now I'm trying to dope myself up in a frantic frenzy or something. It's exciting to find out how to control my problems, and tweak myself up... but as snobby as we can be about Neurontin's effects wearing off/coming on, it's still a sweet drug when it's on.
I remember the first time I playing with Neurontin dosing. I took 2000mg at once to be safe, even paced around for 2 hours, and then went to a kegger with the idea my Neurontin would keep me dry.
Apparently I didn't realize I should have waited 3:05 hrs. (according to my time records since then- the stuff comes on like a switch, too) Well, several drinks later, I passed out and learned I was some crazy freak on the stuff the next day... I found Klonopin is great, but it does require me to mix a single drink with it to make me talk to mates at a party. But at least it lets me remain sober, so long as I drink, or something.
Boy, this is confusing stuff, I hope those drug companies finally come out with short-acting benzo replacers soon enough. The market would die for it, and they know it. I wish I knew when they plan to release that stuff. Someone else said something about how they hope drug companies got tired of devloping me-too SSRIs... whoever makes the first benzo replacer would obviously catch a larger market, since benzos sell more than SSRIs.
Imagine popping a pill, and 20 minutes later you don't have any social anxiety and can talk, and it's as safe as ritalin... gosh, all drugs should be modeled after ritalin, minus the bitter flavor and anxiety-invoking stuff.
This is the end of the thread.
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