![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 13 of 13. This is the beginning of the thread.
Posted by johnnyj on March 11, 2007, at 22:18:43
Went to the ER today, non stop panic. First time and I am at a low point. They gave me 20 mg paxil and xanax. Is the paxil too high?
I am very med sensitive but have reached a point where I would probably take anything they gave me. I hope the xanax doesn't wreck me like the klonopin. I need to accept and overcome this panic/ocd. Please pray for me. Thank you
johnnyj
Posted by Phillipa on March 11, 2007, at 22:51:16
In reply to ER visit, Need some support, posted by johnnyj on March 11, 2007, at 22:18:43
Johnny my first experience with an ad was with paxil. 20mg is a normal starting dose but my pdoc at the time cause of my high anxiety only gave me l0mg with xanax. It took also so lopressor 25mg to keep the anxiety down but I couldn't take inderal cause of my thyroid. Three months of sleeping before I felt well. I was so tired. But xanax is the best for panic. I'm sure they did an EKG? I'd get a through physical too. And I'll pray for you. Love Phillipa
Posted by yxibow on March 12, 2007, at 0:11:28
In reply to ER visit, Need some support, posted by johnnyj on March 11, 2007, at 22:18:43
> Went to the ER today, non stop panic. First time and I am at a low point. They gave me 20 mg paxil and xanax. Is the paxil too high?
>
> I am very med sensitive but have reached a point where I would probably take anything they gave me. I hope the xanax doesn't wreck me like the klonopin. I need to accept and overcome this panic/ocd. Please pray for me. Thank you
>
Paxil is usually started at 20mg/day for OCD and 10mg/day for Panic Disorder. For OCD the range is 20-60 mg/day, increased 10mg a week. The same can be said for Panic Disorder.It is given once a day.
If you are medication sensitive it is available in 10mg tablets scored so you could conceivably start on 5mg. I have heard of people responding to 5mg a day but that is anecdotal and seems close to placebo.
The Xanax should be used short term to overcome any anxiety Paxil might generate even though Paxil is usually among the most sleep-inducing SSRIs. Klonopin could easily be used too or any benzodiazepine but I think they used Xanax because of its association with Panic Disorder.If Xanax is used long term it should be taken on schedule because it may need to be used as much as 4 times a day due to its shorter half life and there can be interdosal withdrawal. Its supposedly why Xanax XR was created although some people even need Xanax XR more than once a day from anectdotal reporting on here. I'm not clear on that one.
But follow the directions of the ER doctor and have a followup consultation with someone they recommend or your regular physician/psychiatrist.-- feel better
Jay
Posted by UGottaHaveHope on March 12, 2007, at 0:14:59
In reply to Re: ER visit, Need some support » johnnyj, posted by yxibow on March 12, 2007, at 0:11:28
Paxil just made me hungry, felt no effect. But every med affects everyone different.
Next time you get in a panic, take more Xanax immediately.
I would ask your doc also about Seroquel. It is the ultimate sleeping drug for insomnia and seems to help panic. Take only at night.
Praying for you, Michael
Posted by kelv on March 12, 2007, at 5:24:45
In reply to ER visit, Need some support, posted by johnnyj on March 11, 2007, at 22:18:43
> Went to the ER today, non stop panic. First time and I am at a low point. They gave me 20 mg paxil and xanax. Is the paxil too high?
Yep-could do more harm at that dose to a med sensitive person.
>
> I am very med sensitive but have reached a point where I would probably take anything they gave me. I hope the xanax doesn't wreck me like the klonopin.Xanax doesn't seem to cause as much depression as Klon-but can be up and down.
I need to accept and overcome this panic/ocd. Please pray for me. Thank you
Ask for a shot of Hypnoval (Midazolam)-guaranteed to calm you right down.:)
Posted by Crazy Horse on March 12, 2007, at 11:33:41
In reply to ER visit, Need some support, posted by johnnyj on March 11, 2007, at 22:18:43
> Went to the ER today, non stop panic. First time and I am at a low point. They gave me 20 mg paxil and xanax. Is the paxil too high?
>
> I am very med sensitive but have reached a point where I would probably take anything they gave me. I hope the xanax doesn't wreck me like the klonopin. I need to accept and overcome this panic/ocd. Please pray for me. Thank you
>
> johnnyjNo, 20 mgs. is a normal starting dose of Paxil. BTW paxil is an excellent med for Panic/OCD so your on the right track. I would also recommend you get some therapy to help you deal with your thoughts and symptoms.
You can count on my prayers Johnny..may God bless you and keep you well.
-Monte
Posted by johnnyj on March 12, 2007, at 13:14:19
In reply to Re: ER visit, Need some support » johnnyj, posted by Crazy Horse on March 12, 2007, at 11:33:41
I cannot describe how much having someone think of me in this time has made me felt. I thank you all more than you will ever know.
I took .5 of zanax last night and got some sleep. Not great but considering what my mind/body has been going through it is not suprising.
I took 5 mg of paxil this morning and did not have an increase in restlessness that I had with luvox. I will move up to 10 this week before seeing my new pdoc and then decide where to go. I was just freaking out over the dose so I started low.
My head is very heavy from the xanax which benzo's do to me so hopefully I won't have to be on it for long.
The ER was devastating for me at first. I thought "how far have I fallen" I am struggling but will try and relax into it. My biggest fear was I was going to lose everything and just wanted to give up. Without meds I don't know what I would have done. I actually got a little groggy after taking the paxil so for me I hope that is a good sign that it is sedating and not too activating. I wouldn't mind sleeping 10 hours a night and with my sleep debt I am sure I need a couple of months with lots of sleep.
It may be a placebo affect but at least I have some hope today. Yesterday was one of worst days in my life. Anxiety is so crippling but what mental illness isn't?
I do need therapy with someone who specializes in panic/ocd but there is no one in my city. I may have to travel a bit. One item I need to face is the childhood bullying I endured as a child. It is time I stop running from it and deal with it.
Thank you again. I will pray for everyone tonight.
johnnyj
Posted by yxibow on March 13, 2007, at 2:51:08
In reply to Thank you, posted by johnnyj on March 12, 2007, at 13:14:19
> I cannot describe how much having someone think of me in this time has made me felt. I thank you all more than you will ever know.
>
> I took .5 of zanax last night and got some sleep. Not great but considering what my mind/body has been going through it is not suprising.
>
> I took 5 mg of paxil this morning and did not have an increase in restlessness that I had with luvox. I will move up to 10 this week before seeing my new pdoc and then decide where to go. I was just freaking out over the dose so I started low.Its interesting that you had restlessness with Luvox but then I've heard it as well -- because it is theoretically the most sedating of all SSRIs. But for some Paxil is. If you're one of the people who can stand Luvox, it actually really is very good for OCD, and not just gained that label for marketing purposes. For whatever reason they went generic early but it did help me for a spell a while ago.
> My head is very heavy from the xanax which benzo's do to me so hopefully I won't have to be on it for long.Xanax is a potent benzodiazepine so this isn't surprising. The quick uptake and the lipophilic nature earns it at the top of the scale. And it serves a purpose -- quick quelling of hard anxiety. For some, people take it for a long period of time for panic disorder. I think really long term use may lose its "immediacy" effect which is why I only use it short term. But I believe your purpose is to aclimatize to Paxil dose changes. Generally dose changes for a sensitive person may bring some anxiety spikes and some possible low grade nausea, especially as slow as you are increasing it.
> The ER was devastating for me at first. I thought "how far have I fallen" I am struggling but will try and relax into it. My biggest fear was I was going to lose everything and just wanted to give up. Without meds I don't know what I would have done. I actually got a little groggy after taking the paxil so for me I hope that is a good sign that it is sedating and not too activating. I wouldn't mind sleeping 10 hours a night and with my sleep debt I am sure I need a couple of months with lots of sleep.
Do not even think of "how far you've fallen", because you made a conscious decision that you needed help and help was given to you. It is far better than the alternative and I don't need to outlay that for you. I spent more than two months in a hospital and a few months in day treatment for OCD because it had gotten so bad that I just couldn't do it on my own. There were some aspects of treatment that could have been better but there were also caring psychiatric nurses there as well.
> It may be a placebo affect but at least I have some hope today. Yesterday was one of worst days in my life. Anxiety is so crippling but what mental illness isn't?
>
> I do need therapy with someone who specializes in panic/ocd but there is no one in my city. I may have to travel a bit. One item I need to face is the childhood bullying I endured as a child. It is time I stop running from it and deal with it.
That's the first step. As for OCD, I don't know what variety you have or what you wish to reveal but find someone that can help you with CBT if you are up to the challenge of cognitive behavioural therapy.What you learn in it will help you down the line, because OCD is a lifelong disorder, as I know. It is quiescent now for me, but I do have garbage thoughts sometimes when my metabolism gets riled up.
Those are really the hardest to control -- pure obsessions, and either require a fair amount of medication depending on how extensive they are, or some tools of CBT that teach one how to brush them aside, which is very difficult of course, I must say.
I wish you well
-- Jay
Posted by johnnyj on March 13, 2007, at 9:14:06
In reply to Re: Thank you » johnnyj, posted by yxibow on March 13, 2007, at 2:51:08
Yes, I wondered about luvox being more sedating but didn't find that.
I may have stumbled onto something too. Last night I took .5 of xanax like I did the night before and after 30 minutes I started to have terrible anxiety, very physical type in my chest. It went on for over an hour. So, I took another 5 mg of paxil and was asleep within 20 minutes. Woke up and thought it was probably 2 am and it was almost 5, and drifted off a again until a little after 6. Felt decent this morning.
So my wife and I thought back when this physical panic started. It was after I started the luvox but became worse when I started klonopin and my sleep became more disrupted as I kept taking it, this was over two weeks ago. It culminated in a Friday afternoon panic when I was just on klonopin. So the doctor switched me to Ambien and the first night ok, but bad panic in the evenig. So I took ambien that night but I slept but had terrible panic the next day. I had depression and disrupted sleep on tranzene too even though I was on it for 10 years and felt a lot better off of it. It was hard to know what was going on since I was on other things at the time.
Could it be the benzo/gaba type drugs that are causing this? I feel a little nervous right now but I wonder if it is the xanax washout? I am having some nausea too (probably paxil related).
My ocd is Pure "O" and it has not been too bad since going off lithobid (not bipolar) and with CBT. But, it was kind of worse when the benzo is washing out.
Maybe the paxil is what I need to stick too? Ramping up to 10 could cause some anxiety but if I sleep I can handle the initial start up.
Thoughts anyone?
thank you
johnnyj
Posted by tessellated on March 13, 2007, at 9:56:34
In reply to Update and any advice? » yxibow, posted by johnnyj on March 13, 2007, at 9:14:06
something to keep in mind is that both xanax and paxil have short half lives, so they tend to create some of the worst withdrawl effects as well.
Posted by johnnyj on March 13, 2007, at 10:13:41
In reply to Re: Update and any advice?, posted by tessellated on March 13, 2007, at 9:56:34
So it is really finding a paxil dose that "fits" me. Or the CR version. I like the sedation though. Sleeping makes things bearable to some extent. No, sleep, and lots of anxiety is a bad, bad combination.
The weird reaction I am having to xanax and GABA related in general points to something other than withdrawal. Either that or their mode of action or something. At least I can tell my pdoc this Friday. Maybe the years of benzos permanately made me sensitive or the drugs just are not for me.
johnnyj
Posted by johnnyj on March 13, 2007, at 10:14:42
In reply to Re: Update and any advice?, posted by tessellated on March 13, 2007, at 9:56:34
So it is really finding a paxil dose that "fits" me. Or the CR version. I like the sedation though. Sleeping makes things bearable to some extent. No, sleep, and lots of anxiety is a bad, bad combination.
The weird reaction I am having to xanax and GABA related in general points to something other than withdrawal. Either that or their mode of action or something. At least I can tell my pdoc this Friday. Maybe the years of benzos permanately made me sensitive or the drugs were just never a good med for me.
johnnyj
Posted by Phillipa on March 13, 2007, at 18:35:16
In reply to Re: Update and any advice? » tessellated, posted by johnnyj on March 13, 2007, at 10:14:42
Johnny how many years have you been on benzos and which ones? And at what doses. Same thing is happening to me. Love Phillipa
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.