![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 12 of 12. This is the beginning of the thread.
Posted by 4WD on December 29, 2007, at 16:09:25
I have a prescription for Gabitril but I am scared to start taking it because I have seen several postings here that suggest it increases anxiety. (And that's the last thing I need.
Anyone who has taken or does take Gabitril - did it increase your anxiety>
Marsha
Posted by Phoenix1 on January 2, 2008, at 18:20:01
In reply to Scared to start Gabitril -increases anxiety?, posted by 4WD on December 29, 2007, at 16:09:25
> I have a prescription for Gabitril but I am scared to start taking it because I have seen several postings here that suggest it increases anxiety. (And that's the last thing I need.
>
> Anyone who has taken or does take Gabitril - did it increase your anxiety>
>
> Marsha
Hi Marsha,I just wanted to post since I guess no one here has tried Gabitril. My understanding is that it is sedating, as are the other GABA agonists. I would doubt that it would cause much anxiety, in fact I have heard of it's used to treat anxiety. The RxList.com monograph does not list anxiety as a possible side effect. If you are worried, start the dose very low, and work your way up. May I ask what it is being prescribed for, and what the dosage is? I have experience with Lyrica and Neurontin, drugs in that same class of meds, and they definitely did not cause increased anxiety.
If you have already started, let us know how it's going.
Phoenix1
Posted by 4WD on January 2, 2008, at 19:59:07
In reply to Re: Scared to start Gabitril -increases anxiety? » 4WD, posted by Phoenix1 on January 2, 2008, at 18:20:01
>
> Hi Marsha,
>
> I just wanted to post since I guess no one here has tried Gabitril. My understanding is that it is sedating, as are the other GABA agonists. I would doubt that it would cause much anxiety, in fact I have heard of it's used to treat anxiety. The RxList.com monograph does not list anxiety as a possible side effect. If you are worried, start the dose very low, and work your way up. May I ask what it is being prescribed for, and what the dosage is? I have experience with Lyrica and Neurontin, drugs in that same class of meds, and they definitely did not cause increased anxiety.
>
> If you have already started, let us know how it's going.
>
>
> Phoenix1
>
I still haven't started it. I got the anxiety info from the web, where when I looked up Gabitril it listed increased anxiety as a possible side effect. It's prescribed as a mood stabilizer (I am bipolar II, depressive type). My pdoc did start me on a low dose, 4mg. I did pretty well on Neurontin so maybe the Gabitril will help. The trouble with Neurontin was that it gave me severe neuralgia in my bottom front teeth. So did Depakote (even worse) and Trileptal. So did Lamictal, Lyrica and Risperdal. I am not on a mood stabilizer now at all because I was afraid of the toothache. I went and had two root canals today. So maybe after I have a chance to see whether the nerve pain stops now I can give Gabitril a try.The weird thing is that in the past, if I stopped Neurontin, Depakote, etc., the toothache went away. This time when I stopped the Trileptal, the neuralgia continued. Maybe I did permanent damage to the nerves? It's doubly weird because some of these drugs are prescribed to *treat* neuralgia-type pain. But I never had pain in those teeth until I started these meds.
Thanks for answering.
Marsha
Posted by Phoenix1 on January 2, 2008, at 21:54:19
In reply to Re: Scared to start Gabitril -increases anxiety? » Phoenix1, posted by 4WD on January 2, 2008, at 19:59:07
Hi Marsha,
That's weird that drugs often used to treat neuropathic pain actually cause or worsen it for you. I don't think I've ever heard of that happening before. It just goes to show that everyone responds really differently to different drugs.
I don't think you should be worried about Gabitril causing anxety, especially not at 4mg. Give it a try, and if it doesn't work or causes anxiety, at least you can cross it off your list and move on to something else. Let me know how it goes! I'm really interested in GABAergic drugs like Gabitril...
Phoenix1
> >
> > Hi Marsha,
> >
> > I just wanted to post since I guess no one here has tried Gabitril. My understanding is that it is sedating, as are the other GABA agonists. I would doubt that it would cause much anxiety, in fact I have heard of it's used to treat anxiety. The RxList.com monograph does not list anxiety as a possible side effect. If you are worried, start the dose very low, and work your way up. May I ask what it is being prescribed for, and what the dosage is? I have experience with Lyrica and Neurontin, drugs in that same class of meds, and they definitely did not cause increased anxiety.
> >
> > If you have already started, let us know how it's going.
> >
> >
> > Phoenix1
> >
> I still haven't started it. I got the anxiety info from the web, where when I looked up Gabitril it listed increased anxiety as a possible side effect. It's prescribed as a mood stabilizer (I am bipolar II, depressive type). My pdoc did start me on a low dose, 4mg. I did pretty well on Neurontin so maybe the Gabitril will help. The trouble with Neurontin was that it gave me severe neuralgia in my bottom front teeth. So did Depakote (even worse) and Trileptal. So did Lamictal, Lyrica and Risperdal. I am not on a mood stabilizer now at all because I was afraid of the toothache. I went and had two root canals today. So maybe after I have a chance to see whether the nerve pain stops now I can give Gabitril a try.
>
> The weird thing is that in the past, if I stopped Neurontin, Depakote, etc., the toothache went away. This time when I stopped the Trileptal, the neuralgia continued. Maybe I did permanent damage to the nerves? It's doubly weird because some of these drugs are prescribed to *treat* neuralgia-type pain. But I never had pain in those teeth until I started these meds.
>
> Thanks for answering.
>
> Marsha
>
Posted by SLS on January 3, 2008, at 7:22:37
In reply to Scared to start Gabitril -increases anxiety?, posted by 4WD on December 29, 2007, at 16:09:25
Hi 4WD.
I tried Gabitril several years ago.
Gabtril is an especially unpredictable drug. In a significant number of people, a mild to moderate increase in anxiety can dissipate as a startup side effect. However, for me, Gabitril did not produce a persistent anxiety. There is a chance that cognitive blunting and "brain fogginess". This might force an end to Gabitril treatment. I think it is a drug worth titrating low and slow. To add to the list of possible untoward reactions: worsened depression, perstent moderate anxiety, and derealization.
As an asside, I forgot to mention that several of my doctor's colleagues have noticed a surprisingly robust antidepressant response when Lamictal is combined with Deplin.
Of the second generation neuroleptics, Geodon is probably the most activating. However, I have noticed more early drop-outs on Geodon than on other drugs of the same class.
Don't neglect the axiom that shows itself at every corner in the treatment of most mental illnesses. It is manifestly true that each individual has a unique structural and biochemical constitution such that there will be people whom take Geodon whom respond robustly to lower dosages - 60mg. She experienced a bit of anxiety in the beginning. Beyond one week, this anxiety has disappeared. For her, Geodon is a magic pill when added to the other miracle pills she takes. Why are they miracle pills? Quite simply, her ability to function with additional energy. Quite nice is the increase in motivation and a feeling of wellness. It is still early in her Geodon treatment, but in a polypharmacy setting, I think most of the atypicals produce minor to moderate improvements in depression. They generally do not poop out at a rate commensurate with SSRIs. If you can stick it out beyond the first 1-3 weeks, you may see the anxiogenic effect gradually disappear. Geodon is not one of my favorite drugs. However, an absolutely gorgeous lady friend of mine began taking Geodon a little more than a week ago. She is feeling better than she can remember.
EVERYONE IS DIFFERENT. THERE ARE NO COOKIE-CUTTER PEOPLE. THE DIRECT RESULT OF THE EXISTING, AND POSSIBLY UNIQUE INTERVIDUAL DIFFERENCES IN THE BRAIN / CNS FUNCTION. PATTERNS OF RESPONSE TO TREATMENT ARE EXTREMELY VARIABLE, EVEN WHEN TREATMENTS BETWEEN INDIVIDUALS IS EXACTLY THE SAME.
One thing to consider are the results of experiments using identical twins. One twin can become psychiatry ill, while the other not.
Any explanation of mental illness must account for this phenomenono. Twin studies offer unique opportunities to determine the differences in gene activity.Sorry...
Started with Gabitril and ended up at Geodon as an example of inconsistencies in the way researchers postulate pathology.
I am not a big fan of Gabitril. I believe it oversaturates the synaptic cleft with GABA. This could explain the variability in the responses patterns seen with Gabitril and its tendency to upset and skew the GABA/glutamate balance. Gabatril is a GABA reuptake inhibitor. Too much GABA is no good. This probably occurs early in treatment as the "brakes" on the glutamate/DA are no longer. Through an accomodation process, postsynaptic receptors downregulate.
Thanks for reading.
Time for me to live a little. I have a date later this afternoon. I enjoy socialization and connecting with people. Since I still have a long way to go to reach FULL remeission, I am confident that it is happening, especialy with the Deplin on board.
- Scott
Posted by johnj on January 3, 2008, at 15:32:23
In reply to Re: Scared to start Gabitril -increases anxiety? » 4WD, posted by SLS on January 3, 2008, at 7:22:37
Scott:
I noticed you do not post much but I had one question for you. I recall from previous posts you tried lyrica. Did you stay on it?
Would you be so kind to tell me your dx and what has worked for you. Thank you. Good luck on the date :)
johnj
Posted by SLS on January 3, 2008, at 23:27:02
In reply to Re: Scared to start Gabitril -increases anxiety? » SLS, posted by johnj on January 3, 2008, at 15:32:23
Hi John.
> I noticed you do not post much but I had one question for you. I recall from previous posts you tried lyrica. Did you stay on it?Lyrica produced a significant worsening of my depression that lasted well over a month after taking my last dose. Neurontin affects me similarly. What these two drugs have in common is that they attach themselves to the alpha2delta subunit of L-type calcium channels. Here we have an association that can be acted upon. I would probably avoid drugs with this property in the future.
Yes. Lyrica can feel a little like alcohol during the first week and upon dosages increases. For me, though, this effect dissipated rapidly.
Have you ever tried Neurontin? What was your reaction to it?
> Would you be so kind to tell me your dx
I had a severe and unremitting anergic and anhedonic depression. Manic reactions to certain drugs helps place the diagnosis of bipolar disorder. In addition, I was an ultrarapid cycler with a 11-day period (3 days up; 8 days down) for over two years until lithium was introduced, whereupon the cycle was abolished and I became stuck in depression.
> and what has worked for you.
Current medication:
Nardil 90mg
nortriptyline 150mg
Lamictal 200mg
Abilify 10mg
Deplin 7.5mg> Good luck on the date :)
We had to postpone. :-(
- Scott
Posted by johnj on January 4, 2008, at 0:17:54
In reply to Re: Scared to start Gabitril -increases anxiety?, posted by SLS on January 3, 2008, at 23:27:02
Thank you Scott.
I have anxiety/ocd/ issues. My sleep is getting worse and I am started to get depressed due to lack of sleep and the inability to shut off my mind. I just get stuck on things. I have never been diagnosed bipolar but I wonder if such a medication might slow me down, allow me to sleep, and reduce anxiety. Benzo's are out as are ssris. My pdoc is good and willing to try things but to tell you the truth I am scared. Remeron was bad as was paxil and luvox. Benzo's seem to calm for a short period but the rebound anxiety is terrible.
Was your reaction to lyrica not the norm? It seems so many people find it rather good for sleep and anxiety. Nardil seems to be a possiblity for me since I see in literature it is used for panic/ocd. I am afraid of the sleep issues though. What to do....
Thank you
johnj
Posted by SLS on January 8, 2008, at 10:10:38
In reply to Re: Scared to start Gabitril -increases anxiety? » SLS, posted by johnj on January 4, 2008, at 0:17:54
Hi JohnJ.
Sorry for the delay.
> Was your reaction to lyrica not the norm?
As far as I can tell, my reaction to Lyrica is idiosyncratic and not terribly common.
> It seems so many people find it rather good for sleep and anxiety. Nardil seems to be a possiblity for me since I see in literature it is used for panic/ocd. I am afraid of the sleep issues though. What to do....
You obviously have done your homework.
Why are benzodiazepines not an alternative?
Maybe using Seroquel would do the trick. You might be able to get away with 25-50mg at bedtime.
- Scott
Posted by okydoky on January 20, 2008, at 12:18:17
In reply to Re: Scared to start Gabitril -increases anxiety? » johnj, posted by SLS on January 8, 2008, at 10:10:38
I wanted particularly to ask someone about Lyrica and Lamacitl.
My urologist put me on Lyrica for pain. It worked great for pain decreased my anxiety wonderfully but worsened my depression for several weeks after I went off of it. I was able to take less oxycontin because of it. I originally thought that was why my depression worsoned.
He tried lamactil because he said it was chemically similar? I am so foggy now it did not occur to me until yesterday that perhaps that taking the lamactil for two weeks increased my depression in the same way. Do you think this could be the case? Perhaps I will begin feeling better in a week or two then. I hope.
Thanks,
okydoky
Posted by SLS on January 25, 2008, at 5:23:36
In reply to Re: Scared to start Gabitril -increases anxiety? » SLS, posted by okydoky on January 20, 2008, at 12:18:17
Hi okydoky.
Sorry for the delay...
> I wanted particularly to ask someone about Lyrica and Lamacitl.
>
> My urologist put me on Lyrica for pain. It worked great for pain decreased my anxiety wonderfully but worsened my depression for several weeks after I went off of it. I was able to take less oxycontin because of it. I originally thought that was why my depression worsoned.
>
> He tried lamactil because he said it was chemically similar? I am so foggy now it did not occur to me until yesterday that perhaps that taking the lamactil for two weeks increased my depression in the same way. Do you think this could be the case?No. I have not yet seen it exacerbate depression. However, it can produce a "brain fog" or memory and cognitive impairments. This happens in a minority of people. Sometimes, lowering the dosage helps with this.
> Perhaps I will begin feeling better in a week or two then. I hope.
You really can't expect much from Lamictal unless you work up to 200mg. So, your countdown should begin one you reach that dosage. In my experience, Lamictal offers an augmenting effect to standard antidepressants as compared to monotherapy. For bipolar disorder, however, Lamictal can be an effect adjunct to lithium and other mood stabilizers.
Lyrica is a different drug altogether. It is more like Neurontin than Lamictal. That Lyrica and Neurontin help with pain is not unexpected.
Good luck.
- Scott
Posted by okydoky on January 25, 2008, at 14:09:43
In reply to Re: Scared to start Gabitril -increases anxiety? » okydoky, posted by SLS on January 25, 2008, at 5:23:36
Thaks for the information. I could not figure out how he came up with Lamctil being like Lyrica!
okydoky
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.