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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 15 of 15. This is the beginning of the thread.
Posted by Phillipa on December 4, 2011, at 11:58:02
Been literally playing with low dose luvox and lexapro for too long. And cutting more and more off xanax and keeping valium at l0mg per new pdoc. But should I ditch the lexapro and just up the luvox? Only reason didn't up luvox was it seems to like my brain and fear that if up it will never get off it? Also luvox isn't supposed to be used with valium and xanax and only ativan. So my old pdocs thoughts were let the luvox increase effects of benzos and don't need a higher dose of benzos. I need suggestions for new pdoc as know this time he will wish to make med changes. Thanks for your help in advance. I realize I've asked this many times but realize I must make changes. Phillipa
Posted by gadchik on December 4, 2011, at 12:09:52
In reply to Best For Ruminating Worry OCD Anxiety?, posted by Phillipa on December 4, 2011, at 11:58:02
You know Im a klonopin fan, so I have to suggest it for ruminating worry.I know it made you depressed though.I just love it,I also thought zoloft was excellent,but had some issues w/weight,and rls for me.
Posted by jono_in_adelaide on December 4, 2011, at 16:12:01
In reply to Re: Best For Ruminating Worry OCD Anxiety? » Phillipa, posted by gadchik on December 4, 2011, at 12:09:52
Have you ever tried clomipramine? As well as inhibiting seretonin reuptake it also inhibits noradrenalin so you're getting the double hit there, and it also blocks the 5HT2 receptors so has an intrinsic antianxiety effect.
Start off at 25mg at bedtiime and slowly increase to 75-150mg at bedtime.
You could still take your Valium or Xanax with this.
Posted by Raisinb on December 4, 2011, at 18:00:32
In reply to Re: Best For Ruminating Worry OCD Anxiety?, posted by jono_in_adelaide on December 4, 2011, at 16:12:01
I thought Paxil was pretty good in that respect. But maybe you have tried that? The thing that really stopped ruminating and anxiety for me was lithium, but that is heavy duty stuff and probably is not right for you if you do not have a bipolar dx.
Posted by Phillipa on December 4, 2011, at 18:32:42
In reply to Re: Best For Ruminating Worry OCD Anxiety?, posted by Raisinb on December 4, 2011, at 18:00:32
Both paxil and zoloft are options as at one time paxil at l0mg worked great with xanax and it didn't poop out. I once tried zoloft probably with xanax also just didn't continue. It worked great for relatives of mine? Thanks guys missed you all!!! Phillipa
Posted by Christ_empowered on December 4, 2011, at 18:56:49
In reply to Re: Best For Ruminating Worry OCD Anxiety?, posted by Phillipa on December 4, 2011, at 18:32:42
Could you just up your current benzos and drop the ADs? Or switch over the xanax xr plus valium at bedtime? I would think that if you could take, I don't know, 3mgs xanax xr and a little bit of valium at bedtime, you'd be OK. Maybe even less? They used 6mgs xanax xr in the study I read, which is effective (how could 6mgs xanax NOT be effective, right?), but I imagine most docs would aim lower. The night time valium might prevent rebound anxiety in the morning.
Posted by Phillipa on December 4, 2011, at 20:24:14
In reply to Best For Ruminating Worry OCD Anxiety?, posted by Phillipa on December 4, 2011, at 11:58:02
A few years ago pdoc took me off low dose luvox before lexapro and made the xanax xr version at 6mg a day and for one week no sleep. The next week he put me on 6mg of ativan didn't sleep. Ended up in ER and the doc after a call to the psych hospital downtown came back and said take the luvox again and the l0mg of valium at night and that night I slept. What do you make of this wierdness? Phillipa
Posted by Phidippus on December 4, 2011, at 21:23:06
In reply to Best For Ruminating Worry OCD Anxiety?, posted by Phillipa on December 4, 2011, at 11:58:02
You did well on a higher dose of Luvox, so I would recommend you stick with that and drop the Lexapro. There's no real reason for two SSRIs.
If you want to get away from the benzos, I would recommend treatment with Lyrica. It treats anxiety well and has literature on it being efficacious in the treatment of OCD.
Eric
Posted by Phillipa on December 4, 2011, at 23:02:02
In reply to Re: Best For Ruminating Worry OCD Anxiety? » Phillipa, posted by Phidippus on December 4, 2011, at 21:23:06
Eric I also think Luvox but to up the dose don't I need to switch to ativan as it is the only benzo that doesn't interract and become stronger with luvox? Thanks Phillipa
Posted by jono_in_adelaide on December 5, 2011, at 16:23:57
In reply to Re: Best For Ruminating Worry OCD Anxiety? » Phidippus, posted by Phillipa on December 4, 2011, at 23:02:02
You could up your Luvox to 100mg per day, and just keep a watching brief on your diazepam, maybe reduce it from 10mg to 7.5mg.... if you start feeling dopey, then drop it a bit more, if you feel good, leave it where it is.
For OCD and panic, you generaly need more than the "standard" dose of antidepressant (50mg luvox or zoloft, 20mg of paxil, prozac, celexa), usualy double or a bit more
Posted by Phidippus on December 5, 2011, at 16:51:39
In reply to Re: Best For Ruminating Worry OCD Anxiety? » Phidippus, posted by Phillipa on December 4, 2011, at 23:02:02
Ativan and Luvox don't interract. Had you tried Lyrica?
Eric
Posted by Phillipa on December 5, 2011, at 21:20:42
In reply to Re: Best For Ruminating Worry OCD Anxiety? » Phillipa, posted by Phidippus on December 5, 2011, at 16:51:39
Eric correct ativan and luvox are the only combo that doesn't. No to lyrica. Phillipa
Posted by Phidippus on December 7, 2011, at 14:59:01
In reply to Re: Best For Ruminating Worry OCD Anxiety? » Phidippus, posted by Phillipa on December 5, 2011, at 21:20:42
Why not Lyrica?
Eric
Posted by Laney on December 12, 2011, at 0:52:54
In reply to Re: Best For Ruminating Worry OCD Anxiety? » Phillipa, posted by Phidippus on December 7, 2011, at 14:59:01
So P- have you decided what your gonna do? Paxil is great for OCD and ruminations. I think someone already said that you might have to take a higher dose though.
Laney
Posted by Phillipa on December 12, 2011, at 18:18:22
In reply to Re: Best For Ruminating Worry OCD Anxiety?, posted by Laney on December 12, 2011, at 0:52:54
Laney years ago l0mg of paxil with a touch of xanax worked well til taken off it. See that new pdoc Wed. So far no med changes so will see. Thanks for caring Phillipa
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