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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 11 of 11. This is the beginning of the thread.
Posted by grunter on November 25, 2000, at 18:09:58
Hi. I have been diagnosed with mixed anxiety/depression/dysthymia
and have tried seemingly every med: Paxil, zoloft, celexa, serzone,
remeron, wellbutrin (increased my anxiety), buspar, effexor. I've also never responded to any anti-convulsants
such as lamictal or gabapentin. Nor do benzodiazepines seem to help--they
only make me more depressed. My anxiety is so bad that
I am dizzy, have chest pain, hot flashes, and blurry vision all the time.
This makes me want to stay in bed all day. I feel like my psychiatrist and I
have reached a standstill. What medication should I try? I NEED to reduce my
anxiety levels--I can't stand it anymore. thank you for your help.
Posted by allisonm on November 25, 2000, at 18:43:50
In reply to Dr. Bob: Please help!, posted by grunter on November 25, 2000, at 18:09:58
Have you tried an MAOI?
What does your doctor say about your current situation? How often do you see him? How long did you take these other drugs?
There are many on this board who have a lot of knowledge about and experience with these drugs and might be able to help you.
Take care.
Allison
Posted by Sigolene on November 26, 2000, at 7:49:40
In reply to Dr. Bob: Please help!, posted by grunter on November 25, 2000, at 18:09:58
The best one for anxiety for me is Remeron. Unfortunalty there is a weight gain with it. But it's worth trying in your case.
Sigolène.
> Hi. I have been diagnosed with mixed anxiety/depression/dysthymia
> and have tried seemingly every med: Paxil, zoloft, celexa, serzone,
> remeron, wellbutrin (increased my anxiety), buspar, effexor. I've also never responded to any anti-convulsants
> such as lamictal or gabapentin. Nor do benzodiazepines seem to help--they
> only make me more depressed. My anxiety is so bad that
> I am dizzy, have chest pain, hot flashes, and blurry vision all the time.
> This makes me want to stay in bed all day. I feel like my psychiatrist and I
> have reached a standstill. What medication should I try? I NEED to reduce my
> anxiety levels--I can't stand it anymore. thank you for your help.
Posted by JaneST on November 26, 2000, at 8:54:49
In reply to Dr. Bob: Please help!, posted by grunter on November 25, 2000, at 18:09:58
> Hi. I have been diagnosed with mixed anxiety/depression/dysthymia
> and have tried seemingly every med: Paxil, zoloft, celexa, serzone,
> remeron, wellbutrin (increased my anxiety), buspar, effexor.Grunter:
When my depression and anxiety was at their peak, I was prescribed Nardil (maoi) and Xanax...and my life was great for 5 years...until the Nardil pooped out...(Nardil is evidently known for its anti-anxiety agents.)
Currently I'm taking 7.5mgs Remeron every other night, due to too much daytime sedation, and Ativan. Life's not perfect but closer to the good old Nardil days...after much trial and error.
Just my experience...let us know how you are.
Jane
Posted by shellie on November 26, 2000, at 9:05:39
In reply to Re: Dr. Bob: Please help!, posted by allisonm on November 25, 2000, at 18:43:50
>I'm assuming you have ruled out all physical causes of your symptoms. And that you've tried klonopin (vs. adivan) and it made you more depressed?
I would tend to agree with Allison, that a trial of an MAOI (particularly nardil) might be useful. If you and your doctor go in that direction, it may be up to six weeks before you feel a benefit. Also, have you tried any of the herbal remedies for short term relief, like kava kava, or others?
I can see why you are feeling overwhelmed; you've tried a lot of meds. Are you feeling that your pdoc is willing to stick with you until you find a solution. I think it is important to know that while going through this process.
shellie
Posted by shellie on November 26, 2000, at 9:20:43
In reply to Re: Dr. Bob: Please help!, posted by shellie on November 26, 2000, at 9:05:39
p.s. There is a thread above called Kava kava or adivan. Look specifically at the post by Sunnely for good info on kava.
Posted by JohnL on November 27, 2000, at 5:24:05
In reply to Dr. Bob: Please help!, posted by grunter on November 25, 2000, at 18:09:58
You have indeed tried a lot of drugs. Regardless, they have all only worked on limited chemistries. There are other chemistries that can cause symptoms such as yours which have not yet been explored in your treatment.
For example antipsychotics such as Zyprexa or Risperdal. Elevated dopamine can cause psychiatric symptoms such as yours. APs are dopamine reducers. None of the drugs you've tried yet had any direct action on dopamine.
Believe it or not, Lithium has solved anxiety for a surprising number of people. Tegretol or Depakote are also good choices. These three drugs work on the chemistries of instable electricity or instable chemistry resulting in psychiatric symptoms.
And in rarer cases, believe it or not, a stimulant like Ritalin or Adderall can actually calm anxiety. The tip-off for this kind of unexpected response is a poor response to benzodiazepines. But of course, Wellbutrin made you worse, and so the other choices listed above are probably higher probability ones.
You could ask for a trial of Zyprexa, Risperdal, Depakote, Tegretol, and Lithium. Try each for at least one week, preferably two. Unlike the other drugs you've tried, these will not require a long trial if they are to work. You'll know fairly soon. If in two weeks you have experienced worsening or no effect, move on to the next choice. The whole point here is to target other chemistries that were missed with all of your previous drug trials. You tried a lot of drugs, but they all basically worked on similar chemistries. There are others that have been neglected. I think the odds of success in treating your symptoms with totally different drugs/chemistries have greatly increased.
John
Posted by S. Howard on November 27, 2000, at 18:54:21
In reply to Re: Dr. Bob: Please help! Try these. , posted by JohnL on November 27, 2000, at 5:24:05
For general anxiety - and mine was very bad - I've had success with seroquel, which I believe is a fairly new drug, and depakote. I thought this might help you as I also did not respond to paxil, prozac or wellbutrin.
Keep trying!
-Gracie
Posted by StaceyLacy on November 27, 2000, at 18:57:56
In reply to Dr. Bob: Please help!, posted by grunter on November 25, 2000, at 18:09:58
I too was diagnosed with mixed anxiety/depression. I too have tried many drugs without much success. Here is what I have tried so far:
Over the last 7 years, I have tried Prozac combined with Klonopin, Zoloft combined with klonopin, or trazadone, or visteral or buspar, Paxil with buspar, Effexor XR. On each drug I was taken up to the Max dose before the drug was abandoned by the psychiatrist.
All of the above helped improve my condition to an extent, but either the depression or anxiety still broke through. It seems that if one is curbed, the other is breaking through.
I am currently taking the Effexor XR at three 75mg capsules per day. It is the first time I only taking 1 medication for both depression and anxiety. I am still experiencing the depression breakthrough and also some anxiety.
I have not been able to really function for some time now. I have not had a job of any sort for over a year now. I too want to lay in bed all day and usually do. I have spent much time wondering if I will ever find a medication that can truly help me and your post reminded me of myself. I would be interested in any suggestions you get that work!! It is a very sad and lonely feeling when you invest so many years with a psychiatrist trying many different drugs with no success.
Posted by jktaddi on November 28, 2000, at 16:34:03
In reply to Dr. Bob: Please help!, posted by grunter on November 25, 2000, at 18:09:58
Hi. I too was diagnosed (originally) with anxiety/depression and prescribed numerous medications. I didn't respond well to any of them and some of the side effects were unbearable. Then, earlier this year, I was diagnosed with bipolar disorder. I took lithium in different forms for many months. It did wonders for my anxiety and depression, but the side effects, again, made it impossible to take. I definately think it would be worth a try, just remember you need to have blood levels done while you take it. Also, it will probably take at least 10 days before you feel any relief. Hope this has helped some.
jktaddi
Posted by S. Howard on November 28, 2000, at 18:08:16
In reply to Dr. Bob: Please help!, posted by grunter on November 25, 2000, at 18:09:58
I don't think Dr. Bob advises personally on medication and darling, I cannot blame him.
-G
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