![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 4 of 4. This is the beginning of the thread.
Posted by BradD on October 26, 2004, at 8:56:38
I've read the studies that Depakote (sodium valproate) increases GABA levels. Wouldn't it be wise to use it with benzos ? Im particularly interested in the social-anxiety effect. I've seen one study where Depakote was used in social-anxiety with good results, so maybe combining it with Klonopin/Xanax would give even better effects?
Posted by Ritch on October 26, 2004, at 10:28:17
In reply to Depakote with benzo - for sociability?, posted by BradD on October 26, 2004, at 8:56:38
> I've read the studies that Depakote (sodium valproate) increases GABA levels. Wouldn't it be wise to use it with benzos ? Im particularly interested in the social-anxiety effect. I've seen one study where Depakote was used in social-anxiety with good results, so maybe combining it with Klonopin/Xanax would give even better effects?
I take Depakote and clonazepam for bipolar and panic. You have to be a little careful with the combined dosages. I've gotten some speech slurring issues when I raise either one too much (and I don't take much of either), so I think there is a little bit of synergism going on there. Depakote on its own seems to reduce anxiety generally, but it also has a flattening effect on emotions, so while it may reduce avoidance for some, you might find it doesn't work well on the 'pro-social' aspect people look for. You might find Neurontin+Benzo to work better. Just a thought.
Posted by jonh kimble on October 26, 2004, at 11:07:54
In reply to Re: Depakote with benzo - for sociability? » BradD, posted by Ritch on October 26, 2004, at 10:28:17
There are at least two studies which have been done recently, and while they were small scale, they showed very significant, if not more so than ssri's, improvement of generalised social anxiety in NON SSRI RESPONDERS with topamax, something I think is very interesting. and even in the benzo maoi range of 60 to 70% response rates. Pregabalin has also had similar results from what Ive seen. While neither is approved for this, I think they would be well worth checking out if ssri's failed. (Sorry in a hurry but the studies arent to terribly hard to find if i remeber) Ill come back to this if you would like. Tom
Posted by Ritch on October 26, 2004, at 13:38:08
In reply to Re: topamax and pregabalin for social anxiety, posted by jonh kimble on October 26, 2004, at 11:07:54
> There are at least two studies which have been done recently, and while they were small scale, they showed very significant, if not more so than ssri's, improvement of generalised social anxiety in NON SSRI RESPONDERS with topamax, something I think is very interesting. and even in the benzo maoi range of 60 to 70% response rates. Pregabalin has also had similar results from what Ive seen. While neither is approved for this, I think they would be well worth checking out if ssri's failed. (Sorry in a hurry but the studies arent to terribly hard to find if i remeber) Ill come back to this if you would like. Tom
I was on a trial of Topamax (25mg 2x daily) in the past (as a Depakote replacement) and I must admit that it did have a very pronounced anxiolytic effect and great sleep. I just got really bad daytime somnolence from the Topamax and the duh's that were so bad it interfered with my job too much. If the half-life were quite a bit shorter (say 6 hrs instead of 24) I would probably still be taking 15mg of Topamax at bedtime as a sleeper (along with the Depakote I take now-perhaps without needing the clonazepam). I read somewhere that Depakote's mechanism of action is not only to be inhibition of GABA metabolism (kind of a GABA MAOI), but has a lot to do with the NMDA receptor. So does Topamax. So does Lamictal. Hmmm. The 15mg capsule is in "sprinkle" form. Maybe I could try a partial capsule at bedtime for sleep without making me a zombie the next day? Thanks for that information.
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.