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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 hockeygirlcanada on December 10, 2004, at 17:29:48
I have severe anxiety disorder. Generalized anxiety. I have never been on a tricyclic or paxil. All the other ssri's didn't work out, Celexa is what I am on now. I see my p-doc on Monday and he was talking about paxil, tricyclics and perhaps adding neurotinin.
Any help or suggestions would be so greatly appreciated. Thank you:)
Posted by banga on December 10, 2004, at 20:32:31
In reply to PLEASE HELP- TRICYCLICS AND PAXIL USERS, posted by hockeygirlcanada on December 10, 2004, at 17:29:48
I think the value of tricyclics has been greatly pushed aside by the SSRI market. I was on Anafranil (clomipramine) and it helped depression and anxiety greatly. Anafranil is well known in helping anxiety and OCD. And I felt more normal and even-keel--SSRIs sometimes helped but it was a sort of high-strung state of happiness, not calm and happy like I felt on Anafranil.
Tricyclics are much more complex in their action, and thus there m=perhaps is more individual variation on their effects. Anafranil for instance--it has a very powerful metabolite that actually acts on norepinephrine VERY powerfully--but how much this metabolite comes into play depends on your personal physiology (ex. your level of certain enzymes that break down Anafranil).
Tricyclics, to sum it up, are underrated I think, especially with depression that's mixed with anxiety.BTW, I did try Paxil and my anxiety was in fact helped....but I gained a LOT of weight. So that is something to keep in mind. Tricyclics also can lead to gain weight...but for me Paxil was worse. Having said that, remember we ARE all different in how we respond to a drug.
Posted by Emily Elizabeth on December 10, 2004, at 22:29:02
In reply to Re: PLEASE HELP- TRICYCLICS AND PAXIL USERS, posted by banga on December 10, 2004, at 20:32:31
Do you have depressive symptoms, or just anxiety? I have some experience w/ these drugs. When I started on meds 2.5 yrs ago I had dysthymia and GAD. I found Paxil to be somewhat, but not completely, helpful with both anxiety and depression. However, it was AWFUL to get off of after 1.5 yrs. In retrospect, I don't know if I would have started it if I knew how awful it would be to get off of. From paxil I switched to Prozac and then Lexapro (which I'm still on). I also found them to be somewhat, but not completely helpful.
I have had Neurontin in my mix for probably 2 yrs now. I found it very helpful, particularly at 1st, to stop my ruminations. However, I know that it doesn't work for a lot of people. On the other hand, it supposedly has low side effects and interactions, so it isn't a big deal to add.
A few months ago I added a TCA (desipramine). I added it to help out w/ a bout of major depression, but i noticed that it really made me calmer. (So in case I'm not being clear, I currently take Lexapro, Neurontin and Desipramine.) The combo has been good for anxiety, but it still hasn't helped the depression. :(
Hope that some of this helps. I'd say go for the Neurontin and TCA. If you've been on a few SSRI's, I don't know how much longer you want to keep trying to find the right one. Might be time to add something to the mix.
Best,
EE
Posted by theo on December 12, 2004, at 8:22:08
In reply to PLEASE HELP- TRICYCLICS AND PAXIL USERS, posted by hockeygirlcanada on December 10, 2004, at 17:29:48
I would try Paxil and if he also suggests adding Neurontin, ask him about Keppra instead and see what he says.
This is the end of the thread.
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