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Dr. Bob is Robert Hsiung, MD,
[email protected]Shown: posts 1 to 8 of 8. This is the beginning of the thread.
Posted by David Newhouse on October 12, 2000, at 14:17:45
Does anyone know of a good med. cocktail for severe generalized anxiety. I know it's subjective. I've tried the ssri,maoi's,and a bunch of other crap. If anyone out there has had any luck or knows of a effect combination, please let me know.
Posted by JohnL on October 13, 2000, at 3:53:15
In reply to Looking for the experts, posted by David Newhouse on October 12, 2000, at 14:17:45
> Does anyone know of a good med. cocktail for severe generalized anxiety. I know it's subjective. I've tried the ssri,maoi's,and a bunch of other crap. If anyone out there has had any luck or knows of a effect combination, please let me know.
David,
I sense frustration, and rightly so. Some people get lucky and find the right meds for themselves quickly, while some of us aren't so lucky. A lot of it is just a guessing game based on statistics, and so luck is a big part of it I think. But hang in there. There is indeed an answer.Anxiety, like any other psychiatric condition, has a chemical imbalance cause at its core. But there are many different chemical causes. Finding the right one is the key to fixing it. From your previous trials, I think it would be safe to assume low serotonin is not the cause, and thus the SSRIs didn't help much.
In one pdoc's office during one year, these statistics were compiled showing what medications worked with complete longlasting results on anxiety. I think it's interesting to note that some of the things that ended up working are not things we would normally think of in treating anxiety, and they did not have clinical justification for trying them. But they worked nevertheless, proving that there are multiple chemistries that could be at fault, beyond the ones we normally think of in anxiety. One patient for example found complete robust response to a small dose of Lithium, and even more remarkable is the fact that it worked the very first day, indicating that this treatment scored a bullseye in targeting the underlying chemical cause directly. In another patient, Depakote did the same thing. In another, a beta blocker worked. For others, antipsychotics in very small doses work. Maybe these statistics will help provide some direction for you.
Serotonin antidepressants Worked 48% of the time
Benzodiazapines 24%
Lithium 22%
Stimulants 14%
Antipsychotics 13%
Depakote 11%
Tegretol 3%
Thyroid, even when blood tests were OK 24%Stimulant required low dose antipsychotic blend 21% of the time.
Also worth noting is that while the benzos are usually the primary treatment for anxiety, one may work where others don't. It's all a matter of a good match at a molecular level. Our body will embrace a particular medication molecule yet reject others that are similar but not the same.
John
Posted by salarmy4me on October 14, 2000, at 3:33:42
In reply to Looking for the experts, posted by David Newhouse on October 12, 2000, at 14:17:45
> Does anyone know of a good med. cocktail for severe generalized anxiety. I know it's subjective. I've tried the ssri,maoi's,and a bunch of other crap. If anyone out there has had any luck or knows of a effect combination, please let me know.
Did you try a benzodiazepine? Like Klonopin?
Posted by Cindy W on October 14, 2000, at 22:42:58
In reply to Re: Looking for the experts, posted by salarmy4me on October 14, 2000, at 3:33:42
> > Does anyone know of a good med. cocktail for severe generalized anxiety. I know it's subjective. I've tried the ssri,maoi's,and a bunch of other crap. If anyone out there has had any luck or knows of a effect combination, please let me know.
>
> Did you try a benzodiazepine? Like Klonopin?I'm no expert, but if you haven't tried Serzone, would recommend it for anti-anxiety properties. It really decreasd my social anxiety as well as depression and have read many people comment on its anxiolytic effects.--Cindy W
Posted by Buffet on October 18, 2000, at 0:03:08
In reply to Looking for the experts, posted by David Newhouse on October 12, 2000, at 14:17:45
> Does anyone know of a good med. cocktail for severe generalized anxiety. I know it's subjective. I've tried the ssri,maoi's,and a bunch of other crap. If anyone out there has had any luck or knows of a effect combination, please let me know.
I am looking for the exact same thing. All I can add is that xanax works ok but you will become dependent. That is what I am on. I just tried buspar and do not recomend it. It put me into depression and had to stop taking it. I just heard that buspar works by lowering seratonin levels (high levels cause anxiety in some people). I guesss this means it does the exact opposite of prozac and other ssri's but I'm not sure. I'm considering trying klonapin/celexa combo. I'll post again if it works.
Posted by Snowie on October 18, 2000, at 6:54:36
In reply to Looking for the experts, posted by David Newhouse on October 12, 2000, at 14:17:45
David,
Xanax works on GAD; Klonopin does as well and supposedly lasts longer than Xanax, but that wasn't my experience. Some people like Valium, which I've never tried. I have tried Tranxene, which is similar to Valium. Those drugs are called benzodiazepines, and once you start taking them on a regular basis, you will develop a dependency. However, some of the SSRIs (anti-depressants) also produce withdrawal symptoms, so I guess it's all in your perspective. For a long time, the benzos were the only drugs that helped me. As an Internet pdoc once wrote me, what is a functional life worth to you?
If you prefer to avoid the benzos, you might want to try Neurontin, which for some reason has helped me. Serzone wasn't bad either, but it made me dizzy and didn't last long. Serzone may have been a better drug for me had I not already been taking Xanax. Celexa was great, but I lost my libido. To borrow a phrase, prescribing brain drugs is an art, not an absolute. It can be a trial and error process to find the right drug or combination that helps you, with the least side effects.
Snowie
> Does anyone know of a good med. cocktail for severe generalized anxiety. I know it's subjective. I've tried the ssri,maoi's,and a bunch of other crap. If anyone out there has had any luck or knows of a effect combination, please let me know.
Posted by laural on October 20, 2000, at 7:23:38
In reply to Re: Looking for the experts » David Newhouse, posted by Snowie on October 18, 2000, at 6:54:36
david, why does your name sound familiar, do I know you? my name would be laural, really. (of course you don't have to tell me)
Posted by S. Howard on October 20, 2000, at 21:03:26
In reply to Looking for the experts, posted by David Newhouse on October 12, 2000, at 14:17:45
I was so stressed out before treatment that I couldn't sleep, couldn't concentrate, and I would cry or go into a rage at the drop of a hat. This is the "cocktail" that drugged me into being mellow: 50 mg. Seroquel in am, 50 mg. Seroquel at midday, 100 mg. Seroquel at bedtime, 500 mg. Depakote at bedtime, and 30 mg. Paxil once a day.
To be honest, this may be an excessive amount for most people because when it was first prescribed for me 6 months ago, I had a considerable history of "self-medication" (read: substance abuse). I have made great progress toward cleaning up my act, I sleep much better, and I no longer suffer from anxiety attacks or wide mood swings. My only complaint is that I don't have as much energy and I tire easily, so hopefully I am ready to cut down on the medication. I wish you luck! -SGH
This is the end of the thread.
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