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Dr. Bob is Robert Hsiung, MD,
[email protected]Shown: posts 1 to 4 of 4. This is the beginning of the thread.
Posted by upsndowns on October 19, 2004, at 18:53:40
Over the past three or four months, my anxiety level has soared to the point where I am afraid, to the point of almost paranoia, of being in my own house alone, of the dark, of going anywhere unless I am forced out of the same house that I am afraid to be in.....and at the same time, I do not want to be out of the house almost to the point of agoraphobia. I have been diagnosed BPII with hypomanic states of irritability and hostility but have been in the more depressed part of my cycle lately. I take 5mg of Abilify, 36 mg Concerta, tranxene prn and ambien for sleep. Does anyone have experience like this as a side effect of any of these drugs? I have been on them for several months, almost a year with Abilify, and it has until lately been the best thing I have taken, bar none. Oh, yes, I also take a smidge....25mg...of nefazadone. Please, everyone, I am getting desperate about this situation, it is impacting my life in a very negative manner, as you can imagine. Thank you for any help and advice.
Posted by jboud24 on October 19, 2004, at 22:36:24
In reply to major anxiety, don't know which med to blame, posted by upsndowns on October 19, 2004, at 18:53:40
I'm sorry you feel down and out. Depression feels overwhelming and unbearable alot of the time, I can relate to that. I have heard that abilify can amplify paranoia and agoraphobia, so perhaps you could talk to your pdoc about another anti-psychotic if you haven't tried one before. I would recommend olanzepine(Zyprexa), or Risperdal at low doses. I have heard that Abilify can exacerbate paranoia anecdotally, possibly by binding to pre-synaptic dopamine autoreceptors and decreasing dopamine release by the receptor it acts on. Also, maybe increasing the dose of your anti-depressant to say 50 or 100mg would help. I say this because 25mg is a very low dose of Serzone, I've never heard of a dose that low. Serzone is a very weak anti-depressant at that dose compared to the other SSRI's like Paxil, Zoloft, Celexa, Prozac, etc.
I hope I gave you some ideas to work with and I hope you feel better.
Justin
Posted by upsndowns on October 20, 2004, at 9:08:26
In reply to Re: major anxiety, don't know which med to blame, posted by jboud24 on October 19, 2004, at 22:36:24
Thanks for the anecdotal evidence; I just add it to my own perceptions of what has happened and am seeing my pdoc Friday. The reason for the extremely low dose of Serzone, as well as most other meds I take is that I am exquisitely sensitive to drugs and the smallest dose has the same effect as a much larger dose to others. Serzone, or Nefazadone as we now must call it, is the only AD that I have been able to take, the SSRI's make me manic or just plain horrendous and I cannot take a higher dose, it gives me the worst of the SE's, but I am also unable to delete that tiny dose, it keeps the major depression away....go figure! Abilify has been the only adjunctive med that has had positive effects in years of trying everything on the market, so I am dismayed by this anxiety, paranoia, call it what you will, but also convinced it is the cause, especially with me being someone who has whatever might be an unusual reaction or uncommon SE. Thanks also for the suggestions, will see what the doc thinks....it is a good relationship, he listens and tweaks.
Posted by Ritch on October 20, 2004, at 11:35:23
In reply to major anxiety, don't know which med to blame, posted by upsndowns on October 19, 2004, at 18:53:40
> Over the past three or four months, my anxiety level has soared to the point where I am afraid, to the point of almost paranoia, of being in my own house alone, of the dark, of going anywhere unless I am forced out of the same house that I am afraid to be in.....and at the same time, I do not want to be out of the house almost to the point of agoraphobia. I have been diagnosed BPII with hypomanic states of irritability and hostility but have been in the more depressed part of my cycle lately. I take 5mg of Abilify, 36 mg Concerta, tranxene prn and ambien for sleep. Does anyone have experience like this as a side effect of any of these drugs? I have been on them for several months, almost a year with Abilify, and it has until lately been the best thing I have taken, bar none. Oh, yes, I also take a smidge....25mg...of nefazadone. Please, everyone, I am getting desperate about this situation, it is impacting my life in a very negative manner, as you can imagine. Thank you for any help and advice.
Abilify can cause akathisia (restlessness), the nefazodone metabolite can induce anxiety, and the concerta could aggravate the agoraphobic stuff. I've had a really bad experience with taking stimulants with antipsychotics in the past (inducing panic). Taking ritalin with Depakote worked out ok. The stim+antipsychotic might be depleting GABA.
This is the end of the thread.
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