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Dr. Bob is Robert Hsiung, MD,
[email protected]Shown: posts 1 to 25 of 25. This is the beginning of the thread.
Posted by Sky Brite Line on May 10, 2008, at 10:36:29
Im sorry, any anti-mood/psychotic makes me feel like a zombie with no emotions.
I dont feel to life, i feel the enthusiasm that i feel from life that i should. I rather just sit in a chair and "stare", i hate it. DOWN THE TOILET ABILIFY! BYE BYE
And first of all benzo's have worked well for years with me, but i'll have to be brave and suffer the anxiety i have during the day, but ill be on Abilify or something. My doctor does not believe in the way my other doctor believed in treating anxiety. He would rather put me on depakote. Which is fine.....ill do it, but its frustrating that when you switch doctors. Their moral views change about medication. But he still believes in treating something to help with focus. Vyvanse is the main treatment right now, well ill have to go back and see him.
So, its caused anxiety itself knowing that this doctor is totally diffrent from my past pdoc.
So wish me luck.....i'll be brave.
Sky Line
Posted by Racer on May 10, 2008, at 11:11:44
In reply to I dont feel like taking my Abilify, posted by Sky Brite Line on May 10, 2008, at 10:36:29
It sounds as though you've just started taking the Abilify. During the initial period of taking any medication, as I'm sure you know, there are always adjustment phase effects. For the most part, these will subside over time. If you stop taking the medication too soon, you'll never know whether it could have been the revelation you were hoping for -- maybe Abilify is the medication which turns your life around, and you might miss out because of a bit of initial discomfort.
I strongly urge you to continue on with it for now. Give it a chance.
Also, while I haven't tried Vyvanse -- I do take a stimulant, but as an older person with a low-risk personality it's not a problem -- but I've heard positive reviews of it. I did take Strattera, which was pretty wonderful for me -- effective antidepressant action, as well as focus. It can't be taken with Prozac, but the other SSRIs should be OK with it. If Vyvanse doesn't work out, maybe that's something for you to try?
As for Depakote, it can be a life saver for many people. There is some chance of weight gain, but that can be mitigated with OTC medications such as Zantac or Pepcid. Just regular doses of those, nothing more -- I think it's about 10mg per day. More is not better.
I wish you the best.
Posted by Phillipa on May 10, 2008, at 12:29:59
In reply to Keep taking the Abilify for now » Sky Brite Line, posted by Racer on May 10, 2008, at 11:11:44
What is the dose maybe start out as other posters have with a lower dose. Discuss with pdoc though and good luck. Phillipa
Posted by med_empowered on May 10, 2008, at 16:49:49
In reply to Re: Keep taking the Abilify for now, posted by Phillipa on May 10, 2008, at 12:29:59
not to pry but...do you have a history of substance abuse? Its just weird to switch a patient from a BZD treatment to antipsychotics and/or depakote unless..there's a reason. And if there were a reason, you'd think he'd stop w/ the schedule II med first. But whatevs...shrinks often don't make sense, and a lot of what they do is more rooted in how they were trained or what they "feel" to be correct than in anything helpful like, say, "data," or "science."
If I had to stick it out with your doc, I'd go for Depakote over the Abilify (I take both, BTW, but Depakote is arguably a lower-risk medication...I mean, as long as your doc keeps up on all the blood work, including liver enzyme tests). I'd also look for a new doc, cuz yours seems a little ridiculously anti-BZD (I mean, unless you had some ridiculously high dose..then it might make sense to get you off of them completely).
Posted by llurpsienoodle on May 10, 2008, at 17:29:43
In reply to Re: Keep taking the Abilify for now, posted by Phillipa on May 10, 2008, at 12:29:59
Sky,
I urge you to take your Abilify and give it a good trial before you decide it's not for you. It has actually helped me calm down without the sedation or loss of IQ associated with benzo (yeah, I took a klonopin a while ago, so I know what I'm talking about)I started on 5mg, now I take 10mg of abilify.
what else do you take, if you don't mind me asking
sorry you're feeling so rotten :(
-Ll
Posted by Bob on May 10, 2008, at 18:28:33
In reply to Re: Keep taking the Abilify for now, posted by llurpsienoodle on May 10, 2008, at 17:29:43
> Sky,
> I urge you to take your Abilify and give it a good trial before you decide it's not for you. It has actually helped me calm down without the sedation or loss of IQ associated with benzo (yeah, I took a klonopin a while ago, so I know what I'm talking about)
>
> I started on 5mg, now I take 10mg of abilify.
>
> what else do you take, if you don't mind me asking
>
> sorry you're feeling so rotten :(
>
> -Ll
I thought Abilify was known for causing anxiety and agitation in many people, not alleviating it. Is it dose dependent?
Posted by llurpsienoodle on May 10, 2008, at 18:36:36
In reply to Re: Keep taking the Abilify for now » llurpsienoodle, posted by Bob on May 10, 2008, at 18:28:33
I noticed a big difference in "calmness" when I increased from 5mg to 10mg. Keeping all else the same.
-Ll
Posted by bleauberry on May 10, 2008, at 19:41:33
In reply to I dont feel like taking my Abilify, posted by Sky Brite Line on May 10, 2008, at 10:36:29
You don't seem to be having any discomforting side effects from abilify, but rather it makes you feel like your other APS did...flat, lethargic, sit and stare. I guess if you were going nuts on a psych ward or in a prison that would be a desired outcome. But for purposes of healing, that is not remotely close to the desired outcome. I wonder if a dosage change would reverse that or not? I don't know, just asking. In any case, if your gut intuition tells you it feels like the antipsychotics you are familiar with, your intuition is probably correct. Just my opinion. If it causes you to just sit and stare and have no emotion, I cannot possibly see how that is an improvement in your life or a step closer to healing.
I do not like the idea of giving hardcore meds like antipsychotics or mood stabilizers for anxiety except when other less invasive methods have been exhausted. Benzos are a lot more time tested, safer, and effective. Of all the antipsychotics, I think abilify has the least amount of risk. But still, I would favor a doctor who understands benzos are the most commonly prescribed meds on the planet for a reason. Compared to other meds they are rapidly effective, predictable, cheap, and relatively safe. Mileage varies of course.
An anti-benzo doc is not allowed on my payroll. Not that I've ever needed benzos for more than a day or two, but I just don't like the idea of venturing into risky unknown expensive territory when simple time tested options are ignored.
Posted by Phillipa on May 10, 2008, at 20:18:34
In reply to Re: I dont feel like taking my Abilify, posted by bleauberry on May 10, 2008, at 19:41:33
Klonopin depressed me made me feel suicidal and I wasn't. So pdoc switched me back to xanax and it went away. Valium is weaker no problems with that either. But that is my experience but agree with blueberry that no benzos would never see the doc too many bad side effects and unknown ones from this new class of meds. But that is just my own opinion. Love Phillipa
Posted by Racer on May 10, 2008, at 21:49:16
In reply to Re: I dont feel like taking my Abilify, posted by Phillipa on May 10, 2008, at 20:18:34
It may be that the doctor in question is prescribing Abilify rather than a benzo to this patient for a reason. It may not be that the doctor is fundamentally anti-benzo. It may be that is the case -- but we really don't have sufficient information to draw that conclusion.
So, for the sake of argument, I'm going to offer up some scenarios that come to my mind for why a doctor might not prescribe a benzo to someone:
1. The doctor is fundamentally anti-benzo.
2. The patient is not suffering from simple anxiety, but from bipolar disorder.
3. The patient in question has a history of substance abuse, perhaps including abuse of prescribed medications.
4. The patient has had prior bad reactions to benzos or related medications, but for some reason possibly related to the underlying psychopathology does not acknowledge that fact.
5. The antipsychotic medication is the correct indication based on the actual symptomology -- the patient may actually be psychotic, or may be floridly manic.
6. It could just be that the patient actually likes that space of hypomania/mania, and doesn't want his/her mood stabilized for that reason.
Many of you who have read my posts about my problems finding anxiolytic medication which is effective and tolerable know that I am not able to turn to benzos. I have a history of paradoxical reactions, and the times they've had a more beneficial effect they've also increased my depression. Not everyone is a good candidate for benzos.
And I worry a great deal, based on the possibility that this situation involves one of the scenarios above, that advising this poster to give up a medication so soon after starting it may not be the best advice we can offer. Could be Abilify isn't the right medication for this poster. Could also be that it would turn out to be much better than other options already tried.
OK. That's my view, on offer for all. I hope that no one feels offended by these views, but I really felt the need to express them.
Posted by Phillipa on May 10, 2008, at 23:44:21
In reply to I dont feel like taking my Abilify, posted by Sky Brite Line on May 10, 2008, at 10:36:29
Sky I feel that going to the poster and asking is a good thing to do. Are you manic, abuse med, alchohol, I think you mentioned that your benzos worked well for you in the past what dose were you on. Most importantly have you asked your new pdoc why he wants you on an antipsychotic instead of a benzo? Most important is to call and ask.Phillipa
Posted by Sky Brite Line on May 11, 2008, at 0:16:51
In reply to I'd like to point something out here..., posted by Racer on May 10, 2008, at 21:49:16
I'm reading some of the posts, excuse me, all the posts.
Its really a bad time in life when you have stinging anxiety going through your nerves every single second. Never knowing what happening next.... some good, or some thing horrible. Which, devestation is prompt feeling in my life, and im burden with the after math of it.
I was put on alprazolam for panic attacks, then they stopped, now there back. I only use it when nessesary, and i also take a benzodiapine for sleep (not alprazolam). My psychiatrist says thats like drinking scotch and "Gin" together, i can't presibe that to you. Its against his practicing standards.
Well, knowing that in a few weeks i will be off benzo's, which that is not something to look forward to. I'll have to go through life with anxiety, he said depakote....well if it works...I'll do it. But this doctor is not benzodiapine-friendly at all, almost hates hearing any type of treatment using benzodiapines.
I admit, benzo's have worked for years for me, but maybe its time no more. The fear will not leave, i can't take it. I live in a world of fear. Even talking about this, puts the the dread that this doctor is not going to treat me for anxiety well.
I told him, i've been on following:
Seroquel
Trazadone
ZoloftInside i really unstable, i act like i can cope with reality fine, but its not true. I go through the days smiling. Every night, i take something to sleep (strong benzodiapine), and pray to god for his immidate help from fear.
"i dont want to feel blue" is my motto.
But, i need to read some more posts. I just hate my life inside
Sky Line
Posted by Sky Brite Line on May 11, 2008, at 10:51:05
In reply to whats with your doc?, posted by med_empowered on May 10, 2008, at 16:49:49
hello.
No, i have not had any reported history with my doctor with substance abuse with benzodiapines. Never.
This doctor does not believe really in treating with benzo's. He thinks, and stated "taking Gin" to calm down. I argued and said, no it has a very calming effect, but he wants to approach anxiety with a new form treatment.
I do belive my old pdoc fired me because, there was alot of stuff going on. And i would get on his nerves. And he referred me to another pdoc. But i went to another one, and to find out, he doenst believe in any methods my old pdoc did.
So maybe it will be good....maybe i wont be panic, anxiety all the time. I just have to see. Its such a dread that my old pdoc didnt want anything to do with me anymore. "Dont let the door hit you in the ***" is what i got from him.
And i know your thinking why? why? did he do this. I will reveal it in time, i have wait. It did not have any thing to do with benzodiapines, never called in early or anything. Thats why he was ok with prescibing me benzo's. I didnt have a problem with benzo's becuase they helped my anxiety and panic.
Thanks for asking...
Sky Line
Posted by Sky Brite Line on May 11, 2008, at 10:59:46
In reply to I'd like to point something out here..., posted by Racer on May 10, 2008, at 21:49:16
Thank you for your long chart that you used.
This doctor, i dont know, i only saw him once. Again, i state, i did not have a problem with benzdiapines. They make me groggy, but when the time comes to use them, its a good time.
I do have some symptoms of hypomania, which benzo's did not treat. So abilify is going to be the awnser, at least for now. He donest believe in "older" medications. That what frustrates me so badly. And 2nd of all, some did help (older medicaitons)
This is more of a new-age, Bi-polar related doctor. He belives in treating bi-polar symtoms right away, thats his practice, in his statement. So i can see why he mentioned abilify right away.
My other doctor belived in treating anxiety and mood.
But thanks......i just dont know if this is going to work. But i'll be brave with this doctor. Ill go in, what ever he says i'll try.
Be with me!
Sky Line
Posted by Racer on May 11, 2008, at 12:26:47
In reply to Re: i'd like to point something out here....racer, posted by Sky Brite Line on May 11, 2008, at 10:59:46
Yeah, I'm here with you. I hope that helps. (And I sent you a BabbleMail, in case you haven't seen it yet.)
What you're saying about this psychiatrist sounds very encouraging to me. The fact that he's treating one of the underlying problems -- bipolar disorder -- rather than trying to treat the symptoms as though each were a separate disorder, sounds quite encouraging. I think that's a very good thing, and I hope it works out for you.
From some of the things you've posted here, Depakote also sounds like it might be a worthwhile option to try down the line, if the Abilify doesn't work out.
I wish you the best.
Posted by Bob on May 11, 2008, at 13:19:17
In reply to I'd like to point something out here..., posted by Racer on May 10, 2008, at 21:49:16
> Many of you who have read my posts about my problems finding anxiolytic medication which is effective and tolerable know that I am not able to turn to benzos. I have a history of paradoxical reactions, and the times they've had a more beneficial effect they've also increased my depression. Not everyone is a good candidate for benzos.
>So if you cannot use benzos, what did you eventually settle on for anxiety?
Posted by Racer on May 11, 2008, at 14:18:56
In reply to Re: I'd like to point something out here... » Racer, posted by Bob on May 11, 2008, at 13:19:17
>
> > Many of you who have read my posts about my problems finding anxiolytic medication which is effective and tolerable know that I am not able to turn to benzos. I have a history of paradoxical reactions, and the times they've had a more beneficial effect they've also increased my depression. Not everyone is a good candidate for benzos.
> >
>
> So if you cannot use benzos, what did you eventually settle on for anxiety?You mean besides shaking, crying, and hiding under the bed? ;-)
The sad answer is that I haven't come up with anything for it. Yet. I've spoken with both my psychopharmacologist and my therapist about biofeedback and neurofeedback, both of which look promising to me. Most of my anxiety problems are physical -- I can deal pretty well with the thoughts, it's the physical side that's a problem for me. It's too expensive right now, and my insurance would consider it another form of psychotherapy, so it would limit the actual psychotherapy I do. Grrr...
(Hm... Maybe I could talk my medical doctor into prescribing it for my joint problems? That's something to consider...)
Anyway, as far as meds go, so far the medications which are effective for my anxiety tend to increase depression, and the medications which have been most effective for my depression increase my anxiety.
Sometimes I think the cosmos has a very cruel sense of humor, you know? Other days I just laugh at it all...
Posted by undopaminergic on May 11, 2008, at 16:14:55
In reply to Re: I'd like to point something out here... » Bob, posted by Racer on May 11, 2008, at 14:18:56
Have you tried any "alternative" substances, such as L-theanine and picamilon?
Posted by Bob on May 11, 2008, at 16:51:24
In reply to Re: I'd like to point something out here... » Bob, posted by Racer on May 11, 2008, at 14:18:56
> >
> > > Many of you who have read my posts about my problems finding anxiolytic medication which is effective and tolerable know that I am not able to turn to benzos. I have a history of paradoxical reactions, and the times they've had a more beneficial effect they've also increased my depression. Not everyone is a good candidate for benzos.
> > >
> >
> > So if you cannot use benzos, what did you eventually settle on for anxiety?
>
> You mean besides shaking, crying, and hiding under the bed? ;-)
>
> The sad answer is that I haven't come up with anything for it. Yet. I've spoken with both my psychopharmacologist and my therapist about biofeedback and neurofeedback, both of which look promising to me. Most of my anxiety problems are physical -- I can deal pretty well with the thoughts, it's the physical side that's a problem for me. It's too expensive right now, and my insurance would consider it another form of psychotherapy, so it would limit the actual psychotherapy I do. Grrr...
>
> (Hm... Maybe I could talk my medical doctor into prescribing it for my joint problems? That's something to consider...)
>
> Anyway, as far as meds go, so far the medications which are effective for my anxiety tend to increase depression, and the medications which have been most effective for my depression increase my anxiety.
>
> Sometimes I think the cosmos has a very cruel sense of humor, you know? Other days I just laugh at it all...Very, very true Racer. Very true. I am quite like you in this respect: meds that alleviate my depression (not sure there are any now) increase anxiety and all the physical problems associated with that. Meds that alleviate anxiety cause significant sedation and depression. It's an extremely difficult problem.
Posted by Sky Brite Line on May 11, 2008, at 23:35:21
In reply to Re: I'd like to point something out here... » Racer, posted by Bob on May 11, 2008, at 16:51:24
Going off benzodiapines are going to be hard, not to that i abused them. This pdoc could not believe the amount of benzodipine dose I was on.
He said, again i will not scripts for 2 benzodiapines. Very strict. I tried my best to tell him that Restoril was good, then he asked me do you mix your benzodiapines at night? sometimes, well that's what i've been doing for years. He, said "i'm sorry, that is not how it going to be done in my practice"
Very stict doctor, but if he know the emotional pain i have at night, oh god this is going to be one big "smack" on the concrete when he tweaks my meds. (when you say "emotional" its kinda disregared in the medical community because your placing your self as a drama queen, thats just my experince)
Yes, i've tried so many, valerian root, kava, Melatonin (this is the substance he said "your going on this" im like gosh this guy is a boss!) I've always had insomnia, not knowing what i need, just agaitation, or thoughts that wont stop, or just when you just get stuck "platue" in sleep stages which is notorious for me.
I just hate the feeling, should i go to another doctor....no, i need to work with this one, because i need 2....3rd opinions from medical communities. Its just this one is "new age", is more for ambien, seroquel, all the drugs that are being advertised very popular.
Getting to go through a transition. Wish me luck with this doctor.
Sky Line
Posted by Racer on May 12, 2008, at 1:00:06
In reply to Re: I'd like to point something out here..., posted by Sky Brite Line on May 11, 2008, at 23:35:21
> Going off benzodiapines are going to be hard, not to that i abused them. This pdoc could not believe the amount of benzodipine dose I was on.
>
> He said, again i will not scripts for 2 benzodiapines. Very strict. I tried my best to tell him that Restoril was good, then he asked me do you mix your benzodiapines at night? sometimes, well that's what i've been doing for years. He, said "i'm sorry, that is not how it going to be done in my practice"
Sorry -- there's a contradiction there. Your new doctor is correct -- it's not a good idea to mix benzos that way, and that does sound like abuse to me. Did your old doctor tell you to mix the two? If so, I have grave reservations regarding the treatment you were getting.As for the way you've described your doctor and your state, I think this one may be a better choice for you. You're describing emotional dysregulation which will probably respond better to Seroquel or Risperdal than it does to Xanax. And the new non-benzodiazepine benzo receptor agonists are very effective for sleep -- with a lower risk of recreational use.
I think you're in better hands now, and I hope that you'll give this doctor a fair chance to prove the wisdom of his choices for you.
Posted by SLS on May 12, 2008, at 6:00:24
In reply to Re: I'd like to point something out here... » Sky Brite Line, posted by Racer on May 12, 2008, at 1:00:06
I safely and effectively used two different benzodiazepine to remediate total insomnia produced by combining Parnate + desipramine.
The deal was this: I needed something strong to induce sleep and something else to sleep through the night. My doctor chose Halcion and Ativan. Halcion is the strongest marketed benzodiazepine. It can put anyone to sleep. However, with its short half-life, there was a tendency for it to wear off early or even produce a rebound awakening. With its longer half-life, Ativan prevents rebound awakenings and promotes sleep through the remainder of the night, although it is not strong enough to induce sleep. Restoril can fill the same role as the Ativan. Sonata can perhaps substitute for Halcion.
- Scott
Posted by MidnightBlue on May 12, 2008, at 15:13:27
In reply to Re: I'd like to point something out here..., posted by SLS on May 12, 2008, at 6:00:24
Scott,
What about the combo of Ambien and Xanax? I've never tried it. I usually take Ambien but my doctor has been encouraging me to try Xanax. I'm afraid if I take a Xanax and it doesn't work or makes me feel worse then I can't take the Ambien?
MB
Posted by Phillipa on May 12, 2008, at 19:10:09
In reply to Re: I'd like to point something out here..., posted by SLS on May 12, 2008, at 6:00:24
Scott I too was given more than one benzo at a time. At one point in the hospital on xanax, valium, chloral hydrate. My other pdocs also combined benzos usually it was a very low does of klonopin like l.25mg with 2-3mg of xanax. Then there was the chloral hydrate was on for years. Weaned off that about 4 years ago. Phillipa
Posted by undopaminergic on May 15, 2008, at 23:34:53
In reply to Re: I'd like to point something out here..., posted by SLS on May 12, 2008, at 6:00:24
> I safely and effectively used two different benzodiazepine to remediate total insomnia produced by combining Parnate + desipramine.
>
> The deal was this: I needed something strong to induce sleep and something else to sleep through the night. My doctor chose Halcion and Ativan. Halcion is the strongest marketed benzodiazepine. It can put anyone to sleep. However, with its short half-life, there was a tendency for it to wear off early or even produce a rebound awakening. With its longer half-life, Ativan prevents rebound awakenings and promotes sleep through the remainder of the night, although it is not strong enough to induce sleep. Restoril can fill the same role as the Ativan. Sonata can perhaps substitute for Halcion.
>I agree with the above, except that I wouldn't compare the drugs in terms of strength. Triazolam (Halcion) and midazolam (Dormicum, Versed) - which I use personally - are more usefully described as having a rapid onset and short duration of action.
Although combinations of benzodiazepines have legitimate and safe applications, it may be possible to find alternatives, such as a drug with both rapid onset and sufficient duration of action - zolpidem (Ambien) and [es]zopiclone (Imovane, Lunesta) are some possibilities that come to mind.
This is the end of the thread.
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Dr. Bob is Robert Hsiung, MD,
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