Question:

I  am  frty  yrs. old and have asthma.  I take accolate twice daily and use the inhalers albuterol, flovent, and combivent.   My mother has same symptoms as  I  do, but her Doctor says hers is Emphysema she is sixty yrs old. They have told  her adults dont get asthma,  they get emphysema. My question is whats the difference in the two and why is it treated the same way.

Asthma is an inflammation-induced bronchoconstriction.  Treatment of the bronchospasm with short- and long-acting bronchodilators, and the underlying inflammation with inhaled steroids can quell the inflammation; and permit an asthmatic to lead a near-normal life. Emphysema [which can result from long-untreated asthma] is a permanent loss of elasticity in the aveoli. They are treated the same because many of the same drugs will assist both conditions. Chris Owens – Hide quoted text — Show quoted text – Thank You [Image]

Response:

I  am  frty  yrs. old and have asthma.  I take accolate twice daily and use the inhalers albuterol, flovent, and combivent.   My mother has same symptoms as  I  do, but her Doctor says hers is Emphysema she is  sixty yrs old. They have told  her adults dont get asthma,  they get emphysema. My question is whats the difference in the two and why is it treated the same way.

Adults do get asthma, called adult onset asthma. Emphesema is generally contracted by smokers tho there is a hereditary version. Asthma is generally considered a reversible condition with drugs. Emphesema is only slightly reversible with drugs. Many older patients have a combination of the 2. Asthma and emphesema are not treated exactly the same way, although some drugs are used for both. Accolate would only be used for asthma–it helps about 1/2 to 2/3 who try it, if it doesn’t help it should be stopped. Combivent (albuterol + Atrovent) is primarily intended for emphesema but may benefit some asthmatics. Albuterol is used for both. Flovent is used to treat the inflammation of asthmatic bronchial tubes tho some with emphysema may benefit. Ellis

Response:

Question:

You have learned a very important thing about there being no upward bound.  The key is to make sure the patient is titrated upward properly.  Many doctors mistakenly believe that at a certain dosage, resp failure will ensue.  That is BS just as long as the patient has been *gradually* taken up to their dosages. As for cost, Oxy and MS-Con are VERY expensive.  Oramorph is about the same price also.   90 Oxycontin of 40 mg strength can run anywhere from $400 to $500. (I’ve heard that the methadone equivalent of these is about $15-$25. You can see why some patients might need to use methadone). That is ALOT of dough for either Oxy or MS-Contin.  It is important for pain physicians to discuss what insurance their patients have and to work with them to make sure they can afford the meds.  Before the doc even pulls out the prescription pad, a discussion should take place about what insurance the patient has (if any).  Most people can simply not afford paying over $1000 per month out of pocket (assuming prescriptions for Oxycontin and a breakthru med like Oxyfast). – Jon  (:o)}< – Hide quoted text — Show quoted text – First, this is my own personal preferences.  Doctors are allowed to be fickle too (most are MORE so).  I guess if I start using it more and get more comfortable with it, then I’ll start to use it more.  The hospice I direct has contracts for MS Contin/Oxy Contin so they get it cheaper.  The residency program I came from had a pharmacy that had both Oxy/MS and methadone.  I just preferred the first two. Now allow me to clear up one misconception you stated: there are no upper limits for ANY opiate that is not mixed with something else.  So there is no upper limit for morphine, oxycodone or methadone.  You keep taking more until you get the dose that benefits you.  That is one simple rule that many docs don’t like.  Some incorrectly believe that there is some "magic" number that if they pass that dose, the patient (still in horrible pain) will stop breathing.  That is simply NOT true.  No one will be dying from respiratory failure from too much narcotic while they still have significant pain.  Pain is the PERFECT antagonist for opiates…better than naloxone. Cost can be a significant factor, but I have not encountered that yet.  I know I will, just not yet. It does sound like you have a great pain doc.  Stick with her and tell your friends about her too. — Bill Work Personally, it is my last choice for long-acting, oral narcotics. Notice I said "personally".  It has a half-life of 24 hours but you must take it three times a day for pain relief. Is the 3x/day dosing the reason you don’t like the methadone, or is there another reason for not liking it? It surely is a life saver cost wise for those who cannot afford the high prices of OxyContin and other meds which have no generics. My pain-management physician also says that there is no upper limit on methadone. She prescribes whatever it takes to reach the goal that one is seeking for pain relief and gives breakthrough medication also. Now a few questions…who in the world put you on OxyContin four times a day?  What if you took 80 mg every 12 hours (not twice a day but every 12 hours)?  Does it make you too sleepy?  Do you get too much breakthrough pain? I was on OxyContin a while back and found it to be practically useless for me. My first pain-management physician started me out on 3x/day because he said that it didn’t last longer than 8 hours for most people. I can’t see any difference between taking OxyContin 3x/day and methadone 3x/day except for the fact that methadone works much better for me than OxyContin, and I have saved a bundle of money. Annie B.

Response:

Thank you Harley for the inforation you provided….printed alot of it off and have it ready for my Dr appointment  on Thursday. It should give him some idea on what I’m talking about. Thanks again…I appreciate all the help everyone has given me…….Joan

Response:

Hi Joan. I am 28yrs. and I would like to share my medication history with you.  I have been on narcotics for the treatment of Avascular Necrosis for the past 3yrs  I am currently taking 30mg of methadone every 6hrs; 120mg/day.  75mg of morphine ER/day ;30-45mg twice a day . Also, oxycodone 10mg every 4hrs.; 60mg/day.  However, I am still in a great deal of pain every second of the day.  Before switching to Methadone, I was on oxycontin 80mg/day along with the same dose of oxycodone and things where pretty much the same.  So, if cost is the only issue, I would give methadone a try.But i was recently told that methadone can damage the bones.  Therefor, I am now lookng for a drug to replace methadone since I already have a bone disease. I pray that you will soon find the right medication for you.

Response:

I agree…so I guess I need to only treat patients with good insurance????? No, you made some good points. — Bill Work

– Hide quoted text — Show quoted text – You have learned a very important thing about there being no upward bound.  The key is to make sure the patient is titrated upward properly.  Many doctors mistakenly believe that at a certain dosage, resp failure will ensue.  That is BS just as long as the patient has been *gradually* taken up to their dosages. As for cost, Oxy and MS-Con are VERY expensive.  Oramorph is about the same price also. 90 Oxycontin of 40 mg strength can run anywhere from $400 to $500. (I’ve heard that the methadone equivalent of these is about $15-$25. You can see why some patients might need to use methadone). That is ALOT of dough for either Oxy or MS-Contin.  It is important for pain physicians to discuss what insurance their patients have and to work with them to make sure they can afford the meds.  Before the doc even pulls out the prescription pad, a discussion should take place about what insurance the patient has (if any).  Most people can simply not afford paying over $1000 per month out of pocket (assuming prescriptions for Oxycontin and a breakthru med like Oxyfast). – Jon  (:o)}< First, this is my own personal preferences.  Doctors are allowed to be fickle too (most are MORE so).  I guess if I start using it more and get more comfortable with it, then I’ll start to use it more.  The hospice I direct has contracts for MS Contin/Oxy Contin so they get it cheaper. The residency program I came from had a pharmacy that had both Oxy/MS and methadone.  I just preferred the first two. Now allow me to clear up one misconception you stated: there are no upper limits for ANY opiate that is not mixed with something else.  So there is no upper limit for morphine, oxycodone or methadone.  You keep taking more until you get the dose that benefits you.  That is one simple rule that many docs don’t like.  Some incorrectly believe that there is some "magic" number that if they pass that dose, the patient (still in horrible pain) will stop breathing.  That is simply NOT true.  No one will be dying from respiratory failure from too much narcotic while they still have significant pain. Pain is the PERFECT antagonist for opiates…better than naloxone. Cost can be a significant factor, but I have not encountered that yet.  I know I will, just not yet. It does sound like you have a great pain doc.  Stick with her and tell your friends about her too. — Bill Work Personally, it is my last choice for long-acting, oral narcotics. Notice I said "personally".  It has a half-life of 24 hours but you must take it three times a day for pain relief. Is the 3x/day dosing the reason you don’t like the methadone, or is there another reason for not liking it? It surely is a life saver cost wise for those who cannot afford the high prices of OxyContin and other meds which have no generics. My pain-management physician also says that there is no upper limit on methadone. She prescribes whatever it takes to reach the goal that one is seeking for pain relief and gives breakthrough medication also. Now a few questions…who in the world put you on OxyContin four times a day?  What if you took 80 mg every 12 hours (not twice a day but every 12 hours)?  Does it make you too sleepy?  Do you get too much breakthrough pain? I was on OxyContin a while back and found it to be practically useless for me. My first pain-management physician started me out on 3x/day because he said that it didn’t last longer than 8 hours for most people. I can’t see any difference between taking OxyContin 3x/day and methadone 3x/day except for the fact that methadone works much better for me than OxyContin, and I have saved a bundle of money. Annie B.

Response:

May I ask why you are on so many different narcotics?????  You should be on only ONE narcotic and maximize that to its fullest potential. Reminds me of hospice referrals we would get from the Internal Medicine teams.  They would discharge someone on Duragesic patches, OxyContin, Percocets and MS IR (no joke!).  BTW, the patient would still be in 7/10 pain. So, your dose of methadone is too small.  If this is the drug of choice for you (I hadn’t heard about the bone stuff), then it should be maximized. What is the limit?  There is NO limit.  You take an increasing dose until you either have the pain to a manageable level or you get tired of taking so many pills. As a pain physician, I would be VERY uncomfortable giving you that diverse of a medication regimen.  It sounds too complex and more likely to have problems getting the proper doses. Just my two cents…and I didn’t even bill you for it… — Bill Work

– Hide quoted text — Show quoted text – Hi Joan. I am 28yrs. and I would like to share my medication history with you.  I have been on narcotics for the treatment of Avascular Necrosis for the past 3yrs  I am currently taking 30mg of methadone every 6hrs; 120mg/day.  75mg of morphine ER/day ;30-45mg twice a day . Also, oxycodone 10mg every 4hrs.; 60mg/day.  However, I am still in a great deal of pain every second of the day.  Before switching to Methadone, I was on oxycontin 80mg/day along with the same dose of oxycodone and things where pretty much the same.  So, if cost is the only issue, I would give methadone a try.But i was recently told that methadone can damage the bones.  Therefor, I am now lookng for a drug to replace methadone since I already have a bone disease. I pray that you will soon find the right medication for you.

Response:

Ironman is quite right. Trying to last 12 hours on one pill did not come close to helping me anyway. I have found the change to QID, yes every 6 hours for oxycontin has a made major improvement in my quality of life – at least for me. TID is a near norm with many I’ve read over the last year. Some thoughts I wanted to pass along. My previous pain doc used methadone as his fist narcotic of choice for some chronic patients because of it being affordable. This enabled him to treat all folks with pain both rich and the poor uninsured – me. Fortunately I now receive help due to past employment before I could not work. I’m still paying on the previous bills for medication over several years.  I hope and pray each month my medications go through one more time. I could never afford the meds and would be back to my past situation borrowing money. Oxy works best for me, unfortunately. Thought you might find this interesting. Have a good day, Matt

– Hide quoted text — Show quoted text – Personally, it is my last choice for long-acting, oral narcotics.  Notice I said "personally".  It has a half-life of 24 hours but you must take it three times a day for pain relief. Now a few questions…who in the world put you on OxyContin four times a day?  What if you took 80 mg every 12 hours (not twice a day but every 12 hours)?  Does it make you too sleepy?  Do you get too much breakthrough pain? Dr. Work, While OxyContin is a very good pain reliever, it doesn’t last 12 hours. IMHO it stops being effective after 6-8 hours. YMMV, but she could need to take 40 mg. 4x per day. This is just my spin on the situation. ironman Got questions?  Get answers over the phone at Keen.com. Up to 100 minutes free! http://www.keen.com

Response:

Dear Doc.  Thank you for the info.  I am certainly going to request that my medications be re_ evaluated.  My pain alway ranges 7to 10.  I was starting to feel that there was no hope of having my pain managed.  My doc said that 120mg of methadone was as high as it could be.  That is why morphine er was added.  The oxycodone is for breakthrough pain and my pain is so grea that I take it every 4hrs. around the clock. THANKS FOR ANY HELP YOU CAN GIVE

Response:

William: I know you were joking, but no…..the key is to use drugs that have generic formularies with under- or noninsured patients. Methadone comes to mind for a "long-term" delivery drug. Another option is to use a suspension form of hydrocodone in syrup form.  This tends to stay in the body for an extended period of time. Bunch of these on the market for people with severe coughing. Still nothing wrong with Percocet/dan.  Keep in mind that the drug companies have now come out with 2.5/5/10 mg formulations.  Drs need to specify which strength they are writing for. Vicoden ES or its generics are cheaper (by comparison).  Norco is not all that expensive either. OR…..if you have a compounding pharmacy near your practice and you want to avoid APAP toxicity……have the pharmacist compound pure hydrocodone.  IT CAN BE DONE. With poorer folks, you just need to be a little bit more creative. They will thank you for it 1000% over tho  (:o) – Jon  (:o)}< – Hide quoted text — Show quoted text – I agree…so I guess I need to only treat patients with good insurance????? No, you made some good points. — Bill Work You have learned a very important thing about there being no upward bound.  The key is to make sure the patient is titrated upward properly.  Many doctors mistakenly believe that at a certain dosage, resp failure will ensue.  That is BS just as long as the patient has been *gradually* taken up to their dosages. As for cost, Oxy and MS-Con are VERY expensive.  Oramorph is about the same price also. 90 Oxycontin of 40 mg strength can run anywhere from $400 to $500. (I’ve heard that the methadone equivalent of these is about $15-$25. You can see why some patients might need to use methadone). That is ALOT of dough for either Oxy or MS-Contin.  It is important for pain physicians to discuss what insurance their patients have and to work with them to make sure they can afford the meds.  Before the doc even pulls out the prescription pad, a discussion should take place about what insurance the patient has (if any).  Most people can simply not afford paying over $1000 per month out of pocket (assuming prescriptions for Oxycontin and a breakthru med like Oxyfast). – Jon  (:o)}< First, this is my own personal preferences.  Doctors are allowed to be fickle too (most are MORE so).  I guess if I start using it more and get more comfortable with it, then I’ll start to use it more.  The hospice I direct has contracts for MS Contin/Oxy Contin so they get it cheaper. The residency program I came from had a pharmacy that had both Oxy/MS and methadone.  I just preferred the first two. Now allow me to clear up one misconception you stated: there are no upper limits for ANY opiate that is not mixed with something else.  So there is no upper limit for morphine, oxycodone or methadone.  You keep taking more until you get the dose that benefits you.  That is one simple rule that many docs don’t like.  Some incorrectly believe that there is some "magic" number that if they pass that dose, the patient (still in horrible pain) will stop breathing.  That is simply NOT true.  No one will be dying from respiratory failure from too much narcotic while they still have significant pain. Pain is the PERFECT antagonist for opiates…better than naloxone. Cost can be a significant factor, but I have not encountered that yet.  I know I will, just not yet. It does sound like you have a great pain doc.  Stick with her and tell your friends about her too. — Bill Work Personally, it is my last choice for long-acting, oral narcotics. Notice I said "personally".  It has a half-life of 24 hours but you must take it three times a day for pain relief. Is the 3x/day dosing the reason you don’t like the methadone, or is there another reason for not liking it? It surely is a life saver cost wise for those who cannot afford the high prices of OxyContin and other meds which have no generics. My pain-management physician also says that there is no upper limit on methadone. She prescribes whatever it takes to reach the goal that one is seeking for pain relief and gives breakthrough medication also. Now a few questions…who in the world put you on OxyContin four times a day?  What if you took 80 mg every 12 hours (not twice a day but every 12 hours)?  Does it make you too sleepy?  Do you get too much breakthrough pain? I was on OxyContin a while back and found it to be practically useless for me. My first pain-management physician started me out on 3x/day because he said that it didn’t last longer than 8 hours for most people. I can’t see any difference between taking OxyContin 3x/day and methadone 3x/day except for the fact that methadone works much better for me than OxyContin, and I have saved a bundle of money. Annie B.

Response:

What this demonstrates is that everyone is different and everything about the person must be taken into account…..snippage I am never concerned about a chronic pain patient over-medicating.  They would have to prove to me that they are incompetant with their meds before I begin to get worried.  I know a pain doc here in town who on the first visit, gives the patient a large amount of MS IR to use and asks them to write down each day how much and how often they use it.  He then re-evaluates them in one month and starts them on a chronic dose.  I personally don’t do that but instead make an educated guess as to how much to start and give breakthrough MS IR/Oxy IR then make the adjustment.

When I began methadone I was prescribed 100 5 mg tablets. I was instructed to start at 5 mg every 6 hours for three days and then titrate the doseage by 5 mg increments every three days till I felt comfortable. I then settled at 10mg every 6 hours, a relatively small dose. I am now at 20 mg every 6 hours but I have only needed two small adjustments in 18 months. It took me two years of agony to get into that doctor’s care, I certainly don’t recommend that you take that long to find the right MD! I never take stuff for granted after having gone through so much. I know how fortunate I am because I don’t live in this NG anymore! I actually have days now, where I forget about this stuff entirely. Jim S Jim S

Response:

Many many patients find that Oxycontin does not last 12 hours.  It is more like 8 hours.  Many Oxy prescriptions are now for dosing one TID. I’ve read reports of patients on 4x daily dosing.  Since the drug comes in so many different strengths, it is very useful for the clinician since they can easily titrate the dose. Since different patients metabolize oxycodone at different rates, I can imagine patients who might need QID dosing.  We’ve had patients on this newsgroup that were/are taking "heroic" amounts of Oxycontin on a daily basis and their pain was barely in check. Pain management requires an "exploratory" mindset.  Just because the manufacturer promises a certain delivery, does not mean a given patient will achieve that. If I had lost my insurance, I would give methadone major consideration.  It is dirt cheap and works very well. – Jon  (:o)}< – Hide quoted text — Show quoted text – Personally, it is my last choice for long-acting, oral narcotics.  Notice I said "personally".  It has a half-life of 24 hours but you must take it three times a day for pain relief. Now a few questions…who in the world put you on OxyContin four times a day?  What if you took 80 mg every 12 hours (not twice a day but every 12 hours)?  Does it make you too sleepy?  Do you get too much breakthrough pain? — Bill Work I have been lurking for several months and have gotten alot of help from this group. I am looking for information on methodone…how well does it work for pain control and where could I find web sites to learn more about it? I am on oxycontine 40 mg 4 x a day right now for neck and arm pain (cervical injury)…..however my insurance company, workers comp, has stopped paying for my meds and I am having a very difficult time paying for all the meds my dr. prescribes. I have heard that methodone is cheaper, but want to know if it is some thing I should , or would want to start on in place of oxycontine. I have a very compassionate dr who is willing to help me in any way he can, however admits he does not know enough about the methadone, being used for chronic pain, to tell me if it would be the right drug for me, or how well it really works. I would appreciate any help that you could give me on this. Thank you…..Joan

Response:

First, this is my own personal preferences.  Doctors are allowed to be fickle too (most are MORE so).  I guess if I start using it more and get more comfortable with it, then I’ll start to use it more.  The hospice I direct has contracts for MS Contin/Oxy Contin so they get it cheaper.  The residency program I came from had a pharmacy that had both Oxy/MS and methadone.  I just preferred the first two. Now allow me to clear up one misconception you stated: there are no upper limits for ANY opiate that is not mixed with something else.  So there is no upper limit for morphine, oxycodone or methadone.  You keep taking more until you get the dose that benefits you.  That is one simple rule that many docs don’t like.  Some incorrectly believe that there is some "magic" number that if they pass that dose, the patient (still in horrible pain) will stop breathing.  That is simply NOT true.  No one will be dying from respiratory failure from too much narcotic while they still have significant pain.  Pain is the PERFECT antagonist for opiates…better than naloxone. Cost can be a significant factor, but I have not encountered that yet.  I know I will, just not yet. It does sound like you have a great pain doc.  Stick with her and tell your friends about her too. — Bill Work

– Hide quoted text — Show quoted text – Personally, it is my last choice for long-acting, oral narcotics. Notice I said "personally".  It has a half-life of 24 hours but you must take it three times a day for pain relief. Is the 3x/day dosing the reason you don’t like the methadone, or is there another reason for not liking it? It surely is a life saver cost wise for those who cannot afford the high prices of OxyContin and other meds which have no generics. My pain-management physician also says that there is no upper limit on methadone. She prescribes whatever it takes to reach the goal that one is seeking for pain relief and gives breakthrough medication also. Now a few questions…who in the world put you on OxyContin four times a day?  What if you took 80 mg every 12 hours (not twice a day but every 12 hours)?  Does it make you too sleepy?  Do you get too much breakthrough pain? I was on OxyContin a while back and found it to be practically useless for me. My first pain-management physician started me out on 3x/day because he said that it didn’t last longer than 8 hours for most people. I can’t see any difference between taking OxyContin 3x/day and methadone 3x/day except for the fact that methadone works much better for me than OxyContin, and I have saved a bundle of money. Annie B.

Response:

I was wondering if you or anyone else would know where I can find information on methodone for pain management that I can print out for my Dr to read.

Joan–.–    I’ll find you something and either post it or send it to you directly, your choice.  Methadone is `wonderful` stuff!  It, at the very LEAST, doubled the quality and intensity of my life! –

Question:

My  12 year old son was the same way, our first Dr. had this kids on 5 different things, 3 and 3 times a day – no adult would want to do that, so why should I expect a 12 year old to?  We changed Drs. last fall.  I explained to him the hassle of getting Aaron to take his meds.  We are now on just Pulmicort and Rhinocort once a day with saline nose spray a few times a day and Claritin as needed. what a difference in compliance!  I don’t pester anymore, life is much nicer in our household – no more crabby mom and dad and a kid who actually takes his meds on schedule.

– Hide quoted text — Show quoted text – Hello Sally, My son has been guilty of not taking his meds daily, also.  He is 16 and one would think he would be responsible!  I always note the day he starts a new inhaler and if it isn’t pretty much empty when it should be, then I know he’s not been taking his meds.  His doctor is very good about discussing the need for taking meds on a regular basis.  I think part of the problem is that since his asthma is in good control (the good part) he tends to ignore the importance of preventative meds. Good luck in your campaign to quit smoking!  It’s a tough battle (I quit in 1998) but well worth it! Patrice I took my 12 yr old son to an appointment with a Pulmonologist yesterday. As of the one visit, I liked her no-nonsense attitude.  After reviewing his breathing tests, current meds and recent breathing tests from the Allergist’s office, she flat out told my Son she didn’t trust his age group as they tend to lie about taking their meds.  Turns out she was right on the money. He’s only been taking the Serevent and Pulmicort about half the time, although he does take the Singulair and allergy meds as he should.  She gave him a good lecture about what being on Prednisone too often would do for him, that he’s already a severe asthmatic and isn’t doing himself any good, etc.  He didn’t deny it and finally admitted it.  Seems for 113% effort, his bottom line was only 70%.  She let him know that the meds he’s on should be working great for him.  Feels that if he takes it all as he should then next winter he should be able to participate in ski club like he wanted to this year.  At least there’s no flying allergens on a snow-covered slope!!! The only changes she made to his meds were she ordered him to take him in front of us parents each time, to stay on the nebulized Albuterol for another two weeks, and added Zantac to work along with the Prilosec for his stomach. Today he saw the Family Dr and tomorrow he sees the Allergist.  Within the next few weeks he’ll be seeing a Pediatric Gastro since it’s pretty much felt he has GERD…which isn’t surprising considering his asthma level and meds. The dog leaves Saturday afternoon…being returned to the shelter we got her from three years ago as a small puppy. The cat is in the works as soon as we can reach DH’s niece to arrange the hand-off.  DH will be looking into what wood stuff he wants for Son’s room floor. Here’s the Big One…DH and I have Rx’s for Zyban (and for me the patch too since I’ve been smoking for over 20 years). — Sally Avery

Response:

Glad to see I’m not alone on this.  True, even adults don’t like to take meds all the time…let alone so many and frequently.  Why should a kid? Regardless how intelligent and responsible he is….DS is still only 12. The Family Dr and the Allergist didn’t lecture him as the Pulmonologist did. Basicially, they let him know they were glad he was out of the hospital and okay now…and hopefully he has learned why needs to take his meds unless he wants to experience a close encounter again. Sally Avery

Hello Sally, My son has been guilty of not taking his meds daily, also.  He is 16 and one would think he would be responsible!  I always note the day he starts a

new

Response:

I believe that as he begins to take his meds as he should, eventually we may be able to cut some things down….hopefully.  Thanks for the message.  It helps to know others have same problems. Sally Aver

– Hide quoted text — Show quoted text – My  12 year old son was the same way, our first Dr. had this kids on 5 different things, 3 and 3 times a day – no adult would want to do that, so why should I expect a 12 year old to?  We changed Drs. last fall.  I

Response:

The most important part is your not smoking.   Hard! Hard! Hard! to do and I wish only you the best and may your willpower be strong enough to overcome the addiction.  I was very happy 19 years ago when I quit cold turkey. I had a nightmare about being in a hospital and the Doc telling me I had emphysema.  I woke the next day and have not smoked since, however; this last year my doc made my dream come true (50% FEV1).  I feel that by quitting when I did at 33 that I am much better off with my lungs that had I not. Good Luck and keep the faith!!! Tim Washington State

– Hide quoted text — Show quoted text – I took my 12 yr old son to an appointment with a Pulmonologist yesterday. As of the one visit, I liked her no-nonsense attitude.  After reviewing his breathing tests, current meds and recent breathing tests from the Allergist’s office, she flat out told my Son she didn’t trust his age group as they tend to lie about taking their meds.  Turns out she was right on the money. He’s only been taking the Serevent and Pulmicort about half the time, although he does take the Singulair and allergy meds as he should.  She gave him a good lecture about what being on Prednisone too often would do for him, that he’s already a severe asthmatic and isn’t doing himself any good, etc.  He didn’t deny it and finally admitted it.  Seems for 113% effort, his bottom line was only 70%.  She let him know that the meds he’s on should be working great for him.  Feels that if he takes it all as he should then next winter he should be able to participate in ski club like he wanted to this year.  At least there’s no flying allergens on a snow-covered slope!!! The only changes she made to his meds were she ordered him to take him in front of us parents each time, to stay on the nebulized Albuterol for another two weeks, and added Zantac to work along with the Prilosec for his stomach. Today he saw the Family Dr and tomorrow he sees the Allergist.  Within the next few weeks he’ll be seeing a Pediatric Gastro since it’s pretty much felt he has GERD…which isn’t surprising considering his asthma level and meds. The dog leaves Saturday afternoon…being returned to the shelter we got her from three years ago as a small puppy. The cat is in the works as soon as we can reach DH’s niece to arrange the hand-off.  DH will be looking into what wood stuff he wants for Son’s room floor. Here’s the Big One…DH and I have Rx’s for Zyban (and for me the patch too since I’ve been smoking for over 20 years). — Sally Avery

Response:

Hello Sally, My son has been guilty of not taking his meds daily, also.  He is 16 and one would think he would be responsible!

You do have to watch these kids.When they have something chronic like asthma, I think they just want to try and ignore it sometimes. My son was like that . I put my daughter’s meds out for her even though she is 16 so she can’t "forget". The scary thing is I have to watch to see that she doesn’t decide to take an extra dose of something when she feels she isn’t getting relief. This has happened before(luckily not harmful) and I never would have dreamed she would be so careless. Hopefully now she does understand the seriousness of this.

Response:

I took my 12 yr old son to an appointment with a Pulmonologist yesterday. As of the one visit, I liked her no-nonsense attitude.  After reviewing his breathing tests, current meds and recent breathing tests from the Allergist’s office, she flat out told my Son she didn’t trust his age group as they tend to lie about taking their meds.  Turns out she was right on the money. He’s only been taking the Serevent and Pulmicort about half the time, although he does take the Singulair and allergy meds as he should.  She gave him a good lecture about what being on Prednisone too often would do for him, that he’s already a severe asthmatic and isn’t doing himself any good, etc.  He didn’t deny it and finally admitted it.  Seems for 113% effort, his bottom line was only 70%.  She let him know that the meds he’s on should be working great for him.  Feels that if he takes it all as he should then next winter he should be able to participate in ski club like he wanted to this year.  At least there’s no flying allergens on a snow-covered slope!!! The only changes she made to his meds were she ordered him to take him in front of us parents each time, to stay on the nebulized Albuterol for another two weeks, and added Zantac to work along with the Prilosec for his stomach. Today he saw the Family Dr and tomorrow he sees the Allergist.  Within the next few weeks he’ll be seeing a Pediatric Gastro since it’s pretty much felt he has GERD…which isn’t surprising considering his asthma level and meds. The dog leaves Saturday afternoon…being returned to the shelter we got her from three years ago as a small puppy. The cat is in the works as soon as we can reach DH’s niece to arrange the hand-off.  DH will be looking into what wood stuff he wants for Son’s room floor. Here’s the Big One…DH and I have Rx’s for Zyban (and for me the patch too since I’ve been smoking for over 20 years). — Sally Avery

Response:

Hello Sally, My son has been guilty of not taking his meds daily, also.  He is 16 and one would think he would be responsible!  I always note the day he starts a new inhaler and if it isn’t pretty much empty when it should be, then I know he’s not been taking his meds.  His doctor is very good about discussing the need for taking meds on a regular basis.  I think part of the problem is that since his asthma is in good control (the good part) he tends to ignore the importance of preventative meds. Good luck in your campaign to quit smoking!  It’s a tough battle (I quit in 1998) but well worth it! Patrice

– Hide quoted text — Show quoted text -I took my 12 yr old son to an appointment with a Pulmonologist yesterday. As of the one visit, I liked her no-nonsense attitude.  After reviewing his breathing tests, current meds and recent breathing tests from the Allergist’s office, she flat out told my Son she didn’t trust his age group as they tend to lie about taking their meds.  Turns out she was right on the money. He’s only been taking the Serevent and Pulmicort about half the time, although he does take the Singulair and allergy meds as he should.  She gave him a good lecture about what being on Prednisone too often would do for him, that he’s already a severe asthmatic and isn’t doing himself any good, etc.  He didn’t deny it and finally admitted it.  Seems for 113% effort, his bottom line was only 70%.  She let him know that the meds he’s on should be working great for him.  Feels that if he takes it all as he should then next winter he should be able to participate in ski club like he wanted to this year.  At least there’s no flying allergens on a snow-covered slope!!! The only changes she made to his meds were she ordered him to take him in front of us parents each time, to stay on the nebulized Albuterol for another two weeks, and added Zantac to work along with the Prilosec for his stomach. Today he saw the Family Dr and tomorrow he sees the Allergist.  Within the next few weeks he’ll be seeing a Pediatric Gastro since it’s pretty much felt he has GERD…which isn’t surprising considering his asthma level and meds. The dog leaves Saturday afternoon…being returned to the shelter we got her from three years ago as a small puppy. The cat is in the works as soon as we can reach DH’s niece to arrange the hand-off.  DH will be looking into what wood stuff he wants for Son’s room floor. Here’s the Big One…DH and I have Rx’s for Zyban (and for me the patch too since I’ve been smoking for over 20 years). — Sally Avery

Response:

Question:

– Hide quoted text — Show quoted text –     I was just reading through the FAQ about stacking.  I wasnt aware of the fact that ephedra was also used in asthma medications as i have been taking both for the past 6 weeks.  I take metabolife (12mg epedra per pill/6 a day) and i am also on Singulair, Pulmacort (steroid), and albuterol.  Does anyone know anything about these medications because i tried asking my doctor about them when they were prescibed but i am still a minor so he feels that he doesnt have time to explain things to me…  I just looked at the little pamphlet that came with metabolife and noticed that it shouldnt be taken with asthma medications containing ephedra.  I am the kind of person who hates doctor visits so when i have been getting dizzy spells lately when i stand up or sit up in bed i just sort of shrugged it off, i didnt connect it with the metabolife.  Ill try to get through to my doctor tomorrow but if anyone has any knowledge about these medications please let me know.  Thanks all Ryan

I’m the world’s biggest stacking fan, but COME OFF THE EPHEDRINE IMMEDIATELY!!! Don’t touch it until you’ve seen a _knowledgable_ physician. If your own doctor won’t give you the time to discuss this, then ask him politely but firmly to refer you to someone who _will_, as the level of care you are receiving is going to have serious lifestyle amd quality-of-life consequences for you. If he balks at the notion of a second opinion, ask him to recommend an alternative physician who has adequate time to spend on patients’ medical problems. If he sees you are serious (but don’t present all mouthy and right in his face, though,) he’ll find the time to help you rather than risk reputation problems and, tacitly, litigation Until you’ve sorted this out, you MUST leave the ephedrine alone. You’re setting yourself up for heart irregularity problems and thermal runaway.. another "boil in the bag" kid statistic we don’t need. I’m supposing that Pulmacart is purely steroid-based, in which case its just a local anti-inflammitory that basically stops your air-tracts swelling up and choking you. Unlikely to have a direct interactive problem with ephedrine.The other stuff, however may well have a similar beta-agonist effect as the ephedrine (or may even _contain_ ephedrine or pseudo-ephedrine, which _may_ push the dosage acting on your nervous system _way_ up. What this means is that you’ll notice certain obvious phyical effects. Body temperature and pulse go up, and pulse may become erratic. That is NOT good. You may get mild euphoria and feel like you’re having an adrenalin surge and you want to keep on dancing the night away… etc. Your kidneys will be ripping fluid out of you that you didn’t know you had and you’ll wasnt to live in a urinal. Your libido may go down too, temporarily. With a very high dosage, you’ll feel like you’ve not only got fresh batteries in your body, but they’re too high a voltage. The analogy holds good for exceeding design limits too. Everything runs faster but feels like it’s about to tear itself apart, and when you come down you’ll be knackered beyond belief. THAT is why the stuff is so damned difficult to get hold of, here in England and in a lot of US States.. a few cases of wild dehydrated overdose and these get reported as the normal usage pattern. The metabolife dosage, if that’s an ephedrine count, is average to high. If it’s ephedra, the herbal stuff from which natural ephedrine is extracted, then it’s pretty low. I don’t recall exactly but I think ephedra contains about 6% active ephedrine, so 15 mg ephedra is olmost homeopathically weak, and if that’s the case, shouldn’t be consequential re. any other medication. Check the label again, please. I suspect it’s 12Mg of refined stuff, not the herb. You’ll get a noticable stacking effect from 15mg once or twice a day, depemding on bodyweight. I weigh around 330 (210 when lean) and I can feel the efect of 20Mg… Six times is, I believe, a bit too too high for general use – unless you’re solidly muscled and in the gym for hours on end every day. You’ve reported some nasty-sounding side-effects and they are enough for you to stop using until you’ve taken advice relevant to your own medical history. If you get the go-ahead, I dount you’ll have any appetite at all, in the short term. If you keep that intake up, you’ll find it loses its effectiveness and you’ll have to cycle off it again, get it out of your system and start again. It’s great stuff but it mustn’t become your master. Hope this is some use to you. Good luck! –Borg.   Resistance is progressive, for maximum gains… — WANT TO REACH MILLIONS OF PEOPLE AND LOOKING FOR THE BEST BULK EMAIL SOFTWARE?? <rot 13 instructions – chg n ybnqrq tha va lhe rne naq chyy gur gevttre, lbh fcnzzvat onfgneq!- Znlor vg’yy or ba Gur Arjf…

Response:

Ryan!! me too about the singulair!!  Love the stuff!! — -Beth BikeE FX, AT and rans gliss Anchorage, Alaska http://home.gci.net/~dawg/

– Hide quoted text — Show quoted text –     Ok thanks beth i’ll still talk to my doctor but you have set some of my worries aside.  I usually only take the albuterol before i work out and sometimes before i go to bed.  I used to take it 4-5 times a day but since i have gotten the singulair and steriod inhaler i find that my asthma has improved a lot. Ryan, ephedra is no longer used in asthma medications as they have found much better stuff with less side effects. I also take singulair, an inhaled steroid and albuterol (on demand, which is rarely needed) both the singulair and the inhaled steroid are preventative medicines and do not raise your heart rate the way that ephedra and albuterol do. Albuterol and ephedra migh not be the best combination How often are you taking albuterol?  Supposedly the latest thinking is that your doc should give you enough other meds that its VERY rare that you need to use that inhaler – that your lungs will continue to get worse if you are not controlling the asthma attacks in the first place, due to something called remapping. In any case, since you are a minor, I would ask your doc about the metabolife. — -Beth BikeE FX, AT and rans gliss Anchorage, Alaska http://home.gci.net/~dawg/     I was just reading through the FAQ about stacking.  I wasnt aware of the fact that ephedra was also used in asthma medications as i have been taking both for the past 6 weeks.  I take metabolife (12mg epedra per pill/6 a day) and i am also on Singulair, Pulmacort (steroid), and albuterol.  Does anyone know anything about these medications because i tried asking my doctor about them when they were prescibed but i am still a minor so he feels that he doesnt have time to explain things to me…  I just looked at the little pamphlet that came with metabolife and noticed that it shouldnt be taken with asthma medications containing ephedra.  I am the kind of person who hates doctor visits so when i have been getting dizzy spells lately when i stand up or sit up in bed i just sort of shrugged it off, i didnt connect it with the metabolife.  Ill try to get through to my doctor tomorrow but if anyone has any knowledge about these medications please let me know. Thanks all Ryan

Response:

Check out this site http://onhealth.webmd.com/conditions/resource/pharmacy/multum9/item,6… for things that can affect albuterol inhalation.  Caffeine, diet pills and decongestants are listed. Sandy – Hide quoted text — Show quoted text – Singulair is a leukotriene D4 antagonist, you know that Pulmacort is an inhaled steroid, and I think albuterol is a Beta-agonist.  That alone can make you jittery and dizzy after a good couple puffs on the inhaler.  Ephedra (aka ephedrine or ma huang) is a non-selective beta-agonist and likely is acting in conjunction with the albuterol to make you dizzy.  Certainly do read and reread the stacking FAQ as that method is not for everyone.  It sounds as if it may not be for you. Good luck, Sandy don’t have an answer for you, but would love to hear what your doc says J     I was just reading through the FAQ about stacking.  I wasnt aware of the fact that ephedra was also used in asthma medications as i have been taking both for the past 6 weeks.  I take metabolife (12mg epedra per pill/6 a day) and i am also on Singulair, Pulmacort (steroid), and albuterol.  Does anyone know anything about these medications because i tried asking my doctor about them when they were prescibed but i am still a minor so he feels that he doesnt have time to explain things to me…  I just looked at the little pamphlet that came with metabolife and noticed that it shouldnt be taken with asthma medications containing ephedra.  I am the kind of person who hates doctor visits so when i have been getting dizzy spells lately when i stand up or sit up in bed i just sort of shrugged it off, i didnt connect it with the metabolife.  Ill try to get through to my doctor tomorrow but if anyone has any knowledge about these medications please let me know. Thanks all Ryan

Response:

Ryan, ephedra is no longer used in asthma medications as they have found much better stuff with less side effects. I also take singulair, an inhaled steroid and albuterol (on demand, which is rarely needed) both the singulair and the inhaled steroid are preventative medicines and do not raise your heart rate the way that ephedra and albuterol do.  Albuterol and ephedra migh not be the best combination How often are you taking albuterol?  Supposedly the latest thinking is that your doc should give you enough other meds that its VERY rare that you need to use that inhaler – that your lungs will continue to get worse if you are not controlling the asthma attacks in the first place, due to something called remapping. In any case, since you are a minor, I would ask your doc about the metabolife. — -Beth BikeE FX, AT and rans gliss Anchorage, Alaska http://home.gci.net/~dawg/

– Hide quoted text — Show quoted text –     I was just reading through the FAQ about stacking.  I wasnt aware of the fact that ephedra was also used in asthma medications as i have been taking both for the past 6 weeks.  I take metabolife (12mg epedra per pill/6 a day) and i am also on Singulair, Pulmacort (steroid), and albuterol.  Does anyone know anything about these medications because i tried asking my doctor about them when they were prescibed but i am still a minor so he feels that he doesnt have time to explain things to me…  I just looked at the little pamphlet that came with metabolife and noticed that it shouldnt be taken with asthma medications containing ephedra.  I am the kind of person who hates doctor visits so when i have been getting dizzy spells lately when i stand up or sit up in bed i just sort of shrugged it off, i didnt connect it with the metabolife.  Ill try to get through to my doctor tomorrow but if anyone has any knowledge about these medications please let me know. Thanks all Ryan

Response:

    Ok thanks beth i’ll still talk to my doctor but you have set some of my worries aside.  I usually only take the albuterol before i work out and sometimes before i go to bed.  I used to take it 4-5 times a day but since i have gotten the singulair and steriod inhaler i find that my asthma has improved a lot.

– Hide quoted text — Show quoted text – Ryan, ephedra is no longer used in asthma medications as they have found much better stuff with less side effects. I also take singulair, an inhaled steroid and albuterol (on demand, which is rarely needed) both the singulair and the inhaled steroid are preventative medicines and do not raise your heart rate the way that ephedra and albuterol do. Albuterol and ephedra migh not be the best combination How often are you taking albuterol?  Supposedly the latest thinking is that your doc should give you enough other meds that its VERY rare that you need to use that inhaler – that your lungs will continue to get worse if you are not controlling the asthma attacks in the first place, due to something called remapping. In any case, since you are a minor, I would ask your doc about the metabolife. — -Beth BikeE FX, AT and rans gliss Anchorage, Alaska http://home.gci.net/~dawg/     I was just reading through the FAQ about stacking.  I wasnt aware of the fact that ephedra was also used in asthma medications as i have been taking both for the past 6 weeks.  I take metabolife (12mg epedra per pill/6 a day) and i am also on Singulair, Pulmacort (steroid), and albuterol.  Does anyone know anything about these medications because i tried asking my doctor about them when they were prescibed but i am still a minor so he feels that he doesnt have time to explain things to me…  I just looked at the little pamphlet that came with metabolife and noticed that it shouldnt be taken with asthma medications containing ephedra.  I am the kind of person who hates doctor visits so when i have been getting dizzy spells lately when i stand up or sit up in bed i just sort of shrugged it off, i didnt connect it with the metabolife.  Ill try to get through to my doctor tomorrow but if anyone has any knowledge about these medications please let me know. Thanks all Ryan

Response:

don’t have an answer for you, but would love to hear what your doc says J

– Hide quoted text — Show quoted text –     I was just reading through the FAQ about stacking.  I wasnt aware of the fact that ephedra was also used in asthma medications as i have been taking both for the past 6 weeks.  I take metabolife (12mg epedra per pill/6 a day) and i am also on Singulair, Pulmacort (steroid), and albuterol.  Does anyone know anything about these medications because i tried asking my doctor about them when they were prescibed but i am still a minor so he feels that he doesnt have time to explain things to me…  I just looked at the little pamphlet that came with metabolife and noticed that it shouldnt be taken with asthma medications containing ephedra.  I am the kind of person who hates doctor visits so when i have been getting dizzy spells lately when i stand up or sit up in bed i just sort of shrugged it off, i didnt connect it with the metabolife.  Ill try to get through to my doctor tomorrow but if anyone has any knowledge about these medications please let me know. Thanks all Ryan

Response:

You could try talking to a pharmacist.  IMHO they are often much more competent to discuss drugs than MD’s are.  Make sure you are talking with a pharmacist and not the assistant.   I’ll bet you they will say not to take the stack since you are on the asthma meds.   Also I would advise not to mix these anymore, at least until you speak with a pharmacist and MD,  since you are already having symptoms that concern you. Take care of you health.  It’s no fun being skinny when your dead. Sassy

– Hide quoted text — Show quoted text – don’t have an answer for you, but would love to hear what your doc says J     I was just reading through the FAQ about stacking.  I wasnt aware of the fact that ephedra was also used in asthma medications as i have been taking both for the past 6 weeks.  I take metabolife (12mg epedra per pill/6 a day) and i am also on Singulair, Pulmacort (steroid), and albuterol.  Does anyone know anything about these medications because i tried asking my doctor about them when they were prescibed but i am still a minor so he feels that he doesnt have time to explain things to me…  I just looked at the little pamphlet that came with metabolife and noticed that it shouldnt be taken with asthma medications containing ephedra.  I am the kind of person who hates doctor visits so when i have been getting dizzy spells lately when i stand up or sit up in bed i just sort of shrugged it off, i didnt connect it with the metabolife.  Ill try to get through to my doctor tomorrow but if anyone has any knowledge about these medications please let me know. Thanks all Ryan

Response:

    I was just reading through the FAQ about stacking.  I wasnt aware of the fact that ephedra was also used in asthma medications as i have been taking both for the past 6 weeks.  I take metabolife (12mg epedra per pill/6 a day) and i am also on Singulair, Pulmacort (steroid), and albuterol.  Does anyone know anything about these medications because i tried asking my doctor about them when they were prescibed but i am still a minor so he feels that he doesnt have time to explain things to me…  I just looked at the little pamphlet that came with metabolife and noticed that it shouldnt be taken with asthma medications containing ephedra.  I am the kind of person who hates doctor visits so when i have been getting dizzy spells lately when i stand up or sit up in bed i just sort of shrugged it off, i didnt connect it with the metabolife.  Ill try to get through to my doctor tomorrow but if anyone has any knowledge about these medications please let me know.  Thanks all Ryan

Response:

Question:

i have to agree they all tell me that zoloft isn’t addicting either, but screw them all i go off it for 2 days and then have to start it again they say hardly any of the newer drugs are addicting, well i say, that they should try them themselves and then they will see

– Hide quoted text — Show quoted text – Zoloft Withdrawal–The Darkest Period of my Life Antidepressants  "I had all the classic symptoms of a junkie coming off of heroine." My name is Virginia and I just finished seeing a segment on 2020 regarding withdrawal symptoms after getting off of an antidepressant. THANK GOD!!! There are other people out there that have experienced the same symptoms I have experienced! Every doctor in the past, (3), I have told about my withdrawal symptoms have told me that it’s not possible or that they’ve never heard of anyone having these

symptoms months after – Hide quoted text — Show quoted text – attempting to get off Zoloft. I even got very upset at one of the doctor’s and told him that the symptoms I was experiencing were "real" and that I was not crazy! To make a long story short– The six months I was off the Zoloft was the darkest period of my life. I had all the classic symptoms of a junkie coming off of heroine. For three weeks straight, I had dry heaves, nausea, dizziness, panic attacks so severe I thought I was having a heart attack, cold sweats, a weird sound in my head, like breaking glass every time I’d blink my eyes, the disconnection of your brains ability to catch up with your vision when you look sharply to the left or right (almost like the old slide projectors that take a second and then click to the next picture), severe paranoia, and continual suicidal thoughts. If it were not for my husband taking time of from work to watch over me, I would not be here today! Unfortunately, I lost my job, and ended up having to get back on the Zoloft in order to live a so-called "normal life". And I can honestly say, it was like a miracle how quickly my nausea and dry heaves went away. I only wish that the first doctor I saw would have informed me about the possibility of becoming addicted to this drug, and given me the choice of alternative treatment or a life long commitment to Zoloft. Now the only symptoms I have are dry mouth and a stiff jaw…Oh, and paranoia about ever losing my health insurance. Virginia — Psychiatry is to Science as Astrology is to Astronomy

Response:

- Hide quoted text — Show quoted text – i have to agree they all tell me that zoloft isn’t addicting either, but screw them all i go off it for 2 days and then have to start it again they say hardly any of the newer drugs are addicting, well i say, that they should try them themselves and then they will see Zoloft Withdrawal–The Darkest Period of my Life Antidepressants  "I had all the classic symptoms of a junkie coming off of heroine."

Well, in my experience, if you taper off of the drug, much the same as you slowly build up to a dose perscribed by your pdoc, you will experience less side effects.  The reason why it seems like you are addicted is because your nervous system has become dependant on the drug, and if you were to just stop it, you will experience severe side effects for several months afterwards, which happened to me a few years ago.  However, it’s not anywhere near as severe of an *addiction* as heroine or alcohol. Frost

Response:

i have to agree they all tell me that zoloft isn’t addicting either, but screw them all i go off it for 2 days and then have to start it again they say hardly any of the newer drugs are addicting, well i say, that they should try them themselves and then they will see

– Hide quoted text — Show quoted text – Zoloft Withdrawal–The Darkest Period of my Life Antidepressants  "I had all the classic symptoms of a junkie coming off of heroine." My name is Virginia and I just finished seeing a segment on 2020 regarding withdrawal symptoms after getting off of an antidepressant. THANK GOD!!! There are other people out there that have experienced the same symptoms I have experienced! Every doctor in the past, (3), I have told about my withdrawal symptoms have told me that it’s not possible or that they’ve never heard of anyone having these

symptoms months after – Hide quoted text — Show quoted text – attempting to get off Zoloft. I even got very upset at one of the doctor’s and told him that the symptoms I was experiencing were "real" and that I was not crazy! To make a long story short– The six months I was off the Zoloft was the darkest period of my life. I had all the classic symptoms of a junkie coming off of heroine. For three weeks straight, I had dry heaves, nausea, dizziness, panic attacks so severe I thought I was having a heart attack, cold sweats, a weird sound in my head, like breaking glass every time I’d blink my eyes, the disconnection of your brains ability to catch up with your vision when you look sharply to the left or right (almost like the old slide projectors that take a second and then click to the next picture), severe paranoia, and continual suicidal thoughts. If it were not for my husband taking time of from work to watch over me, I would not be here today! Unfortunately, I lost my job, and ended up having to get back on the Zoloft in order to live a so-called "normal life". And I can honestly say, it was like a miracle how quickly my nausea and dry heaves went away. I only wish that the first doctor I saw would have informed me about the possibility of becoming addicted to this drug, and given me the choice of alternative treatment or a life long commitment to Zoloft. Now the only symptoms I have are dry mouth and a stiff jaw…Oh, and paranoia about ever losing my health insurance. Virginia — Psychiatry is to Science as Astrology is to Astronomy

Response:

- Hide quoted text — Show quoted text – i have to agree they all tell me that zoloft isn’t addicting either, but screw them all i go off it for 2 days and then have to start it again they say hardly any of the newer drugs are addicting, well i say, that they should try them themselves and then they will see Zoloft Withdrawal–The Darkest Period of my Life Antidepressants  "I had all the classic symptoms of a junkie coming off of heroine."

Well, in my experience, if you taper off of the drug, much the same as you slowly build up to a dose perscribed by your pdoc, you will experience less side effects.  The reason why it seems like you are addicted is because your nervous system has become dependant on the drug, and if you were to just stop it, you will experience severe side effects for several months afterwards, which happened to me a few years ago.  However, it’s not anywhere near as severe of an *addiction* as heroine or alcohol. Frost

Response:

Question:

Philately = the study of stamps (FIH-lah-teh-lee) Philatelist = (fih-LAH-ta-list) Damn. That’s not what *I* thought it meant.

Philatelists do it first class, don’tcha know? <g Myra

Response:

I just figured out something. I drink a lot of ice tea, I mean a lot. At lunch I usually can put away about 5-8 tall glasses of the stuff. Now, tea has some carbs. I wonder how much extra carbs I’m getting. Anyone?

Response:

I just figured out something. I drink a lot of ice tea, I mean a lot. At lunch I usually can put away about 5-8 tall glasses of the stuff. Now, tea has some carbs. I wonder how much extra carbs I’m getting. Anyone? You can look up any food or drink at: http://www.nal.usda.gov/fnic/cgi-bin/nut_search.pl According to them, brewed unsweetened tea is approx .71 carbs per 8 ounce cup. Brewed unsweetened herbal teas are approx. .47 carbs per 8 ounce cup.

Response:

I just figured out something. I drink a lot of ice tea, I mean a lot. At lunch I usually can put away about 5-8 tall glasses of the stuff. Now, tea has some carbs. I wonder how much extra carbs I’m getting. Anyone?

My cookbook software lists 8 cups of tea, brewed, as 5.8 carb. CAD 2/94 LC 7/01 188/167/126

Response:

I just figured out something. I drink a lot of ice tea, I mean a lot. At lunch I usually can put away about 5-8 tall glasses of the stuff. Now, tea has some carbs. I wonder how much extra carbs I’m getting. Anyone? My cookbook software lists 8 cups of tea, brewed, as 5.8 carb.

… and if  you’re adding and AS packet to each glass, add another five to  8g of carbs.  DAMN those sneaky carbs! — Stop By And Sign My Guest Book! My LC Home Page:  http://www.angelfire.com/nc3/marengo Peter

Response:

Not to mention all the caffeine. – Violet

– Hide quoted text — Show quoted text – I just figured out something. I drink a lot of ice tea, I mean a lot. At lunch I usually can put away about 5-8 tall glasses of the stuff. Now, tea has some carbs. I wonder how much extra carbs I’m getting. Anyone? My cookbook software lists 8 cups of tea, brewed, as 5.8 carb. … and if  you’re adding and AS packet to each glass, add another five to  8g of carbs.  DAMN those sneaky carbs! — Stop By And Sign My Guest Book! My LC Home Page:  http://www.angelfire.com/nc3/marengo Peter

Response:

… and if  you’re adding and AS packet to each glass, add another five to  8g of carbs.  DAMN those sneaky carbs!

I will never give up my beloved teas!  NEVER! Of course, I don’t use sweeteners, lemon or cream, and I try to keep my tea consumption to just a couple of times a week. The thing is – I’m hooked on teas the way an oenologist is hooked on wines.   And it didn’t help matters much when a new restaurant opened up nearby that not only has quite a few low-carb food choices, but the biggest tea selection I have ever seen.  And you can buy teas to take home, too!   My last visit to the place netted me an ounce of lapsang souchong (a tea I’ve been looking for for *years*), as well as a lovely oolong and the best jasmine tea I’ve ever tried.  (I went for one of each kind – black, oolong and green.)  And I’ve hardly even scratched the surface. One of my great pleasures is to sit down with a cup of one of my teas (brewed loose-leaf in a French press), and just relax.  <g Myra

Response:

Oenologist. Myra, is that pronounced "ween ol o jist" as it would have been if it were a Latin word? Because if it is, I’m gonna love springing it on my 13 year old. CAD 2/94 LC 7/01 188/167/126

Response:

Oenologist. Myra, is that pronounced "ween ol o jist" as it would have been if it were a Latin word? Because if it is, I’m gonna love springing it on my 13 year old.

Oenology is a variant of enology, which is pronounced "eh-nah-low-gee."  I guess it would be pronounced "eh-nah-low-jist." Here’s some other words – all directly related to my business – to spring on your kidlet: Philately = the study of stamps (FIH-lah-teh-lee) Philatelist = (fih-LAH-ta-list) Numismatics = the study of coins (NOO-miz-mah-tiks) Numismatist = (noo-MIZ-mah-tist) Deltiology = the study of postcards (DEL-tee-ah-low-gee) Deltiologist = (del-TEE-ah-low-jist) <g Myra

Response:

My last visit to the place netted me an ounce of lapsang souchong (a tea I’ve been looking for for *years*), as well as a lovely oolong and the best jasmine tea I’ve ever tried.  (I went for one of each kind – black, oolong and green.)  And I’ve hardly even scratched the surface.

Ooooohhhhhh Myra.  It’s a good thing I don’t live anywhere near you or I’d be there buying them up regularly.  I’m LLLLLOOOOOVVVVVEEEEE tea, unadulterated of course.  Lapsang (aka Bushfire Tea) is a real favourite of mine, as are both oolong and jasmine.   One of my great pleasures is to sit down with a cup of one of my teas (brewed loose-leaf in a French press), and just relax.  <g Myra

I love using my Favourite Teapot (actually, an old china Coffee pot painted with delicate violets, part of a demitasse kit I picked up for a song in an antique shop about 15 years ago) together with one of my collection of fine bone china teacups with a Really Good Tea.  My favourite cup is a deep burgundy with delicate traceries of gold leaf, 3 darling little legs (yes, legs – similar in shape though not (of course) in size to those found on clawfooted bath tubs) also gold. The inside of the cup is a delicate mother-of-pearl finish and the saucer is also mother-of-pearl and gold, and has deep indented ‘cut work’ edge that makes it appear to be edged in china ‘lace’.  Even an average tea seems to taste better when drunk from such beautiful things. Aramanth (sipping a mug of Earl Grey as I type).

Response:

Ooooohhhhhh Myra.  It’s a good thing I don’t live anywhere near you or I’d be there buying them up regularly.  

I have to keep myself away.  Those teas are *expensive* – up to $200 a pound ($387 AUS).  Of course, I only buy one ounce at a time…. LOL! I’m LLLLLOOOOOVVVVVEEEEE tea, unadulterated of course.

Of course.  Putting stuff in tea just kills the taste. Lapsang (aka Bushfire Tea) is a real favourite of mine, as are both oolong and jasmine.

Is that what you call it there?  I think of it as hickory-smoked tea.   Or tarry tea.  It just has that wonderful aroma and flavor – so rich, that I keep myself to no more than a cup of it a week. I love using my Favourite Teapot (actually, an old china Coffee pot painted with delicate violets, part of a demitasse kit I picked up for a song in an antique shop about 15 years ago) together with one of my collection of fine bone china teacups with a Really Good Tea.  

Sounds lovely!  And those special finds in little shops are so much more fun to have than anything you could get in a big department store.  I call it the thrill of the hunt. Alas, I never got into tea cups, preferring mugs instead.  Besides my French press, I have a teapot-for-one that comes with a 12-ounce pot, lid and cup that fits over the top.  I also have my Portmeirion botanical garden pattern – pot, tray and four mugs. There’s a little store about a mile from where I live called "Almost and Perfect English China," that has all kinds of interesting little things – a very good store if you’re missing a piece of something or other.  I remember the lid to my Portmeirion pot was broken (either an earthquake or move – I don’t remember now), and they had a replacement for me. My favourite cup is a deep burgundy with delicate traceries of gold leaf, 3 darling little legs (yes, legs – similar in shape though not (of course) in size to those found on clawfooted bath tubs) also gold. The inside of the cup is a delicate mother-of-pearl finish and the saucer is also mother-of-pearl and gold, and has deep indented ‘cut work’ edge that makes it appear to be edged in china ‘lace’.  Even an average tea seems to taste better when drunk from such beautiful things.

Oh, that cup sounds gorgeous!  Beats hell out of my favorite Boynton cat mug – the one with the big cat on it with the caption, "I am not fat.   I’m fluffy!" (sipping a mug of Earl Grey as I type).

Ah, there, now you’ve lost me.  I’m just not an Earl Grey fan – the bergemot oil tastes weird to me. Myra Sipping a mug of Eight Immortals Oolong

Response:

Oenologist. Myra, is that pronounced "ween ol o jist" as it would have been if it were a Latin word? Because if it is, I’m gonna love springing it on my 13 year old. Oenology is a variant of enology, which is pronounced

"eh-nah-low-gee."  I guess it would be pronounced "eh-nah-low-jist." Here’s some other words – all directly related to my business – to spring on your kidlet: Philately = the study of stamps (FIH-lah-teh-lee) Philatelist = (fih-LAH-ta-list) Numismatics = the study of coins (NOO-miz-mah-tiks) Numismatist = (noo-MIZ-mah-tist) Deltiology = the study of postcards (DEL-tee-ah-low-gee) Deltiologist = (del-TEE-ah-low-jist)

Myram I love when you talk dirty!  <g — Stop By And Sign My Guest Book! My LC Home Page:  http://www.angelfire.com/nc3/marengo Peter

Response:

Myram I love when you talk dirty!  <g

You want to see dirty (messy)?  You should see our office – looks like Santa’s Workshop exploded into a stamp show.  Oy. Myra Busy scanning stamps and inspecting toy soldiers today

Response:

Ooooohhhhhh Myra.  It’s a good thing I don’t live anywhere near you or I’d be there buying them up regularly.   I have to keep myself away.  Those teas are *expensive* – up to $200 a pound ($387 AUS).  Of course, I only buy one ounce at a time…. LOL!

I’d have to limit myself to that, too, at those prices.  Good thing you can get a lot of cups from an ounce of leaves! Lapsang (aka Bushfire Tea) is a real favourite of mine, as are both oolong and jasmine. Is that what you call it there?  I think of it as hickory-smoked tea.   Or tarry tea.  It just has that wonderful aroma and flavor – so rich, that I keep myself to no more than a cup of it a week.

Most people just call it "urgh"!  "Bushfire Tea" is the name a friend and I gave it after the Ash Wednesday Fires (January 83?  I think – substantial amounts of bushland in 3 states went  up in flames) when you could smell and taste the burnt-eucalypt on the air for weeks.  It smelled much like the aroma of lapsang. Alas, I never got into tea cups, preferring mugs instead.  Besides my French press, I have a teapot-for-one that comes with a 12-ounce pot, lid and cup that fits over the top.  I also have my Portmeirion botanical garden pattern – pot, tray and four mugs.

It depends on my mood.  If I’m rushed or not able to sit and enjoy I’ll use a mug because it stays hotter longer.  If I’ve got time to sit and enjoy then it’s a dainty cup every time.   I also have a pot-for-one with cup that fits over the top, a HUGE pot in a cat shape that a friend painted for me, and several ‘ordinary’ pots that I accumulated as gifts. (sipping a mug of Earl Grey as I type). Ah, there, now you’ve lost me.  I’m just not an Earl Grey fan – the bergemot oil tastes weird to me. Myra Sipping a mug of Eight Immortals Oolong

I like the mild undertang of the citrus – I also like Lady Grey, which is EG with lemon and orange.   Aramanth

Response:

I’d have to limit myself to that, too, at those prices.  Good thing you can get a lot of cups from an ounce of leaves!

I managed to resist the $200 tea, but I did buy them in the $40-120 range.  Three ounces was about $18 U.S. (about $33 AUS). Most people just call it "urgh"!  "Bushfire Tea" is the name a friend and I gave it after the Ash Wednesday Fires (January 83?  I think – substantial amounts of bushland in 3 states went  up in flames) when you could smell and taste the burnt-eucalypt on the air for weeks.  It smelled much like the aroma of lapsang.

You’re right – it *does* smell like a brushfire!  But it’s heavenly to drink.   I first learned about it when I was a kid and read James Michener’s "Centennial."  One of the characters got hooked on it. It depends on my mood.  If I’m rushed or not able to sit and enjoy I’ll use a mug because it stays hotter longer.  If I’ve got time to sit and enjoy then it’s a dainty cup every time.  

For me, growing up with my coffee-drinking folks meant that mugs were pretty much all there were.  My mother never used her "dainty" cups because my father just couldn’t hold them due to his essential tremor.   He needs to wrap his hand around a thick mug, and so I’ve just carried that around ever since. I also have a pot-for-one with cup that fits over the top, a HUGE pot in a cat shape that a friend painted for me, and several ‘ordinary’ pots that I accumulated as gifts.

My mother collects tiny little pots in unusual shapes, but none of them are usable.  I just have the ones I mentioned, plus an Italian coffee service and a sake set.  And I don’t even drink sake! Oh, wait a sec – I do have a Chinese tea set, too. I like the mild undertang of the citrus – I also like Lady Grey, which is EG with lemon and orange.  

Lady Grey is pretty new around here – I just started seeing it in stores. I’m not tempted to try it, though, because it still has the bergemot oil in it. Myra

Response:

Oenologist. Myra, is that pronounced "ween ol o jist" as it would have been if it were a Latin word? Because if it is, I’m gonna love springing it on my 13 year old. Oenology is a variant of enology, which is pronounced "eh-nah-low-gee."  I guess it would be pronounced "eh-nah-low-jist." Here’s some other words – all directly related to my business – to spring on your kidlet: Philately = the study of stamps (FIH-lah-teh-lee) Philatelist = (fih-LAH-ta-list)

Damn. That’s not what *I* thought it meant.

Response:

some nice teas at www.alltea.com allison – Hide quoted text — Show quoted text – I’d have to limit myself to that, too, at those prices.  Good thing you can get a lot of cups from an ounce of leaves! I managed to resist the $200 tea, but I did buy them in the $40-120 range.  Three ounces was about $18 U.S. (about $33 AUS). Most people just call it "urgh"!  "Bushfire Tea" is the name a friend and I gave it after the Ash Wednesday Fires (January 83?  I think – substantial amounts of bushland in 3 states went  up in flames) when you could smell and taste the burnt-eucalypt on the air for weeks.  It smelled much like the aroma of lapsang. You’re right – it *does* smell like a brushfire!  But it’s heavenly to drink.   I first learned about it when I was a kid and read James Michener’s "Centennial."  One of the characters got hooked on it. It depends on my mood.  If I’m rushed or not able to sit and enjoy I’ll use a mug because it stays hotter longer.  If I’ve got time to sit and enjoy then it’s a dainty cup every time.   For me, growing up with my coffee-drinking folks meant that mugs were pretty much all there were.  My mother never used her "dainty" cups because my father just couldn’t hold them due to his essential tremor.   He needs to wrap his hand around a thick mug, and so I’ve just carried that around ever since. I also have a pot-for-one with cup that fits over the top, a HUGE pot in a cat shape that a friend painted for me, and several ‘ordinary’ pots that I accumulated as gifts. My mother collects tiny little pots in unusual shapes, but none of them are usable.  I just have the ones I mentioned, plus an Italian coffee service and a sake set.  And I don’t even drink sake! Oh, wait a sec – I do have a Chinese tea set, too. I like the mild undertang of the citrus – I also like Lady Grey, which is EG with lemon and orange.   Lady Grey is pretty new around here – I just started seeing it in stores. I’m not tempted to try it, though, because it still has the bergemot oil in it. Myra

"I love my decadent, cosmopolitan, self-indulgent, racially-mixed, godless, intellectually dilletante, drug-abusing, promiscuous, queer-loving country. And its flag is the Stars and Stripes." Patrick Nielsen Hayden

Response:

Question:

I’ve taken Valerian and Kava Kava (not together of course) but I am currently on Zoloft for anxiety and panic attacks. I was wondering if there is another herbal treatment. I go to acupuncture but it is not covered by insurance and is very costly. thank you for your time. Faith

Response:

Faith, I am not a doctor, so please consider that carefully when you read my response. I did, however, attend several presentations on how stressors affect the overall body and, specifically, the immune system. I also got quite an education when I was having vasovagal episodes with increasing frequency. There are many things contributing to a stress load that manifests in anxiety and panic attacks. There are three basic types of stressors – physical (injury, illness, fatigue, etc.), chemical (food, drugs, alcohol, blood sugar levels, etc.), and emotional. Each body can handle a maximum combined stress load before it starts showing ‘overstressed’ symptoms. Each type of stress contributes to the total stress load. If two are fine and one is off the charts, symptoms flare. For this reason, it is necessary to keep each of the types of stress as much to a minimum as reasonably possible to lessen the effect of the situation that drives that stress load over the top. When I was having severe anxiety attacks (vasovagal near syncope), I wasn’t ‘cured’ by just taking anti-anxiety medicine. I had to modify my eating, exercise, and sleeping habits AND I had to be removed from the environment that was the major contributor to  the stress. I also had to learn (try to learn) different healthy methods to deal with my stress. Meditation helped a lot. The first anti-anxiety medicine I was given was not helpful, so a second was added to it. The combination was too much, so I eventually wound up using the second medicine with an additional RX for Xanax on as as-needed basis. If I felt an attack coming on, I took a Xanax. In the beginning I was taking the Xanax 3xdaily, but over time it lessened to where I rarely take it at all. But I still carry it in my purse as a backup. I have learned what kinds of situations trigger my anxiety and, as much as reasonably possible, I avoid those situations entirely or at least when I know I am vulnerable to a stress overload (i.e., overtired, hungry, annoyed already). I know your are looking for herbal treatments. Others may have good suggestions for that. If they do, please check with your Dr. or pharmacist for medication interactions and precautions. What I am hoping to supply here is natural as well. Lifestyle changes made the biggest difference for me. If I hadn’t made the changes, no amount of drugs could have gotten me through the experience. Best of luck to you, ccc – Hide quoted text — Show quoted text – I’ve taken Valerian and Kava Kava (not together of course) but I am currently on Zoloft for anxiety and panic attacks. I was wondering if there is another herbal treatment. I go to acupuncture but it is not covered by insurance and is very costly. thank you for your time. Faith

Response:

| 2.  St. John’s Wort – Mild Depression (NOT anxiety) I took it on a regular basis for months, in various available forms. No effect whatsoever. What works against bouts of nervous depression is kava-kava. It is the only herbal psychotropic stuff I have ever tried whose effects can be undeniably FELT. Whether it has healing, rather than only symtomatic properties, and whether is really does induce no tolerance is open to doubt. I take it on and off, not as a treatment. Against sustained depression DHEA definitely worked with me. It may not qualify as a "natural" remedy, however, and its harmlessness is disputed. James

Response:

2.  St. John’s Wort – Mild Depression (NOT anxiety)

Uh… =ahem!=   It most certainly IS listed for treatment for anxiety, as well as depression.  I ain’t gonna spoon-feed you the URL’s. Got to a good search engine or web crawler ( I like Altavista, Hotbot, Google and AskJeeves) and look it up.   Besides,  anxiety is often a symptom of depression!   As Gomer Pyle would say: "Well,  surprise, surpriiiiise!" That man-made crap,  like Zoloft and Paxil,  is for the birds! —   -john "Always listen to experts. They’ll tell you what can’t be done and why. Then do it."    - Robert Heinlein

Response:

I’ve taken Valerian and Kava Kava (not together of course) but I am currently on Zoloft for anxiety and panic attacks.

I would be careful with Zoloft

Question:

– Hide quoted text — Show quoted text – Ugh I had a rotten night yesterday. It started out alright – I decided to drop my Serzone and see if maybe that was making me feel so icky lately.  So I never took my morning dose.  Things went fine for most of the day. I had some things to get ready – it was our 3rd year anniversary today and I was waiting for my partner to get home from work. After supper things really went downhill – I started to feel really nauseated and bloated (it wasn’t my less than wonderful cooking either – Mel my partner was fine).  And from there is just lead to just horrible anxiety – by late in the evening I was just pacing back and forth – wondering if I should head to the emergency or not.  I decided to start the Serzone again and took my evening dose and it seemed to settle things down after about an hour or so.  Serzone does help some of the way for me – but I still don’t feel 100% or even 75% well on it – but it does take me to at least a somewhat toerable level of anxiety. I am making an appointment with the pdoc and see what can be done.  I had horrible luck on  a few of the SSRI’s but I have some good things about Celexa (yes I know it is an SSRI too) so maybe I will suggest that and see what the pdoc thinks.  Oh yes I do have Xanax around but for some reason I never take it – I don’t know why – I just cannot seem to make the decision to take it when I really need it.  If under docs orders of course, I started to take Xanax regularly – would it clear up these anxiety symptoms fast – would I notice a marked improvement almost right away ? – or would it take several weeks of usage to make me feel good again ?

Hi, Patrick….. I have been taking the same dose of Xanax for about 15 years now…… 0.5mg three times a day.  If I have a really bad pa, or if I’m facing something very challenging for me, I have my pdoc’s permission to take an extra tablet or two…… What it seems to do *for me* is to keep the panic and anxiety more *at bay*…… I rarely have a full-blown pa anymore…… maybe once a year.  As I remember, the Xanax was rather quick…….I didn’t have to wait weeks for it to help…. While you may likely become *dependent* on it after a long time (meaning you would have to wean off of it very slowly), it is not addictive…… I have never had the urge to take more and more….. as I said, I’m still at the same dosage I began with 15 years ago. I hope this helps a bit…… and I hope you get to feeling better soon, guy! I know it must suck to be feeling puny all the time….. Take care….. MikeH

Response:

- Hide quoted text — Show quoted text – Ugh I had a rotten night yesterday. It started out alright – I decided to drop my Serzone and see if maybe that was making me feel so icky lately.  So I never took my morning dose.  Things went fine for most of the day. I had some things to get ready – it was our 3rd year anniversary today and I was waiting for my partner to get home from work. After supper things really went downhill – I started to feel really nauseated and bloated (it wasn’t my less than wonderful cooking either – Mel my partner was fine).  And from there is just lead to just horrible anxiety – by late in the evening I was just pacing back and forth – wondering if I should head to the emergency or not.  I decided to start the Serzone again and took my evening dose and it seemed to settle things down after about an hour or so.  Serzone does help some of the way for me – but I still don’t feel 100% or even 75% well on it – but it does take me to at least a somewhat toerable level of anxiety.

Serzone is not a first choice med for PAD although it works for some people. But stopping it suddenly will cause a reaction like yours. All AD’s should be weaned off. I am making an appointment with the pdoc and see what can be done.  I had horrible luck on  a few of the SSRI’s but I have some good things about Celexa (yes I know it is an SSRI too) so maybe I will suggest that and see what the pdoc thinks.  Oh yes I do have Xanax around but for some reason I never take it – I don’t know why – I just cannot seem to make the decision to take it when I really need it.  If under docs orders of course, I started to take Xanax regularly – would it clear up these anxiety symptoms fast – would I notice a marked improvement almost right away ? – or would it take several weeks of usage to make me feel good again ?

Xanax works *immediately*, after 10-40 minutes, that is. It is IMO the best anti-anxiety med around (as a rule). You will get dependent on it which means you will have to stop it by way of a slow taper (like the AD’s) which is easy for some and very difficult for others. Some doctors don’t prescribe benzodiazepines (*benzos*) like Xanax because they confuse *dependence* with *addiction*. This means they haven’t done their homework. Hopefully your doc is not a so-called *benzophobe*. Of the SSRI’s Celexa seems to be the one with the lowest side effect profile. Still, if you had bad experiences with two or three other SSRI’s (after having given them enough time for a fair trial – 6-8 weeks) you might want to ask your doc about a TCA. Don’t mix Serzone and Xanax. It’s a bad combo as Serzone more than doubles the effect of Xanax and generally the two don’t interact well. I am feeling really achy today – and my stomach is still bothering me. Could be a stomach flu I suppose – but I tend to feel achy a lot these days so who can say for sure (I had all the tests done for achy muscles – there is no physical problem there).  I feel like my body was just beaten up.  I am so tired of feeling sick all the time.

Yeah…tell me about it…. this may well be Serzone withdrawal. Philip

Response:

I am feeling really achy today – and my stomach is still bothering me. Could be a stomach flu I suppose – but I tend to feel achy a lot these days so who can say for sure (I had all the tests done for achy muscles – there is no physical problem there).  I feel like my body was just beaten up.  I am so tired of feeling sick all the time. Yeah…tell me about it…. this may well be Serzone withdrawal. Philip

I found Serzone to be the most potent meds I was ever on. I just found that I was taking 300mgs a day and after a couple of months stopped it cold turkey. Bad mistake…don’t stop it without your Drs help. I became very sick and depressed for a couple of weeks. Lorri http://hometown.aol.com/lorr1/myhomepage5indexhtlm.html http://hometown.aol.com/lorr1/myhomepage4index.html

Response:

– Hide quoted text — Show quoted text – Ugh I had a rotten night yesterday. It started out alright – I decided to drop my Serzone and see if maybe that was making me feel so icky lately.  So I never took my morning dose.  Things went fine for most of the day. I had some things to get ready – it was our 3rd year anniversary today and I was waiting for my partner to get home from work.   After supper things really went downhill – I started to feel really nauseated and bloated (it wasn’t my less than wonderful cooking either – Mel my partner was fine).  And from there is just lead to just horrible anxiety – by late in the evening I was just pacing back and forth – wondering if I should head to the emergency or not.  I decided to start the Serzone again and took my evening dose and it seemed to settle things down after about an hour or so.  Serzone does help some of the way for me – but I still don’t feel 100% or even 75% well on it – but it does take me to at least a somewhat toerable level of anxiety. I am making an appointment with the pdoc and see what can be done.  I had horrible luck on  a few of the SSRI’s but I have some good things about Celexa (yes I know it is an SSRI too) so maybe I will suggest that and see what the pdoc thinks.  Oh yes I do have Xanax around but for some reason I never take it – I don’t know why – I just cannot seem to make the decision to take it when I really need it.  If under docs orders of course, I started to take Xanax regularly – would it clear up these anxiety symptoms fast – would I notice a marked improvement almost right away ? – or would it take several weeks of usage to make me feel good again ? I am feeling really achy today – and my stomach is still bothering me. Could be a stomach flu I suppose – but I tend to feel achy a lot these days so who can say for sure (I had all the tests done for achy muscles – there is no physical problem there).  I feel like my body was just beaten up.  I am so tired of feeling sick all the time.

Hi Patrick! I’m hoping you feel better today! Hugs, Di

Response:

Ugh I had a rotten night yesterday. It started out alright – I decided to drop my Serzone and see if maybe that was making me feel so icky lately.  So I never took my morning dose.  Things went fine for most of the day. I had some things to get ready – it was our 3rd year anniversary today and I was waiting for my partner to get home from work.   After supper things really went downhill – I started to feel really nauseated and bloated (it wasn’t my less than wonderful cooking either – Mel my partner was fine).  And from there is just lead to just horrible anxiety – by late in the evening I was just pacing back and forth – wondering if I should head to the emergency or not.  I decided to start the Serzone again and took my evening dose and it seemed to settle things down after about an hour or so.  Serzone does help some of the way for me – but I still don’t feel 100% or even 75% well on it – but it does take me to at least a somewhat toerable level of anxiety. I am making an appointment with the pdoc and see what can be done.  I had horrible luck on  a few of the SSRI’s but I have some good things about Celexa (yes I know it is an SSRI too) so maybe I will suggest that and see what the pdoc thinks.  Oh yes I do have Xanax around but for some reason I never take it – I don’t know why – I just cannot seem to make the decision to take it when I really need it.  If under docs orders of course, I started to take Xanax regularly – would it clear up these anxiety symptoms fast – would I notice a marked improvement almost right away ? – or would it take several weeks of usage to make me feel good again ? I am feeling really achy today – and my stomach is still bothering me. Could be a stomach flu I suppose – but I tend to feel achy a lot these days so who can say for sure (I had all the tests done for achy muscles – there is no physical problem there).  I feel like my body was just beaten up.  I am so tired of feeling sick all the time.

Response:

I know it is hard to up the xanax, but .25 is an extremly low dose. A few years ago , I  started getting panic attacks, and the doc prescibed .25/3X per day. It did abosolutely nothing, but I was too scared to take more. So after 2 weeks of constant attacks and horrible anxiety, I finally told myself "if I take 2 of these, what do I have to lose, I am going to die anyway and I took a .5 dose and another .5 dose 4 hrs later and boom..it was gone..I felt normal again. The point is  a .25 dose is not a dose for us panic sufferers. Dr’s give a dose like that to a patient who does not have PA or GAD , but just "going thru a roughtime". Talk to your Doc and bump the dose up to .5 3x a day. Believe me , it will help. Then when the zoloft kicks in (and it will) start lowering the xanax and soon you will be xanax free. When I was on zoloft, it hit me hard as well for the 1st 2 months, I was up to 4-5 mgs of xanax a day. But by the 5th month, the zoloft was working great and I was completely off the xanax. Hope this helps – Hide quoted text — Show quoted text – I had a pretty rotten night these last two.  The night before last I hardly slept at all but I managed to get to work and get through the day – barely.  Then last night after work I was doing some work on the computer and I felt strange – I started to perspire profusely, got all shaky, hot flushes up and down my body and felt short of breath  - basically it started to get out of hand – I paced the hallway in our apt here for a bit tried to calm myself but I just felt like I was gonna die.  I took a .25 mg Xanax – still phobic about taking anymore for some reason and it help a small bit but not enough.  I couldn’t do it this morning – I took the day off sick and made an appt to see the pdoc again (see him this Tuesday). I am on Zoloft – first 10 days at 25 mg and today would be my fifth day at 50 mg.  I don’t understand why the drug is hitting me so hard this time since when I was on it before for anxiety problems I seemed to handle it better.  Zoloft worked so well for me the last time I took it – I hope it starts to work soon for me here – it seems that it started to work faster for me the first time I took it – the thing that does concern me is that I am not seeing any positive effects after 15 days – I know 4-6 weeks for effect but shouldn’t I be seeing some improvement by now?

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If you had a positive response to Zoloft before, you will most likely have a positive response again. The first few days of any increase in Zoloft dose often results in increased anxiety as a side effect. Xanax 0.25 mg is a very small dose (at least for me). I used to take 10.0 mg/day. I would suggest you increase your dose of Xanax (i.e. take 0.50 or 0.75 mg as needed) until you stop having PAs and this side effect of the Zoloft dissipates. Good luck, Chip last night   I had a pretty rotten night these last two. The night before last I hardly slept at all but I managed to get to work and get through the day – barely. Then last night after work I was doing some work on the computer and I felt strange – I started to perspire profusely, got all shaky, hot flushes up and down my body and felt short of breath – basically it started to get out of hand – I paced the hallway in our apt here for a bit tried to calm myself but I just felt like I was gonna die. I took a .25 mg Xanax – still phobic about taking anymore for some reason and it help a small bit but not enough. I couldn’t do it this morning – I took the day off sick and made an appt to see the pdoc again (see him this Tuesday). I am on Zoloft – first 10 days at 25 mg and today would be my fifth day at 50 mg. I don’t understand why the drug is hitting me so hard this time since when I was on it before for anxiety problems I seemed to handle it better. Zoloft worked so well for me the last time I took it – I hope it starts to work soon for me here – it seems that it started to work faster for me the first time I took it – the thing that does concern me is that I am not seeing any positive effects after 15 days – I know 4-6 weeks for effect but shouldn’t I be seeing some improvement by now?

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Question:

Well, I am happy to say that I am down to 1 mid-night pee.  I had never heard of the effects that Margrove described, but perhaps this is the case with me (temporary urethra dilation).  I do think that the derealization is probably related to the reduction in Zoloft as Chip suggested.  Thanks for thinking about me!! ~Valerie

– Hide quoted text — Show quoted text – This has increased the frequency of nocturnal urination to once every 2 hours (it’s a pisser!). *groan* Yeah, and if you get constipation, you can also say it’s a pain in the ass. BTW Valerie, have you had a urine culture? Sometimes urinary frequency is the main symptom of a UTI, even without pain or burning. -elizabeth

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There is also a new home test for UTI called AZO

Yeah, I noticed that. I wonder how reliable it is. -elizabeth

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- Hide quoted text — Show quoted text – Hi folks!  Well I survived another family vacation.  I even managed to tackle my fear of lakes and go swimming.  (of course I had to tackle the fear of wearing a bathing suit in public first .  Anyway, I have a few questions:  I started taking desipramine 10mgs for 1 week then upped it to 20 this week. Concurrently, I decreased my Zoloft to 75mgs and continue using .5mg Ativan PRN.  I’m happy to report that so far I have not been bothered by the more obnoxious anticholergenic side effects of TCAs. However, since introducing the TCA, I have the tiniest tank in the world….2-3 night time pees and all throughout the day!  Is this a common side effect and will it go away?  I never had this with imiprimine and it’s really obnoxious.  My second question has to do with photosensitivity and meds.  Are any of these meds known to increase photosensitivity.  I burned my face off on vacation…even with sunscreen and I fear the I am doomed to spending the rest of the summer with peeling skin… or having to avoid the sun!  Yuck.  My last question has to do with increased derealization.  Since the med change I am having a horrible time with this symptom….one that I rarely have had in the past.  It’s quite annoying.  Your suggestions and opinions are much appreciated as always!!! ~Valerie

all of them are photosensitizing including ativan so stay aweay from mr sol unless really lathered in sun screen the urolological pee problem-the tca’s can cause a minor temporary dilation of the urethra its harmless and no big problem it will adjust as you reach a homeostasis with the drug-also when you begin a tca it seems to load a lot of conjugated brain amines and drug into the kidneys this is a good thing and its what you want it means the stuff is doing its job-you can help it along by drinking a lot of water and of course peeing more it will abate in a few weeks if it doesn’t and you get burning when you pee it could be cystitis so get a urinalysis for bugs. LM

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There is also a new home test for UTI called AZO Cathy P.H.O.B.I.A. People Helping Others Become Independent Again Off-line Panic/Anxiety Support Group Learn about us at http://community.nj.com/cc/phobia

– Hide quoted text — Show quoted text – This has increased the frequency of nocturnal urination to once every 2 hours (it’s a pisser!). *groan* Yeah, and if you get constipation, you can also say it’s a pain in the ass. BTW Valerie, have you had a urine culture? Sometimes urinary frequency is the main symptom of a UTI, even without pain or burning. -elizabeth

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This has increased the frequency of nocturnal urination to once every 2 hours (it’s a pisser!).

*groan* Yeah, and if you get constipation, you can also say it’s a pain in the ass. BTW Valerie, have you had a urine culture? Sometimes urinary frequency is the main symptom of a UTI, even without pain or burning. -elizabeth

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snip I also notice a very small amount of urinary retention. I can’t squeeze the last several drops out, always one of the goals in my life. : ))

Chip, I’m up to 1oo mg of imipramine a day and have the urinary retention problem as well. Don’t laugh….but what really helps to get "started" and squeeze out those last few drops is to blow short panting breaths (yeah I know, you’re laughing your face off right now). Think of a pregnant woman in labour and how she relaxes her muscles so she doesn’t push at the wrong time-relaxing these muscles helps the urine to pass. Of course this is all from a woman’s perpective with her unique (LOL and in my case, very firm, tight) muscles. If it works for a man, could someone let me know??? I’m dying of curiousity here. Your pal in urinary retention, Charley

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Hi folks!  Well I survived another family vacation.  I even managed to tackle my fear of lakes and go swimming.  (of course I had to tackle the fear of wearing a bathing suit in public first .  Anyway, I have a few questions:  I started taking desipramine 10mgs for 1 week then upped it to 20 this week. Concurrently, I decreased my Zoloft to 75mgs and continue using .5mg Ativan PRN.  I’m happy to report that so far I have not been bothered by the more obnoxious anticholergenic side effects of TCAs. However, since introducing the TCA, I have the tiniest tank in the world….2-3 night time pees and all throughout the day!  Is this a common side effect and will it go away?  I never had this with imiprimine and it’s really obnoxious.  My second question has to do with photosensitivity and meds.  Are any of these meds known to increase photosensitivity.  I burned my face off on vacation…even with sunscreen and I fear the I am doomed to spending the rest of the summer with peeling skin… or having to avoid the sun!  Yuck.  My last question has to do with increased derealization.  Since the med change I am having a horrible time with this symptom….one that I rarely have had in the past.  It’s quite annoying.  Your suggestions and opinions are much appreciated as always!!! ~Valerie

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Hi folks!  Well I survived another family vacation.  I even managed to tackle my fear of lakes and go swimming.  (of course I had to tackle the fear of wearing a bathing suit in public first .

There are some fears we all have to face! Anyway, I have a few questions:  I started taking desipramine 10mgs for 1 week then upped it to 20 this week. Concurrently, I decreased my Zoloft to 75mgs and continue using .5mg Ativan PRN.  I’m happy to report that so far I have not been bothered by the more obnoxious anticholergenic side effects of TCAs. However, since introducing the TCA, I have the tiniest tank in the world….2-3 night time pees and all throughout the day!  Is this a common side effect and will it go away?  I never had this with imiprimine and it’s really obnoxious.

Desipramine is not very anticholinergic for a TCA, so it’s not too surprising you’re not getting those side effects. One anticholinergic side effect is urinary retention. I’ve never heard of desipramine doing the reverse, though, unless you’re getting dry mouth and therefore drinking a lot of water. (Lithium *does* cause this as a side effect, BTW!) My second question has to do with photosensitivity and meds.  Are any of these meds known to increase photosensitivity.  I burned my face off on vacation…even with sunscreen and I fear the I am doomed to spending the rest of the summer with peeling skin… or having to avoid the sun!  Yuck.

Yeah, sometimes they can. Time to stock up on sunscreen, it sounds like! My last question has to do with increased derealization.  Since the med change I am having a horrible time with this symptom….one that I rarely have had in the past.  It’s quite annoying.  Your suggestions and opinions are much appreciated as always!!! ~Valerie

That’s kind of a weird one. It might be from decreasing the Zoloft, so that your body will adjust to it. You’re not getting any jitters or anything like that, are you? -elizabeth

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- Hide quoted text — Show quoted text – Hi folks!  Well I survived another family vacation.  I even managed to tackle my fear of lakes and go swimming.  (of course I had to tackle the fear of wearing a bathing suit in public first .  Anyway, I have a few questions:  I started taking desipramine 10mgs for 1 week then upped it to 20 this week. Concurrently, I decreased my Zoloft to 75mgs and continue using .5mg Ativan PRN.  I’m happy to report that so far I have not been bothered by the more obnoxious anticholergenic side effects of TCAs. However, since introducing the TCA, I have the tiniest tank in the world….2-3 night time pees and all throughout the day!  Is this a common side effect and will it go away?  I never had this with imiprimine and it’s really obnoxious.  My second question has to do with photosensitivity and meds.  Are any of these meds known to increase photosensitivity.  I burned my face off on vacation…even with sunscreen and I fear the I am doomed to spending the rest of the summer with peeling skin… or having to avoid the sun!  Yuck.  My last question has to do with increased derealization.  Since the med change I am having a horrible time with this symptom….one that I rarely have had in the past.  It’s quite annoying.  Your suggestions and opinions are much appreciated as always!!! ~Valerie

Hi Valerie, Welcome back!! Sounds like you are having fun with this med change<g.  I have noticed with the Paxil, I am sun sensitive too. I am real fair so I burn easily any way, but now all I need is one hour out in the sun, and I get roasted. It took me getting bad sunburns three times this summer to make the connection. Take care and hope the Desipramine works for you. JAckie

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Valerie, I’ve  been  desipramine 50mg/day for several weeks now, and this was added to Zoloft 150 mg/day which I’ve been on for several years. I do notice a dry mouth and have been sipping on ice water frequently for several weeks now. This has increased the frequency of nocturnal urination to once every 2 hours (it’s a pisser!).  Are you sure you don’t have a dry mouth? Not even a teeny-weeny bit dry?  : )) I also notice a very small amount of urinary retention. I can’t squeeze the last several drops out, always one of the goals in my life. : )) As far the feelings of  derealization, these are likely do to  increased levels of anxiety related to the increased dosage of desipramine. It tends to increase anxiety levels briefly. I had insomnia the first several nights after starting desipramine. You could treat the derealization by taking Ativan more often.  You might want to try Ativan 0.25 mg (1/2 the regular  PRN dose) at intervals frequent enough to keep the derealization away. Zoloft withdrawal can cause depersonalization, and I’d suspect it could cause derealiation as well. Same treatment: take Ativan. Zoloft can increase levels of desipramine by up to 30 per cent by inhibiting a liver enzyme that metabolizes desipramine. Maybe that’s why your doc cut back on the dose of Zoloft.   Take care, Chip questions for everyone!   Hi folks! Well I survived another family vacation. I even managed to tackle my fear of lakes and go swimming. (of course I had to tackle the fear of wearing a bathing suit in public first . Anyway, I have a few questions: I started taking desipramine 10mgs for 1 week then upped it to 20 this week. Concurrently, I decreased my Zoloft to 75mgs and continue using 5mg Ativan PRN. I’m happy to report that so far I have not been bothered by the more obnoxious anticholergenic side effects of TCAs. However, since introducing the TCA, I have the tiniest tank in the world….2-3 night time pees and all throughout the day! Is this a common side effect and will it go away? I never had this with imiprimine and it’s really obnoxious. My second question has to do with photosensitivity and meds. Are any of these meds known to increase photosensitivity. I burned my face off on vacation…even with sunscreen and I fear the I am doomed to spending the rest of the summer with peeling skin… or having to avoid the sun! Yuck. My last question has to do with increased derealization. Since the med change I am having a horrible time with this symptom….one that I rarely have had in the past. It’s quite annoying. Your suggestions and opinions are much appreciated as always!!! ~Valerie

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Question:

Can someone with some pharmacology expertise please explain the difference between Effexor and Meridia. My understanding is that both are SSRI/NRIs. Shouldn’t they work the same? Is Meridia used as an antidepressants in other countries? Please feel free to post here or via email.

Well, I don’t have any pharmacology experience, but I did read an article comparing venlafaxine (Effexor) to sibutramine (Meridia). Venlafaxine is more balanced to the serotonin side, and sibutramine is about 50/50. This may be why Meridia works better for weight loss and Effexor better for OCD. Barbara Barbara Hirsch, Publisher OBESITY MEDS AND RESEARCH NEWS http://www.obesity-news.com

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Can someone with some pharmacology expertise please explain the difference between Effexor and Meridia. My understanding is that both are SSRI/NRIs. Shouldn’t they work the same? Is Meridia used as an antidepressants in other countries? Please feel free to post here or via email.

Meridia was originally studied as an antidepressant by Knoll (BASF), but was never marketed as one.  If my memory serves me, the initial investigational doses used in studies of its antidepressant effects were rather high; on the order of 60mg/day.  Usually, the reasons why a drug might not be developed for the treatment of one indication yet pursued for another aren’t made public, though side effects at a given dose or lack of efficacy are likely candidates.  Ultimately, a drug gets used to treat a condition based solely on the empirical evidence collected in controlled trials, so another reason why Effexor isn’t used to treat obesity may simply reflect the fact that Effexor was placed on an antidepressant "track" early in its development as one of the first SSRI/NERI agents, and its effects on appetite and weight only became appreciated after doctors and patients gained some experience with it, and controlled studies might not have been performed for Effexor in obesity.  (I’m making a general statement here; I don’t have any knowledge of the particulars.) Also, note that drugs in the same class might have subtle (or not so subtle) differences between them.  For example, phentermine and pseudoephedrine are both sympathomimetic drugs and similar in chemical structure and at least some of their pharmacological actions, but pseudoephedrine isn’t very useful as an anorectic/appetite suppressant agent. — Steve Dyer

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Can someone with some pharmacology expertise please explain the difference between Effexor and Meridia. My understanding is that both are SSRI/NRIs. Shouldn’t they work the same? Is Meridia used as an antidepressants in other countries? Please feel free to post here or via email. Thanks in advance! Zila

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