Question:

Theoretically the canisters should last 30 days, but I find them running low quicker than that.  So with Advair you wouldn’t have to worry about that.

Right 28 days with a counter which reduces after each dose,

Response:

there is a major advantage in patient compliance having only one product to use instead of two. Another advantage is that the dose is adjustable. – it comes in low and high doses. It seems that the attractive package does make it more patient compliant, as soon as he recovers from the sticker shock. Murray Grossan, M.D. http://www.ent-consult.com http://www.TinnitusRelief.net http://www.emedicine.com/ent/topic516.htm

Response:

My doctor told me the Advair was more expensive.   Is it really true that the Servent/Flovent is more expensive?  And, I’m talking about the real cost, not the fact that I’d have one copay instead of two. Another factor is, for me, I don’t get

Advair is more expensive versus one inhaler but if you add the Flovent inhaler and the Serevent inhaler they will be less.

Response:

 The final question is cost: does your health insurance cover Advair.

It should as you save around $30.00 by using the advair rather then the Flovent and Serevent separately.I would think if you presented this to the insurance people they would appreciate you trying to save them money.

Response:

 The final question is cost: does your health insurance cover Advair. It should as you save around $30.00 by using the advair rather then the Flovent and Serevent separately.I would think if you presented this to the insurance people they would appreciate you trying to save them money.

My doctor told me the Advair was more expensive.   Is it really true that the Servent/Flovent is more expensive?  And, I’m talking about the real cost, not the fact that I’d have one copay instead of two. Another factor is, for me, I don’t get the 120 doses per canister of Serevent and Flovent.  Theoretically the canisters should last 30 days, but I find them running low quicker than that.  So with Advair you wouldn’t have to worry about that.

Response:

Is there something about combining Flovent and Serevent into one package that is more effective than taking them separately?

There are two advantages. 1) The delivery system takes less kill/practice and since MDI technique is notoriously horrible it is hoped that the delivery will be better. 2) Cost. The Advair discuss is priced less than the two inhalers separately and if you pay by the copay it will probably be only one instead of two. — CBI, MD "Believe those who are seeking the truth; doubt those who find it." -Andre Gide

Response:

My doctor told me the Advair was more expensive.   Is it really true that the Servent/Flovent is more expensive?  And, I’m talking about the real cost, not the fact that I’d have one copay instead of two.

All prices are AWP (average wholesale price). Induhvidual indusurers may make special deals. That said: Advair is more expensive that either Flovent or Serevent alone but less expensive than both. Since the Pulmicort Turbuhaler has three months worth of medicine in each device it is less expensive than Flovent and the combo od Pulmicort and Serevent is about the same as Advair. Oc course, if it cuts two co-pays to one it is cheaper for you regardless of AWP. In my experience the only insurers that won’t pay for Advair also don’t pay for Serevent. Another factor is, for me, I don’t get the 120 doses per canister of Serevent and Flovent.  Theoretically the canisters should last 30 days, but I find them running low quicker than that.  So with Advair you wouldn’t have to worry about that.

Correct. Since it has a numerical counter and a delivery device that does not rely on gas pressures you would not have to guess exactly when it will run out either. — CBI, MD

Response:

Why all this hype about Advair?  All it is, is a combination of Flovent’s active ingredient + Serevent’s active ingredient, in a funny new package. Is there something about combining Flovent and Serevent into one package that is more effective than taking them separately? — Steven D. Litvintchouk                   Advair cuts down on number of inhalers used: from two to one. Also  the

delivery system is different: Advair uses a powder and Flovent is a mdi. If you have problems with an mdi, then, on that basis, the switch to advair could be indicated. The problem with Advair is that during an exacerbation you cannot vary the Advair dosage, you will have to supplement with Flovent in whatever strength is required. In terms of efficacy, from personal experience, I find no difference and this is supported by my pulmonologist.  The final question is cost: does your health insurance cover Advair. John – Hide quoted text — Show quoted text –

Response:

Why all this hype about Advair?  All it is, is a combination of Flovent’s active ingredient + Serevent’s active ingredient, in a funny new package. Is there something about combining Flovent and Serevent into one package that is more effective than taking them separately?

According to my Pulmologist the powder form is more effective in getting into your lungs and does a better job.

Response:

Only a couple of differences. — It’s a dry powder inhaler, so no propellant to react to. — It’s one puff twice daily, not 2 each twice daily (i.e., 1 not 4, twice daily)  Helps compliance — There’s a counter on the device.  Helps keep track of when to replace. There were studies about it being more effective than just flovent, but I haven’t seen anything about it being better than the pair of medications prescribed separately.  Other than what’s listed above, it would appear to be a compliance issue.  I prefer it since I cough after taking the 4 puffs, but not after taking advair.  YMMV. Liam

– Hide quoted text — Show quoted text – My pulmonologist wants to try switching me from Flovent to Advair. And I’ve heard so many other asthma and COPD patients praising Advair. Why all this hype about Advair?  All it is, is a combination of Flovent’s active ingredient + Serevent’s active ingredient, in a funny new package. Is there something about combining Flovent and Serevent into one package that is more effective than taking them separately? — Steven D. Litvintchouk

Response:

My pulmonologist wants to try switching me from Flovent to Advair. And I’ve heard so many other asthma and COPD patients praising Advair. Why all this hype about Advair?  All it is, is a combination of Flovent’s active ingredient + Serevent’s active ingredient, in a funny new package. Is there something about combining Flovent and Serevent into one package that is more effective than taking them separately? — Steven D. Litvintchouk                  

Response:

Question:

It seems like all the doctors are the same way with where they put the blame. As far as they see it, the meds don’t have any bad effects. My doctor is that way.

Get a new doctor. Chris Owens

Response:

Lisa, I was increased from 2 to 3 puffs twice daily of Flovent 44 about 3 months ago.  Although I haven’t noticed increased cramping, the muscles in my lower legs and arms are very weak and feel like I’ve worked the muscles too hard (which I haven’t, unfortunately).  Actually, they feel sort of like "spaghetti" at times.  I have also gained about 10 pounds since the increase.  What a drag!  Have you experienced any muscle weakness?  My doctor is always reluctant to "blame" oddities on my medicine.

Steroid use can cause upper limb weakness, both legs and arms.  I lift weights and take potassium and calcium suppliments to counter this. Sue – Hide quoted text — Show quoted text -Patrice I am on Flovent 44 three puffs twice a day.  I am having terrible cramping as of late.  I used to be on Serevent that I know also caused cramping, and have since went off of it because of side effects.  Now I am wondering if the inhaled steroids are causing this and if it is the particular brand I am on (Flovent) or if there is another type that doesn’t cause so much of this cramping. I am on Potassium, cacium, and magnesium supplements.  I am wondering if I should switch, go off of the steroid, or what to do. I am also wondering if anyone else has noticed mood swings while on inhaled steriods.  I noticed these symptoms increase after increasing from two puffs to three puffs twice a day.  Any ideas will be appreciated.  Lisa N

Smoke Often. Die Young.

Response:

Hello-   your dose of flovent is VERY SMALL. I doubt it would cause those problems. Most of us complaining/talking about it are on 220, at least twice a day, sometimes four. Remember to use a spacer and rinse/garble your mouth out well after you take it, it can never hurt. -jenny I am on Flovent 44 three puffs twice a day.  I am having terrible cramping as of late.  I used to be on Serevent that I know also caused cramping, and have since went off of it because of side effects.  Now I am wondering if the inhaled steroids are causing this and if it is the particular brand I am on (Flovent) or if there is another type that doesn’t cause so much of this cramping. I am on Potassium, cacium, and magnesium supplements.  I am wondering if I should switch, go off of the steroid, or what to do. I am also wondering if anyone else has noticed mood swings while on inhaled steriods.  I noticed these symptoms increase after increasing from two puffs to three puffs twice a day.  Any ideas will be appreciated.  Lisa N

Jennifer Gerbi                          http://www.students.uiuc.edu/~gerbi Univ. of Illinois at Urbana-Champaign   1-113 ESB             (217)244-0332

Response:

Yes I have noticed muscle weakness!!  I am going back to 2 puffs of Flovent, and like I said, I have cut out Serevent. I have just added Intal also, which I hope will help.  My doctor does the same thing, but enough people here have written about all these side effects to prove to me it is the medicine. I have NEVER had cramps and muscle weakness in my life, I am 32 and healthy otherwise.  And I have had all the strange symptoms for the past 8 months, the exact amount of time I was put on all these asthma drugs. So that is my proof.  I am hoping to get some good results from the Intal so I can reduce the Flovent and maybe get off of it all together.  So you aren’t alone, your symptoms go along with my theory anyway. Lisa – Hide quoted text — Show quoted text – Lisa, I was increased from 2 to 3 puffs twice daily of Flovent 44 about 3 months ago.  Although I haven’t noticed increased cramping, the muscles in my lower legs and arms are very weak and feel like I’ve worked the muscles too hard (which I haven’t, unfortunately).  Actually, they feel sort of like "spaghetti" at times.  I have also gained about 10 pounds since the increase.  What a drag!  Have you experienced any muscle weakness?  My doctor is always reluctant to "blame" oddities on my medicine. Patrice I am on Flovent 44 three puffs twice a day.  I am having terrible cramping as of late.  I used to be on Serevent that I know also caused cramping, and have since went off of it because of side effects.  Now I am wondering if the inhaled steroids are causing this and if it is the particular brand I am on (Flovent) or if there is another type that doesn’t cause so much of this cramping. I am on Potassium, cacium, and magnesium supplements.  I am wondering if I should switch, go off of the steroid, or what to do. I am also wondering if anyone else has noticed mood swings while on inhaled steriods.  I noticed these symptoms increase after increasing from two puffs to three puffs twice a day.  Any ideas will be appreciated.  Lisa N

Response:

It seems like all the doctors are the same way with where they put the blame. As far as they see it, the meds don’t have any bad effects. My doctor is that way. But even though he thinks that way, I got my second VERY BAD cramp in my calf last night while I was sleeping. This is the second one since I started Flovent and Serevent. (And I have only had one other leg cramp in my life 5 years ago) Something has to give. Shannon

– Hide quoted text — Show quoted text – Lisa, I was increased from 2 to 3 puffs twice daily of Flovent 44 about 3 months ago.  Although I haven’t noticed increased cramping, the muscles in my lower legs and arms are very weak and feel like I’ve worked the muscles too hard (which I haven’t, unfortunately).  Actually, they feel sort of like "spaghetti" at times.  I have also gained about 10 pounds since the increase.  What a drag!  Have you experienced any muscle weakness?  My doctor is always reluctant to "blame" oddities on my medicine. Patrice I am on Flovent 44 three puffs twice a day.  I am having terrible cramping as of late.  I used to be on Serevent that I know also caused cramping, and have since went off of it because of side effects.  Now I am wondering if the inhaled steroids are causing this and if it is the particular brand I am on (Flovent) or if there is another type that doesn’t cause so much of this cramping. I am on Potassium, cacium, and magnesium supplements.  I am wondering if I should switch, go off of the steroid, or what to do. I am also wondering if anyone else has noticed mood swings while on inhaled steriods.  I noticed these symptoms increase after increasing from two puffs to three puffs twice a day.  Any ideas will be appreciated.  Lisa N

Response:

I am on Flovent 44 three puffs twice a day.  I am having terrible cramping as of late.  I used to be on Serevent that I know also caused cramping, and have since went off of it because of side effects.  Now I am wondering if the inhaled steroids are causing this and if it is the particular brand I am on (Flovent) or if there is another type that doesn’t cause so much of this cramping. I am on Potassium, cacium, and magnesium supplements.  I am wondering if I should switch, go off of the steroid, or what to do. I am also wondering if anyone else has noticed mood swings while on inhaled steriods.  I noticed these symptoms increase after increasing from two puffs to three puffs twice a day.  Any ideas will be appreciated.  Lisa N

Response:

Lisa, I was increased from 2 to 3 puffs twice daily of Flovent 44 about 3 months ago.  Although I haven’t noticed increased cramping, the muscles in my lower legs and arms are very weak and feel like I’ve worked the muscles too hard (which I haven’t, unfortunately).  Actually, they feel sort of like "spaghetti" at times.  I have also gained about 10 pounds since the increase.  What a drag!  Have you experienced any muscle weakness?  My doctor is always reluctant to "blame" oddities on my medicine. Patrice – Hide quoted text — Show quoted text – I am on Flovent 44 three puffs twice a day.  I am having terrible cramping as of late.  I used to be on Serevent that I know also caused cramping, and have since went off of it because of side effects.  Now I am wondering if the inhaled steroids are causing this and if it is the particular brand I am on (Flovent) or if there is another type that doesn’t cause so much of this cramping. I am on Potassium, cacium, and magnesium supplements.  I am wondering if I should switch, go off of the steroid, or what to do. I am also wondering if anyone else has noticed mood swings while on inhaled steriods.  I noticed these symptoms increase after increasing from two puffs to three puffs twice a day.  Any ideas will be appreciated.  Lisa N

Response:

Question:

 He has already been to his peditrician twice since his loss of appetite started. He sees his allergist next week for a regular scheduled appointment and I plan on talking to him about it then.  The Dilantin was prescribed by a neurologist after he had a seizure. The Singulair was prescribed by the allergist, and he knows about the Dilantin. I tell all the doctors he sees about the all the meds he is on. That includes the dentist and the eye doctor.  My reason for posting was to get different opinions from a variety of people. I have found this is often helpfull in obtaining answers. – Hide quoted text — Show quoted text -no advice is intended in this reply, I am merely providing information. QUstions like yours should definitely be referred to your sons doc .. his pediatrician as well as his allergist/pulmonologist. Appetite loss is NOT reported as a common adverse effect of anti-leukotrienes.  Diarrhea and nausea are listed just abouyt at the 3% "reportable" level.  These same side effects occur with Dilantin and are more common. Did the same doc prescribe the Dilantin and the Singulair? Dilantin is NOT on any common are path for asthma that this researcher is aware of.

Response:

I have been on SINGULAIR for the past month and have noticed no loss of appitite.  Actually I find myself more hungry–that’s probably due to the fact that I’m the the height of track season not the SINGULAIR.  I was taking ACCOLATE, but trying not to eat two hours before or two hours after taking it was a real drag.  Not only is my eating schedule a lot more flexible, but my peak flow is on averege better now that I am on SINGULAR instead of ACCOLATE.

Response:

 My 8 year old son started on Singulair about 3 weeks ago. In the middle of March he started on Dilantin. I noticed no change in his appetite until the Singulair was started. A few days after he started it he would hardly eat at all. Now he will only eat in the mornings and afternoons if I make him. He says he is just not hungry. He does eat a full meal at dinner time. But one meal a day is not good for a growing boy. At least not over a long period of time. My thoughts are it may be the Singulair. But then again maybe it is the Dilantin. His first check of Dilantin level was fine. The peditrician had tests done again today for the Dilantin plus a liver and CBC test. I’ll get those results tomorrow. I’m wondering if any others of you who have started Singulair have noticed a loss of appetite?

Loss of appetite is one of the possible listed effects of Dilantin, per the US Pharmacopeia. Perhaps he needs a lower dose of Dilantin. Here’s a link: http://www.rxlist.com/cgi/generic/phenyt.htm phenytoin sodium (Dilantin) Excerpt: "Adverse Reactions: Gastrointestinal System: Nausea, vomiting, constipation, toxic hepatitis  and liver damage." Info on Singulair ar www.singulair.com But I think the problem is the Dilantin. (I assume he is taking the child dose of Singulair). Ellis

Response:

 My 8 year old son started on Singulair about 3 weeks ago. In the middle of March he started on Dilantin. I noticed no change in his appetite until the Singulair was started. A few days after he started it he would hardly eat at all. Now he will only eat in the mornings and afternoons if I make him. He says he is just not hungry. He does eat a full meal at dinner time. But one meal a day is not good for a growing boy. At least not over a long period of time. My thoughts are it may be the Singulair. But then again maybe it is the Dilantin. His first check of Dilantin level was fine. The peditrician had tests done again today for the Dilantin plus a liver and CBC test. I’ll get those results tomorrow. I’m wondering if any others of you who have started Singulair have noticed a loss of appetite?  Sorry this is kind of rambling but I wanted to get it out and I’m listening to my son talk well I type. We are discussing what we are going to do for Cub Scouts tonight.  Thanks

Response:

Question:

Thanks… Right now, I am doing quite well handling my depression / not having depression.  I have surounded myself with as many supportive people as possible, and I am doing everything I can to deal with issues cognitivly… However, If I dont get this pain a little better under controal, I am afarid that I might slip into a state of depression, which I of course would perfer not to, as I have worked so hard to get out of it…. jamie

– Hide quoted text — Show quoted text – As Mel has mentioned, Jamie, and Gabe indicates here, the advice we give you and others is from our own experiences and different meds affect people in different ways. In my experience, Buspar was a no-winner for anxiety!  I have been on Doxepin (a TCA) for years, and it works better than anything else I have taken for anxiety.  In fact, that was what it was first prescribed for: anxiety and an aid for sleep.  Some of the older TCAs are better than some of the newer meds, in my own opinion, and certainly cheaper.  For me, an exception would be Elavil, which my Rheumy had me on just to see how I would do on that vs. Doxepin.  After a couple months, I was back to Doxepin, so that is my med of choice. I must add that I have Clinical Depression, so your experience may be different, but anxiety goes hand in hand with depression, of which I’m well aware!  So, the 2 antidepressants that I take are Paxil during the day and Doxepin in late afternoon/evening/bedtime.  Both work well for me.  Nanny Hey, I’m a bit confused about what you are on but I’ve had a lot of experience with TCAs. First of all, ditch Elavil (amitryptilene). It is the king of side effects, a dinosaur. Nortryp really is a toss-up. It has helped a lot of people and it is marked for pain relief. It hits NE with a negligible effect on serotonin. It’s pretty good for anxiety. My experience is — and I’ve seen this echoed in the anxiety group — if you are having anxiety don’t be afraid of the TCAs. Nortryp is prob the best and most balanced. As for going off Effexor it’s tough to tell. I can tell you that wellbutrin in prob 90 percent of people worsens anxiety. Effexor withdrawl is tough and long-lasting for many. So it could be the source of the anxiety if you hadn’t really had it before. I don’t know jack about Cymbalta except that it hits NE faster and at lower doses than Effexor. Supposedly. This is all anecdotal- based on some reseach- but mainly other people’s and my experiences. Finally, sometimes you really have to choose btwn depression and anxiety. Like WB for example, won’t do shit for anxiety, but may lift you into a less depressed, more anxious state. So you have to think?? There is prob no perfect solution, which is worse. I find anxiety much easier to live with honestly. There’s excersise of course, or just getting used to it. As for sexual side effects, the serotonin drugs hit that harder than the NE dopamine drugs. And buspar is a total mystery for me. Gabe

Response:

Years ago I was prescribed Zoloft for Anxiety and light OCD symptoms. Buspar was later added on top of the Zoloft for anxiety…but I can’t say it did anything.  To me, it was like taking vitamin C.  However, being many years ago, I don’t remember how large the dose was.

Response:

Hi, Matt, I was on Buspar many years ago for a short period of time for anxiety also. I also felt it didn’t do much for my anxiety level.  Then I was put on Xanax for many years and now onto Klonopin.  I prefer the Klonopin, though it isn’t as fast acting as Xanax, since it stays in the body longer.  I take 1 mg twice daily and it does help a lot. smiles, Elise

– Hide quoted text — Show quoted text – Years ago I was prescribed Zoloft for Anxiety and light OCD symptoms. Buspar was later added on top of the Zoloft for anxiety…but I can’t say it did anything.  To me, it was like taking vitamin C.  However, being many years ago, I don’t remember how large the dose was.

Response:

Research has shown in a couple of studies that high doses of buspar can actually recruit anxiety, whereas the lower doses did not.  I find that the people who are on less than (or equal to) 30 mgs a day seem happiest with it.

I certinally can use it at lower doses.  Then if I find it doesnt do anything then I can drop it…  I think that makes sence, because getting up to 30mg a day should not take too long to get used to… Thanks Jamie

Response:

Actually for some people, the stimulant meds DO have anxiolytic effect, so it’s really not fair to say that they "don’t do shit" for anxiety.  That is true for "most people", but for some, stimulants are calming, which is almost diagnostic for ADD. G

– Hide quoted text — Show quoted text – HI, I am off of Effexor now, with my doctors permission.  Only thing I have really noticed in that my Anxeity is up a little bit, and I cant decide if this is: a. a withdrawl symptom from effexor b. effexor was doing a little more to help with my anxeity than I thought…. but anyway, I am feeling pretty decent, and really not too depressed,,, I guess a little stressed, but not to depressed at all…  The initial plan I made with my doctor was to start wellbutrin 150XL and buspar now.  Since I made that plan, I have seen the rheumy, who wants me to try, nortriptline or Amitriptyline, and after discussing this with several of you, it sounds like this is worth a try… Here is where I am stuck…  I don’t want to take more meds than I have to… I know I can always dc them later, but,,, I am wondering if I should start WB and buspar if I know I am going to start a TCA? The question I have that I dont really know the answer to at all is this, Can WB and buspar help reduce the side effects of a TCA the way they can help reduce the side effects of a SSRI?  Would it be reasonalbe to try WB, buspar and a TCA all together and see what happends, and reduce if necessary? I really really really want to avoid the majority of sexual side effects if I can, as I am quite sure I will be depressed from that if I have major sexular side effects…  I know there will be a transition period where I have to take time to get used to the tca, but I cant live on a ongoing basis (espically long term, as using the tca for fibro could be a life long type of thing) with major sexual disfunction…… One last question is this, Is it worth thinking about trying cymbalta first before the TCA, or not since I have already tried effexor?  I know larry commented on this and said that the TCA’s can be quite different from effexor, but does the same hold true for cymbalta, I am guessing it does since they are in the same class (effexor and cymbalta = ssnri)  but I have heard thatt cymbalta is a lot better with pain and such from some people…..  Any thoughs on this?  Sorry to make this so confusing…. Thanks again for your time, and your comments on this…. Jamie

Response:

Gabe’s statement about Cymbalta is correct, however the mechanism by which it has impact on pains (neuropathic) is different than the TCA group, and it’s a little harder to tolerate initially than Effexor.  I would like to hear what the definition of the pains / symptoms are, prior to commenting on this much more.

My pain has been wide spread, in most all of my muscles, but much more severe is some than others.  My legs, often ache, even with rest, then they can progress to sharp pain with exersize.  My hands, arms sholders are in pain with a minumal amount of movement.  Also have neck and back pain, which doesnt usally stay as bad because the chiro treats that… Well it would be WB, buspar, and one of the TCA’s…  Plus tricor, and a painkiller like ultram (but ultram is not working well now), and hopefull with the pain more undercontroal, I will be less fatigured and we can reduce / drop dexidrine.  There is also inderal for migranes, that has helped sooo much that I dont really see droping that… jamie – Hide quoted text — Show quoted text – I do not agree that one has to choose betw. being depressed or being anxious, nor does the medical community at large. From a strictly statistical standpoint, anxiety is indeed "easier to live with", given the mortality rates of depression, however, again, see above. Buspar has little, if any effect on sexual function, but it also takes a fair amount of time for it to start working – it’s a "partial serotonin agonist", and takes usually 4 to 6 weeks to really start working well – not going to cover that wellbutrin awfully well.  Honestly, I’m not so sure I really like this plan Jamie.  What is the total med list going to be? Gary Hey, I’m a bit confused about what you are on but I’ve had a lot of experience with TCAs. First of all, ditch Elavil (amitryptilene). It is the king of side effects, a dinosaur. Nortryp really is a toss-up. It has helped a lot of people and it is marked for pain relief. It hits NE with a negligible effect on serotonin. It’s pretty good for anxiety. My experience is — and I’ve seen this echoed in the anxiety group — if you are having anxiety don’t be afraid of the TCAs. Nortryp is prob the best and most balanced. As for going off Effexor it’s tough to tell. I can tell you that wellbutrin in prob 90 percent of people worsens anxiety. Effexor withdrawl is tough and long-lasting for many. So it could be the source of the anxiety if you hadn’t really had it before. I don’t know jack about Cymbalta except that it hits NE faster and at lower doses than Effexor. Supposedly. This is all anecdotal- based on some reseach- but mainly other people’s and my experiences. Finally, sometimes you really have to choose btwn depression and anxiety. Like WB for example, won’t do shit for anxiety, but may lift you into a less depressed, more anxious state. So you have to think?? There is prob no perfect solution, which is worse. I find anxiety much easier to live with honestly. There’s excersise of course, or just getting used to it. As for sexual side effects, the serotonin drugs hit that harder than the NE dopamine drugs. And buspar is a total mystery for me. Gabe

Response:

Atleast anxeity responds very quickly to benzos…. I have not heard of WB causing any weight gain… Wonder if the buspar is causing that?? Jamie

– Hide quoted text — Show quoted text – Crossposted reply: Gabe is correct about wellbutrin and anxiety for sure.  I personally would not want to start that if I was coming off Effexor, but you and your MD Elavil and Pamelor both do the same thing in terms of pain relief, so it’s really a matter of side effect toleration, and yes, Elavil causes more. Usually the starting dose is around 10 mgs of Elavil for sodium channel blockade/NMDA antagonism for chronic pain mgmt. Gabe’s statement about Cymbalta is correct, however the mechanism by which it has impact on pains (neuropathic) is different than the TCA group, and it’s a little harder to tolerate initially than Effexor.  I would like to hear what the definition of the pains / symptoms are, prior to commenting on this much more. I do not agree that one has to choose betw. being depressed or being anxious, nor does the medical community at large. From a strictly statistical standpoint, anxiety is indeed "easier to live with", given the mortality rates of depression, however, again, see above. Buspar has little, if any effect on sexual function, but it also takes a fair amount of time for it to start working – it’s a "partial serotonin agonist", and takes usually 4 to 6 weeks to really start working well – not going to cover that wellbutrin awfully well.  Honestly, I’m not so sure I really like this plan Jamie.  What is the total med list going to be? Gary I’ll add that from what happened to me and others is that Wellbutrin and Buspar. WILL MAKE YOU FAT!  Now that is depressing! And I agree with Gary that Anxiety is easier to control than depression. (IMHO) SnL Hey, I’m a bit confused about what you are on but I’ve had a lot of experience with TCAs. First of all, ditch Elavil (amitryptilene). It is the king of side effects, a dinosaur. Nortryp really is a toss-up. It has helped a lot of people and it is marked for pain relief. It hits NE with a negligible effect on serotonin. It’s pretty good for anxiety. My experience is — and I’ve seen this echoed in the anxiety group — if you are having anxiety don’t be afraid of the TCAs. Nortryp is prob the best and most balanced. As for going off Effexor it’s tough to tell. I can tell you that wellbutrin in prob 90 percent of people worsens anxiety. Effexor withdrawl is tough and long-lasting for many. So it could be the source of the anxiety if you hadn’t really had it before. I don’t know jack about Cymbalta except that it hits NE faster and at lower doses than Effexor. Supposedly. This is all anecdotal- based on some reseach- but mainly other people’s and my experiences. Finally, sometimes you really have to choose btwn depression and anxiety. Like WB for example, won’t do shit for anxiety, but may lift you into a less depressed, more anxious state. So you have to think?? There is prob no perfect solution, which is worse. I find anxiety much easier to live with honestly. There’s excersise of course, or just getting used to it. As for sexual side effects, the serotonin drugs hit that harder than the NE dopamine drugs. And buspar is a total mystery for me. Gabe

Response:

As Mel has mentioned, Jamie, and Gabe indicates here, the advice we give you and others is from our own experiences and different meds affect people in different ways. In my experience, Buspar was a no-winner for anxiety!  I have been on Doxepin (a TCA) for years, and it works better than anything else I have taken for anxiety.  In fact, that was what it was first prescribed for: anxiety and an aid for sleep.  Some of the older TCAs are better than some of the newer meds, in my own opinion, and certainly cheaper.  For me, an exception would be Elavil, which my Rheumy had me on just to see how I would do on that vs. Doxepin.  After a couple months, I was back to Doxepin, so that is my med of choice. I must add that I have Clinical Depression, so your experience may be different, but anxiety goes hand in hand with depression, of which I’m well aware!  So, the 2 antidepressants that I take are Paxil during the day and Doxepin in late afternoon/evening/bedtime.  Both work well for me.  Nanny

– Hide quoted text — Show quoted text – Hey, I’m a bit confused about what you are on but I’ve had a lot of experience with TCAs. First of all, ditch Elavil (amitryptilene). It is the king of side effects, a dinosaur. Nortryp really is a toss-up. It has helped a lot of people and it is marked for pain relief. It hits NE with a negligible effect on serotonin. It’s pretty good for anxiety. My experience is — and I’ve seen this echoed in the anxiety group — if you are having anxiety don’t be afraid of the TCAs. Nortryp is prob the best and most balanced. As for going off Effexor it’s tough to tell. I can tell you that wellbutrin in prob 90 percent of people worsens anxiety. Effexor withdrawl is tough and long-lasting for many. So it could be the source of the anxiety if you hadn’t really had it before. I don’t know jack about Cymbalta except that it hits NE faster and at lower doses than Effexor. Supposedly. This is all anecdotal- based on some reseach- but mainly other people’s and my experiences. Finally, sometimes you really have to choose btwn depression and anxiety. Like WB for example, won’t do shit for anxiety, but may lift you into a less depressed, more anxious state. So you have to think?? There is prob no perfect solution, which is worse. I find anxiety much easier to live with honestly. There’s excersise of course, or just getting used to it. As for sexual side effects, the serotonin drugs hit that harder than the NE dopamine drugs. And buspar is a total mystery for me. Gabe

Response:

No, buspar is weight neutral.  As a partial agonist, it functions as a sort of "dimmer switch" (like you might find in a dining room for the light fixture).  If you don’t have enough serotonin, it will boost it up some, and if you have too much it will dampen the serotonin down.  It has limitations on how high or low it can change the levels though, and is really not a particularly great medicine (for a lot of people – maybe not you though…) for anxiety control.  Psychiatrists tell me that it yields particularly poor results in patients who have previously taken benzodiazepines for anxiety. The most common side-effects that people tell me they get from taking it – a disconcerting feeling of dizziness, some nausea, inability to tolerate loud or sharp sounds (all these usually go away in about a month or so) and almost everyone tells me that this drug causes them vivid dreams, often frightening and very colorful and/or violent.  I have never had a single person tell me that this drug caused them to gain weight – there may be people who have though, I just haven’t met them.  Prescribing literature describes weight gain as "infrequent", which means it happens more often than if it was cited as "rare".  The dizziness is BY FAR the thing that is most bitterly complained about, and almost virtually universal. Research has shown in a couple of studies that high doses of buspar can actually recruit anxiety, whereas the lower doses did not.  I find that the people who are on less than (or equal to) 30 mgs a day seem happiest with it. Gary

– Hide quoted text — Show quoted text – Atleast anxeity responds very quickly to benzos…. I have not heard of WB causing any weight gain… Wonder if the buspar is causing that?? Jamie Crossposted reply: Gabe is correct about wellbutrin and anxiety for sure.  I personally would not want to start that if I was coming off Effexor, but you and your MD Elavil and Pamelor both do the same thing in terms of pain relief, so it’s really a matter of side effect toleration, and yes, Elavil causes more. Usually the starting dose is around 10 mgs of Elavil for sodium channel blockade/NMDA antagonism for chronic pain mgmt. Gabe’s statement about Cymbalta is correct, however the mechanism by which it has impact on pains (neuropathic) is different than the TCA group, and it’s a little harder to tolerate initially than Effexor.  I would like to hear what the definition of the pains / symptoms are, prior to commenting on this much more. I do not agree that one has to choose betw. being depressed or being anxious, nor does the medical community at large. From a strictly statistical standpoint, anxiety is indeed "easier to live with", given the mortality rates of depression, however, again, see above. Buspar has little, if any effect on sexual function, but it also takes a fair amount of time for it to start working – it’s a "partial serotonin agonist", and takes usually 4 to 6 weeks to really start working well – not going to cover that wellbutrin awfully well.  Honestly, I’m not so sure I really like this plan Jamie.  What is the total med list going to be? Gary I’ll add that from what happened to me and others is that Wellbutrin and Buspar. WILL MAKE YOU FAT!  Now that is depressing! And I agree with Gary that Anxiety is easier to control than depression. (IMHO) SnL Hey, I’m a bit confused about what you are on but I’ve had a lot of experience with TCAs. First of all, ditch Elavil (amitryptilene). It is the king of side effects, a dinosaur. Nortryp really is a toss-up. It has helped a lot of people and it is marked for pain relief. It hits NE with a negligible effect on serotonin. It’s pretty good for anxiety. My experience is — and I’ve seen this echoed in the anxiety group — if you are having anxiety don’t be afraid of the TCAs. Nortryp is prob the best and most balanced. As for going off Effexor it’s tough to tell. I can tell you that wellbutrin in prob 90 percent of people worsens anxiety. Effexor withdrawl is tough and long-lasting for many. So it could be the source of the anxiety if you hadn’t really had it before. I don’t know jack about Cymbalta except that it hits NE faster and at lower doses than Effexor. Supposedly. This is all anecdotal- based on some reseach- but mainly other people’s and my experiences. Finally, sometimes you really have to choose btwn depression and anxiety. Like WB for example, won’t do shit for anxiety, but may lift you into a less depressed, more anxious state. So you have to think?? There is prob no perfect solution, which is worse. I find anxiety much easier to live with honestly. There’s excersise of course, or just getting used to it. As for sexual side effects, the serotonin drugs hit that harder than the NE dopamine drugs. And buspar is a total mystery for me. Gabe

Response:

I am not sure they are quite calming, but they normally dont make my anxeity freak out like I would have though they would.  The pschylogists have always diagnosised me with ADD and GAD, so maybe I am getting a patial benefit from the stimulant in terms of anxeity, or atleast that might explain why it doesnt make it much worse… jamie

– Hide quoted text — Show quoted text – Actually for some people, the stimulant meds DO have anxiolytic effect, so it’s really not fair to say that they "don’t do shit" for anxiety.  That is true for "most people", but for some, stimulants are calming, which is almost diagnostic for ADD. G HI, I am off of Effexor now, with my doctors permission.  Only thing I have really noticed in that my Anxeity is up a little bit, and I cant decide if this is: a. a withdrawl symptom from effexor b. effexor was doing a little more to help with my anxeity than I thought…. but anyway, I am feeling pretty decent, and really not too depressed,,, I guess a little stressed, but not to depressed at all…  The initial plan I made with my doctor was to start wellbutrin 150XL and buspar now.  Since I made that plan, I have seen the rheumy, who wants me to try, nortriptline or Amitriptyline, and after discussing this with several of you, it sounds like this is worth a try… Here is where I am stuck…  I don’t want to take more meds than I have to… I know I can always dc them later, but,,, I am wondering if I should start WB and buspar if I know I am going to start a TCA? The question I have that I dont really know the answer to at all is this, Can WB and buspar help reduce the side effects of a TCA the way they can help reduce the side effects of a SSRI?  Would it be reasonalbe to try WB, buspar and a TCA all together and see what happends, and reduce if necessary? I really really really want to avoid the majority of sexual side effects if I can, as I am quite sure I will be depressed from that if I have major sexular side effects…  I know there will be a transition period where I have to take time to get used to the tca, but I cant live on a ongoing basis (espically long term, as using the tca for fibro could be a life long type of thing) with major sexual disfunction…… One last question is this, Is it worth thinking about trying cymbalta first before the TCA, or not since I have already tried effexor?  I know larry commented on this and said that the TCA’s can be quite different from effexor, but does the same hold true for cymbalta, I am guessing it does since they are in the same class (effexor and cymbalta = ssnri)  but I have heard thatt cymbalta is a lot better with pain and such from some people…..  Any thoughs on this?  Sorry to make this so confusing…. Thanks again for your time, and your comments on this…. Jamie

Response:

HI, I am off of Effexor now, with my doctors permission.  Only thing I have really noticed in that my Anxeity is up a little bit, and I cant decide if this is: a. a withdrawl symptom from effexor b. effexor was doing a little more to help with my anxeity than I thought…. but anyway, I am feeling pretty decent, and really not too depressed,,, I guess a little stressed, but not to depressed at all…  The initial plan I made with my doctor was to start wellbutrin 150XL and buspar now.  Since I made that plan, I have seen the rheumy, who wants me to try, nortriptline or Amitriptyline, and after discussing this with several of you, it sounds like this is worth a try… Here is where I am stuck…  I don’t want to take more meds than I have to… I know I can always dc them later, but,,, I am wondering if I should start WB and buspar if I know I am going to start a TCA? The question I have that I dont really know the answer to at all is this, Can WB and buspar help reduce the side effects of a TCA the way they can help reduce the side effects of a SSRI?  Would it be reasonalbe to try WB, buspar and a TCA all together and see what happends, and reduce if necessary? I really really really want to avoid the majority of sexual side effects if I can, as I am quite sure I will be depressed from that if I have major sexular side effects…  I know there will be a transition period where I have to take time to get used to the tca, but I cant live on a ongoing basis (espically long term, as using the tca for fibro could be a life long type of thing) with major sexual disfunction…… One last question is this, Is it worth thinking about trying cymbalta first before the TCA, or not since I have already tried effexor?  I know larry commented on this and said that the TCA’s can be quite different from effexor, but does the same hold true for cymbalta, I am guessing it does since they are in the same class (effexor and cymbalta = ssnri)  but I have heard thatt cymbalta is a lot better with pain and such from some people…..  Any thoughs on this?  Sorry to make this so confusing…. Thanks again for your time, and your comments on this…. Jamie

Response:

– Hide quoted text — Show quoted text – HI, I am off of Effexor now, with my doctors permission.  Only thing I have really noticed in that my Anxeity is up a little bit, and I cant decide if this is: a. a withdrawl symptom from effexor b. effexor was doing a little more to help with my anxeity than I thought…. but anyway, I am feeling pretty decent, and really not too depressed,,, I guess a little stressed, but not to depressed at all…  The initial plan I made with my doctor was to start wellbutrin 150XL and buspar now. Since I made that plan, I have seen the rheumy, who wants me to try, nortriptline or Amitriptyline, and after discussing this with several of you, it sounds like this is worth a try… Here is where I am stuck…  I don’t want to take more meds than I have to… I know I can always dc them later, but,,, I am wondering if I should start WB and buspar if I know I am going to start a TCA? The question I have that I dont really know the answer to at all is this, Can WB and buspar help reduce the side effects of a TCA the way they can help reduce the side effects of a SSRI?

Just a guess: Probably, except that the TCA is likely to have more unpleasant side effects than the SSRI. Would it be reasonalbe to try WB, buspar and a TCA all together and see what happends, and reduce if necessary?

As much sense as it would to take an SSRI with the others and tailer the others. – Hide quoted text — Show quoted text – I really really really want to avoid the majority of sexual side effects if I can, as I am quite sure I will be depressed from that if I have major sexular side effects…  I know there will be a transition period where I have to take time to get used to the tca, but I cant live on a ongoing basis (espically long term, as using the tca for fibro could be a life long type of thing) with major sexual disfunction…… One last question is this, Is it worth thinking about trying cymbalta first before the TCA, or not since I have already tried effexor?  I know larry commented on this and said that the TCA’s can be quite different from effexor, but does the same hold true for cymbalta, I am guessing it does since they are in the same class (effexor and cymbalta = ssnri)  but I have heard thatt cymbalta is a lot better with pain and such from some people…..  Any thoughs on this?  Sorry to make this so confusing…. Thanks again for your time, and your comments on this…. Jamie

– Nom dePlume, Ph.D. Why, yes, in fact, I am a rocket scientist. Guide to Medications for Mental Illness: http://www.geocities.com/nomdeplume1000/ =====

Response:

Hey, I’m a bit confused about what you are on but I’ve had a lot of experience with TCAs. First of all, ditch Elavil (amitryptilene). It is the king of side effects, a dinosaur. Nortryp really is a toss-up. It has helped a lot of people and it is marked for pain relief. It hits NE with a negligible effect on serotonin. It’s pretty good for anxiety. My experience is — and I’ve seen this echoed in the anxiety group — if you are having anxiety don’t be afraid of the TCAs. Nortryp is prob the best and most balanced. As for going off Effexor it’s tough to tell. I can tell you that wellbutrin in prob 90 percent of people worsens anxiety. Effexor withdrawl is tough and long-lasting for many. So it could be the source of the anxiety if you hadn’t really had it before. I don’t know jack about Cymbalta except that it hits NE faster and at lower doses than Effexor. Supposedly. This is all anecdotal- based on some reseach- but mainly other people’s and my experiences. Finally, sometimes you really have to choose btwn depression and anxiety. Like WB for example, won’t do shit for anxiety, but may lift you into a less depressed, more anxious state. So you have to think?? There is prob no perfect solution, which is worse. I find anxiety much easier to live with honestly. There’s excersise of course, or just getting used to it. As for sexual side effects, the serotonin drugs hit that harder than the NE dopamine drugs. And buspar is a total mystery for me. Gabe

Response:

Gabe is correct about wellbutrin and anxiety for sure.  I personally would not want to start that if I was coming off Effexor, but you and your MD must Elavil and Pamelor both do the same thing in terms of pain relief, so it’s really a matter of side effect toleration, and yes, Elavil causes more. Usually the starting dose is around 10 mgs of Elavil for sodium channel blockade/NMDA antagonism for chronic pain mgmt. Gabe’s statement about Cymbalta is correct, however the mechanism by which it has impact on pains (neuropathic) is different than the TCA group, and it’s a little harder to tolerate initially than Effexor.  I would like to hear what the definition of the pains / symptoms are, prior to commenting on this much more. I do not agree that one has to choose betw. being depressed or being anxious, nor does the medical community at large. From a strictly statistical standpoint, anxiety is indeed "easier to live with", given the mortality rates of depression, however, again, see above. Buspar has little, if any effect on sexual function, but it also takes a fair amount of time for it to start working – it’s a "partial serotonin agonist", and takes usually 4 to 6 weeks to really start working well – not going to cover that wellbutrin awfully well.  Honestly, I’m not so sure I really like this plan Jamie.  What is the total med list going to be? Gary

– Hide quoted text — Show quoted text – Hey, I’m a bit confused about what you are on but I’ve had a lot of experience with TCAs. First of all, ditch Elavil (amitryptilene). It is the king of side effects, a dinosaur. Nortryp really is a toss-up. It has helped a lot of people and it is marked for pain relief. It hits NE with a negligible effect on serotonin. It’s pretty good for anxiety. My experience is — and I’ve seen this echoed in the anxiety group — if you are having anxiety don’t be afraid of the TCAs. Nortryp is prob the best and most balanced. As for going off Effexor it’s tough to tell. I can tell you that wellbutrin in prob 90 percent of people worsens anxiety. Effexor withdrawl is tough and long-lasting for many. So it could be the source of the anxiety if you hadn’t really had it before. I don’t know jack about Cymbalta except that it hits NE faster and at lower doses than Effexor. Supposedly. This is all anecdotal- based on some reseach- but mainly other people’s and my experiences. Finally, sometimes you really have to choose btwn depression and anxiety. Like WB for example, won’t do shit for anxiety, but may lift you into a less depressed, more anxious state. So you have to think?? There is prob no perfect solution, which is worse. I find anxiety much easier to live with honestly. There’s excersise of course, or just getting used to it. As for sexual side effects, the serotonin drugs hit that harder than the NE dopamine drugs. And buspar is a total mystery for me. Gabe

Response:

Crossposted reply:

– Hide quoted text — Show quoted text – Gabe is correct about wellbutrin and anxiety for sure.  I personally would not want to start that if I was coming off Effexor, but you and your MD Elavil and Pamelor both do the same thing in terms of pain relief, so it’s really a matter of side effect toleration, and yes, Elavil causes more. Usually the starting dose is around 10 mgs of Elavil for sodium channel blockade/NMDA antagonism for chronic pain mgmt. Gabe’s statement about Cymbalta is correct, however the mechanism by which it has impact on pains (neuropathic) is different than the TCA group, and it’s a little harder to tolerate initially than Effexor.  I would like to hear what the definition of the pains / symptoms are, prior to commenting on this much more. I do not agree that one has to choose betw. being depressed or being anxious, nor does the medical community at large. From a strictly statistical standpoint, anxiety is indeed "easier to live with", given the mortality rates of depression, however, again, see above. Buspar has little, if any effect on sexual function, but it also takes a fair amount of time for it to start working – it’s a "partial serotonin agonist", and takes usually 4 to 6 weeks to really start working well – not going to cover that wellbutrin awfully well.  Honestly, I’m not so sure I really like this plan Jamie.  What is the total med list going to be? Gary

I’ll add that from what happened to me and others is that Wellbutrin and Buspar. WILL MAKE YOU FAT!  Now that is depressing! And I agree with Gary that Anxiety is easier to control than depression. (IMHO) SnL – Hide quoted text — Show quoted text – Hey, I’m a bit confused about what you are on but I’ve had a lot of experience with TCAs. First of all, ditch Elavil (amitryptilene). It is the king of side effects, a dinosaur. Nortryp really is a toss-up. It has helped a lot of people and it is marked for pain relief. It hits NE with a negligible effect on serotonin. It’s pretty good for anxiety. My experience is — and I’ve seen this echoed in the anxiety group — if you are having anxiety don’t be afraid of the TCAs. Nortryp is prob the best and most balanced. As for going off Effexor it’s tough to tell. I can tell you that wellbutrin in prob 90 percent of people worsens anxiety. Effexor withdrawl is tough and long-lasting for many. So it could be the source of the anxiety if you hadn’t really had it before. I don’t know jack about Cymbalta except that it hits NE faster and at lower doses than Effexor. Supposedly. This is all anecdotal- based on some reseach- but mainly other people’s and my experiences. Finally, sometimes you really have to choose btwn depression and anxiety. Like WB for example, won’t do shit for anxiety, but may lift you into a less depressed, more anxious state. So you have to think?? There is prob no perfect solution, which is worse. I find anxiety much easier to live with honestly. There’s excersise of course, or just getting used to it. As for sexual side effects, the serotonin drugs hit that harder than the NE dopamine drugs. And buspar is a total mystery for me. Gabe

Response:

Question:

I watched the Primetime report on Paxil. We all know what sensationalist, alarmist crap many of these media reports are, but here’s what I DID get from the report: 1. I suspect, because it was claimed outright, that the makers of antidepressant drugs haven’t much of a clue how they work. The main evidence claimed was that the drug increases brain weight, so it MUST be getting to the brain. [So does a bullet.] 2. 20-40% of patients on Paxil have significant withdrawal symptoms. Over 100 adolescents committed suicide because of it. These numbers were in internal documents but denied to the public because they were "not statistically significant". . 3. Its main target in many adolescents is headaches . . . yet look at the nature of depression and consider the range of effects any drug must have to fight that many symptoms. SURELY any drug that does THAT many things to our MINDS has a strong potential to be much worse than the hot flashes it’s intended to mitigate in HT patients. 4. Some patients require "months" of agony to withdraw from Paxil. Guess what? IAD resumes in "months". The biggest message I came away with? I’m going to do a lot of reading before I even consider an antidepressant drug. And since the only "cure" I’ ve read about yet for hot flashes is antidepressants, and the "cure" is just a 50% reduction, and hot flashes are virtually guaranteed, I’m going to complete that reading before choosing HT. Now multiply that scenario by the number of SEs of HT, and realize that the fix for many of those SEs is another drug . . . with its own SEs, and that no drug company WILLINGLY admits to SEs. I.P. – Hide quoted text — Show quoted text – I was just watching GMA whereby they discussed Paxil and how the withdrawal symptoms have been greatly downplayed.  The side effects can vary from headaches to debilitating electrical shock sensations. Apparently the company producing the drug have this repressed data from their own studies although they state that they have made the physicians aware.  They will be presenting this story tonight on Primetime for those interested.

Response:

I was just watching GMA whereby they discussed Paxil and how the withdrawal symptoms have been greatly downplayed.  The side effects can vary from headaches to debilitating electrical shock sensations. Apparently the company producing the drug have this repressed data from their own studies although they state that they have made the physicians aware.  They will be presenting this story tonight on Primetime for those interested. Sandi

Paxil is about the worst to get off because it has a very short half-life. http://www.citypages.com/databank/23/1141/article10788.asp the 2nd page addresses the half-life issues. HTH Lori

Response:

conviction: Now THAT would worry my wife. I’m irritable enough as it is; is Clarence — and will I become — grouchy because of ADT? Or has ADT made Clarence more pleasant than he was pre-PC by suppressing his emotions? I.P.

When I was a kid, I put my hand on the stove. It was HOT! I’m that sort of person who lives outside the edge. As for being pleasant at any time, my wife has called me "Grumpy" for as long as I can remember. Point is, I’m trying to get in a few days work every week to maintain my "Millionaire" status, branded on me by CentreLink, (our learned Welfare Organisation), 4 yrs ago after I’d been ratting trash cans for sustenance for 3 months due to a slight economic downturn. Believe me, if you get on ADT, you can kiss it all goodbye. I’m starting to feel I’ll end up like Jack Nicholson in "One Flew Over The Cuckoo’s Nest". Androcur Tabs 50mg/day plus a shot of Lucrin quarterly. and revert to the ADT for another 12 months. What a blast!! — "if you can see it coming, head it off at the pass, else put the wagons in a circle" — Please reply to this ng as: — my email adress is 100% faked to prevent proliferation of SPAM!! — Regards — Clarence Crow

Response:

I.P. wrote The real message of my personal dilemma for others in this forum is this: PC and its treatment are EXTREMELY complicated stuff . . . far more so than any doctor has time to explain thoroughly. Read. And read. And read. Those two points are possibly the most important of any when dealing with this bastard.

Oh . . . you mean the CANCER. I.P.

Response:

The real message of my personal dilemma for others in this forum is this: PC and its treatment are EXTREMELY complicated stuff . . . far more so than any doctor has time to explain thoroughly. Read. And read. And read.

Those two points are possibly the most important of any when dealing with this bastard. — Prostate Cancer Survivor (so far), not a doctor Biopsy 11/01/2000 G7 (3+4), T2c RRP 12/15/2000 G7 (3+4), T3bN0M0 PSA  .1  .1  .1  .27  .37  .75 PSA  .34 .22 .15 .21 .32 PSA  .07 .05 .06 Lupron (3 mo) 8/03 (48), 12/03, 4/04 (49), 09/04 (50) non Illegitimi carborundum

Response:

Now THAT would worry my wife. I’m irritable enough as it is; is Clarence — and will I become — grouchy because of ADT? Or has ADT made Clarence more pleasant than he was pre-PC by suppressing his emotions? I.P.

– Hide quoted text — Show quoted text – And a hearty ‘Good Morning’ to you too, Clarence. — Prostate Cancer Survivor (so far), not a doctor Biopsy 11/01/2000 G7 (3+4), T2c RRP 12/15/2000 G7 (3+4), T3bN0M0 PSA  .1  .1  .1  .27  .37  .75 PSA  .34 .22 .15 .21 .32 PSA  .07 .05 .06 Lupron (3 mo) 8/03 (48), 12/03, 4/04 (49), 09/04 (50) non Illegitimi carborundum up off the mat and advised with conviction: Antidepressant treats hot flashes in men taking hormonal therapy for prostate cancer, Mayo study finds Paxil (paroxetine) diminishes hot flashes in men who are receiving hormone therapy for prostate cancer. <snip BLAH, BLAH, BLAH, BLAH!! There’s just too many REAMS of doubtful INFORMATION being posted here!! Listen up, all you pussies, I’m a grouchy old buzzard currently on ADT Hormones  prior to RAD.

Response:

Hi All Men don’t have hot flashes, they have power surges!! Jamie

Response:

Hi Sandi…. I know all about the withdrawal symptoms of these SSRI drugs simply because my daughter and my sister suffer from seratonin deficiency and are on them. One on Welbutrin (Zyban) and the other on Effexor. Our ditz of a family doctor told my daughter to just cut them out in two days.  She couldn’t get off the couch due to dizzy spells and nausea!!  I phoned the pharmacy and they were horrified.  Thanks to them, she cut them down VERY gradually and was OK.  It would have happened to my sister as well, had I not gone thru this with my daughter, and warned her. Who should we blame??  Doctors who do not read the literature and drug companies who do not disclose all the details.  All of these drugs are Prozac derivatives (some 30 of them, I believe) and they do have major withdrawal problems.  Paxil has been found to cause suicidal tendencies……which it is supposed to be eliminating. These anti-depressants are very powerful drugs, so use them as your pharmacist directs you to…..they seem to know more.  And check to see if there are any cross-medication problems as well. And thanks for the info on Primetime….I will look for it tonight. Heather

– Hide quoted text — Show quoted text – I was just watching GMA whereby they discussed Paxil and how the withdrawal symptoms have been greatly downplayed.  The side effects can vary from headaches to debilitating electrical shock sensations. Apparently the company producing the drug have this repressed data from their own studies although they state that they have made the physicians aware.  They will be presenting this story tonight on Primetime for those interested. Sandi

Response:

The effects you list, side or not, are but a very small part of the menu, and don’t address the severity some people encounter with some effects or the relative commonality of various effects. Some effects take months to show up, some take months to disappear after ADT cessation, and some can be permanent. And even the benefits of ADT are debatable, regardless of the SEs. If I become convinced I can try ADT for a month or two and realisticaly assess its impacts without being committed to long-term impacts, I’ll jump on the bandwagon. My research so far doesn’t strongly support that approach. I consider the distinction between intended effects and SEs vital because generally, intended effects address benefit and SEs address harm. If a treatment doesn’t work, SEs are irrelevant because I’m not trying it. And many trials study only the intended effect — prolonged heartbeat — without considering QOL. IMO, that renders some studies almost moot. The real message of my personal dilemma for others in this forum is this: PC and its treatment are EXTREMELY complicated stuff . . . far more so than any doctor has time to explain thoroughly. Read. And read. And read. I took several pages of typewritten questions to each of the several doctors I consulted about my PC. Every doctor was very pleased and impressed at this, and some said they wished every patient would do it. I.P.

– Hide quoted text — Show quoted text – 10. I did, and it makes me wonder . . . Do I want to spend my last years obsessed with juggling chemicals and side effects with a chemically impaired brain, or spend maybe fewer — or maybe more — years being I.P. Freely rather than a nut case? I imagine most people relatively recently diagnosed obsess of the issues of ‘life as I knew it’ vs. ‘life as it will be or may be.’ But, what you really need to concern yourself with is the effects of the drugs.  Calling some effects "intended" and the others as "side" effects is, IMHO, a distraction.  Everything you put in your body has effects.  Every place you put your body has effects.  Every position you put your body in and the duration you keep your body in that position has effects.  Every day of your life, you make decisions on thousands, if not hundreds of thousands of permutations that have effects on your body.  It is silly to consider them intended and side effects.  They are just plane effects.  You do this, and that, that and that happens.  Some effects may be positive.  They may be negative.  They may be positive now and negative later.  Or visa versa. They may be positive and negative concurrently. What you really have to do is list the effects and possible effects of ADT. They are; 1. extended life.  2. temporary impotence.  3. temporary disinterest.  They may also be; 1. permanent impotence, 2. emotional instability, 3. bone mass loss, 4. hot flashes. Then, decide if some of the effects are worth it in lieu of the others. But, with ADT, you have this great option.  Try it for 30, 60, 90 days. If you don’t like it, send it back… no questions asked.

Response:

And a hearty ‘Good Morning’ to you too, Clarence. — Prostate Cancer Survivor (so far), not a doctor Biopsy 11/01/2000 G7 (3+4), T2c RRP 12/15/2000 G7 (3+4), T3bN0M0 PSA  .1  .1  .1  .27  .37  .75 PSA  .34 .22 .15 .21 .32 PSA  .07 .05 .06 Lupron (3 mo) 8/03 (48), 12/03, 4/04 (49), 09/04 (50) non Illegitimi carborundum

– Hide quoted text — Show quoted text – up off the mat and advised with conviction: Antidepressant treats hot flashes in men taking hormonal therapy for prostate cancer, Mayo study finds Paxil (paroxetine) diminishes hot flashes in men who are receiving hormone therapy for prostate cancer. <snip BLAH, BLAH, BLAH, BLAH!! There’s just too many REAMS of doubtful INFORMATION being posted here!! Listen up, all you pussies, I’m a grouchy old buzzard currently on ADT Hormones  prior to RAD. The other day I was in a bad mood, so I downed a couple of Amitryptiline (Endep 25) and they damn near killed me. Apart from my being useless for a day and a half, all my Osteo-Arthritis pains magnified, plus a few new ones emerged. I phoned into the Rad Oncology Dept, but was only able to get a nurse, who advised me to CEASE them immediately, and see my GP about some alternative. — "if you can see it coming, head it off at the pass, else put the wagons in a circle" — Please reply to this ng as: — my email adress is 100% faked to prevent proliferation of SPAM!! — Regards — Clarence Crow

Response:

I was just watching GMA whereby they discussed Paxil and how the withdrawal symptoms have been greatly downplayed.

I wonder who is accused of downplaying the withdrawal symptoms.  My wife’s doctor was very frank about the danger of self-unmedicating with it.  To be sure, he called me to tell me, just in case my wife was in a poor state of mind if and when she decided to do it.

Response:

  Each time I’ve seen that yet another antidepressant fixes hot flashes, several thoughts spring to mind: 1. Depression is serious stuff, and antidepressants are serious meds, so any problem requiring antidepressants must be pretty serious.

  (snip) IP is worried about very little. Maybe he should pop a pill The dosage of antidepressant that is required for hot flash control is far less than the therapeutic dosage for depression. Frex, I was prescribed Effexor, an antidepressant, to control the hot flashes caused by Zoladex. The prescription called for a beginning dosage of just 37.5mg. Something similar exists with Proscar, which is used to treat BPH and PCa, and Propecia, which is used to treat male-pattern baldness. Both are finasteride, but the Propecia dosage is far less than Proscar. As it happens, as I reported elsewhere in the NG, I recently switched from Zoladex to Lupron and have far fewer and milder hot flashes so I elected not to proceed with the Effexor. A SE of that decision is that I have saved mucho dinero; Effexor is expensive. Regards, Steve J

Response:

10. I did, and it makes me wonder . . . Do I want to spend my last years obsessed with juggling chemicals and side effects with a chemically impaired brain, or spend maybe fewer — or maybe more — years being I.P. Freely rather than a nut case?

I imagine most people relatively recently diagnosed obsess of the issues of ‘life as I knew it’ vs. ‘life as it will be or may be.’ But, what you really need to concern yourself with is the effects of the drugs.  Calling some effects "intended" and the others as "side" effects is, IMHO, a distraction.  Everything you put in your body has effects.  Every place you put your body has effects.  Every position you put your body in and the duration you keep your body in that position has effects.  Every day of your life, you make decisions on thousands, if not hundreds of thousands of permutations that have effects on your body.  It is silly to consider them intended and side effects.  They are just plane effects.  You do this, and that, that and that happens.  Some effects may be positive.  They may be negative.  They may be positive now and negative later.  Or visa versa. They may be positive and negative concurrently. What you really have to do is list the effects and possible effects of ADT. They are; 1. extended life.  2. temporary impotence.  3. temporary disinterest.  They may also be; 1. permanent impotence, 2. emotional instability, 3. bone mass loss, 4. hot flashes. Then, decide if some of the effects are worth it in lieu of the others. But, with ADT, you have this great option.  Try it for 30, 60, 90 days.  If you don’t like it, send it back… no questions asked.

Response:

I was just watching GMA whereby they discussed Paxil and how the withdrawal symptoms have been greatly downplayed.  The side effects can vary from headaches to debilitating electrical shock sensations. Apparently the company producing the drug have this repressed data from their own studies although they state that they have made the physicians aware.  They will be presenting this story tonight on Primetime for those interested. Sandi

Response:

up off the mat and advised with conviction: Antidepressant treats hot flashes in men taking hormonal therapy for prostate cancer, Mayo study finds Paxil (paroxetine) diminishes hot flashes in men who are receiving hormone therapy for prostate cancer. <snip

BLAH, BLAH, BLAH, BLAH!! There’s just too many REAMS of doubtful INFORMATION being posted here!! Listen up, all you pussies, I’m a grouchy old buzzard currently on ADT Hormones  prior to RAD. The other day I was in a bad mood, so I downed a couple of Amitryptiline (Endep 25) and they damn near killed me. Apart from my being useless for a day and a half, all my Osteo-Arthritis pains magnified, plus a few new ones emerged. I phoned into the Rad Oncology Dept, but was only able to get a nurse, who advised me to CEASE them immediately, and see my GP about some alternative. — "if you can see it coming, head it off at the pass, else put the wagons in a circle" — Please reply to this ng as: — my email adress is 100% faked to prevent proliferation of SPAM!! — Regards — Clarence Crow

Response:

Each time I’ve seen that yet another antidepressant fixes hot flashes, several thoughts spring to mind: 1. Depression is serious stuff, and antidepressants are serious meds, so any problem requiring antidepressants must be pretty serious. 2. Any med that can combat a serious problem must have some pretty serious deliberate effects. If their purpose is to reduce depression, then reducing hot flashes is by definition a SE of the antidepressant. Jeez . . . what are its INTENDED effects? i.e., What changes do they make in my body to achieve their INTENDED effect of reducing depression . . . and obsessive-compulsive disorder, panic disorder, generalized anxiety disorder and social anxiety disorder, among others? 3. Do I want to add those intended effects to the SEs of my meds, which, after all, are the reasons I need antidepressants in the first place? 4. What are the other SEs of the antidepressant, besides reducing the number and severity of hot flashes? 5. How many of the antidepressant’s SEs need additional meds to combat THEM? 6. Worse yet, look up the SEs of these antidepressants. Some of the lists run into scores of effects, many of them serious. 7. When do we stop ingesting exponentially increasing numbers of meds and just get on with our lives and hope we beat the statistics? 8. Who sez the statistics aren’t skewed by all the freaking cancatenated SE meds? 9. And in case that list of questions didn’t give me pause, ask Google about the side effects of Paxil/Prozac . . . and stand back. 10. I did, and it makes me wonder . . . Do I want to spend my last years obsessed with juggling chemicals and side effects with a chemically impaired brain, or spend maybe fewer — or maybe more — years being I.P. Freely rather than a nut case? My wife prefers I.P. Freely. That’s why she married him. And I can think of 647 things more fun to do than sitting here researching medications and SEs. But in case I’m overreacting, I’ll keep reading. The problem with THAT plan is that as I expand my search into an exponentially increasing fan of links, I find more support than opposition to my tentative plan . . . such as the end of this Mayo Clinic reference itself. But maybe that’s a good thing, because the confusion factor shrinks with every new report like this one. Following this Mayo Clinic study leads to scores — hundreds? — of related studies . . . most of them spiralling towards the same dilemma: do we want to maximize our heartbeats with the certainty of SEs, or maximize our QOL with the possibility of many SE-free years, then when (IF?) the PC hits the fan we decide an optimal course based on data at that point? Hell, I just spent half an hour on this, when I couldda been actually WATCHING West Wing . . . or maybe making out with my wife. Now multiply that dilemma by a thousand and add 645 other activities. I suspect that many of us would LOSE free time, not gain it, by opting for HT and its complications. I’ve already spent most of a month researching it, and I haven’t even had one shot or one symptom or one SE yet. I.P.

Antidepressant treats hot flashes in men taking hormonal therapy for prostate cancer, Mayo study finds Paxil (paroxetine) diminishes hot flashes in men who are receiving hormone therapy for prostate cancer, Mayo Clinic researchers report.  An antidepressant medication is an effective treatment to reduce hot flashes in men who are taking hormone therapy for prostate cancer, Mayo Clinic researchers report in the October issue of Mayo Clinic Proceedings. The five-week study followed 18 men who completed the therapy, illustrating that their hot flashes decreased from 6.2 per day to 2.5 per day. Hot flash scores, the frequency multiplied by the severity, decreased in the same period from 10.6 per day to 3 per day. "Newer antidepressants have been proven effective in reducing hot flashes in women but have not been studied in men," says Charles Loprinzi, M.D., Mayo Clinic Division of Medical Oncology and the lead author of the study. "Although hot flashes in men with prostate cancer are well documented," he said, "their treatment has not received as much attention." Some doctors treat hot flashes in men receiving hormonal therapy with a short course of a secondary hormone such as Megestrol acetate. But the Mayo team now expresses some "concern" about these secondary treatments (see below). The study looked at men receiving androgen ablation therapy, also known as hormonal deprivation therapy, or hormonal blockade, which is a well-established treatment for various stages of prostate cancer. The antidepressant tested, paroxetine (Paxil), has been used to treat mental depression, obsessive-compulsive disorder, panic disorder, generalized anxiety disorder and social anxiety disorder, among others. A placebo-controlled trial had previously demonstrated that paroxetine reduced hot flashes in women. The study was conducted between August 2001 and October 2003. Men eligible for the study had to have a history of prostate cancer for which they were receiving androgen ablation therapy. Previous Mayo studies suggested that venlafaxine (Effexor) is effective to treat hot flashes in men undergoing hormonal therapy and that citalopram (Celexa) reduces such hot flashes in women. A commoner, older treatment for hot flashes is Megace (Megestrol acetate). Megace is a progestogen, a man-made form of the female hormone progesterone. Megace is sometimes used to treat prostate cancer and when given with newer hormone blockade drugs like Lupron or Zoladex it reduces hot flashes by up to 90 per cent, according to a Mayo study in 2002. But there have been reports of men whose prostate cancer progressed while taking Megace, In  1999 Oliver Sartor M.D. at Louisiana State University Medical Center, reported "a case in which megestrol acetate (20 mg bid) was administered for symptomatic control of hot flashes in a medically castrated patient with prostate cancer. The patient was subsequently noted to have a rising prostate-specific antigen (PSA) level. Megestrol acetate administration was discontinued, and the PSA level declined. These data indicate that even the low doses of megestrol acetate used for control of hot flashes can be associated with PSA increases in some patients with prostate cancer." This may be especially a concern because, as another study points out, patients whose doctors prescribed Megace for hot flashes have been found to stay on this treatment for three years or more. The authors of the current Mayo study say this therapy "may affect prostate cancer growth and/or cause significant side effects." Patients who do not wish to take an antidepressant for hot flashes need not feel like mavericks. Most patients who experience hot flashes are not interested in adding a medication to suppress them. In a presentation at ASCO in 2001, a team from University of Pennsylvania Cancer Center said that although over 70 per cent of prostate cancer patients they studied complained of "a little" to "some" discomfort during hot flashes, "of those not receiving treatment, fewer than 50 per cent would consider taking medication to treat them." Hot flashes are "a significant side-effect of hormonal treatment," this team concluded, and drugs are available to manage the flashes, but "a significant percentage of patients do not find it as an acceptable option. Therefore, alternative support/educational interventions should also be considered to help patients better understand manage and cope with this treatment side effect. " Others who worked with Dr. Loprinzi on the Paxil study are: Debra Barton, R.N., Ph.D.; Lisa Carpenter; Jeff Sloan, Ph.D.; Paul Novotny; Matthew Gettman, M.D.; and Bradley Christensen, all from Mayo Clinic. knowledge is power – growing old is mandatory – growing wise is optional "Many more men die with prostate cancer than of it. Growing old is invariably fatal. Prostate cancer is only sometimes so." http://community.webtv.net/PALMER_ENT/doc

Response:

Antidepressant treats hot flashes in men taking hormonal therapy for prostate cancer, Mayo study finds Paxil (paroxetine) diminishes hot flashes in men who are receiving hormone therapy for prostate cancer, Mayo Clinic researchers report.  An antidepressant medication is an effective treatment to reduce hot flashes in men who are taking hormone therapy for prostate cancer, Mayo Clinic researchers report in the October issue of Mayo Clinic Proceedings. The five-week study followed 18 men who completed the therapy, illustrating that their hot flashes decreased from 6.2 per day to 2.5 per day. Hot flash scores, the frequency multiplied by the severity, decreased in the same period from 10.6 per day to 3 per day. "Newer antidepressants have been proven effective in reducing hot flashes in women but have not been studied in men," says Charles Loprinzi, M.D., Mayo Clinic Division of Medical Oncology and the lead author of the study. "Although hot flashes in men with prostate cancer are well documented," he said, "their treatment has not received as much attention." Some doctors treat hot flashes in men receiving hormonal therapy with a short course of a secondary hormone such as Megestrol acetate. But the Mayo team now expresses some "concern" about these secondary treatments (see below). The study looked at men receiving androgen ablation therapy, also known as hormonal deprivation therapy, or hormonal blockade, which is a well-established treatment for various stages of prostate cancer. The antidepressant tested, paroxetine (Paxil), has been used to treat mental depression, obsessive-compulsive disorder, panic disorder, generalized anxiety disorder and social anxiety disorder, among others. A placebo-controlled trial had previously demonstrated that paroxetine reduced hot flashes in women. The study was conducted between August 2001 and October 2003. Men eligible for the study had to have a history of prostate cancer for which they were receiving androgen ablation therapy. Previous Mayo studies suggested that venlafaxine (Effexor) is effective to treat hot flashes in men undergoing hormonal therapy and that citalopram (Celexa) reduces such hot flashes in women. A commoner, older treatment for hot flashes is Megace (Megestrol acetate). Megace is a progestogen, a man-made form of the female hormone progesterone. Megace is sometimes used to treat prostate cancer and when given with newer hormone blockade drugs like Lupron or Zoladex it reduces hot flashes by up to 90 per cent, according to a Mayo study in 2002. But there have been reports of men whose prostate cancer progressed while taking Megace, In  1999 Oliver Sartor M.D. at Louisiana State University Medical Center, reported "a case in which megestrol acetate (20 mg bid) was administered for symptomatic control of hot flashes in a medically castrated patient with prostate cancer. The patient was subsequently noted to have a rising prostate-specific antigen (PSA) level. Megestrol acetate administration was discontinued, and the PSA level declined. These data indicate that even the low doses of megestrol acetate used for control of hot flashes can be associated with PSA increases in some patients with prostate cancer." This may be especially a concern because, as another study points out, patients whose doctors prescribed Megace for hot flashes have been found to stay on this treatment for three years or more. The authors of the current Mayo study say this therapy "may affect prostate cancer growth and/or cause significant side effects." Patients who do not wish to take an antidepressant for hot flashes need not feel like mavericks. Most patients who experience hot flashes are not interested in adding a medication to suppress them. In a presentation at ASCO in 2001, a team from University of Pennsylvania Cancer Center said that although over 70 per cent of prostate cancer patients they studied complained of "a little" to "some" discomfort during hot flashes, "of those not receiving treatment, fewer than 50 per cent would consider taking medication to treat them." Hot flashes are "a significant side-effect of hormonal treatment," this team concluded, and drugs are available to manage the flashes, but "a significant percentage of patients do not find it as an acceptable option. Therefore, alternative support/educational interventions should also be considered to help patients better understand manage and cope with this treatment side effect. "

Question:

– Hide quoted text — Show quoted text -I am hoping someone may have some suggestions/advice for me. I have been diagnosed with ADD for which I take Concerta (36 mgs at 6:00 am). This has helped me quite a bit. I however start to feel tense and anxious in the afternoon which will build up until I take 100 mg Seroquel about 1/2 hour before sleeping. I work in the computer field which I enjoy very much. I can’t seem to let my work go and am constantly studying and extremely curious about computers/networks in general. It seems I am always thinking out scenarios in my head about various ways to do things. The problem is that this compulsive thinking is leading to my anxious state. My dr. has tried me on numerous meds such as paxil, zoloft, effexor, luvox, depakote, lithium, remeron, wellebutrin, etc. I am not depressed, I just am (and have always been) somewhat hyper and cannot relax. It seems any med that works with serotonin just gives me bad headaches. I respond easily to Klonipin, not so well with Antivan. I guess I have ADD and am somewhat obsessive/compulsive. Erv

ever try strattera? or good old tca meds like imipramine? LM — The charter is available at:

Question:

Hi Y’all!  Doing better today.  Been hungry!  That’s a good sign.  It means my PMS is stronger than my withdrawal symptoms!  I’m not suprised. Vivid dreams I can’t remember last night. Slept all the way through.  There’s really not much to report.  I was bouncing off the walls yesterday.  Kava helped, as usual.  So did yoga and an after dinner walk in the neighborhood. I have shin-splints.  Interestingly, I wasn’t tired last night until later than usual, (11:00), but when I was it hit all at once.  Nothing gradual or subtle about it. Life without meds may actually be possible for me.  It’s looking good so far.  After 15 years of struggle with anxiety, panic, and an assortment of other secondary disorders there may actually be some hope for a life!  I hope someone out there reads this and catches some hope for themselves. Be Well! PW

Response:

I’ve been following this thread and I’m glad to hear you’re doing well without meds. I orginally didn’t respond since I was never on Zoloft nor do I have PMS I’m curious. Was it easier to wean on or off Zoloft? I had a hell of a time weaning onto Paxil CR and after 3 months of it not working, I decided to forget about it but had no problems stopping it. BTW How’s Kava effectiveness? Do you take it as needed or daily? Oh and don’t be afraid to throw some of that hope my way Kevin… – Hide quoted text — Show quoted text – Hi Y’all!  Doing better today.  Been hungry!  That’s a good sign.  It means my PMS is stronger than my withdrawal symptoms!  I’m not suprised. Vivid dreams I can’t remember last night. Slept all the way through.  There’s really not much to report.  I was bouncing off the walls yesterday.  Kava helped, as usual.  So did yoga and an after dinner walk in the neighborhood. I have shin-splints.  Interestingly, I wasn’t tired last night until later than usual, (11:00), but when I was it hit all at once.  Nothing gradual or subtle about it. Life without meds may actually be possible for me.  It’s looking good so far.  After 15 years of struggle with anxiety, panic, and an assortment of other secondary disorders there may actually be some hope for a life!  I hope someone out there reads this and catches some hope for themselves. Be Well! PW

Response:

It’s definately easier coming on Zoloft than off, for me.  I was lethargic at first, but after getting up to 50mg it only took about a week to get level. The total time was about 3 weeks.  Then I had a LOT of energy.  Bear in mind that I was extremely depressed by the time I started on Zoloft so in contract I felt quite energetic.  The reality was that I was feeling level. Coming off is harder. I feel wired for about 3 days, then I level out for about a week, then I cut the dosage by 50% and start all over again.  Paxil was hell for me.  I was a vegetable on it, crying all the time – very depressed.  Kava works really well for me during those few days when i’m wired, coming off. It takes some of the edge off, though just enough that I don’t feel like being mean to anyone or running over slow people in my car! My anxiety is scary.  I get impatient, critical, irritable, consescending and generally unpleasant to be around at all before I become downright verbally violent.  I called someone a bitch on the phone yesterday.  True, she was being incompetent at her job, but it didn’t help the situation to vent like that.  I take the kava as needed.  I usually need it around lunchtime.  I get edgy when I get hungry.  Then again in the evenings when I want to wind down and relax if I feel too keyed up to sit still.  I haven’t needed it much lately.  I anticipate not needing it all in a month. PW

– Hide quoted text — Show quoted text – I’ve been following this thread and I’m glad to hear you’re doing well without meds. I orginally didn’t respond since I was never on Zoloft nor do I have PMS I’m curious. Was it easier to wean on or off Zoloft? I had a hell of a time weaning onto Paxil CR and after 3 months of it not working, I decided to forget about it but had no problems stopping it. BTW How’s Kava effectiveness? Do you take it as needed or daily? Oh and don’t be afraid to throw some of that hope my way Kevin… Hi Y’all!  Doing better today.  Been hungry!  That’s a good sign.  It means my PMS is stronger than my withdrawal symptoms!  I’m not suprised. Vivid dreams I can’t remember last night. Slept all the way through.  There’s really not much to report.  I was bouncing off the walls yesterday. Kava helped, as usual.  So did yoga and an after dinner walk in the neighborhood. I have shin-splints.  Interestingly, I wasn’t tired last night until later than usual, (11:00), but when I was it hit all at once.  Nothing gradual or subtle about it. Life without meds may actually be possible for me.  It’s looking good so far.  After 15 years of struggle with anxiety, panic, and an assortment of other secondary disorders there may actually be some hope for a life!  I hope someone out there reads this and catches some hope for themselves. Be Well! PW

Response:

Thanks for your input. I’ve researched and read about the liver damage.   Where do you recommend buying the best Kava? How much do yo take each day? DiA

Response:

Thanks for your input. I’ve researched and read about the liver damage.   Where do you recommend buying the best Kava? How much do yo take each day? DiA

DiA, I’ve been using several labels of an extract called Kaviar(TM). You can read background info on their product(s) at http://www.cosmopolitantrading.com/ I’ve used their soft gels; they’re quite good, but take a bit longer to get into your system because it’s a thick paste inside of a softgel (available from Source Naturals as Kava Gold softgels – http://www.vitacost.com/Store/products/Products.cfm?SubCategoryID=313… own1=product I have a slight preference for their powdered version because of the bioabsorption issue; I get it from http://www.health-pages.com/kk/index.html PW is using one of the Gaia Herbs products (not sure if it’s the tincture or the phyto-capsules).  I’ve not tried them, but they have an excellent reputation, and the liquid versions do work much faster. My dosage level flucuates because I supplement the capsules with "kava tonics" I make from raw powder; I probably average around 700 mg/day.  The medical impllications of prolonged daily use at that level is very uncertain. Start with one or two capsules and evaluate your response.  Next time increase the dosage by another capsule until you get what feels like a good response. Take kava on an empty stomach, no matter what the label says, and wait awhile (about an hour, but it varies by individual, before you eat) If you get to 300mg without any significant effect, then kava may not work for you, but give it 3-4 days at a consistent dosage level before you drop it; sometimes it takes a while for the full effect to settle in. Hope it works for you, but even if not, I’d be interested in hearing your opinion. Figaro

Response:

Thanks for the info..I do have more anxiety and no depression anymore and thats why I think the Kava may be better.. It’s worth a try, anyway:) DiA

Response:

I coud use some of that hope, too,PW, so send some my way!   Have been taking St, John’s but will try the Kava after reading about it,. DiA

St. John’s Wort is an anti-depressant.  Kava-kava is (primarily) an anti-anxiety drug; it won’t help mood unless you have anxiety-driven depression.  If you take both, the SJW will interfere with the effectiveness of the kava. You *must* research kava extensively before you take it on a regular basis. There are unresolved health issues involving possible liver damage. Make an informed decision. Although I’m a regular kava user I try not to advocate nor discourage its use by anyone else.  That statement notwithstanding, my personal opinion is that kava has the potential to be an outstanding alternative to the benzodiazepenes, but the current kava products on the market varying in effectiveness from useless to excellent, so you may need to try several before finding one that works for you.

Response:

I coud use some of that hope, too,PW, so send some my way!   Have been taking St, John’s but will try the Kava after reading about it,. DiA

Response:

DiA I have read that St. John’s wort is good for depression.  It can be a bit stimulating.  I skirt away from it because by depression is secondary to my anxiety.  I am not really qualified to make any suggestions, though I can offer some of my own prsonal experience.  St. John’s Wort never helped me at all.  It never hurt me either.  Though it can aggravate some ppls’ anxiety – so I’ve read. PW

– Hide quoted text — Show quoted text – I coud use some of that hope, too,PW, so send some my way!   Have been taking St, John’s but will try the Kava after reading about it,. DiA

Response:

It’s definately easier coming on Zoloft than off, for me.  I was lethargic at first, but after getting up to 50mg it only took about a week to get level. The total time was about 3 weeks.  Then I had a LOT of energy. Bear in mind that I was extremely depressed by the time I started on Zoloft so in contract I felt quite energetic.  The reality was that I was feeling

level. I had the same reaction to Paxil but I was taking it for anxiety and was on a mania streak the entire 3 months I was on it. Thanfully I had Xanax to calm me down. Coming off is harder. I feel wired for about 3 days, then I level out for about a week, then I cut the dosage by 50% and start all over again. Paxil was hell for me.  I was a vegetable on it, crying all the time – very depressed.  Kava works really well for me during those few days when i’m wired, coming off. It takes some of the edge off, though just enough that I don’t feel like being mean to anyone or running over slow people in my car! My anxiety is scary.  I get impatient, critical, irritable, consescending and generally unpleasant to be around at all before I become downright verbally violent.

We have something in common but my anger has nothing to do my anxiety. Still trying to figure out what it is. I have these rage relapses once on a while and cannot control it right in the middle of it. But they usually only last one day now. I was in this state of mind for years in the past. Suicidal up the ying yang. I called someone a bitch on the phone yesterday.  True, she was being incompetent at her job, but it didn’t help the situation to vent like that.  I take the kava as needed.  I usually need it around lunchtime.  I get edgy when I get hungry.

Remind me to never get on your bad side : ) Then again in the evenings when I want to wind down and relax if I feel too keyed up to sit still.  I haven’t needed it much lately.  I anticipate not needing it all in a month.

Good, I’m glad you’re succesfully weaning off of it…

Thanks! Have a good one Ms. PW, Kevin…

Response:

Question:

How many here are at least 50 years old? If you are what anti-depressant are you using and have you been using it since turning 50 years young? I know this probably doesn’t make much sense to lots of people in here–but I’m trying to find out if one medicine is prescribed more for older folks? We live in a world of numbers and age of course bing the biggest factor of all in the numbers "game". (Another example of numbers that I read is that 66% of all alcoholics who have quit drinking, have mental problems of some sort) Even car insurance companies use age in figuring their fees for insurance–another number. What is your income level–another number. So what I’m asking here is simple. 50 years of age and up: what anti-depressant are you taking and how is it working for you? Now if no one replies, then I know that I’m the oldie in here. Thanks Much and allways remember in all you do this one very important factor: "If it doesn’t fit, You MUST acquit"

Response:

Dan: I am 51, and while I stopped taking meds this fall, I was previously on Celexa 20 mg for 3 years and Paxil 20 mg and then 30 mg for one year. – Anne

Response:

- Hide quoted text — Show quoted text – How many here are at least 50 years old? If you are what anti-depressant are you using and have you been using it since turning 50 years young? I know this probably doesn’t make much sense to lots of people in here–but I’m trying to find out if one medicine is prescribed more for older folks? We live in a world of numbers and age of course bing the biggest factor of all in the numbers "game". (Another example of numbers that I read is that 66% of all alcoholics who have quit drinking, have mental problems of some sort) Even car insurance companies use age in figuring their fees for insurance–another number. What is your income level–another number. So what I’m asking here is simple. 50 years of age and up: what anti-depressant are you taking and how is it working for you? Now if no one replies, then I know that I’m the oldie in here. Thanks Much and allways remember in all you do this one very important factor: "If it doesn’t fit, You MUST acquit"

I am 54 and am currently on *imipramine* and Xanax and they work well for me. In the first 18 years or so of my PD which started in 1968 when I was 20 I was only on a benzo. Around age 42 or so I needed to add an AD which was *clomipramine*, another TCA (and one that is much researched and  often prescribed in Europe while imipramine seems more of an American first choice TCA). At some point clomipramine seemed to *poop out* on me and I tried SSRI’s and even the RIMA *moclobemide* (always together with a benzo) which worked but I seem to respond just a bit better to TCA’s. In my case I don’t think any of this has anything to do with age. Philip – Hide quoted text — Show quoted text –

Response:

– Hide quoted text — Show quoted text -How many here are at least 50 years old? If you are what anti-depressant are you using and have you been using it since turning 50 years young? I know this probably doesn’t make much sense to lots of people in here–but I’m trying to find out if one medicine is prescribed more for older folks? We live in a world of numbers and age of course bing the biggest factor of all in the numbers "game". (Another example of numbers that I read is that 66% of all alcoholics who have quit drinking, have mental problems of some sort) Even car insurance companies use age in figuring their fees for insurance–another number. What is your income level–another number. So what I’m asking here is simple. 50 years of age and up: what anti-depressant are you taking and how is it working for you? Now if no one replies, then I know that I’m the oldie in here. Thanks Much and allways remember in all you do this one very important factor: "If it doesn’t fit, You MUST acquit"

I’m 57, and have been on the TCA dothiepin (prothiaden) for some years – though recently discontinued it, and have felt no ill effect from that: therapy alone is now enough for me. Before the TCA, I was on Paxil, which didn’t agree with me – too many side effects. If I needed an AD again, I would go back to dothiepin. -David-

Response:

Hi Dan! I’m 57 and I’ve been on Paxil for about 4 – 5 years.  I only require 10 mg.  I seem to be very sensitive to meds, but I don’t know if it’s due to age or not.  Even that amount, combined with .5 mg Ativan twice a day makes me lethargic. Dot

Response:

- Hide quoted text — Show quoted text – How many here are at least 50 years old? If you are what anti-depressant are you using and have you been using it since turning 50 years young? I know this probably doesn’t make much sense to lots of people in here–but I’m trying to find out if one medicine is prescribed more for older folks? We live in a world of numbers and age of course bing the biggest factor of all in the numbers "game". (Another example of numbers that I read is that 66% of all alcoholics who have quit drinking, have mental problems of some sort) Even car insurance companies use age in figuring their fees for insurance–another number. What is your income level–another number. So what I’m asking here is simple. 50 years of age and up: what anti-depressant are you taking and how is it working for you? Now if no one replies, then I know that I’m the oldie in here. Thanks Much and allways remember in all you do this one very important factor: "If it doesn’t fit, You MUST acquit" I am 54 and am currently on *imipramine* and Xanax and they work well for me. In the first 18 years or so of my PD which started in 1968 when I was 20 I was only on a benzo. Around age 42 or so I needed to add an AD which was *clomipramine*, another TCA (and one that is much researched and  often prescribed in Europe while imipramine seems more of an American first choice TCA). At some point clomipramine seemed to *poop out* on me and I tried SSRI’s and even the RIMA *moclobemide* (always together with a benzo) which worked but I seem to respond just a bit better to TCA’s. In my case I don’t think any of this has anything to do with age. Philip Thanks Philip, Is that "imipramine" the generic name or the other name form.

It’s the generic name. Most common brand name: *Tofranil*. I should buy a medical book to look these up.

You can find them on the net at Arthur’s excellent dictionary at http://www.anxiety-panic.com Is it taken daily and in what measurements does it come.

Here the smalles dosage is 25 mg (and I also mean the pill is so small that one can hardly cut it in half). In the US tabs 0f 10 mg are available. It is taken daily, like with all AD’s it’s a matter of finding out whether taking it in the AM or in the PM agrees best with you. I actually take part of it in the AM and part of it in the PM, don’t really remember why Like all TCA’s is has a large therapeutic window, from 75 mg to, say, 225 mg. Too high TCA doses are toxic though which angain is individual and can, if necessary, being measured by blood work. (Just as a side note, my regular MD, told me yesterday–that I sould ask my psycharist to switch me to another medicine, when I told him I was no lonfer taking celexa-because of excessive sleepiness).

If that sleepiness bothers you too much it may be a good idea. I am going to ask my Pdoc about it–but I’m not so sure he’ll put me on it anyway.

Another good choice may be Effexor, a newer med which, like TCA’s but in a somewhat different way, targets both serotonin and norepinephrine receptors. The different types of doctors–if they do one thing–it is protect their territory–when you ask for a med. change.

I have been rather lucky in this dept. as my pdoc actually agreed to my own choice of meds. Also you MAY be right about age making no difference, but if so–then it’s one of those very RARE things where age doesn’t count.

This is a big *YMMV*, I was strictly talking about myself. Medication for the elderly (but we’re not yet there when we are in our fifties or early sixties IMO) can sometimes be different (as in smaller benzo doses, for instance, or no TCA’s when having cardiovascular problems etc.etc.) Philip – Hide quoted text — Show quoted text –

Response:

So what I’m asking here is simple. 50 years of age and up: what anti-depressant are you taking and how is it working for you?

Zoloft for anxiety and depression, Ativan when needed, and Concerta to keep me peppy. Take care, Liz

Response:

So what I’m asking here is simple. 50 years of age and up: what anti-depressant are you taking and how is it working for you? Now if no one replies, then I know that I’m the oldie in here. I’m 58 and started Zoloft for depression 10 years ago (when I was 48). My dose of Zoloft depends on whether I am depressed or not. I also take a TCA called desipramine to boost the effects of the Zoloft. Zoloft works well for me. I take Klonopin for anxiety/panic/agoraphobia. Chip

Thank you each and every one . As for zoloft–I just could not take that–it kept me awake. Celexa–the opposite. Basically–I can use xanax for attacks of anxiety–with no problem, but I would definately like to try something else. Good suggestions here–will he write me something different is the question.

Response:

I am posting this for LM being his post never showed up – Hide quoted text — Show quoted text -ubject: If You are at least 50 Years of age and on anti-depressants How many here are at least 50 years old? If you are what anti-depressant are you using and have you been using it since turning 50 years young? I know this probably doesn’t make much sense to lots of people in here–but I’m trying to find out if one medicine is prescribed more for older folks? We live in a world of numbers and age of course bing the biggest factor of all in the numbers "game". (Another example of numbers that I read is that 66% of all alcoholics who have quit drinking, have mental problems of some sort) Even car insurance companies use age in figuring their fees for insurance–another number. What is your income level–another number. So what I’m asking here is simple. 50 years of age and up: what anti-depressant are you taking and how is it working for you? Now if no one replies, then I know that I’m the oldie in here. Thanks Much and allways remember in all you do this one very important factor: "If it doesn’t fit, You MUST acquit"

the only time age is a factor in prescribing any medication is if the patient is geriatric in nature, or has some compromised abilities in metabolizing some types of drugs-usually the longer half life drugs like valium, klonopin and prozac etc… other then that profile of patient and drug are used as a methodology for prescribing LM ~*~I may not be perfectly beautiful, I may not be perfectly wise, I may not be perfectly obedient, but I am perfectly me~*~

Response:

- Hide quoted text — Show quoted text – How many here are at least 50 years old? If you are what anti-depressant are you using and have you been using it since turning 50 years young? I know this probably doesn’t make much sense to lots of people in here–but I’m trying to find out if one medicine is prescribed more for older folks? We live in a world of numbers and age of course bing the biggest factor of all in the numbers "game". (Another example of numbers that I read is that 66% of all alcoholics who have quit drinking, have mental problems of some sort) Even car insurance companies use age in figuring their fees for insurance–another number. What is your income level–another number. So what I’m asking here is simple. 50 years of age and up: what anti-depressant are you taking and how is it working for you? Now if no one replies, then I know that I’m the oldie in here. Thanks Much and allways remember in all you do this one very important factor: "If it doesn’t fit, You MUST acquit" I am 54 and am currently on *imipramine* and Xanax and they work well for me. In the first 18 years or so of my PD which started in 1968 when I was 20 I was only on a benzo. Around age 42 or so I needed to add an AD which was *clomipramine*, another TCA (and one that is much researched and  often prescribed in Europe while imipramine seems more of an American first choice TCA). At some point clomipramine seemed to *poop out* on me and I tried SSRI’s and even the RIMA *moclobemide* (always together with a benzo) which worked but I seem to respond just a bit better to TCA’s. In my case I don’t think any of this has anything to do with age. Philip

Thanks Philip, Is that "imipramine" the generic name or the other name form. I should buy a medical book to look these up. Is it taken daily and in what measurements does it come. (Just as a side note, my regular MD, told me yesterday–that I sould ask my psycharist to switch me to another medicine, when I told him I was no lonfer taking celexa-because of excessive sleepiness). I am going to ask my Pdoc about it–but I’m not so sure he’ll put me on it anyway. The different types of doctors–if they do one thing–it is protect their territory–when you ask for a med. change. Also you MAY be right about age making no difference, but if so–then it’s one of those very RARE things where age doesn’t count. Thanks much for your comment.

Response:

So what I’m asking here is simple. 50 years of age and up: what anti-depressant are you taking and how is it working for you? Now if no one replies, then I know that I’m the oldie in here.

I’m 58 and started Zoloft for depression 10 years ago (when I was 48). My dose of Zoloft depends on whether I am depressed or not. I also take a TCA called desipramine to boost the effects of the Zoloft. Zoloft works well for me. I take Klonopin for anxiety/panic/agoraphobia. Chip

Response:

Question:

Hello everyone, I have severe generalized social phobia and I’m 20 years old. Currently, I’m on Zoloft to help with depression. However, it does not do much for my anxiety. I recently started to consider adding a Benzodiazepine like Klonopin (clonazepam) to help with my anxiety. I mentioned this to my physician and he freaked out. He said it is prescribed on a short-term basis to individuals who do not have generalized anxiety. My physician referred me to a psychiatrist… and I’m probably going to make an appointment tomorrow. My problem is this: My physician kind of made me feel like a drug addict or something. I don’t want the same thing to happen with the psychiatrist. Do most doctors feel this way about Benzodiazepines? Is it a good idea to pursue this? I know therapy is an important factor, and I have been through CBT. Obliviously it didn’t work very well. Right now, I can’t afford therapy on a regular basis. -William

Response:

William wrote:

Hello everyone, I have severe generalized social phobia and I’m 20 years old. Currently, I’m on Zoloft to help with depression. However, it does not do much for my anxiety. I recently started to consider adding a Benzodiazepine like Klonopin (clonazepam) to help with my anxiety. I mentioned this to my physician and he freaked out. He said it is prescribed on a short-term basis to individuals who do not have generalized anxiety.

Yeah it’s used for Epilepsy mainly. But of course it also has a use in treating anxiety. As does xanax which you should also look at. And a whole lot of other drugs as well.

My physician referred me to a psychiatrist… and I’m probably going to make an appointment tomorrow. My problem is this: My physician kind of made me feel like a drug addict or something. I don’t want the same thing to happen with the psychiatrist.

Your not a drug addict for requesting a drug that you believe will relieve your anxiety. Are cancer patients drug addicts when they get chemotherapy on the odd chance it might save their life? Are diabetics drug addicts because they stick a needle in their bodies all the time? Do you know how many billions of dollars could be saved if social anxiety was eliminated from the population? Not to mention how many people would be better off. Do most doctors feel this way

about Benzodiazepines? Is it a good idea to pursue this?

It depends on their training and knowledge of your past history. If you had a history of drug dependence or alchohol abuse almost no doctor would provide you with benzo’s. If you don’t then again it depends on their training and most Pychiatrists are better trained in the use of these drugs than Doctors. IMHO it is a good idea for you to pursue any therapy that is safe for you, as long as it helps you. That includes drug therapies as well as others.

I know therapy is an important factor, and I have been through CBT. Obliviously it didn’t work very well. Right now, I can’t afford therapy on a regular basis.

Yeah it can be so expensive. Richard — Registered Lunatic #100347

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On 5 Feb 2002 23:53:33 -0800, willhk…@earthlink.net (William) wrote: – Hide quoted text — Show quoted text -

Hello everyone, I have severe generalized social phobia and I’m 20 years old. Currently, I’m on Zoloft to help with depression. However, it does not do much for my anxiety. I recently started to consider adding a Benzodiazepine like Klonopin (clonazepam) to help with my anxiety. I mentioned this to my physician and he freaked out. He said it is prescribed on a short-term basis to individuals who do not have generalized anxiety. My physician referred me to a psychiatrist… and I’m probably going to make an appointment tomorrow. My problem is this: My physician kind of made me feel like a drug addict or something. I don’t want the same thing to happen with the psychiatrist. Do most doctors feel this way about Benzodiazepines? Is it a good idea to pursue this? I know therapy is an important factor, and I have been through CBT. Obliviously it didn’t work very well. Right now, I can’t afford therapy on a regular basis. -William

Hi William, Is Zoloft the only anti depressant you’ve tried?  I know this doesn’t seem logical, but different brands of ssri anti depressants don’t always have the same effect on people.  If Zoloft isn’t working for your anxiety, you could try Paxil or Celexa.  Just a thought.  BTW, what is your current Zoloft dose? Whether you have or haven’t tried other ssri meds, and at a workable dosage level, adding a benzodiazepine is still a common practice.  I base this comment on my own experience, my previous doctor’s revelations, postings to this group and research.  (My new family doctor, a result of moving to a different state in the U.S., reacted similarly to your MD when I told him what meds I took.  A shrink I subsequently saw did not have a problem and I was given a green light to continue my med regimen.) The big deal with benzos is that they are considered addictive and fall into the controlled substances category, although at the bottom of the list.  Apparently they can be difficult to come off of, if you ever decide to take one, then quit  There is also a concern that users will require increasingly larger doses to attain the same calming effect.  I can’t comment re. any difficulties in quitting a benzo because I’ve never done that.  I can say, though, that once I reached an effective dose level of Xanax several years ago, I have NEVER felt the need to take more to achieve the same anxiety relief.  There is also, at least in my case, no euphoric or high feeling associated with taking a benzo (Valium could be an exception because some people do get a buzz from it.)  If you were to compare the potential addictiveness of benzos with, say, alcohol abuse, it’s like day and night.  Benzos help me and others to function and sometimes lead at least a semblance of a normal life.  In spite of their supposed addictiveness, I can drive, I can work, I can talk to people, and look and feel pretty much ok (well as ok as an sp’ic can be anyway).  OTOH, alcohol abuse ALWAYS involves drinking greater quantities over time to reach the desired effect.  And the side effects can be horrific. Drunks can’t effectively handle even simple tasks and their thinking and judgment are clouded to say the least.  You hear about drunk drivers killing people on the highways all the time, yet this drug is an over the counter purchase.  So far I haven’t read or heard anything about someone killing others or himself as a result of taking benzos. Of the benzos, Klonopin is probably the most subtle in its action.  It has a calming effect, but not the "right now" relief you get within an hour or so of taking something like Xanax.  Klonopin also has a relatively long half life, meaning it stays with you for several hours versus a med like Xanax which begins to poop out after anywhere from 3 hours and up.  Here’s an interesting aside too.  Klonopin was developed to control seizures in people.  A normal daily intake, when taken for seizures,  is somewhere around 10 mg give or take.  However, some people need as much as 20 mg to control their seizures.  When used for anxiety, Klonopin doses range from 1 to 4 mg daily.  Some people undoubtedly take a couple of more mg, but you won’t find anyone even near the dose level needed to control seizures. Here’s the bottom line.  It’s your life.  Anxiety is messing it up. Zoloft, and maybe other ssri anti depressants, plus CBT have not helped.  That pretty much leaves maoi’s and benzos as the remaining choices in the prescription med category.  Maoi’s are considered the last choice because they have a lot of restrictions, particularly as relates to what you can safely eat, and significant side effects. Asking for a benzo such as Klonopin is a reasonable request to try to gain some degree of normalcy with your life.  Ask your family doctor which is preferable:  living in anxiety hell forever or taking a benzo to get some relief.   If you don’t get the answer you want, there are other doctors.  And yes, I know how hard it is to see a new doctor and discuss your anxiety disorder, but it could come to that. If you see the psychiatrist, there’s a good probability you’ll get an ok to try Klonopin.  S/he’ll probably want to see you periodically to see if you’re getting relief and to evaluate if dosage should be changed.  Your starting dose might be 1, maybe 2 mg per day, taken in equal amounts spread out over your waking hours.  If that doesn’t cut it, you can always request a higher dose, also to be split up evenly over each day.  One last comment about Klonopin. I didn’t realize this until I started taking it, but unlike Xanax, you don’t gain its full benefit until after you’ve been on it for a week or so.  In spite of this lag, you’ll still probably notice a calming effect the first day of use. You might want to do some research on the web or elsewhere for Klonopin and anxiety so you’ll be somewhat knowledgeable about it when you see the shrink.  Good luck. Doug

Response:

Thanks Doug and Richard for your advice… I feel much better about the whole thing now.

Is Zoloft the only anti depressant you’ve tried?

Actually, I’ve been on Paxil as well. At one point I was on 100mg of Zoloft, but I started to get side-effects with that dosage. I could try other SSRI’s. I’m aware that this could take anywhere up to a couple of months to notice a difference. In my situation, I don’t really have the luxury of time to experiment with all the SSRI’s out there.

If you see the psychiatrist, there’s a good probability you’ll get an ok to try Klonopin.

I made an appointment with a psychiatrist this morning. It’s on Friday. This is the psychiatrist that my physician referred me to. Do you think that my physician can interfere in my choice of medication? Or do you think it’s a better idea to get a psychiatrist who is not connected to my doctor? Thanks, -William

Response:

William, On 6 Feb 2002 12:11:53 -0800, willhk…@earthlink.net (William) wrote:

Thanks Doug and Richard for your advice… I feel much better about the whole thing now. Is Zoloft the only anti depressant you’ve tried? Actually, I’ve been on Paxil as well. At one point I was on 100mg of Zoloft, but I started to get side-effects with that dosage. I could try other SSRI’s. I’m aware that this could take anywhere up to a couple of months to notice a difference. In my situation, I don’t really have the luxury of time to experiment with all the SSRI’s out there.

OK.

If you see the psychiatrist, there’s a good probability you’ll get an ok to try Klonopin. I made an appointment with a psychiatrist this morning. It’s on Friday. This is the psychiatrist that my physician referred me to. Do you think that my physician can interfere in my choice of medication? Or do you think it’s a better idea to get a psychiatrist who is not connected to my doctor?

I saw the psychiatrist that my new family doctor recommended and he okayed my drugs.  Had the shrink said no, I would have sought out another psychiatrist and another till I got what I wanted.  In my case I’ve been taking Xanax for over 15 years so it’s not like I have no experience with it or don’t know about its negatives. If you believe your family MD has your best interests at heart, there’s no harm in seeing whoever he recommends.  I’m inclined to think he’s passing the buck due more to a lack of knowledge than because he’s dead set against your taking Klonopin.  I mean he could have just said no and let that be the end of it, not even recommending that you see a shrink.  One other thing to consider is that the psychiatrist is going to have a lot more familiarity with your illness and meds that can help you than your MD does. Doug – Hide quoted text — Show quoted text -

Thanks, -William

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Question:

hello all….I have receantly been diagnosed with PD… this is a scary thing!!!!!!!     I have been reading this NG for a week or so and seem to relate to many of you. I am studing up on this PD thing and "trying to stay vertical" I am on Zoloft and Xanax as needed. Just saying "Hello I have a problem" is enough to flip me out! Be gentle with me K? J

No problem J. Welcome to ASAP. Most of us are here because we have the same problem you do. It’s really difficult inthe beginning,but it does get better. Curious, do you have depression to? If not, why the Zoloft? Xanax works great for panic without any additional meds. And, with lots less )or no) side effects. Just something you might want to talk to your doc about. Your best bet is to talk topeople who are positive and supportive here. Ignore the flames and trolls. They come and go. Don’t let them get to you. Get the weekly FAQ and also visit lots of the great web sites that are out there. Like Arthur Anderon’s website! It’s one of the best. Educating yourself about this disorder is one of the best things you can do! Feel free to e-mail me if you’d like. Regards, Jen

Response:

hello all….I have receantly been diagnosed with PD… this is a scary thing!!!!!!!     I have been reading this NG for a week or so and seem to relate to many of you. I am studing up on this PD thing and "trying to stay vertical" I am on Zoloft and Xanax as needed. Just saying "Hello I have a problem" is enough to flip me out! Be gentle with me K? J

Response:

HI J!!! Sorry to hear you have become "One of us", but glad you found this NG all the same! Jen really said it best as far as educating yourself about panic/anxiety… The best thing you could do, at least for me anyway, is to read as much as you can. I found what was the scariest of all was the not knowing, the lack of understanding as to what was exactly a panic attack meant, what the terms were, etc. Once I understood what was taking place during an attack, I was able to then try and find ways to cope with them. Of course, I am still searching for ways, but…. I am on the Zoloft also… How are you doing with that? I bet at times you may feel a little lost…Dont get down! You will survive! Oh, and for what its worth.. Know the best thing about panic sufferers? They are probably the most understanding, caring, compassionate folk you will ever come across… What you were seeing, like Jen said, is the trouble makers…. Wishing you the best!! — Miriam     (These opinions are mine and mine alone… YMMV) Energizer bunny arrested, charged with battery. – Hide quoted text — Show quoted text – hello all….I have receantly been diagnosed with PD… this is a scary thing!!!!!!!     I have been reading this NG for a week or so and seem to relate to many of you. I am studing up on this PD thing and "trying to stay vertical" I am on Zoloft and Xanax as needed. Just saying "Hello I have a problem" is enough to flip me out! Be gentle with me K? J

Response:

hello all….I have receantly been diagnosed with PD… this is a scary thing!!!!!!!     I have been reading this NG for a week or so and seem to relate to many of you. I am studing up on this PD thing and "trying to stay vertical" I am on Zoloft and Xanax as needed. Just saying "Hello I have a problem" is enough to flip me out! Be gentle with me K?

Hi, J – welcome to ASAP Glad to hear that you’re getting proper treatment and I hope you find this NG the valuable resource that so many of us have. — Gary Cooper

Response:

JSmittie schreef: hello all….I have receantly been diagnosed with PD… this is a scary thing!!!!!!!     I have been reading this NG for a week or so and seem to relate to many of you. I am studing up on this PD thing and "trying to stay vertical" I am on Zoloft and Xanax as needed. Just saying "Hello I have a problem" is enough to flip me out! Be gentle with me K? J

Hi J! Don’t worry. You’ll find much knowledge and support here. It’s a shame that new people should have to worry about posting here these days. The only reason why anybody will not be gentle with someone else here is when this someone else is consciously posting desinformation or writing insulting posts just to disrupt the newsgroup. These people are called *trolls* in Internet lingo and they’re to be found in every newsgroup on Usenet. Don’t worry about them. How long have you been on Zoloft? Does it work for you? It’s often a good idea to take a benzo like Xanax in at least the initial stages of a AD like Zoloft, to let your body adjust itself to it. Hope that you will post more often! Philip

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Hi there!  I’ve only been here a little over 2 months, but some of the folks have been here literally for years.  So, there’s quite a lot of accumulated wisdom that has been of great help to me. I’m glad to have you here, "fellow newbie".  Just ignore the flame threads, delete the whole thread if it bothers you.  You’ll do fine. E. Brent Price

– Hide quoted text — Show quoted text -hello all….I have receantly been diagnosed with PD… this is a scary thing!!!!!!!     I have been reading this NG for a week or so and seem to relate to many of you. I am studing up on this PD thing and "trying to stay vertical" I am on Zoloft and Xanax as needed. Just saying "Hello I have a problem" is enough to flip me out! Be gentle with me K? J

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Hi J, I think the more you find out about PD the less you will be afraid…now you have a name for what you have been feeling, when I was diagnosed this summer and had the "names" spelled out for me, I felt a little "nuts", but now I DON’T feel that way. This isn’t some "head thing". For me trying to cope with it on my own was barely tolerable and now I am on the way to developing more appropriate methods of dealing with it. Keep reading and coming to this ng, there’s a lot of good info and support to be found here. Michelle says… – Hide quoted text — Show quoted text -hello all….I have receantly been diagnosed with PD… this is a scary thing!!!!!!!     I have been reading this NG for a week or so and seem to relate to many of you. I am studing up on this PD thing and "trying to stay vertical" I am on Zoloft and Xanax as needed. Just saying "Hello I have a problem" is enough to flip me out! Be gentle with me K? J

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