Question:

Hello everybody,     I have just been prescribed a corticosteroid inhaler (Flovent) for mild asthma.  The pharmacist told me about thrush, and that I should be sure to rinse my mouth after I take my dose.  I later called the pharmacist back and asked if I got it, could I give it to someone else (through kissing) and the answer was yes.  So my question is, how common is it if you rinse, and how much of an inconvenience is it if you get it?  Has anyone ever given it to a boyfriend/girlfriend?  Is it easy to control with a fungal mouthwash?  I’m afraid to kiss my boyfriend before I find out more (I couldn’t find much on the web beyond the basic description, and the fact that you can get it even if you rinse well).  Of course I am going to put a call into my allergist, but he only has a clinic once a week or maybe less, so I don’t know when I will get a response.  PLEASE e-mail me about this if anyone has any input on the subject! Thanks!     Mary

Response:

- Hide quoted text — Show quoted text – Hello everybody,     I have just been prescribed a corticosteroid inhaler (Flovent) for mild asthma.  The pharmacist told me about thrush, and that I should be sure to rinse my mouth after I take my dose.  I later called the pharmacist back and asked if I got it, could I give it to someone else (through kissing) and the answer was yes.  So my question is, how common is it if you rinse, and how much of an inconvenience is it if you get it?  Has anyone ever given it to a boyfriend/girlfriend?  Is it easy to control with a fungal mouthwash?  I’m afraid to kiss my boyfriend before I find out more (I couldn’t find much on the web beyond the basic description, and the fact that you can get it even if you rinse well).  Of course I am going to put a call into my allergist, but he only has a clinic once a week or maybe less, so I don’t know when I will get a response.  PLEASE e-mail me about this if anyone has any input on the subject! Thanks!     Mary

Mary, the germs that cause thrush are found in the normal flora of the mouth.  This means your bf already has them.  The reason that the inhalers can cause this problem is that they change the pH of the mouth.  If you rinse well [drink an entire 16 oz glass of water, and swish it around], you shouldn’t have a problem.  I have been using inhaled steroids for more than a decade, and have never gotten thrush. Chris Owens

Response:

Mary, I currently have Oral Thrush and have to fight it continuously.  I gargle very carefully and rinse after every use of Flovent, but still am prone to it.  I think it is very similar to women that are sensitive to vaginal yeast infections also.  One of the things I have found to really help is to eat yogurt everyday.  I also have a prescription for Mycelex lozenges that I can have filled whenever I need it, although I have found that if I rinse well and eat the yogurt I can usually keep the Thrush at bay without having to overuse the Mycelex. Chrystal – Hide quoted text — Show quoted text -Mary, the germs that cause thrush are found in the normal flora of the mouth.  This means your bf already has them.  The reason that the inhalers can cause this problem is that they change the pH of the mouth.  If you rinse well [drink an entire 16 oz glass of water, and swish it around], you shouldn’t have a problem.  I have been using inhaled steroids for more than a decade, and have never gotten thrush. Chris Owens

Response:

You may also want to try a spacer if you are not currently using one.  It is difficult to time inhalation of the drug with depressing or actuating the inhaler.  If you find you are hitting the back of your throat or tasting the medication when you use your inhaler you need to work on your technique.  A spacer helps you to get more of the medication to your airway instead of your mouth or throat. Don’t forget to shake the canister really well between each dose and wait 30sec to a minute between each puff. Hope this helps. Shane J. Varnum – Hide quoted text — Show quoted text – Mary, I currently have Oral Thrush and have to fight it continuously.  I gargle very carefully and rinse after every use of Flovent, but still am prone to it.  I think it is very similar to women that are sensitive to vaginal yeast infections also.  One of the things I have found to really help is to eat yogurt everyday

Response:

Mary:  regarding Flovent and thrush.  Generally speaking, thrush from Flovent and other inhaled corticosteriods is kind of hard to get.  Simple mouth care is all that is really necessary.  For example, if you take Flovent 2x/day, take it first thing in the a.m., eat breakfast, brush teeth … take it before bedtime and brush teeth before sleeping.  If you’re on the road, drink a few sips of water, soda, breath mints, etc.  Yes, thrush is transmittable, avoid kissing and wash eating utensils thoroughly afterwards.  To get thrush in the first place, you must be immunocompromised, or not eating/drinking for days (say an unconscious patient in ICU).  I take Azmacort (another corticosteroid) and honestly the aftertaste is so bad,  it’s not hard to remember to use mouthwash/drink/eat/brush teeth!! An asthmatic health professional

Response:

I take Flovent and the only problems I have with it is it makes your throat sore if I dont rinse well. As far as passing thrush on to a boyfriend, I have never heard of that..

Response:

The use of a spacer, can reduce the risk of getting thrush.  It is also a good idea to use a spacer, so the meds get in your lungs, not on on your tongue, roof of your mouth etc…

Response:

rinsing your mouth out, with just water, after each inhaler treatment, will greatly reduce the odds of getting thrush. btw, white oak bark tea works great on killing thrush.  i am not usually a proponent of alternative styles of medicine, but it worked for me.

Response:

You should always rinse out your mouth after using an inhaler.  Especially if you are using any type of steroid inhalers.

The use of a spacer, can reduce the risk of getting thrush.  It is also a good idea to use a spacer, so the meds get in your lungs, not on on your tongue, roof of your mouth etc…

Response:

Question:

- Hide quoted text — Show quoted text -I’ve been taking Serevent 2 puffs twice a day and Flovent two puffs twice a day for about 6 months with amazing results.  I’ve gotten to the point that I rarely use my Proventil which is almost a miracle to me. In the last week or so I’ve started having anxiety-like attacks in the evening. I don’t have racing hearbeat but I feel extremely anxious and weird.  Kinda like I took too much Theo-Dur, if any of you know that feeling.  It is very intense.  The only thing I can link it to is the evening dose of Serevent. Has anyone else had this? Maybe I only need to take the Serevent in the a.m.?  I’m going to see my doc but thought I would ask here just in case he tries to tell me I’m nuts (G). Thanks for your help. CarolR

Saw my doctor today and he said the Serevent can cause the anxiety problems. He suggested I try 1 puff twice a day, or 2 puffs in the a.m. and 1 at night to see if that would work.  Also told me to use my peak flow meter to see if I even needed to the Serevent to open the airways.  I had been using to open it up so the Flovent would work.  So…we shall see how it goes. Thanks for all your notes. CarolR

Response:

I’ve been taking Serevent 2 puffs twice a day and Flovent two puffs twice a day for about 6 months with amazing results.  I’ve gotten to the point that I rarely use my Proventil which is almost a miracle to me. In the last week or so I’ve started having anxiety-like attacks in the evening.  I don’t have racing hearbeat but I feel extremely anxious and weird.  Kinda like I took too much Theo-Dur, if any of you know that feeling.  It is very intense.  The only thing I can link it to is the evening dose of Serevent.  Has anyone else had this? Maybe I only need to take the Serevent in the a.m.?  I’m going to see my doc but thought I would ask here just in case he tries to tell me I’m nuts (G). Thanks for your help. CarolR

Response:

You are not nuts. I had the same experience and had to eventually cut out the Serevent due to the anxiety attacks. I know I am very sensitive to medications, and even one puff once a day was too much for me. I am feeling alot better as far as the anxiety goes since stopping Serevent. Hope this helps.

Response:

You are not nuts. I had the same experience and had to eventually cut out the Serevent due to the anxiety attacks. I know I am very sensitive to medications, and even one puff once a day was too much for me. I am feeling alot better as far as the anxiety goes since stopping Serevent. Hope this helps.

It helps a lot.  At least I know I’m not the only one this has happened to! What’s weird is that it doesn’t happen witht he morning dose but just the evening dose.  Maybe I can only take 1 dose a day now? I didn’t take it this morning and I found I really needed it.   Is nothing simple anymore?? (G) CarolR

Response:

Hello: This is EXACTLY why I stopped taking serevent. The exact same symptoms you have. You know, I don’t know why there is so much emphasis on using serevent to get off of a shorter acting type of albuterol. In my opinion, serevent has more severe side effects. I’d talk to your doctor about stopping the serevent. The flovent for me made a HUGE difference. Mabye up that if it gets worse when you go off the serevent. On 12 Aug 1999, – Hide quoted text — Show quoted text – I’ve been taking Serevent 2 puffs twice a day and Flovent two puffs twice a day for about 6 months with amazing results.  I’ve gotten to the point that I rarely use my Proventil which is almost a miracle to me. In the last week or so I’ve started having anxiety-like attacks in the evening.  I don’t have racing hearbeat but I feel extremely anxious and weird.  Kinda like I took too much Theo-Dur, if any of you know that feeling.  It is very intense.  The only thing I can link it to is the evening dose of Serevent.  Has anyone else had this? Maybe I only need to take the Serevent in the a.m.?  I’m going to see my doc but thought I would ask here just in case he tries to tell me I’m nuts (G). Thanks for your help. CarolR

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

Response:

Question:

Candy, It could be the Celexa.  I am banking on the fact that it may be your routine being goofed up.  Most SSRI’s have the possibility of anxiety as a side affect.  You know I have had no problems, but thats just me. What dosage are you on? Chad Love is true when you can’t see eye to eye, but can still walk hand in hand.

Response:

:Hi I havent posted for a while but i have some questions. I have been on :the xanax for about 1 yr now for the second time around. I used to take anax and zoloft but the zoloft didnt do anything for me really. now i :am on the xanax again and i am taking celexa. I feel like i am ready to :go back on zoloft. With the celexa i feel a little jittery and i have :been having alot of anxiety which i think is strange because i am taking :my xanax regularly. does celexa cause or make anxiety heighten?

All the antidepressants may increase anxiety initially. However, this usually stops when they "kick-in," but that may take 3-8 weeks. You can reduce this side effect by starting on a low dose, usually 1/4 the smallest dose tablet (in this case 5mg) and upping the dose by 1/4 tablet every 7-10 days. Those that are particularly sensitive may need to start on and ramp up by only 1/8th of a tablet. :i have :been on the celexa for 4 weeks now and im trying to give it time but i :am so tired of feeling certin ways because of a med or no med. i jsut :dont know why im feeling this way  is it the celexa or is it just the :anxiety?

It may be a combination of both a chemical effect, and also a psychological one. A lot of us have pill phobia too. :why would i do this after taking my xanax though. i have never :had this problem before.

There are limits to how much anxiety any med, including the benzos, can control at any given dose. It seems that the Xanax dose you’re on isn’t sufficient to handle the increased anxiety Celexa is producing. Talk to your doctor about increasing Xanax for a few weeks. :i know m xanax use to last for about 8 hours :then it was about down to six and that is about all the time now but :since taking celexa about 4 hours after taking my xanax i feell lie im :going to have a panic attack.

Although it varies from person to person, Xanax is usually only effective for 4-5 hours. :i just dont understand. i have gone on 3rd :shift working now which has everything all screwed up anyway. my sleep :is screwed up and i am irritable.

All of which is probably contributing to the increased anxiety. :i hope none of this has to do with the :new med(celexa) my psychiatrist told me to give it some time.Any :suggestions or help, i really could use it right now.Thanks :

Only to hang in for a few more weeks. Antidepressants are generally very effective anxiety medications, but they do make matters worse initially. But when they begin working they make the pain and misery worthwhile. Its a bit like giving birth, but "labour" lasts much longer. :Candy Harvey

Best wishes Ian

Response:

Candy, Stick with it a couple more weeks.  The other posts are very informative.  I have worked 3rd shift, and the effects that gave me were almost as bad as the panic.  Your sleep pattern is all out of whack, plus the other things that are going on ith you.  Slow down, relax, and try to be nice to yourself, I am praying the Celexa will work for you! Chad Love is true when you can’t see eye to eye, but can still walk hand in hand.

Response:

Thanks for the info everyone. i will hang in there for a while and see what hapens. it is realy great to have you guys ther all of the time. hanks a million and i love yaall. Candy

Response:

Chad Im only on 20mg a day. but i tell you it is rough. one med always has to alter the other or symptoms  everythign is so messed up sometimes. Thanks for the advice. Candy

Response:

Hi Candy- I just switched from paxil to celexa.  For the first month I had increased anxiety and the jitters.  My pdoc said that if it didn’t subside I might need a higher dose, but she wanted to wait till I had been taking it eight weeks before any adjustments were made.  Even with low dose xanax I was still anxious.   The good news, is that at about five weeks the anxiety subsided and I am now doing better at six weeks into celexa than I did in ten months on paxil. If I were you I’d call the doc and try to hang in just a little bit longer.   YMMV Take care, Jess – Hide quoted text — Show quoted text -Hi I havent posted for a while but i have some questions. I have been on the xanax for about 1 yr now for the second time around. I used to take xanax and zoloft but the zoloft didnt do anything for me really. now i am on the xanax again and i am taking celexa. I feel like i am ready to go back on zoloft. With the celexa i feel a little jittery and i have been having alot of anxiety which i think is strange because i am taking my xanax regularly. does celexa cause or make anxiety heighten? i have been on the celexa for 4 weeks now and im trying to give it time but i am so tired of feeling certin ways because of a med or no med. i jsut dont know why im feeling this way  is it the celexa or is it just the anxiety? why would i do this after taking my xanax though. i have never had this problem before. i know m xanax use to last for about 8 hours then it was about down to six and that is about all the time now but since taking celexa about 4 hours after taking my xanax i feell lie im going to have a panic attack. i just dont understand. i have gone on 3rd shift working now which has everything all screwed up anyway. my sleep is screwed up and i am irritable. i hope none of this has to do with the new med(celexa) my psychiatrist told me to give it some time.Any suggestions or help, i really could use it right now.Thanks Candy Harvey

Response:

Hi I havent posted for a while but i have some questions. I have been on the xanax for about 1 yr now for the second time around. I used to take xanax and zoloft but the zoloft didnt do anything for me really. now i am on the xanax again and i am taking celexa. I feel like i am ready to go back on zoloft. With the celexa i feel a little jittery and i have been having alot of anxiety which i think is strange because i am taking my xanax regularly. does celexa cause or make anxiety heighten? i have been on the celexa for 4 weeks now and im trying to give it time but i am so tired of feeling certin ways because of a med or no med. i jsut dont know why im feeling this way  is it the celexa or is it just the anxiety? why would i do this after taking my xanax though. i have never had this problem before. i know m xanax use to last for about 8 hours then it was about down to six and that is about all the time now but since taking celexa about 4 hours after taking my xanax i feell lie im going to have a panic attack. i just dont understand. i have gone on 3rd shift working now which has everything all screwed up anyway. my sleep is screwed up and i am irritable. i hope none of this has to do with the new med(celexa) my psychiatrist told me to give it some time.Any suggestions or help, i really could use it right now.Thanks Candy Harvey

Response:

Question:

my only intent on this matter… was to warn Karen that this is something she should be concerned about… and that she should be in contact with her dr……. You stated:" warnings are only to remind the drs" I would disagree. The pharmacies in this area give out a "patient information leaflet" on each medication that they fill. This is listed on the warnings that goes out to the patient. You also stated that is was "unfair" for me::" to characterize that prozac and serzone have the potential to cause suicidal tendancies. "  I am not on the payroll for these companies…..(unfortunately    ) My only concern was to advise Karen b4 she attempted that warning… Tami…:) ) – Hide quoted text — Show quoted text – I don’t believe tha your PDR states specifically that suicidal tendancies are a side effect of prozac or serzone. Instead, I believe that it says something slightly different. Am I right? my mistake..  it is not listed under side effects .it is listed under contraindications: "use with extreme caution in patients at risk for suicide." "monitor moods and allow minimal supply to be filled at pharmacy." my point being.. that u can feel this way while taking this medication and she needs to contact her dr. and be monitored so she does not follow thru on this. Yeah. Well, the reason I asked a question instead of made a statement is that I thought you might learn a bit better if you looked it up yourself. Anyway, suicidal ideation is a not uncommonly encountered symptom of depression itself. I thought I’d refine your post, because it’s really not fair to characterize prozac or other ad’s as contrib- uting to suicidal ideation. Medications that have such warnings usually do so to remind the physician that their patient may be suicidal; in fact, some medications — particularly those that can be overdosed — make this warning very clear so as to alert the physician to the possibility of using the medication itself as an instrument of suicide. C/

Response:

Serzone was the last anti-depressant I took last January through July. I have taken zolft, prozac, effexor, and trazodone when it comes to anti-depressants.  Of all of them Effexor has worked the best.  I am about to be put back on an anti-depressant for circumstances I don’t want to say, but I have been on about 18 meds because I am bipolar. – Hide quoted text — Show quoted text – I have been on Serzone a month and a half.  I am afraid to be alone any time at all and I have a lot of suicidal thoughts…how can I safely get off and what other anti-depressant could I mix with it and start taking immediately that would be safe? I also take synthroid and ativan. Before you buy.

Response:

I was also on Serzone for several months and found myself tearful most of the time,almost suicidal. I talked with my Md. and was changed to Celexa. I have found myself much better. Talk with your doctor as there are many more medicines that may help you. http://community.webtv.net/strawsmom/MERRYCHRISTMASTOALL

Response:

I don’t believe tha your PDR states specifically that suicidal tendancies are a side effect of prozac or serzone. Instead, I believe that it says something slightly different. Am I right? my mistake..  it is not listed under side effects .it is listed under contraindications: "use with extreme caution in patients at risk for suicide." "monitor moods and allow minimal supply to be filled at pharmacy." my point being.. that u can feel this way while taking this medication and she needs to contact her dr. and be monitored so she does not follow thru on this.

Yeah. Well, the reason I asked a question instead of made a statement is that I thought you might learn a bit better if you looked it up yourself. Anyway, suicidal ideation is a not uncommonly encountered symptom of depression itself. I thought I’d refine your post, because it’s really not fair to characterize prozac or other ad’s as contrib- uting to suicidal ideation. Medications that have such warnings usually do so to remind the physician that their patient may be suicidal; in fact, some medications — particularly those that can be overdosed — make this warning very clear so as to alert the physician to the possibility of using the medication itself as an instrument of suicide. C/

Response:

my mistake..  it is not listed under side effects .it is listed under contraindications: "use with extreme caution in patients at risk for suicide." "monitor moods and allow minimal supply to be filled at pharmacy." my point being.. that u can feel this way while taking this medication and she needs to contact her dr. and be monitored so she does not follow thru on this. tami – Hide quoted text — Show quoted text –  i got out my nursing drug handbook.. and as i thought .. it is a side effect of serzone, just as it is for prozac…suicidal tendancies. I don’t believe tha your PDR states specifically that suicidal tendancies are a side effect of prozac or serzone. Instead, I believe that it says something slightly different. Am I right? C/

Response:

 i got out my nursing drug handbook.. and as i thought .. it is a side effect of serzone, just as it is for prozac…suicidal tendancies.

I don’t believe tha your PDR states specifically that suicidal tendancies are a side effect of prozac or serzone. Instead, I believe that it says something slightly different. Am I right? C/

Response:

 i got out my nursing drug handbook.. and as i thought .. it is a side effect of serzone, just as it is for prozac…suicidal tendancies. u need to get in touch with your dr right away…. he needs to know this…. so he can change your med… 1 rule to follow..:u need to go to "one "pharmacy to get your drugs filled. so your pharmicist is aware of the meds u are on, for any drug interactions..  tami….. – Hide quoted text — Show quoted text – I have been on Serzone a month and a half.  I am afraid to be alone any time at all and I have a lot of suicidal thoughts…how can I safely get off and what other anti-depressant could I mix with it and start taking immediately that would be safe? I also take synthroid and ativan. Before you buy.

Response:

    I posted this before http://www.ozemail.com.au/~drobb/bms/pi.htm for info on Serzone. It has some interesting things to say.     I use Valium when I need it and passed on the offers of Zoloft, Xanax, Prozac, and the like. I was already aware, from first hand observation of those taking them, of what they are capable of. I will stay with what I have, thank you. It may not be popular but it seems to be a whole lot safer if you don’t need the effects that the others bring. It may not be the best solution but it is one that works for me to take the edge off when needed. The best part is that I was allowed to use the minimum dosage and when I need it. The hard part is trying to get through those times when you may want to take it but you know the feelings will pass faster than the pill can take effect so you just tough it out. If you can do that, you have half the battle won. Good Luck.

– Hide quoted text — Show quoted text -my mistake..  it is not listed under side effects .it is listed under contraindications: "use with extreme caution in patients at risk for suicide." "monitor moods and allow minimal supply to be filled at pharmacy." my point being.. that u can feel this way while taking this medication and she needs to contact her dr. and be monitored so she does not follow thru on this. tami  i got out my nursing drug handbook.. and as i thought .. it is a side effect of serzone, just as it is for prozac…suicidal tendancies. I don’t believe tha your PDR states specifically that suicidal tendancies are a side effect of prozac or serzone. Instead, I believe that it says something slightly different. Am I right? C/

Response:

If you are hypo-thyroid and feeling suicidal 1) make sure your thyroid hormone level is adequate 2) get switched onto a T4/T3 combo And just because a TSH test was done and the numbers are in "the normal range" does NOT mean you are not hypo-  there are problems with how the TSH normal range is calibrated, most MDs are not aware of the issues and questions about this.  They are taught that the TSH test is definite, accurate and extremely sensitive — sensitive it is, but the accuracy depends upon how it is interpreted (not blindly) and it can never be definite — because there are forms of thyroid disease where TSH numbers become meaningless.   T3 is one of the best anti-depressants in the shinks arsenal, most MDs however ignore or don’t know this. Depression and suicidal feelings are a symptom of hypo-, you may be undermedicated for hypo- or mis-diagnosed as NOT hypo- when you are. I know nothing about Serzone, I am not a medical doctor, do not change your medication without checking with your doctor(s) — Kevin G. Rhoads, Ph.D. (The Cheshire Cat for official Internet mascot.)

Response:

I have been on Serzone a month and a half.  I am afraid to be alone any time at all and I have a lot of suicidal thoughts…how can I safely get off and what other anti-depressant could I mix with it and start taking immediately that would be safe? I also take synthroid and ativan. Before you buy.

Karen, The only idvise i can give, see your dokter. Efexor helped me get over the suicadal thoughts. taking now 300 mg, two times 150 mg. Kevin

Response:

    You know, suicidal thoughts occur to a lot of people a lot of the time. There are days when it is a thought and something distracts you and you go about your business until the next time. Depression doesn’t help things either but staying busy and having an active social life is a tremendous help. Most of us here have had bouts with depression ( some severe and some accompanying PTSS ). My heart goes out to you. Please feel free to write if the need arises.     I have found a link to the product information on Serzone. It may help you ( or even the others here to help )  you understand better how it works and if you should discuss it at length with your doctor ( my personal opinion from experience is to talk to them at length about it ). The link is http://www.ozemail.com.au/~drobb/bms/pi.htm and it goes into some depth so assistance from someone like Ted or one of the others that are more medically or chemically knowledgeable may be needed to understand it better and maybe explain it all to you in lay terms ( Lord knows I don’t understand it all ).     If the thoughts of suicide become too much I suggest you get a hold of a friend and have them take you to the hospital for observation until it passes. Life is too short and precious to waste on a disease that is treatable. The hospital cannot keep you if you wish to leave so you shouldn’t worry about that, but, having caring people available with the knowledge to help will save you from doing anything rash. It would also be of benefit if a different type of medication needed in it’s place.     From all that I can gather on Ativan, it is in the same family as Valium and has potential for dependence. Personally, I take Valium in as small a dose as possible when needed. I wouldn’t, however, discontinue use of your medication under any circumstance unless it is under observation and approval by a health professional. ( this doesn’t mean it has to be in a hospital but your doctor does need to know if you are discontiuing use as potential for withdrawl symptoms can cause complications ).     Yes, you have a couple of issues that need to be resolved. I found that as the level of thyroid medication was increased I needed less and less of the Valium for the anxiety attack ( of course mine are PTSS related ). I’ve had to learn that they will pass in time and that I will be okay ( I can feel when they are coming on so I take a small dose of Valium at the onset ). Even without the Valium, I know it will pass but I try to stay active during the episodes ( it seems to help ). After learning to cope, the episodes tend to diminish in intensity when they do happen and so they happen less frequently than they used to.     You may find you have similar result or find something else that works for you. In either case you need to talk to your doctor about it and discuss your options. Always remember you have people you can talk to and if nothing else, I monitor this group and my own mail regularly. Feel free to write if you need. You are not alone, even when you are by yourself. All you need to do is let someone know.

– Hide quoted text — Show quoted text -I have been on Serzone a month and a half.  I am afraid to be alone any time at all and I have a lot of suicidal thoughts…how can I safely get off and what other anti-depressant could I mix with it and start taking immediately that would be safe? I also take synthroid and ativan. Before you buy.

Response:

A month and a half is just enough time to get onto the first rung, re: dose. Since his dose is not working well enough, ask your doctor about another step up.  It is a long process to find the right med and the right dose… but it sounds like it may be too early to give up on this one yet. If you are having suicidal thoughts, the important thing is to NOT be alone, while your meds are adjusted and stabilize (which can take many weeks). Don’t be discouraged….  but also, don’t be alone until you are at a dose that works well enough. I was on serzone for  8 months over which i went from 50 mg/day up to 600mg/day.  I liked serzone re: lack of adverse side effects, but it just wasn’t enough for me.  It was thoughts (and detailed plans) of suicide at the 600mg/day level that got me to change (i.e. give up).  The difficult part in any change is the interface, the drop out from one med, the drop in of the other.  If you reach a point where you need to change meds, do not trust yourself being alone during this period.  Ask a close friend to ride with you.  Or if all else fails, the hospital is there to ensure that you are protected during these transitions.  There is no shame.  The right medication will help, and you will be glad, and safe, and free from the suicidal thoughts…. once you find it. Again, I think it may be too early for you to give up on the serzone yet… try higher doses with your pdoc (what dose are you on now?).   For many people serzone is very effective, and it’s the one they stay with….  once the find the right dose. best wishes, Han

– Hide quoted text — Show quoted text – I have been on Serzone a month and a half.  I am afraid to be alone any time at all and I have a lot of suicidal thoughts…how can I safely get off and what other anti-depressant could I mix with it and start taking immediately that would be safe? I also take synthroid and ativan. Before you buy.

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You should talk to the prescribing doctor (s) as soon as  possible. What works for one of us may not work for you.  Bob

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I have been on Serzone a month and a half.  I am afraid to be alone any time at all and I have a lot of suicidal thoughts…how can I safely get off and what other anti-depressant could I mix with it and start taking immediately that would be safe? I also take synthroid and ativan. Before you buy.

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Question:

Twice a day won’t work with Neurontin unless you are worried about seizures. It wears off! If you can’t do at least 3x a day I am afraid you may be wasting your money. On 4x a day maybe you could take less. I don’t think Wellbutrin is the AD for you. I suggest something in the Celexa line, or if you could use help getting to sleep, Remeron. Just have your pharmacist give me a call. Keith – Hide quoted text — Show quoted text -Do you think going higher in dosage would help?  James suggests taking it every 6 hours would help.  I have a hard enough time remembering it twice a day.  At work it is chaos at times and remembering to take the medication would be very difficult.  So far I see no adverse reactions.  I can go higher.  It is costing me 300 a month but I would pay 500 or even 1000 dollars a month if I could enjoy life on a daily basis.  It took away my high highs… now I am left with really some bad bad lows.  But I do cycle out for a few short hours… but mornings are hell.  I take the meds at noon and in the evening.  That isn’t spaced out right though.  Should take the evening dose later but the morning dose wears off.  I don’t know if raising the wellbutrin would help.  Maybe I need to ask for Lamictal.  So tired of this.  Life was so much easier years ago.

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Do you think going higher in dosage would help?  James suggests taking it every 6 hours would help.  I have a hard enough time remembering it twice a day.  At work it is chaos at times and remembering to take the medication would be very difficult.  So far I see no adverse reactions.  I can go higher.  It is costing me 300 a month but I would pay 500 or even 1000 dollars a month if I could enjoy life on a daily basis.  It took away my high highs… now I am left with really some bad bad lows.  But I do cycle out for a few short hours… but mornings are hell.  I take the meds at noon and in the evening.  That isn’t spaced out right though.  Should take the evening dose later but the morning dose wears off.  I don’t know if raising the wellbutrin would help.  Maybe I need to ask for Lamictal.  So tired of this.  Life was so much easier years ago. —   O  ooo   Cindy          O – Hide quoted text — Show quoted text – I am on 2400mg and still cycle….I just have lower lows and lower highs. I don’t feel clearer in thinking…but compared to lithium..whew!  This is MUCH better.  Just wish it would help more with the depressions. There appears to be no known therapeutic blood serum level for gabapentin used in bipolar. Each person will need a different amount. You could go as high as your doctor would allow, but money would be a limiting factor.

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I am on 2400mg and still cycle….I just have lower lows and lower highs.  I don’t feel clearer in thinking…but compared to lithium..whew!  This is MUCH better.  Just wish it would help more with the depressions.

There appears to be no known therapeutic blood serum level for gabapentin used in bipolar. Each person will need a different amount. You could go as high as your doctor would allow, but money would be a limiting factor.

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– Hide quoted text — Show quoted text – 4800mg is considered high, and the therapeutic range seems to span all dosages, at least for bipolar. Greetings everybody, I have rapid cyclings with sometimes mixed states. I never had any manic episode. I never took any mood stabilizer in my life. I’ve been taking antidepressants and anxiolytics for 10 years now with moderate results. And i lost so many jobs… So Neurontin is my first mood stabilizer. I’ve been taking Neurontin (100 mg x 4 per day) for 2 weeks now. I also take Effexor XR 150 mg per day. My mood is better. I’m not anymore angry and the anxiety is almost gone. My concentration is improved too. It’s great. I’m starting again to live after a long nightmare. However, i still have sometimes cyclings even if they are more rare and lower in intensity. What is the therapeutic range of Neurontin? I want to feel fine but to be honest i’m afraid to be *zombified* by a too much high dose of Neurontin. Suggestions? Thanks in advance. Eric

Eric when I was on this drug, which was way back when it first came out on the market.  I was one of the test people for the drug.  I took 3600mgs. So higher doseages can be tolerated for this drug.  I was on it at least 3 different times for different reasons.  I was taken off 2 times and put back on it 2 other times to make it a total of 3 times.  The other mood stabilizer I was on it with I think was either Depakote or Lithium.  I am almost quite sure it was Depakote.   Betsy

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I am on 2400mg and still cycle….I just have lower lows and lower highs.  I don’t feel clearer in thinking…but compared to lithium..whew!  This is MUCH better.  Just wish it would help more with the depressions. —   O  ooo   Cindy          O – Hide quoted text — Show quoted text – Neurontin has been extremely helpful to me as an anti-depressant, mood stabilizer for me recently. I am a manic depressive. I’m nearly certain that the therapeutic range is about 400 to 2500 mgs. I am taking 2000mgs or just simply 2gs. By the way, I don’t feel "zombefied". On the contrary I feel very alert and relatively up. Good luck Ephriam Greetings everybody, I have rapid cyclings with sometimes mixed states. I never had any manic episode. I never took any mood stabilizer in my life. I’ve been taking antidepressants and anxiolytics for 10 years now with moderate results. And i lost so many jobs… So Neurontin is my first mood stabilizer. I’ve been taking Neurontin (100 mg x 4 per day) for 2 weeks now. I also take Effexor XR 150 mg per day. My mood is better. I’m not anymore angry and the anxiety is almost gone. My concentration is improved too. It’s great. I’m starting again to live after a long nightmare. However, i still have sometimes cyclings even if they are more rare and lower in intensity. What is the therapeutic range of Neurontin? I want to feel fine but to be honest i’m afraid to be *zombified* by a too much high dose of Neurontin. Suggestions? Thanks in advance. Eric

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Which mood stabizer did you use along with neurontin? —   O  ooo   Cindy          O – Hide quoted text — Show quoted text – Greetings everybody, I have rapid cyclings with sometimes mixed states. I never had any manic episode. I never took any mood stabilizer in my life. I’ve been taking antidepressants and anxiolytics for 10 years now with moderate results. And i lost so many jobs… So Neurontin is my first mood stabilizer. I’ve been taking Neurontin (100 mg x 4 per day) for 2 weeks now. I also take Effexor XR 150 mg per day. My mood is better. I’m not anymore angry and the anxiety is almost gone. My concentration is improved too. It’s great. I’m starting again to live after a long nightmare. However, i still have sometimes cyclings even if they are more rare and lower in intensity. What is the therapeutic range of Neurontin? I want to feel fine but to be honest i’m afraid to be *zombified* by a too much high dose of Neurontin. Suggestions? You can use more than one mood stabilizer. Neurontin should be taken every six hours.  A good therapeutic dose for me was 300 mgs 4 x per day until I added another mood stabilizer.  Once I had polytherapy I was able to lower my dose of Neurontin to 600 to 900 mgs per day. Good luck to you. Julie Thanks in advance. Eric

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Do i still have to take Neurontin 4 times a day if i increase the dosage from 400 to 600 or even 800 mg? What are the side effects of Neurontin at this dosage? Thanks.

Eric: The Neurontin is excreted every six hours.  Eight if you have a slow renal excretion rate. The six hours apart is crucial if it is your only mood stabilizer.  Even if you have increased the dosage. I learned that the hard way and ended up ultra rapidly cycling till I joined the ranks of the James Milton Philosophy It had it’s drawbacks, like setting my alarm for three am just to take a pill.  I did get used to it and it was effective.  I also got tired of it and now take 2 mood stabilizers and only take Neurontin 2x per day. Good Luck! Julie – Hide quoted text — Show quoted text – Eric

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4800mg is considered high, and the therapeutic range seems to span all dosages, at least for bipolar. – Hide quoted text — Show quoted text – Greetings everybody, I have rapid cyclings with sometimes mixed states. I never had any manic episode. I never took any mood stabilizer in my life. I’ve been taking antidepressants and anxiolytics for 10 years now with moderate results. And i lost so many jobs… So Neurontin is my first mood stabilizer. I’ve been taking Neurontin (100 mg x 4 per day) for 2 weeks now. I also take Effexor XR 150 mg per day. My mood is better. I’m not anymore angry and the anxiety is almost gone. My concentration is improved too. It’s great. I’m starting again to live after a long nightmare. However, i still have sometimes cyclings even if they are more rare and lower in intensity. What is the therapeutic range of Neurontin? I want to feel fine but to be honest i’m afraid to be *zombified* by a too much high dose of Neurontin. Suggestions? Thanks in advance. Eric

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- Hide quoted text — Show quoted text – Greetings everybody, I have rapid cyclings with sometimes mixed states. I never had any manic episode. I never took any mood stabilizer in my life. I’ve been taking antidepressants and anxiolytics for 10 years now with moderate results. And i lost so many jobs… So Neurontin is my first mood stabilizer. I’ve been taking Neurontin (100 mg x 4 per day) for 2 weeks now. I also take Effexor XR 150 mg per day. My mood is better. I’m not anymore angry and the anxiety is almost gone. My concentration is improved too. It’s great. I’m starting again to live after a long nightmare. However, i still have sometimes cyclings even if they are more rare and lower in intensity. What is the therapeutic range of Neurontin? I want to feel fine but to be honest i’m afraid to be *zombified* by a too much high dose of Neurontin. Suggestions?

You can use more than one mood stabilizer. Neurontin should be taken every six hours.  A good therapeutic dose for me was 300 mgs 4 x per day until I added another mood stabilizer.  Once I had polytherapy I was able to lower my dose of Neurontin to 600 to 900 mgs per day. Good luck to you. Julie – Hide quoted text — Show quoted text – Thanks in advance. Eric

Response:

Neurontin has been extremely helpful to me as an anti-depressant, mood stabilizer for me recently. I am a manic depressive. I’m nearly certain that the therapeutic range is about 400 to 2500 mgs. I am taking 2000mgs or just simply 2gs. By the way, I don’t feel "zombefied". On the contrary I feel very alert and relatively up. Good luck Ephriam

Do i still have to take Neurontin 4 times a day if i increase the dosage from 400 to 600 or even 800 mg? What are the side effects of Neurontin at this dosage? Thanks. Eric

Response:

Greetings everybody, I have rapid cyclings with sometimes mixed states. I never had any manic episode. I never took any mood stabilizer in my life. I’ve been taking antidepressants and anxiolytics for 10 years now with moderate results. And i lost so many jobs… So Neurontin is my first mood stabilizer. I’ve been taking Neurontin (100 mg x 4 per day) for 2 weeks now. I also take Effexor XR 150 mg per day. My mood is better. I’m not anymore angry and the anxiety is almost gone. My concentration is improved too. It’s great. I’m starting again to live after a long nightmare. However, i still have sometimes cyclings even if they are more rare and lower in intensity. What is the therapeutic range of Neurontin? I want to feel fine but to be honest i’m afraid to be *zombified* by a too much high dose of Neurontin. Suggestions? Thanks in advance. Eric

Response:

Neurontin has been extremely helpful to me as an anti-depressant, mood stabilizer for me recently. I am a manic depressive. I’m nearly certain that the therapeutic range is about 400 to 2500 mgs. I am taking 2000mgs or just simply 2gs. By the way, I don’t feel "zombefied". On the contrary I feel very alert and relatively up. Good luck Ephriam – Hide quoted text — Show quoted text – Greetings everybody, I have rapid cyclings with sometimes mixed states. I never had any manic episode. I never took any mood stabilizer in my life. I’ve been taking antidepressants and anxiolytics for 10 years now with moderate results. And i lost so many jobs… So Neurontin is my first mood stabilizer. I’ve been taking Neurontin (100 mg x 4 per day) for 2 weeks now. I also take Effexor XR 150 mg per day. My mood is better. I’m not anymore angry and the anxiety is almost gone. My concentration is improved too. It’s great. I’m starting again to live after a long nightmare. However, i still have sometimes cyclings even if they are more rare and lower in intensity. What is the therapeutic range of Neurontin? I want to feel fine but to be honest i’m afraid to be *zombified* by a too much high dose of Neurontin. Suggestions? Thanks in advance. Eric

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Question:

– Hide quoted text — Show quoted text – <major snippage I’ve been in constant pain for months and they’ve run more tests than I wanted them to, cat scans and ultrasounds in addition to blood tests. They tell me that pain can be from being BP. Are you saying not? brownee Brownee, I’ve had chronic back pain since a teenager, some…er…30 years ago. I even had an operation on a couple of disks back in ‘84, but was still in a lot of pain and used a cane to get around, had a handicapped plate, the whole bit.  When I started on my first antidepressant, I became pain free within three months.  That was 5+ years ago, and I don’t even remember where my cane is now.  So in my case, the pain was certainly related at least to the depressive side of bipolar;  but since I’ve been hypomanic nearly all my life, I’d vote that it’s the BP making me feel the pain.

That makes me think — an occasionally meritorious thing to do IMO — if not carried to excess of course. I wonder if BP-heightened sensitivities could somehow magnify small "normal" aches and pains into what becomes excruciating sensations for us??? It’s like the pain signals are being processed through a mental amplifier before impacting upon the portions of our brains that register pain. Hummm …. So it is all in my head after all. <G Brian

James

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hey mc, same here. recently increased zoloft and all achey all over. also last summer while manic and on no meds i was in terrible pain that i couldn’t explain–neck, back, joints, bones, feet—even my hair hurt. must be that hypersensitivity or maybe the psychic pain manifesting as physical.     best, lny

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Hi Brownee–I have major aches and pains, too. I’ve blamed it on fibromyalgia–or something– for quite some time…… Just read tonight that one of the more obscure side effects of Zoloft ( and the other SSRI’s, I assume ) is major joint aches…..Interesting, since I’ve been alot worse lately and have also recently upped my dose of Z. You might also do a search on Substance P. It’s a neurotransmitter that is related to pain transmission and they’ve also found it to have marvelous AD effects…..They’re making it sound like it’s gonna be the next generation of successful ADs…..and pain relievers.   mc

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- Hide quoted text — Show quoted text – <major snippage I’ve been in constant pain for months and they’ve run more tests than I wanted them to, cat scans and ultrasounds in addition to blood tests. They tell me that pain can be from being BP. Are you saying not? brownee Brownee, I’ve had chronic back pain since a teenager, some…er…30 years ago. I even had an operation on a couple of disks back in ‘84, but was still in a lot of pain and used a cane to get around, had a handicapped plate, the whole bit.  When I started on my first antidepressant, I became pain free within three months.  That was 5+ years ago, and I don’t even remember where my cane is now.  So in my case, the pain was certainly related at least to the depressive side of bipolar;  but since I’ve been hypomanic nearly all my life, I’d vote that it’s the BP making me feel the pain.

Hey, thanks for giving me some hope that there will be some relief to this pain. I have a lot of joint pain which they insist is not arthritis and sometimes move so stiffly and awkwardly that I scare the cats. I was not looking forward to that for the rest of my life. That makes me think — an occasionally meritorious thing to do IMO — if not carried to excess of course. I wonder if BP-heightened sensitivities could somehow magnify small "normal" aches and pains into what becomes excruciating sensations for us??? It’s like the pain signals are being processed through a mental amplifier before impacting upon the portions of our brains that register pain. Hummm …. So it is all in my head after all. <G Brian James

That’s kind of what I was thinking throughout the "intrusions" thread. Maybe it’s all the same thing. Maybe we’re just so hypersensitive to everything. On the other hand, when I had surgery to relieve pain, the doctors felt that, based on my behavior, I could wait until the next non-emergency surgery, 2 weeks away. When I woke up, the doctor was there apologizing for making me wait those 2 weeks — what he’d found inside would have made him schedule immediate surgery if he’d known. Maybe we learn to "maintain" in front of the "normals"? Well, speaking of intrusions, today was a nice rainy day in the NW and I didn’t have to leave the house today or even do too much around the house and got to enjoy the peaceful sound of rain on the skylight. No kids shrieking, no bass thrumming, no basketballs thwumping. no dogs barking. Just rain. It was wonderful. brownee

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Question:

Jim wrote Rob, I’ve taken Zoloft, too. (200 mg: 100 mg 2xday). I have been diagnosed with Depression and Panic Disorder for 11 years now. I have tried every med combo possible and have just tried a new combo. My Xanax has been increased to 4mg per day. In addition I have been given 150 mg of Zoloft per day. After 6 weeks I have had the most marked improvement ever. However the Zoloft seems to give me naseua and loss of appetite. Is this a common side effect and will it ever go away? Anyone ever using Zoloft, Pleas

Rob, I didn’t experience nausea or a lack of appetite. Perhaps I was doing something differently than you.  How are you taking it? (divided dose, twice a day)? Taking any med on a full stomach usually helps with the nausea. I’ve also taken Zanax, briefly, as it didn’t agree with me very well. E-mail me if you want. Best regards, Jim

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Dear Jim, I am interested to know what the side effects were from taking Xanax.  I have been taking inc. amounts of it as per MDs directions and it doesn’t agree with me, either.What did you take in its place, if anything.  Thanks for your help – either e-mail me or post to group your feedback.

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Hey Rob, All I can tell you is that I’ve been diagnosed with manic depression for five years and Zoloft is the only medication that has not in any way caused any side effects. Good luck. .. Yours, Joe Pirrello – Toronto

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me  too

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I have been diagnosed with Depression and Panic Disorder for 11 years now. I have tried every med combo possible and have just tried a new combo. My Xanax has been increased to 4mg per day. In addition I have been given 150 mg of Zoloft per day. After 6 weeks I have had the most marked improvement ever. However the Zoloft seems to give me naseua and loss of appetite. Is this a common side effect and will it ever go away? Anyone ever using Zoloft, Please give some advice to me via E-Mail. Sincerely, Rob

I started taking Zoloft about 6 months ago and had the same problem. Try taking the Zoloft after meals & the nausea should subside.

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I have been diagnosed with Depression and Panic Disorder for 11 years now. I have tried every med combo possible and have just tried a new combo. My Xanax has been increased to 4mg per day. In addition I have been given 150 mg of Zoloft per day. After 6 weeks I have had the most marked improvement ever. However the Zoloft seems to give me naseua and loss of appetite. Is this a common side effect and will it ever go away? Anyone ever using Zoloft, Please give some advice to me via E-Mail. Sincerely, Rob

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Question:

Boy did this one thing you asked ring a bell.I am tired of hearing a doctor or professional tell me , I couldn’t have felt the affects of the medication because its too early.What a bunch of bull.Too often the real truth is professionals and psychiaitry is practiced so unevenly its truly a sin!.Each time you ask someone else you get a different answer.I too have taken Buspar for a day and instantly felt more relaxed.But I don’t take it too often cause I believe its just a stronger version of valium.at least and at most too strong.You have to determine whats right for you.However incidentally I had a doctor tell me, to take it as needed , no need to take it for weeks.With prozac I didn’t need to take that stuff longer then a week (2 bloody noses) to know what I felt and didn’t need  anyone to tell me what I felt was real or not real. what hogwash.Still glad buspar is around but still waiting for better science. Tell daughter to try exercise, stop smoking and eat healthy .

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I do realize however that some meds do work after getting in blood stream , and some especially anti depressants and mood meds might take a few weeks.Every person is different but more importantly  listen to your body , and incidentally Buspar is not one of the drugs that HAVE to be in your system for weeks.

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My teenage daughter (17 years old)  is taking Buspar for sever anxiety and panic disorder. I was wondering if anyone can help me here. She has just been on this medication for nearly 3 weeks now. Her inital does was 5mg morn 5mg afternoon and 10mg beditime. That was the first 2 weeks. She did show some signs of improvement but not nearly enough. Her dosage has now been increased to 7.5mg morn 7.5mg afternoon and 15mg bedtime. Question here is i understand that it takes weeks for it to take full effectivness, but seems when she feels anxiety now and takes the medication within mins she feels somewhat better. Is this possible, or does it have to reach its full limits before it works? Hope you can understand this question. Thanks in advance!

Hi Dad! BuSpar will *not* block panic attacks. The meds of choice for panic disorder are those that *do* block panic attacks. And these include the benzos (e.g. Xanax, Klonopin, etc) and the SSRIs (e.g. Prozac, Zoloft, Paxil, Celexa, etc.). Sounds like your daughter saw a GP instead of a psychiatrist (who she should see for med advice on panic disorder). Feeling better within minutes of taking a  BuSpar pill is a *placebo* effect (i.e. you have "faith" it will help, and thus it does). Chip Before you buy.

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My teenage daughter (17 years old)  is taking Buspar for sever anxiety and panic disorder. I was wondering if anyone can help me here. She has just been on this medication for nearly 3 weeks now. Her inital does was 5mg morn 5mg afternoon and 10mg beditime. That was the first 2 weeks. She did show some signs of improvement but not nearly enough. Her dosage has now been increased to 7.5mg morn 7.5mg afternoon and 15mg bedtime. Question here is i understand that it takes weeks for it to take full effectivness, but seems when she feels anxiety now and takes the medication within mins she feels somewhat better. Is this possible, or does it have to reach its full limits before it works? Hope you can understand this question. Thanks in advance!

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I sympathize, Neal, and oh, Thank You for answering one of my questions! I took the 3 others, for panic/anxiety… Prozac, zoloft, and paxil, and felt worse within a week. When I was prescribed Buspar, I had no high hopes, but I swear within an hour, I felt a heaviness, rather than extreme panic. An almost calmness, maybe sleepy, and it made me feel better immediately. I was given 7.5 mg, in am and again at pm for a week, then 15 mg am and pm, since then, about 2 months now. It hasnt helped completely, but feel a difference. I’m sorry I can’t answer your question, but sometimes, just having someone share an experience helps, a bit. I have been told by therapist that I may need an increase, but I haven’t felt comfortable about it yet. (also, i had been told before that there are no side effects from paxil, zoloft or prozac, and i KNOW that there are!) so go with what feels right, and what seems to be working- even a little bit at a time.

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Hi, I was recently prescribed Buspar for genreral anxiety disorder and after researching it a bit, I find I’m very confused.  I have both depression and GAD, but it’s the anxiety that’s bothering me most at the moment. (It’s hard sometimes to separate these things into categories, btw).  My question is this (I’m a bit of a newbie poster but I’ve read a lot).  Buspar and and SSRI’s appear to do different things.  Anxiety is apparently caused by too much serotonin. According to the www.buspar.com home page (sponsored by Bristol/Myers/Squibb):          "Your symptoms of persistent anxiety may be due to an imbalance of          a chemical called "serotonin" in the brain. It is believed that          an excess of serotonin may be one of the causes of persistent          anxiety. Other anti-anxiety medications work on different          chemicals in the brain.          BuSpar works differently from other anti-anxiety medications –          BuSpar works on the "serotonin system" in the brain to bring          serotonin levels back to normal." But I thought depression was caused by not enough serotonin.  If this is true, how can a person have both GAD and depression? (a common complaint, judging from a.s.d and a.s.p-a).  The SSRI I took several years ago (zoloft) seemed to greatly allieviate both anxiety and depression and I thought the mechanism was by increasing the effectiveness of serotonin (by inhibiting reuptake and leaving it in the synapses longer). Effectively correcting a _deficiency_ of serotonin. I’m confused. Moreover, my pdoc (confirmed by postings here) says that Buspar is sometimes combined with an antidepressant (SSRI or other) to increase the effective relief — either of GAD, depression or both! They seem to be doing opposite things, wouldn’t they cancel each other out? I’m sure I’m confused because I’m oversimplifying things. A quick history – I’ve had depression and anxiety for as long as I can remember and the only medicinal success I’ve had was with Zoloft several years ago.  Zoloft helped tremendously, it seemed to knock out the anxiety and lifted my depression.  There were side effects (drowsiness, sexual dampening, some word finding trouble), but it worked.  I went off it after I decided I was feeling good enough to give it a try.  The depression and anxiety gradually returned. A year later I tried it again but it increased my anxiety so much (like drinking several pots of coffee!) that I was unable to tolerate it even at small doses and I gave up before it gave me any benefit. Right now I’ve been on Buspar for about a week (10mg/day – I’m sensitive to drugs).  I’m not feeling any better, in fact the main effects seem to be dizziness, drowsiness, headache and poor concentration, even worse than before.  And improving concentration is one of the things Buspar is supposed to help!  And as evidenced by this post, my chronic worry doesn’t seem to be getting any better either  :-)  I seem to be getting a bit of the bruxism/jaw clenching that I recall was a side effect of zoloft too. Can anyone out there, either fellow sufferer or pharmacist help me understand the mechanics of these drugs? Anyway, should I should I stick it out with Buspar for a while (it’s been one week) despite the side effects? How long until I know whether it’s doing anything for me? I do recall that I had similar side effects for a couple weeks with zoloft (even worse.. there  was nausea too) before they started to subside and my depression/anxiety started to improve.  This time around, I’m more skeptical (both from the posts here that say Buspar isn’t generally too effective and from my confusion about how this drug is supposed to work.) The doc says that we may try Buspar in combination with a small dose of an antidepressant if it seems to help at all.  Again, this sounds confusing, but I’ve heard people have had some sucess with this. Thanks in advance -Grisha

Response:

(snip) But I thought depression was caused by not enough serotonin.  If this is true, how can a person have both GAD and depression? (a common complaint, judging from a.s.d and a.s.p-a).  The SSRI I took several years ago (zoloft) seemed to greatly allieviate both anxiety and depression and I thought the mechanism was by increasing the effectiveness of serotonin (by inhibiting reuptake and leaving it in the synapses longer). Effectively correcting a _deficiency_ of serotonin.

This is what I understood, too.  I’m on Zoloft. for GAD. I’m confused. Moreover, my pdoc (confirmed by postings here) says that Buspar is sometimes combined with an antidepressant (SSRI or other) to increase the effective relief — either of GAD, depression or both! They seem to be doing opposite things, wouldn’t they cancel each other out? I’m sure I’m confused because I’m oversimplifying things. A quick history – I’ve had depression and anxiety for as long as I can remember and the only medicinal success I’ve had was with Zoloft several years ago.  Zoloft helped tremendously, it seemed to knock out the anxiety and lifted my depression.  There were side effects (drowsiness, sexual dampening, some word finding trouble), but it worked.

Ah, I’ve ben wondering if my "word finding trouble" (<—good description!) is related to the Zoloft.  I guess maybe it is.   I went off it after I decided I was feeling good enough to give it a try.  The depression and anxiety gradually returned. A year later I tried it again but it increased my anxiety so much (like drinking several pots of coffee!) that I was unable to tolerate it even at small doses and I gave up before it gave me any benefit. Right now I’ve been on Buspar for about a week (10mg/day – I’m sensitive to drugs).  I’m not feeling any better, in fact the main effects seem to be dizziness, drowsiness, headache and poor concentration, even worse than before.

(snip) This probably won’t help you much, but I’ve been reading some of the posts from people on Buspar and wondering just how effective this drug is.  Four people I know were prescribed Buspar for anxiety/panic by their GP’s or OBGYN’s, and all 4 said it made them so much worse! They felt totally out of control on the Buspar, and did so much better on a different drug (Zoloft and maybe Prozac, IIRC).   Luckily, my psych. put me on Z from the get-go and I haven’t had any problems.   – Hide quoted text — Show quoted text -Anyway, should I should I stick it out with Buspar for a while (it’s been one week) despite the side effects? How long until I know whether it’s doing anything for me? I do recall that I had similar side effects for a couple weeks with zoloft (even worse.. there  was nausea too) before they started to subside and my depression/anxiety started to improve.  This time around, I’m more skeptical (both from the posts here that say Buspar isn’t generally too effective and from my confusion about how this drug is supposed to work.) The doc says that we may try Buspar in combination with a small dose of an antidepressant if it seems to help at all.  Again, this sounds confusing, but I’ve heard people have had some sucess with this. Thanks in advance -Grisha

Response:

Hi, I was recently prescribed Buspar for genreral anxiety disorder and after researching it a bit, I find I’m very confused.  I have both depression and GAD, but it’s the anxiety that’s bothering me most at the moment. (It’s hard sometimes to separate these things into categories, btw).  My question is this (I’m a bit of a newbie poster but I’ve read a lot).  Buspar and and SSRI’s appear to do different things.  Anxiety is apparently caused by too much serotonin. According to the www.buspar.com home page (sponsored by Bristol/Myers/Squibb):

Hi, Grisha, good to have you posting <some snipping Bristol/Myers/Squibb were, as one might expect, being a leetle selective with the facts there. As I understand it, no one really knows what causes anxiety disorders. Serotonin is one of the substances impilcated – but just one. It’s important to remember, for example, that a very fair proportion of people on this NG don’t use medications that affect serotonin at all and yet get very effective relief from what they do use – benzodiazepines. Arguably their problem concerns GABA, not serotonin. <more snipping But I thought depression was caused by not enough serotonin.  If this is true, how can a person have both GAD and depression? (a common complaint, judging from a.s.d and a.s.p-a).  The SSRI I took several years ago (zoloft) seemed to greatly allieviate both anxiety and depression and I thought the mechanism was by increasing the effectiveness of serotonin (by inhibiting reuptake and leaving it in the synapses longer). Effectively correcting a _deficiency_ of serotonin.

Exactly right, as I understand it, so possibly a clue why Buspar isn’t widely regarded as an effective medication by the majority of people who’ve posted here? I’m confused. Moreover, my pdoc (confirmed by postings here) says that Buspar is sometimes combined with an antidepressant (SSRI or other) to increase the effective relief — either of GAD, depression or both! They seem to be doing opposite things, wouldn’t they cancel each other out? I’m sure I’m confused because I’m oversimplifying things.

I simply don’t know the answer to this but perhaps one of the wetstuff techies can help us? <yet more snipping Anyway, should I should I stick it out with Buspar for a while (it’s been one week) despite the side effects? How long until I know whether it’s doing anything for me? I do recall that I had similar side effects for a couple weeks with zoloft (even worse.. there  was nausea too) before they started to subside and my depression/anxiety started to improve.  This time around, I’m more skeptical (both from the posts here that say Buspar isn’t generally too effective and from my confusion about how this drug is supposed to work.) The doc says that we may try Buspar in combination with a small dose of an antidepressant if it seems to help at all.  Again, this sounds confusing, but I’ve heard people have had some sucess with this.

Personally, I won’t tolerate side effects lasting more than about ten-14 days, but that’s just me. I worry about Buspar – not because I think it does people harm, but because I sense it is being prescribed as an alternative to benzodiazepines by doctors who have swallowed the myths and propaganda about "addiction" concerning the latter. It’s fair enough to try it, but to persist against the odds seems like bad practice to me. Have you tried the combination of an AD and a benzo? Judging by the posts here, that seems to be the most useful combination for those with coincident depression and I wonder if it might be worth discussing it with your doctor? Just a thought — Gary Cooper

Response:

<snipped some good stuff : I just started takign BuSpar as an enhancer to the Effexor that I’m already taking.   In addition, I take klonopin.  The idea is to get me up to 15 mg/day. I have lots of problems with anxiety, but my main hope for BuSpar is that it will pick up the Effexor…. No longer searching for beauty or love, just some kind of life with the edges taken off. –Jarvis Cocker

Response:

Bristol/Myers/Squibb were, as one might expect, being a leetle selective with the facts there. As I understand it, no one really knows what causes anxiety disorders. Serotonin is one of the substances impilcated – but just one. It’s important to remember, for example, that a very fair proportion of people on this NG don’t use medications that affect serotonin at all and yet get very effective relief from what they do use – benzodiazepines. Arguably their problem concerns GABA, not serotonin.

I’ve heard this theory several times before.  I take it that it is possible that people have a problem with levels of serotonin, and this is causing the anxiety, but the increase in the strength of binding of GABA (which is what the benzos do) has an effect that offsets the effects of the serotonin problem.  This might explain why people get relief from anxiety from both serotoninigic and GABA-related treatments.  (Or, maybe the reverse is the case, for that matter.) People like, e.g. Peter Kramer (and many other people I’ve run across in print) move from the fact that drug x increases y and drug x cures depression that depression is caused by (in part, at least) too little y. I just think that this is a bit quick.  It’s certainly one potential explanation, and perhaps the best one.  But it’s not the only one.  Again, it might be that the depression is caused by some other factor, z, whose effects are overridden by the effects of the increase in y. (Gary–not directed at you personally, and please don’t take me as being pedantic; I don’t mean to be.  Just a question I have about an inference that I see made all over.) <more snipping But I thought depression was caused by not enough serotonin.  If this is true, how can a person have both GAD and depression? (a common complaint, judging from a.s.d and a.s.p-a).  The SSRI I took several years ago (zoloft) seemed to greatly allieviate both anxiety and depression and I thought the mechanism was by increasing the effectiveness of serotonin (by inhibiting reuptake and leaving it in the synapses longer). Effectively correcting a _deficiency_ of serotonin.

Though BuSpar does work for some (just not many, it seems).  I think that this just shows that we’re a long way from understanding how these drugs cure depression and anxiety. – Hide quoted text — Show quoted text – I’m confused. Moreover, my pdoc (confirmed by postings here) says that Buspar is sometimes combined with an antidepressant (SSRI or other) to increase the effective relief — either of GAD, depression or both! They seem to be doing opposite things, wouldn’t they cancel each other out? I’m sure I’m confused because I’m oversimplifying things. I simply don’t know the answer to this but perhaps one of the wetstuff techies can help us? Anyway, should I should I stick it out with Buspar for a while (it’s been one week) despite the side effects? How long until I know whether it’s doing anything for me? I do recall that I had similar side effects for a couple weeks with zoloft (even worse.. there  was nausea too) before they started to subside and my depression/anxiety started to improve.  This time around, I’m more skeptical (both from the posts here that say Buspar isn’t generally too effective and from my confusion about how this drug is supposed to work.) The doc says that we may try Buspar in combination with a small dose of an antidepressant if it seems to help at all.  Again, this sounds confusing, but I’ve heard people have had some sucess with this.

It depends on how bad the side effects are–BuSpar, like SSRIs, takes 2-4 weeks to really start working (if it does at all). snip  I worry about Buspar – not because I think it does people harm, but because I sense it is being prescribed as an alternative to benzodiazepines by doctors who have swallowed the myths and propaganda about "addiction" concerning the latter. It’s fair enough to try it, but to persist against the odds seems like bad practice to me.

I totally agree. Have you tried the combination of an AD and a benzo? Judging by the posts here, that seems to be the most useful combination for those with coincident depression and I wonder if it might be worth discussing it with your doctor? Just a thought

And, IMHO, the right thought.  I second the motion. Matt

Response:

<some snipping for space People like, e.g. Peter Kramer (and many other people I’ve run across in print) move from the fact that drug x increases y and drug x cures depression that depression is caused by (in part, at least) too little y. I just think that this is a bit quick.  It’s certainly one potential explanation, and perhaps the best one.  But it’s not the only one.  Again, it might be that the depression is caused by some other factor, z, whose effects are overridden by the effects of the increase in y. (Gary–not directed at you personally, and please don’t take me as being pedantic; I don’t mean to be.  Just a question I have about an inference that I see made all over.)

<rest snipped Oh, I certainly don’t Matt. But, personally, I long ago realised that I hadn’t the dedication to go into the minuteae of the neuro-chemistry of this – particularly as it’s such a conjectural field anyway. To do so to any level that might satisfy me intellectually, I’d effectively have to take a DIY med. degree and even then I’d be banging heads with the experts, who seem hopelessly confused themselves – blown around the map of the brain like pre-chronometer navigators I almost hate admitting this to a philosopher but I trust my intuition and that tells me that Clarke’s Law applies here. Too many eminent pshrinks are talking about serotonin for that to possibly be the answer Maybe it is? Maybe it’s CCK? Maybe it’s dopamine? None of us knows so, for now, all we can be is engineers, rather than theoretical physicists. Sometimes I’m not sure that’s a bad thing, either — Gary Cooper

Response:

– Hide quoted text — Show quoted text – <some snipping for space People like, e.g. Peter Kramer (and many other people I’ve run across in print) move from the fact that drug x increases y and drug x cures depression that depression is caused by (in part, at least) too little y. I just think that this is a bit quick.  It’s certainly one potential explanation, and perhaps the best one.  But it’s not the only one.  Again, it might be that the depression is caused by some other factor, z, whose effects are overridden by the effects of the increase in y. (Gary–not directed at you personally, and please don’t take me as being pedantic; I don’t mean to be.  Just a question I have about an inference that I see made all over.) <rest snipped

snip I almost hate admitting this to a philosopher but I trust my intuition and that tells me that Clarke’s Law applies here. Too many eminent pshrinks are talking about serotonin for that to possibly be the answer

Maybe it is? Maybe it’s CCK? Maybe it’s dopamine? None of us knows so, for now, all we can be is engineers, rather than theoretical physicists.

Yah, I’m certainly not claiming to know either –just looking at an inference Matt

Response:

[...] But I thought depression was caused by not enough serotonin.  If this is true, how can a person have both GAD and depression?

There’s no conflict there. Psychiatric diagnoses are made on the basis of symptoms not pathophysiology. It’s not like having both diabetes and hypoglycemia. (a common complaint, judging from a.s.d and a.s.p-a).  The SSRI I took several years ago (zoloft) seemed to greatly allieviate both anxiety and depression and I thought the mechanism was by increasing the effectiveness of serotonin (by inhibiting reuptake and leaving it in the synapses longer). Effectively correcting a _deficiency_ of serotonin. I’m confused. Moreover, my pdoc (confirmed by postings here) says that Buspar is sometimes combined with an antidepressant (SSRI or other) to increase the effective relief — either of GAD, depression or both! They seem to be doing opposite things, wouldn’t they cancel each other out? I’m sure I’m confused because I’m oversimplifying things.

[...] _You’re_ confused? Think of the people doing the research. They’re making careers out of their confusion. If anything, you’re confused because you’re approaching the matter as though the antidepressant mechanism of SSRI’s were a settled question. (Come to think of it, this probably screws up the researchers’ heads too). Yes, SSRI’s increase synaptic serotonin — that’s known. What isn’t fully understood is what happens next and how it improves mood. Is it 5HT-receptor upregulation? How significant are the well-known ‘downstream’ effects on dopamine and norepinephrine? Three neurotransmitter systems have been implicated in the doings of buspirone. It is a high-affinity 5HT1A partial agonist. Already a pain in the ass, since it’s not always clear whether a partial agonist acts primarily as an agonist or an antagonist. It may be one or the other depending on many factors. So already you wonder: is the anxiolytic effect based on agonist or antagonist activity? Those who attribute the anxiolytic effect to 5HT activity seem to think of it as an agonist (shutting off of 5HT release), but if it is the other way ’round, antagonizing 5HT1A and preventing natural 5HT shutdown, is anything any less (or more) clear? Next, it appears to be a a2-adrenergic antagonist. Some researchers attribute the anxiolytic effect to this. But this also seems odd in light of the fact that the a2-adrenergic _agonist_ clonidine is famed for its ability to reduce anxiety, particularly in drug withdrawal. And a2-adrenergic antagonists promote norepinephrine production. A sympathomimetic anxiolytic? And then there’s its D2-antagonist activity. This has been dismissed as clinically insignificant, though it does appear prominently in the early research. It’s at least more consistent with what one would expect from a non-GABAergic anxiolytic. But it’s probably not the answer. There is no reason not to be confused. In fact, if you’re not confused, you are either delusional or a marketing executive at Bristol-Myers Squibb.

Response:

  How does BuSpar work? It doesn’t.  BuSpar has no effect at all.

Response:

… Exactly right, as I understand it, so possibly a clue why Buspar isn’t widely regarded as an effective medication by the majority of people who’ve posted here?

I have what might be a simpler clue…the doses commonly used (15-30mg/day) may not be high enough!  I think that if you can tolerate it (start low, go slow), it might be worthwhile to try going up to 90mg/day – especially if you have GAD and depression and no history of panic attacks (BuSpar really isn’t for panic).  30-90mg/day is the dose range for major depression (including melancholic depression).  (The original trials for schizophrenia used doses up to, get this, 2400mg/day, with an average dose around 1500mg/day.) -elizabeth

Response:

- Hide quoted text — Show quoted text – Hi, I was recently prescribed Buspar for genreral anxiety disorder and after researching it a bit, I find I’m very confused.  I have both depression and GAD, but it’s the anxiety that’s bothering me most at the moment. (It’s hard sometimes to separate these things into categories, btw).  My question is this (I’m a bit of a newbie poster but I’ve read a lot).  Buspar and and SSRI’s appear to do different things.  Anxiety is apparently caused by too much serotonin. According to the www.buspar.com home page (sponsored by Bristol/Myers/Squibb):          "Your symptoms of persistent anxiety may be due to an imbalance of          a chemical called "serotonin" in the brain. It is believed that          an excess of serotonin may be one of the causes of persistent          anxiety. Other anti-anxiety medications work on different          chemicals in the brain.          BuSpar works differently from other anti-anxiety medications –          BuSpar works on the "serotonin system" in the brain to bring          serotonin levels back to normal." But I thought depression was caused by not enough serotonin.  If this is true, how can a person have both GAD and depression? (a common complaint, judging from a.s.d and a.s.p-a).  The SSRI I took several years ago (zoloft) seemed to greatly allieviate both anxiety and depression and I thought the mechanism was by increasing the effectiveness of serotonin (by inhibiting reuptake and leaving it in the synapses longer). Effectively correcting a _deficiency_ of serotonin. I’m confused. Moreover, my pdoc (confirmed by postings here) says that Buspar is sometimes combined with an antidepressant (SSRI or other) to increase the effective relief — either of GAD, depression or both! They seem to be doing opposite things, wouldn’t they cancel each other out? I’m sure I’m confused because I’m oversimplifying things. A quick history – I’ve had depression and anxiety for as long as I can remember and the only medicinal success I’ve had was with Zoloft several years ago.  Zoloft helped tremendously, it seemed to knock out the anxiety and lifted my depression.  There were side effects (drowsiness, sexual dampening, some word finding trouble), but it worked.  I went off it after I decided I was feeling good enough to give it a try.  The depression and anxiety gradually returned. A year later I tried it again but it increased my anxiety so much (like drinking several pots of coffee!) that I was unable to tolerate it even at small doses and I gave up before it gave me any benefit. Right now I’ve been on Buspar for about a week (10mg/day – I’m sensitive to drugs).  I’m not feeling any better, in fact the main effects seem to be dizziness, drowsiness, headache and poor concentration, even worse than before.  And improving concentration is one of the things Buspar is supposed to help!  And as evidenced by this post, my chronic worry doesn’t seem to be getting any better either  :-)  I seem to be getting a bit of the bruxism/jaw clenching that I recall was a side effect of zoloft too. Can anyone out there, either fellow sufferer or pharmacist help me understand the mechanics of these drugs? Anyway, should I should I stick it out with Buspar for a while (it’s been one week) despite the side effects? How long until I know whether it’s doing anything for me? I do recall that I had similar side effects for a couple weeks with zoloft (even worse.. there  was nausea too) before they started to subside and my depression/anxiety started to improve.  This time around, I’m more skeptical (both from the posts here that say Buspar isn’t generally too effective and from my confusion about how this drug is supposed to work.) The doc says that we may try Buspar in combination with a small dose of an antidepressant if it seems to help at all.  Again, this sounds confusing, but I’ve heard people have had some sucess with this. Thanks in advance -Grisha

Grisha — That’s a long message!  I’ve posted on alt.support.anxiety.panic how SSRIs work to the best of my knowledge (someone already corrected me on a mistake I made).  But I’m not sure how Buspar works.  I don’t the the docs really know either.  Someone read it to me in a counseling book, and the authors weren’t too sure either. my advice:  If the shoe fits, wear it.  If it don’t, throw it out. — Geoff

Response:

  How does BuSpar work? It doesn’t.  BuSpar has no effect at all.

Not exactly true.  Current thought is that BuSpar is ineffective for panic, although it may be better for GAD.  My doc refuses to prescribe it for panic.  However, I have recently spoken to a top anxiety specialist who uses it as a second-line med, and has had some positive results with panic disorder patients.  Not all, but some.  He admits he has been too lazy to write this up and get it into the literature So, while there are many meds that are more effective than BuSpar for panic, it is an option for those who have problems with other meds. YMMV hugely. Hirsch

Response:

My pdoc seems to be down on benzos, he called them tranquilizers and seemed to regard them as masking rather than dealing with the problem.  He also said they’re addictive and sedating like alcohol (though this Buspar is having a sedating/groggy inducing effect)  This seems to be a common story. So I doubt I’ll have luck with him giving me the AD/benzo combination that you’ve recommended.  Shopping for another doctor seems just beyond me at this point. Obviously, I should probably be patient and see if the Buspar does anything for me besides side effects.  But if nothing (as seems likely from the consensus here) then what?  Find an AD I can tolerate, perhaps and see if I can suggest he prescribe a benzo?

If the BuSpar doesn’t work, I’d be firm with him.  It’s your body, after all.  Benzos are called "minor tranquilizers," though the connotations of that word probably are such that tehy shouldn’t be called that.  As to their addictiveness–this amounts to the fact that you need to taper off slowly if you’re going to stop taking them if you’ve taken them for a while.  They’re seldom abused by patients, and they almost never are such that you develop a tolerance to their anti-anxiety properties.  Plus, side effect-wise, they’re good drugs.  Most of the side effects go away after a few weeks (the grogginess, sleepiness, etc.) for most people.  Then the anti-anxiety properties remain. You also could go to your gp and talk to her about your situation.  Maybe she’ll be more rational about benzos. Good luck, Matt

Response:

[...] But I thought depression was caused by not enough serotonin.  If this is true, how can a person have both GAD and depression? There’s no conflict there. Psychiatric diagnoses are made on the basis of symptoms not pathophysiology. It’s not like having both diabetes and hypoglycemia.

Thanks everyone for all the information.  You’re all great! I’m glad to know I’m not the only one confused here (I think I’m glad). The mechanism of buspar must be similar in some ways to zoloft, because my side effect profile is similar.  I’m getting jaw clenching and increased tension in my neck and shoulders (where I carry my stress anyway)  (is this norepinephrine?) similar to when I was starting on zoloft.  I’ve got a constant headache (listed as a common side effect) and am sweating like a pig.  Drowsy, dizzy no concentration, still anxious as ever.  No actual _beneficial_ effects yet (after one week) it seems.  It’s very frustrating to say the least because I’m told to be patient and wait for 2-4 weeks to notice anything.  Just my luck I’ll get the sexual side effects too (not that it matters at the moment . Some people have no side effects whatsoever to this drug (or to many of the others), so obviously this neurochemistry thing is extremely complex. I’ve never been on a benzo, so I have no idea what it would feel like to get immediate relief to this chronic worry, tension and anxiety.  I don’t have true Panic Attacks, I don’t think, where I’m paralyzed with panic and have chest pains and everything, but I do hyperventilate and get the tingly face and hands feeling, particularly in traffic, but sometimes for no apparent reason, it just seems like a slightly more intense version of the anxiety I feel all the time. It’s pretty clearly GAD with depression, now, I just need to find something that will take care of it. My pdoc seems to be down on benzos, he called them tranquilizers and seemed to regard them as masking rather than dealing with the problem.  He also said they’re addictive and sedating like alcohol (though this Buspar is having a sedating/groggy inducing effect)  This seems to be a common story. So I doubt I’ll have luck with him giving me the AD/benzo combination that you’ve recommended.  Shopping for another doctor seems just beyond me at this point. Obviously, I should probably be patient and see if the Buspar does anything for me besides side effects.  But if nothing (as seems likely from the consensus here) then what?  Find an AD I can tolerate, perhaps and see if I can suggest he prescribe a benzo? Thanks again everyone for your continued support and explanations (or approximations) of the chemistry behind these drugs. -Grisha

Response:

Yeh Gary, I asked my Doc here in Australia about Buspar long ago – he laughed and said: "I don’t even prescribe that crap for *minor* anxiety, it’s basically useless for panic disorder. Benzodiazapine’s are safer and *much* more effective" He then wrote me a script for Xanax – and asked *me* to tell him how much worked – then asked that I ring his surgery for repeats as needed….

Blimey, Mike – that’s the second good reason I’ve seen for emigration to Oz in the past few weeks! I wish we had a few doctors like that, over here. — Gary Cooper

Response:

<much interesting commentary snipped There is no reason not to be confused. In fact, if you’re not confused, you are either delusional or a marketing executive at Bristol-Myers Squibb.

And ain’t *that* the truth! — Gary Cooper

Response:

<Good Stuff Snipped Exactly right, as I understand it, so possibly a clue why Buspar isn’t widely regarded as an effective medication by the majority of people who’ve posted here?

<More Good Stuff Snipped Yeh Gary, I asked my Doc here in Australia about Buspar long ago – he laughed and said: "I don’t even prescribe that crap for *minor* anxiety, it’s basically useless for panic disorder. Benzodiazapine’s are safer and *much* more effective" He then wrote me a script for Xanax – and asked *me* to tell him how much worked – then asked that I ring his surgery for repeats as needed…. Cheers, Mike from OZ

Response:

Question:

hi people , i’m new to this group. just a little short question here. my therapist prescribed some SSRI (luvox) together with some benzo to help me with my general anxiety problems ( which has been on going for a few years by this time ). i was just wondering how would an SSRI being an anti-depresent help me in an anxiety situation. will it help alleviate the axiety indirectly ? has anyone ever got to suppress the extreme anxiety they suffer,  through combination of benzo and anti-dep ? thanks. btw, are there any anxiety support groups in singapore ?

Response:

Kelvin schreef: hi people , i’m new to this group. just a little short question here. my therapist prescribed some SSRI (luvox) together with some benzo to help me with my general anxiety problems ( which has been on going for a few years by this time ). i was just wondering how would an SSRI being an anti-depresent help me in an anxiety situation. will it help alleviate the axiety indirectly ? has anyone ever got to suppress the extreme anxiety they suffer,  through combination of benzo and anti-dep ? thanks. btw, are there any anxiety support groups in singapore ?

Hi Kelvin UND welcome at ASAP, Many antidepressants, among which the SSRI-class, are first choice meds for anxiety. The combo with a benzo (which one do you have prescribed?) is a common and sensible one. You should give Luvox about 6-8 weeks max. to kick in. You may experience some side effects like heigtened anxiety in the first few weeks, although the benzo will probably take care of that. Philip

Response:

: hi people , i’m new to this group. Hello, Welcome to ASAP! : just a little short question here. my : therapist prescribed some SSRI (luvox) together with some benzo to help me : with my general anxiety problems ( which has been on going for a few years : by this time ). i was just wondering how would an SSRI being an : anti-depresent help me in an anxiety situation. will it help alleviate the : axiety indirectly ? has anyone ever got to suppress the extreme anxiety they : suffer,  through combination of benzo and anti-dep ? thanks. SRIs (same as SSRIs) are called antidepressants simply because that is what such medications were first used for. SRIs address problems with serotonin balance, and serotonin balance is sometimes the cause of depression and/or anxiety disorders. Benzodiazepines, on the other hand, address problems with another hormone/neurotransmitter called cholecystokinin (CCK), which can also be a cause of anxiety disorders. It is typical for benzos to be prescribed with SRIs. Basically, as your body adjusts to the SRI, your serotonin levels will go through some changes, and this can result in changes of CCK as well. In such cases, the benzo helps control the CCK during this adjustment period. It’s also important to note that in some cases serotonin balance may not be the cause of an anxiety disorder. Some cases seem to be much more related to CCK. In such cases, SRIs seem unnecessary and the disorder may be best treated with a benzo alone. : btw, are there any anxiety support groups in singapore ? I don’t know. Singapore is a bit outside of my neighborhood. (I live in Philadelphia, Pennsylvania, US)                                         Best Wishes,                                         Arthur

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hi people , i’m new to this group. just a little short question here. my therapist prescribed some SSRI (luvox) together with some benzo to help me with my general anxiety problems ( which has been on going for a few years by this time ). i was just wondering how would an SSRI being an anti-depresent help me in an anxiety situation

Kelvin All cases are different.  In my case, I was prescribed some ativan to take until the SSRI I took kicked in.  I was on zoloft which I have weaned myself off of, to go on 5-HTP which seems to be doing the trick without all the side effects of zoloft. The SSRI you are on, lovox, I am not familiar with, but I am sure if your doctor knows you have anxiety attacks, that SSRI will help.  Zoloft helps with anxiety and depression, but takes about 6 weeks to kick in.  Once it kicked in, I was able to wean, VERY SLOWLY, off of the ativan.  In fact, I will never take ativan again, since it was so hard to get off of. sharryn

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hi people , i’m new to this group. just a little short question here. my therapist prescribed some SSRI (luvox) together with some benzo to help me with my general anxiety problems ( which has been on going for a few years by this time ). i was just wondering how would an SSRI being an anti-depresent help me in an anxiety situation. will it help alleviate the axiety indirectly ? has anyone ever got to suppress the extreme anxiety they suffer,  through combination of benzo and anti-dep ? thanks. btw, are there any anxiety support groups in singapore ?

I was on Prozac for three years for pretty severe anxiety.  It worked very well, though it took a while for it to take care of all my anxiety.  Then it pooped out on me (which SSRIs tend to do), and left me in quite a bind psychologically.  (I should also say that I suspect that when it pooped out it actually made my anxiety worse–my anxiety now is worse than it was before I had started Prozac.)    This is just my opinion, of course, but I think that for long-term treatment of anxiety, benzos are a better bet than SSRIs.  We know that benzos are safe, they have fewer side effects, and they don’t poop out.  But, if there is depression along with the anxiety, an SSRI or an SSRI and a benzo together are a good choice. Though many doctors would rather keep someone on an antidepressant long-term for anxiety rather than a benzo, you might want to think about going with just the benzo after things stabilize with the anxiety (in 6 months to a year or so).  Again, I’m not a doctor, but I’d much rather be on something I know is safe long term than take my chances with something that is such that we don’t know its long-term effects.  (I myself am on Zoloft and a benzo right now for anxiety and depression caused by the anxiety, but in six or so months (given that the depression lifts) I plan on going with just the benzo. Anyway, good luck with your treatment! Best, Matt

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What a heart wrenching story! My heart goes out to both of you.  o get back on my Meds.  Whats worse is my husband doesn;t even seem to notice how bad I feel.

 I stronly suspect your husband does not feel that great himself. I’m glad he is alive.  God only knows what they were exposed to during the Gulf War.  Perhaps you just need to sit down with him and tell him quite honestly how you feel.  You need to be there for each other right now. You both have been to hell and back.   Take care of each other. In time you will be working back on insurance….and able to ge on meds and get some therapy if you need it.  You should be proud of yourself for going from zero to being able to buy a house again. Good for you!  Thank God you have a roof over your heads and food on the table.  Hang in there. Hug each other. Take care. ((((((((((((((HUGS))))))))))))))) Chip

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Shall I call you EM? Wow!  I think you are amazing for handling, almost singlehandedly it seems, the pile of stresses and problems you’ve been dealing with.  It sounds like you and your husband have gotten through the worst part of the storm, but still have a lot of pieces to pick up…like getting you back on meds and/or therapy, and re-opening intimate communication between the two of you. I wish I had a magic wand and simple answers. It may be awhile before your finances (or insurance through the new job) help with your immediate need of meds or therapy.  Can you summon up the patience to wait…and get whatever rest you can til then?  Are there any friends, neighbors or relatives nearby that could help with even the smallest things around the house…cleaning?  babysitting? If you are suicidal, please RUN to the phone and start calling hospitals for help in referring you to no cost/low cost community mental health agencies. Hug your hubby as often as you can…I imagine he may feel very useless and low himself right now.  Really good hugs take lots of practice and you may have to show your hubby how good they feel by being the instigator for awhile. After some practice, he’ll find it easier to notice when YOU need a hug. Keep posting o.k.  This is always a good place to vent.  Glad you found us! Leah (posted & e’d) – Hide quoted text — Show quoted text – Hello everyone I have been lurking for a while now looking for some help I guess.  I was in therapy from 1994-1996.  I was on medication Prozac, Effexor, all the new ones any way at the end of my therapy I was on 5 Prozacs a day.  So my husband and I decided to move from Kentucky to Florida my doctor gave me enough Meds to ween me off my meds.  I got to Florida went back to work in a hospital (there is a scary thought I take care of patients) any way that was April 1996.  I was doing great then in August my husband 27 years old was put in the VA Hopspital ICU 125 miles away from home.  I was not able to work and take care of my 2 year pld and be with him so, my work put me on a leave of absence. I was told my husband had a heart condition that would need surgery and he would be transfered to Richmond VI.  Then all of a suden they cancelled saying they found abnormal cells in his spinal fluid (lymphomia) which they felt was falal. At that point he had been in the hospital a month with neither of us working and we lost our home also faced with his illness I felt he should be near his family I convinced his doctor to let me take him back to Kentucky and have him admited there.  They agreed in one weekend I loaded a u-haul and drove strait through to Kentucky towing our car with my husband and 2 year old.  We moved in with his mother while pending VA disability.  As soon as we got back I called my Doctor’s office and told the receptionest what had happened she said "They couldn’t see me with out insurance but it sounded like I should see someone"  Any way then they came and took my car away living with his mother was pure hell (The only person I have ever met who needs meds and therapy much more than me) We lived there for eight months with our only income being 300.00 a month in foodstamps The VA in Kentucky wouldn’t admit him they decided the other VA was wrong and it turned out that they were.  They don’t know what the cells are that make him so sick because it is due to Gulf War Syndrome.  I fought with VA for almost a year they finally rated him at 70% and gave him $20,000 back pay.  We imeadiately moved back to Floriday April 97.  Bought a house, payed off some bills, and bought a car.  So the back pay was gone quicker than I thought and 70 % only pays 1020 a month.  We are pending the other 30% and waiting for a Social Security hearing.  So it became important for me to go back to work.  I am schedualed to start a new job September 22.  Everything seems to be going great so why do I feel so terible.  I can’t sleep I cry all the time, I feel I am loosing control, but I have to hold it together and right now I don’t have the resources to get back on my Meds.  Whats worse is my husband doesn;t even seem to notice how bad I feel.

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Hello everyone I have been lurking for a while now looking for some help I guess.  I was in therapy from 1994-1996.  I was on medication Prozac, Effexor, all the new ones any way at the end of my therapy I was on 5 Prozacs a day.  So my husband and I decided to move from Kentucky to Florida my doctor gave me enough Meds to ween me off my meds.  I got to Florida went back to work in a hospital (there is a scary thought I take care of patients) any way that was April 1996.  I was doing great then in August my husband 27 years old was put in the VA Hopspital ICU 125 miles away from home.  I was not able to work and take care of my 2 year pld and be with him so, my work put me on a leave of absence. I was told my husband had a heart condition that would need surgery and he would be transfered to Richmond VI.  Then all of a suden they cancelled saying they found abnormal cells in his spinal fluid (lymphomia) which they felt was falal. At that point he had been in the hospital a month with neither of us working and we lost our home also faced with his illness I felt he should be near his family I convinced his doctor to let me take him back to Kentucky and have him admited there.  They agreed in one weekend I loaded a u-haul and drove strait through to Kentucky towing our car with my husband and 2 year old.  We moved in with his mother while pending VA disability.  As soon as we got back I called my Doctor’s office and told the receptionest what had happened she said "They couldn’t see me with out insurance but it sounded like I should see someone"  Any way then they came and took my car away living with his mother was pure hell (The only person I have ever met who needs meds and therapy much more than me) We lived there for eight months with our only income being 300.00 a month in foodstamps The VA in Kentucky wouldn’t admit him they decided the other VA was wrong and it turned out that they were.  They don’t know what the cells are that make him so sick because it is due to Gulf War Syndrome.  I fought with VA for almost a year they finally rated him at 70% and gave him $20,000 back pay.  We imeadiately moved back to Floriday April 97.  Bought a house, payed off some bills, and bought a car.  So the back pay was gone quicker than I thought and 70 % only pays 1020 a month.  We are pending the other 30% and waiting for a Social Security hearing.  So it became important for me to go back to work.  I am schedualed to start a new job September 22.  Everything seems to be going great so why do I feel so terible.  I can’t sleep I cry all the time, I feel I am loosing control, but I have to hold it together and right now I don’t have the resources to get back on my Meds.  Whats worse is my husband doesn;t even seem to notice how bad I feel.

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[posted and emailed] Everything seems to be going great so why do I feel so terible.  I can’t sleep I cry all the time, I feel I am loosing control, but I have to hold it together and right now I don’t have the resources to get back on my Meds.  Whats worse is my husband doesn;t even seem to notice how bad I feel.

welcome to the group. albeit not a welcome i like to give. hang in there, I/we will be there through it with you. Are there any public health services in your area that could give you meds? "Dark Prism" – My personality refracts darkly through the serotonigenic spectrum. Thomas A. Ott — ottthoma (at) pipeline.com – [3 t's in ottthoma!!!] http://www.geocities.com/~ottthoma — main site http://www.geocities.com/~ottthoma/depression/index.html—– depression site http://www.geocities.com/~ottthoma/depression/sjw.html —— st. john’s wort stuff FCC Regulations provide up to 500 dollars in damages PER INCIDENT for Unsolicited Commercial E-Mail.  Go ahead.  Make my day.

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