Question:

WK, Now that you’re getting some relief with Xanax, are you going to try getting back into the work world?  Considering how long you’ve had to stay away, you might want to check with your local gov’t., your doctor, whoever, to see if there is "dept." set up to help people with mental disabilities re-enter the work force.  I’d like to say that potential employers will probably just gloss over your 2 year absence, but that’s unlikely.  Sad to say, but there’s still tons of ignorance and some stigma attached to having a disorder.  Anyway, getting back to some sort of go between organization, if it exists, (and I know it does in some states in the U.S.), such a dept. can smooth the waters some in locating employers who’re interested in what you can do and will have been properly briefed that you have an anxiety disorder, but are being treated for it.  Something else to think about, and you may already be doing this, is that for an interview or any particularly stressful event, I’ve found that taking an extra dose or two of Xanax all at once just before the ordeal can make it a lot less stressful. I had to experiment some to find the right amount and you may too (not enuf vs. too much).  Good luck. Doug On 2 Feb 2002 22:19:52 -0800, vegasrules…@yahoo.com (White Knight) wrote: – Hide quoted text — Show quoted text -

I am sick and tired about all these posts trying to scare people away from trying xanax.  As someone who has suffered from bipolar disorder(type 2) for 15 years, tried all the antidepressants, now on a cocktail of meds, including xanax and paxil, my experience is that PAXIL has many more adverse effects versus the marginal benefit of some anxiety relief.  I took Paxil for 5 months and was not taking any xanax, and I got some anticapation anxiety relief at the cost of NO LIBIDO, sleeping 12 hours a day, having no motivation, just didn’t give a shit, already gained 10 pounds in 5 months with the carbo craving…..And people want to talk about xanax dependency and problems with withdrawl.  I am not trying to minimize people’s experience or their pain, but with anxiety or other mental health issues, the word is YOUR MILEAGE MAY VARY(YMMY).  I am a college graduate in electrical engineering from a top 5 engineering college, and now have not worked for over two years mostly because of anxiety and some depression yearly.  After working for 11 years struggling with depression and anxiety, I now have a hard time stepping outside my home.  I have considered suicide 1000’s of times over the last 15 years, actually researched and made the plans and was about to end it, and then I started on the Paxil…….Yeah, my suicidal obsessions went away, but now I was content to veg out all day watching TY or on the Net, my desire to GET A JOB disappeared.  Go research web sites and you will see how many people have problems with SSRI’s, yeah they are alive and taking that $3 pill two times a day or many $3 pills for me, but now I am NUMB and just there.  Prior to Paxil I use to be a emotional person, felt the pain of others and would cry when touched by something, but now I am a Paxil-zombie, yeah some anxiety relief but a LOT OF ME is also gone.  So all those xanax phobics, please allow people to fail with their options without scaring them.  What are people’s choices when it comes to anxiety or panic, yes paxil, yes benzo’s, yes MAIO’s, yes CBT(Cognitive Behavior Therapy).  My experience is PAXIL SUCKS and THE WITHDRAWAL IS HORRIBLE BASED ON MUCH FEEDBACK I HAVE READ ON THE NET, MAIO’S like parnate have some studies that back them up but the food restrictions are VERY DIFFICULT(no cheese, wine, beer, chocolate, many OTC meds, etc.), CBT might work for some but the feedback I have heard is that CBT plus meds work the best and I HAVE DONE THE THERAPY ROUTE and it was a waste of money. As one doctor told me, people who suffer from PANIC and think they are dieing have never been told that "your not going to die, it is all in your head"…Well that was my last session with him.  Just to repeat, this is MY EXPERIENCE and YOUR MILEAGE MAY VARY.  Now I could continue to HIBERNATE IN MY HOUSE, NOT WORK, RUN OUT OF MONEY AND THEN BE HOMELESS…..Or I can be proactive and continue to experiment and try to find some solution that will allow me to work and have a life.  I have taken xanax in the past, just started it one month ago, still taking a low dose of paxil, and I am MUCH MUCH BETTER at dealing with day to day life, interacting with people, giving my shit done, etc. Yeah, maybe I will be taking xanax for the rest of my life but the only side effect I have had is some sleepiness.  And to those who talk about TOLERANCE BUILDUP, that is a CROCK, yes you might have to increase your xanax from .25mg 3 times a day to .50mg 3 times a day, or even 1mg 3 times a day……..The fact is that people level out, there are people who have taken xanax for 5 to 15 years and most leveled out after 1 year at a dose and have no desire to increase. People need to do some research and FIND OUT THE REAL TRUTH, not what BIG PHARMA and BIG BUSINESS OWNED MEDIA OUTLETS want us to believe. Not to be cynical, but $3 no generic available paxil is much better for DRUG COMPANIES, then CHEAP GENERIC XANAX which might be more effective with less side-effects.  Why are benzo’s so hard to get, cause drug lobbiest have access to CONGRESS and made sure that THE NO-PROFIT SOLUTIONS(IE LIKE BENZO’S) are not readily available. Let me make THE NEWCOMERS TO MENTAL ILLNESS aware that HYPE ABOUT THE LATEST ANTIDEPRESSANT HAS EVERYTHING TO DO WITH THE BILLIONS OF DOLLARS THAT WILL BE MADE ON THE DRUG, and the only time you will hear about THE NEGATIVES about that drug will be when it comes off-patent. Now that we have generic prozac, we will hear more about side effects like NO LIBIDO, WEIGHT GAIN, SUICIDE, AND OTHER  EFEECTS.  Of course, as long as Paxil and Zoloft have no generics, MEDIA HYPE will be still muted, but give it time.  Just as all the SSRI’s go generic, we will hear about ALL THE NEGATIVES and out will come the new batch of 8 TO 12 WEEK STUDIED ANTIDEPRESSANTS to start the new profit cycle.  People with mental illness are just pawns, half ass useless meds are approved based on 8 week studies, NO REASON FOR A LONG TERM STUDY, we really don’t want to KNOW THE TRUTH, and as soon as the generics start rolling out, OUT COMES THE DIRTY LAUNDRY, not to HELP US, NO, ONLY SO THAT WE GO ON THE LATEST $5 PILL THAT HAS A 80% SUCCESS RATE AND EVEN LESS SIDE EFFECTS.  Hell as long as everyone is making money, who cares about THE CRAZIES that take the product, we just need them alive and taking their meds.  Now I forget, was I taking about the cigarette industry or drug companies, HELL WHAT IS THE DIFFERENCE.  This of course is just the opinion of a mentally ill patient with 15 years of experience popping pills, all of which have a 70% effective rate, but I guess I am the exception, "ALIVE" AND NOT SUICIDAL, AND NOT HAPPY ABOUT IT. White Knight

Response:

White Knight wrote:

I am sick and tired about all these posts trying to scare people away from trying xanax.  As someone who has suffered from bipolar disorder(type 2) for 15 years, tried all the antidepressants, now on a cocktail of meds, including xanax and paxil, my experience is that PAXIL has many more adverse effects versus the marginal benefit of some anxiety relief.  I took Paxil for 5 months and was not taking any xanax, and I got some anticapation anxiety relief at the cost of NO

Which posts? Anyway do you get pre, during and post anxiety or just anticipation and during anxiety? Cause I get all three and am curious about your experience. I the amount I get of each one depends on the situation. Richard — Registered Lunatic #100347

Response:

I..Am..A..Paxil..Zom Bie..You..Need..To Chill..Out..Man.. Simon. "White Knight" <vegasrules…@yahoo.com

wrote in message

news:28eafa9a.0202022219.7ee7d068@posting.google.com… – Hide quoted text — Show quoted text -

I am sick and tired about all these posts trying to scare people away from trying xanax.  As someone who has suffered from bipolar disorder(type 2) for 15 years, tried all the antidepressants, now on a cocktail of meds, including xanax and paxil, my experience is that PAXIL has many more adverse effects versus the marginal benefit of some anxiety relief.  I took Paxil for 5 months and was not taking any xanax, and I got some anticapation anxiety relief at the cost of NO LIBIDO, sleeping 12 hours a day, having no motivation, just didn’t give a shit, already gained 10 pounds in 5 months with the carbo craving…..And people want to talk about xanax dependency and problems with withdrawl.  I am not trying to minimize people’s experience or their pain, but with anxiety or other mental health issues, the word is YOUR MILEAGE MAY VARY(YMMY).  I am a college graduate in electrical engineering from a top 5 engineering college, and now have not worked for over two years mostly because of anxiety and some depression yearly.  After working for 11 years struggling with depression and anxiety, I now have a hard time stepping outside my home.  I have considered suicide 1000’s of times over the last 15 years, actually researched and made the plans and was about to end it, and then I started on the Paxil…….Yeah, my suicidal obsessions went away, but now I was content to veg out all day watching TY or on the Net, my desire to GET A JOB disappeared.  Go research web sites and you will see how many people have problems with SSRI’s, yeah they are alive and taking that $3 pill two times a day or many $3 pills for me, but now I am NUMB and just there.  Prior to Paxil I use to be a emotional person, felt the pain of others and would cry when touched by something, but now I am a Paxil-zombie, yeah some anxiety relief but a LOT OF ME is also gone.  So all those xanax phobics, please allow people to fail with their options without scaring them.  What are people’s choices when it comes to anxiety or panic, yes paxil, yes benzo’s, yes MAIO’s, yes CBT(Cognitive Behavior Therapy).  My experience is PAXIL SUCKS and THE WITHDRAWAL IS HORRIBLE BASED ON MUCH FEEDBACK I HAVE READ ON THE NET, MAIO’S like parnate have some studies that back them up but the food restrictions are VERY DIFFICULT(no cheese, wine, beer, chocolate, many OTC meds, etc.), CBT might work for some but the feedback I have heard is that CBT plus meds work the best and I HAVE DONE THE THERAPY ROUTE and it was a waste of money. As one doctor told me, people who suffer from PANIC and think they are dieing have never been told that "your not going to die, it is all in your head"…Well that was my last session with him.  Just to repeat, this is MY EXPERIENCE and YOUR MILEAGE MAY VARY.  Now I could continue to HIBERNATE IN MY HOUSE, NOT WORK, RUN OUT OF MONEY AND THEN BE HOMELESS…..Or I can be proactive and continue to experiment and try to find some solution that will allow me to work and have a life.  I have taken xanax in the past, just started it one month ago, still taking a low dose of paxil, and I am MUCH MUCH BETTER at dealing with day to day life, interacting with people, giving my shit done, etc. Yeah, maybe I will be taking xanax for the rest of my life but the only side effect I have had is some sleepiness.  And to those who talk about TOLERANCE BUILDUP, that is a CROCK, yes you might have to increase your xanax from .25mg 3 times a day to .50mg 3 times a day, or even 1mg 3 times a day……..The fact is that people level out, there are people who have taken xanax for 5 to 15 years and most leveled out after 1 year at a dose and have no desire to increase. People need to do some research and FIND OUT THE REAL TRUTH, not what BIG PHARMA and BIG BUSINESS OWNED MEDIA OUTLETS want us to believe. Not to be cynical, but $3 no generic available paxil is much better for DRUG COMPANIES, then CHEAP GENERIC XANAX which might be more effective with less side-effects.  Why are benzo’s so hard to get, cause drug lobbiest have access to CONGRESS and made sure that THE NO-PROFIT SOLUTIONS(IE LIKE BENZO’S) are not readily available. Let me make THE NEWCOMERS TO MENTAL ILLNESS aware that HYPE ABOUT THE LATEST ANTIDEPRESSANT HAS EVERYTHING TO DO WITH THE BILLIONS OF DOLLARS THAT WILL BE MADE ON THE DRUG, and the only time you will hear about THE NEGATIVES about that drug will be when it comes off-patent. Now that we have generic prozac, we will hear more about side effects like NO LIBIDO, WEIGHT GAIN, SUICIDE, AND OTHER  EFEECTS.  Of course, as long as Paxil and Zoloft have no generics, MEDIA HYPE will be still muted, but give it time.  Just as all the SSRI’s go generic, we will hear about ALL THE NEGATIVES and out will come the new batch of 8 TO 12 WEEK STUDIED ANTIDEPRESSANTS to start the new profit cycle.  People with mental illness are just pawns, half ass useless meds are approved based on 8 week studies, NO REASON FOR A LONG TERM STUDY, we really don’t want to KNOW THE TRUTH, and as soon as the generics start rolling out, OUT COMES THE DIRTY LAUNDRY, not to HELP US, NO, ONLY SO THAT WE GO ON THE LATEST $5 PILL THAT HAS A 80% SUCCESS RATE AND EVEN LESS SIDE EFFECTS.  Hell as long as everyone is making money, who cares about THE CRAZIES that take the product, we just need them alive and taking their meds.  Now I forget, was I taking about the cigarette industry or drug companies, HELL WHAT IS THE DIFFERENCE.  This of course is just the opinion of a mentally ill patient with 15 years of experience popping pills, all of which have a 70% effective rate, but I guess I am the exception, "ALIVE" AND NOT SUICIDAL, AND NOT HAPPY ABOUT IT. White Knight

Response:

I am sick and tired about all these posts trying to scare people away from trying xanax.  As someone who has suffered from bipolar disorder(type 2) for 15 years, tried all the antidepressants, now on a cocktail of meds, including xanax and paxil, my experience is that PAXIL has many more adverse effects versus the marginal benefit of some anxiety relief.  I took Paxil for 5 months and was not taking any xanax, and I got some anticapation anxiety relief at the cost of NO LIBIDO, sleeping 12 hours a day, having no motivation, just didn’t give a shit, already gained 10 pounds in 5 months with the carbo craving…..And people want to talk about xanax dependency and problems with withdrawl.  I am not trying to minimize people’s experience or their pain, but with anxiety or other mental health issues, the word is YOUR MILEAGE MAY VARY(YMMY).  I am a college graduate in electrical engineering from a top 5 engineering college, and now have not worked for over two years mostly because of anxiety and some depression yearly.  After working for 11 years struggling with depression and anxiety, I now have a hard time stepping outside my home.  I have considered suicide 1000’s of times over the last 15 years, actually researched and made the plans and was about to end it, and then I started on the Paxil…….Yeah, my suicidal obsessions went away, but now I was content to veg out all day watching TY or on the Net, my desire to GET A JOB disappeared.  Go research web sites and you will see how many people have problems with SSRI’s, yeah they are alive and taking that $3 pill two times a day or many $3 pills for me, but now I am NUMB and just there.  Prior to Paxil I use to be a emotional person, felt the pain of others and would cry when touched by something, but now I am a Paxil-zombie, yeah some anxiety relief but a LOT OF ME is also gone.  So all those xanax phobics, please allow people to fail with their options without scaring them.  What are people’s choices when it comes to anxiety or panic, yes paxil, yes benzo’s, yes MAIO’s, yes CBT(Cognitive Behavior Therapy).  My experience is PAXIL SUCKS and THE WITHDRAWAL IS HORRIBLE BASED ON MUCH FEEDBACK I HAVE READ ON THE NET, MAIO’S like parnate have some studies that back them up but the food restrictions are VERY DIFFICULT(no cheese, wine, beer, chocolate, many OTC meds, etc.), CBT might work for some but the feedback I have heard is that CBT plus meds work the best and I HAVE DONE THE THERAPY ROUTE and it was a waste of money. As one doctor told me, people who suffer from PANIC and think they are dieing have never been told that "your not going to die, it is all in your head"…Well that was my last session with him.  Just to repeat, this is MY EXPERIENCE and YOUR MILEAGE MAY VARY.  Now I could continue to HIBERNATE IN MY HOUSE, NOT WORK, RUN OUT OF MONEY AND THEN BE HOMELESS…..Or I can be proactive and continue to experiment and try to find some solution that will allow me to work and have a life.  I have taken xanax in the past, just started it one month ago, still taking a low dose of paxil, and I am MUCH MUCH BETTER at dealing with day to day life, interacting with people, giving my shit done, etc. Yeah, maybe I will be taking xanax for the rest of my life but the only side effect I have had is some sleepiness.  And to those who talk about TOLERANCE BUILDUP, that is a CROCK, yes you might have to increase your xanax from .25mg 3 times a day to .50mg 3 times a day, or even 1mg 3 times a day……..The fact is that people level out, there are people who have taken xanax for 5 to 15 years and most leveled out after 1 year at a dose and have no desire to increase. People need to do some research and FIND OUT THE REAL TRUTH, not what BIG PHARMA and BIG BUSINESS OWNED MEDIA OUTLETS want us to believe. Not to be cynical, but $3 no generic available paxil is much better for DRUG COMPANIES, then CHEAP GENERIC XANAX which might be more effective with less side-effects.  Why are benzo’s so hard to get, cause drug lobbiest have access to CONGRESS and made sure that THE NO-PROFIT SOLUTIONS(IE LIKE BENZO’S) are not readily available. Let me make THE NEWCOMERS TO MENTAL ILLNESS aware that HYPE ABOUT THE LATEST ANTIDEPRESSANT HAS EVERYTHING TO DO WITH THE BILLIONS OF DOLLARS THAT WILL BE MADE ON THE DRUG, and the only time you will hear about THE NEGATIVES about that drug will be when it comes off-patent. Now that we have generic prozac, we will hear more about side effects like NO LIBIDO, WEIGHT GAIN, SUICIDE, AND OTHER  EFEECTS.  Of course, as long as Paxil and Zoloft have no generics, MEDIA HYPE will be still muted, but give it time.  Just as all the SSRI’s go generic, we will hear about ALL THE NEGATIVES and out will come the new batch of 8 TO 12 WEEK STUDIED ANTIDEPRESSANTS to start the new profit cycle.  People with mental illness are just pawns, half ass useless meds are approved based on 8 week studies, NO REASON FOR A LONG TERM STUDY, we really don’t want to KNOW THE TRUTH, and as soon as the generics start rolling out, OUT COMES THE DIRTY LAUNDRY, not to HELP US, NO, ONLY SO THAT WE GO ON THE LATEST $5 PILL THAT HAS A 80% SUCCESS RATE AND EVEN LESS SIDE EFFECTS.  Hell as long as everyone is making money, who cares about THE CRAZIES that take the product, we just need them alive and taking their meds.  Now I forget, was I taking about the cigarette industry or drug companies, HELL WHAT IS THE DIFFERENCE.  This of course is just the opinion of a mentally ill patient with 15 years of experience popping pills, all of which have a 70% effective rate, but I guess I am the exception, "ALIVE" AND NOT SUICIDAL, AND NOT HAPPY ABOUT IT. White Knight

Response:

Question:

On Sat, 08 Feb 2003 02:09:40 GMT, "Lis" <liont…@ptd.net

wrote: Many people are able to do this, and the next best drug is the clonezapam, it’s also a narcotic (highly addictive).

Clonazepam is NOT a narcotic, but it does have addicting properties (best tapered off slowly).

Response:

On Sat, 08 Feb 2003 00:58:18 GMT, "DenoxiS" <denoxisTHISPARTISFORS…@hotmail.com

wrote: When we sleep with my girlfriend in the same bed, she kicks and sounds like she is going to cry. I hardly stop her and usually cannot have a good night sleep. I saw a program on TV about this sleep disorder and they said there are some medicine available for this. They didn’t give more specific information. Does anybody know anything about the medication? Does it work? Is it expensive?

The usual medicine used for PLMD is Klonopin. It has antiseizure and antianxiety effects. It has been around for many years, and is available generically (which means "inexpensive").

Response:

DenoxiS wrote:

Hi, When we sleep with my girlfriend in the same bed, she kicks and sounds like she is going to cry. I hardly stop her and usually cannot have a good night sleep. I saw a program on TV about this sleep disorder and they said there are some medicine available for this. They didn’t give more specific information. Does anybody know anything about the medication? Does it work? Is it expensive? TIA — – Deniz

Deniz…… before you start thinking of treatment with medicines, you have to diagnose the problem.  She should go to a doctor and be tested. Self treatment is dangerous. Regards Lee in Toronto ———–== Posted via Newsfeed.Com – Uncensored Usenet News ==———-    http://www.newsfeed.com       The #1 Newsgroup Service in the World! —–= Over 100,000 Newsgroups – Unlimited Fast Downloads – 19 Servers =—–

Response:

Thanks for all the answers. Lee, sad thing is medication cost is an important decision maker on going to a doctor. Referring to the responses about the cost, I think we will see a doctor. I’ve never thought about self diagnose. Thanks for the warning. — – Deniz "Lee Babcock" <leebabc…@pathcom.com

wrote in message

news:3E451FD2.E9163DD4@pathcom.com… – Hide quoted text — Show quoted text -

DenoxiS wrote: Hi, When we sleep with my girlfriend in the same bed, she kicks and sounds

like

she is going to cry. I hardly stop her and usually cannot have a good

night

sleep. I saw a program on TV about this sleep disorder and they said

there

are some medicine available for this. They didn’t give more specific information. Does anybody know anything about the medication? Does it

work?

Is it expensive? TIA — – Deniz Deniz…… before you start thinking of treatment with medicines, you have to diagnose the problem.  She should go to a doctor and be tested. Self treatment is dangerous. Regards Lee in Toronto ———–== Posted via Newsfeed.Com – Uncensored Usenet News

==———-

   http://www.newsfeed.com       The #1 Newsgroup Service in the World! —–= Over 100,000 Newsgroups – Unlimited Fast Downloads – 19 Servers

=—–

Response:

On Mon, 10 Feb 2003 21:13:59 GMT, "DenoxiS" <denoxisTHISPARTISFORS…@hotmail.com

wrote: Lee, sad thing is medication cost is an important decision maker on going to a doctor. Referring to the responses about the cost, I think we will see a doctor.

A lot of them (particularly now) seem to know a bit about the cost of meds. An almost foolproof rule is "available as a generic" means considerably cheaper than "not available as a generic." Another one is "available as a generic for more than six months" means cheaper than "available as a generic for less than six months." The one glaring exception in the USA: tamoxifen. It’s all made by AstraZeneca, even if it is in a Barr bottle. (This is expected to change by the end of the month.)

Response:

- Hide quoted text — Show quoted text -Charlie Perrin wrote:

On Mon, 10 Feb 2003 21:13:59 GMT, "DenoxiS" <denoxisTHISPARTISFORS…@hotmail.com wrote: Lee, sad thing is medication cost is an important decision maker on going to a doctor. Referring to the responses about the cost, I think we will see a doctor. A lot of them (particularly now) seem to know a bit about the cost of meds. An almost foolproof rule is "available as a generic" means considerably cheaper than "not available as a generic." Another one is "available as a generic for more than six months" means cheaper than "available as a generic for less than six months." The one glaring exception in the USA: tamoxifen. It’s all made by AstraZeneca, even if it is in a Barr bottle. (This is expected to change by the end of the month.)

Charlie so true. In Canada, many doctors have their prescription pads printed with a statement to issue generics if available. But then, we have a lot more generics here than in the US. If Beth is watching, what is the status of generics in Australia? Regards Lee in Toronto ———–== Posted via Newsfeed.Com – Uncensored Usenet News ==———-    http://www.newsfeed.com       The #1 Newsgroup Service in the World! —–= Over 100,000 Newsgroups – Unlimited Fast Downloads – 19 Servers =—–

Response:

In Canada, many doctors have their prescription pads printed with a statement to issue generics if available. But then, we have a lot more generics here than in the US. If Beth is watching, what is the status of generics in Australia?

oh, we definately have generic brands widely available, in fact, there’s a push to get people to use the generics now.  Thing is, our medication is generally subsidised by the govt (not all, but a lot) and if the govt can get people to use cheaper brands, then they’re pushing people to do it. Which is fine by me, cause the generics are exactly the same save the packaging. — Beth in Australia =================== FAQ for alt.support.sleep-disorder can be found here http://www.anchorweb.com.au/sleepdisorders this site is a work in progress – feel free to submit info/articles

Response:

- Hide quoted text — Show quoted text -Tal wrote:

In Canada, many doctors have their prescription pads printed with a statement to issue generics if available. But then, we have a lot more generics here than in the US. If Beth is watching, what is the status of generics in Australia? oh, we definately have generic brands widely available, in fact, there’s a push to get people to use the generics now.  Thing is, our medication is generally subsidised by the govt (not all, but a lot) and if the govt can get people to use cheaper brands, then they’re pushing people to do it. Which is fine by me, cause the generics are exactly the same save the packaging. — Beth in Australia

Not quite true… The active ingredients are the same but colouring agents, preservatives, binders can be a little different. Regards Lee in Toronto ———–== Posted via Newsfeed.Com – Uncensored Usenet News ==———-    http://www.newsfeed.com       The #1 Newsgroup Service in the World! —–= Over 100,000 Newsgroups – Unlimited Fast Downloads – 19 Servers =—–

Response:

On Tue, 11 Feb 2003 10:04:23 -0500, Lee Babcock <leebabc…@pathcom.com

wrote: In Canada, many doctors have their prescription pads printed with a statement to issue generics if available.

The way they do it in the USA varies from state to state, but here’s how they do it in Texas. The doctor has two lines on the prescription pad and signs one of them:         Dispense As Written         Product Selection Permitted Then, off to the pharmacy… where they then ask you if you want the generic (if there is one). In some states, they make them write out "Dispense as Written" (which the drug industry doesn’t like as much).

Response:

Hi, When we sleep with my girlfriend in the same bed, she kicks and sounds like she is going to cry. I hardly stop her and usually cannot have a good night sleep. I saw a program on TV about this sleep disorder and they said there are some medicine available for this. They didn’t give more specific information. Does anybody know anything about the medication? Does it work? Is it expensive? TIA — – Deniz

Response:

Deniz, There are several medicines. See the last link below for a description of what they can do for you. My husband and I have gotten a "California King" sized bed to prevent the injury problem (we BOTH kick). And I once had such a quick movement with my arm that I gave him a black eye (I woke up the instant my knuckles connected with his head ). And then there’s the time that I dreampt that someone was knocking on the door and no one would answer it. I woke to find that My hand, flung over my head, was shaking, and knocking against the headboard. The problem we are discussing is called either Periodic Limb Movement Disorder (PLMD) if the movements are reflexive and repeated closely together. People who have this sometimes have an itchy or creepy-crawly sensation in their legs or arms before bed time (and sometimes in the day). I have that symptom (thought it was itchy varicose veins for a long time). My husband does not have that symptom. But he has another classic symptom: cramping at night, and legs that tighten up (toes curl upwards) and move up and down. It looks as if he were trying to ride a horse If it’s a single kick or an arm movement It’s Called Restless Leg Syndrome (RLS). It happens at a certain time during the falling-asleep-process (thus the black-eye story, above). I have both these problems. My husband has PLMD as far as I can tell. Either way, your girlfriend will have to see a sleep doctor for a sleep test and treatment if it is causing big problems, something that sufferers are surprised about if the problem doesn’t wake THEM up. Most people find out about such problems from their sleep partners. My husband has always refused testing and treatment, thus the really big bed . All our cuddling happens while awake, because if we sleep "spooning," someone either gets woken in pain, or wakes up with bruises the next morning. Sleep disorders often come in groups. The sleep test is vital to discover if your friend had some other problems (such as a certain breathing problem while sleeping, called apnea, which is sometimes accompanied by these problems). If you have trouble convincing your friend that she needs to see a Doctor for a referral to a sleep doctor/center for a "sleep test," try filming her at night as she sleeps, with her permission. She might be surprised to see herself beating you up in her sleep. There are some things she can do to lessen her problems on her own, if this is indeed the problem I’m talking about. I’m going to list those things as I wrote them to another sufferer (who also got severe leg cramps) last week or so: 1. Melatonin works to induce sleep. This sometimes helps you sleep through cramps. It is fairly safe and non-addictive. Benadryl brand antihistimine (and the generic brands, too) can induce deep enough sleep to over-ride the symptoms. Many people are able to do this, and the next best drug is the clonezapam, it’s also a narcotic (highly addictive). 2. Move your body. Get walking or leg exercise during the day. If you have an attack at night, get up and move a round a bit, then try again to sleep. Experiment with exercise times, as it takes a different routine with different timing (in relation to bedtime) for each person who suffers from this disorder. 3. Lose weight if you need to. Attacks are fewer and less severe when we weigh less. 4. For some people, heat helps. Try a hot water bottle, bed socks, a heating pad or a hot bath before bed. 5. Do as much as you can to be very sleepy before you go to bed. Do as much as you can to fall asleep quickly. The longer it takes to fall asleep, the more likely it is that you’ll be woken by the cramping. So, take hot baths or showers to relax you. 6. Develop good "sleep hygiene," which means do not use your bed to do anything but sleep in (no TV, reading, exercising, radio, etc…). Go to bed on a rigid schedule. Develop a bedtime routine that you can take with you wherever you go. If you cannot sleep, get out of bed and do something quietly until you are sleepy again. This trains your body to go to sleep as soon as you are in bed, and not wait for something interesting to happen . 7.Learn meditation and relaxation skills. They help. 8.Check with a dietitian to see what you can do with your diet to lessen leg cramps (get lots of potassium, magnesium, calcium, etc.). 9. Get educated! Educate your Physician. There are some links on this page (same tips, but it saves me typing web addresses):  http://www.anchorweb.com.au/sleepdisorders/RLS.htm And to add to those links, this is the Restless Leg Support Group homepage: http://www.rlshelp.org/  They are in Southern California, but there is a ton of really good informationon that page. I highly reccomend it. Good Luck! Lis "DenoxiS" <denoxisTHISPARTISFORS…@hotmail.com

wrote in message

news:KCY0a.43775$ce4.11927096@twister.socal.rr.com… – Hide quoted text — Show quoted text -

Hi, When we sleep with my girlfriend in the same bed, she kicks and sounds

like

she is going to cry. I hardly stop her and usually cannot have a good

night

sleep. I saw a program on TV about this sleep disorder and they said there are some medicine available for this. They didn’t give more specific information. Does anybody know anything about the medication? Does it

work?

Is it expensive? TIA — – Deniz

Response:

Question:

spewed forth: Hello. Into my 3rd week with Effexor still lots of side-effects and not much relief. I know my depression is a main reason for my terrible sleeping pattern but Effexor seems to make it worse. Is there any over-the-counter drug that would be good for helping me sleep longer and deeper? TIA.

You might want to try Benadryl.  Yes, it’s an anti-histamine.  But it can make you very drowsy.  And by far it’s the only ’sleep aid’ that you might be able to take on any kind of depression medication. Anything else you might take could possibly increase the effects of the anti-depressants you’re on – and in a very bad way.

Response:

- Hide quoted text — Show quoted text – : Hello. Into my 3rd week with Effexor still lots of side-effects and not much : relief. I know my depression is a main reason for my terrible sleeping : pattern but Effexor seems to make it worse. Is there any over-the-counter : drug that would be good for helping me sleep longer and deeper? : TIA. I’m really impressed by zopiclone (Imovane). It’s only available in Canada. The impression that i get is that it’s similar to Ambien. No hangover!! Emma

Yeah, ambien is some good stuff. You might try asking your doc about it.

Response:

If you take the effexor at night, try switching the dose to morning or afternoon.  If you take it in the morning, try taking it at night to see if it makes you drowsy.  All antidepressants can cause either drowsiness or insomnia in different people, and rather than taking sleeping medication, you might want to try changing when you take the effexor first. Good luck Kylie.

– Hide quoted text — Show quoted text – Hello. Into my 3rd week with Effexor still lots of side-effects and not much relief. I know my depression is a main reason for my terrible sleeping pattern but Effexor seems to make it worse. Is there any over-the-counter drug that would be good for helping me sleep longer and deeper? TIA.

Response:

Hello Emma: This is a over the counter drug? – Hide quoted text — Show quoted text – : Hello. Into my 3rd week with Effexor still lots of side-effects and not much : relief. I know my depression is a main reason for my terrible sleeping : pattern but Effexor seems to make it worse. Is there any over-the-counter : drug that would be good for helping me sleep longer and deeper? : TIA. I’m really impressed by zopiclone (Imovane). It’s only available in Canada. The impression that i get is that it’s similar to Ambien. No hangover!! Emma — X-no-Archive:yes

Response:

: Hello. Into my 3rd week with Effexor still lots of side-effects and not much : relief. I know my depression is a main reason for my terrible sleeping : pattern but Effexor seems to make it worse. Is there any over-the-counter : drug that would be good for helping me sleep longer and deeper? : TIA. I’m really impressed by zopiclone (Imovane). It’s only available in Canada. The impression that i get is that it’s similar to Ambien. No hangover!! Emma — X-no-Archive:yes

Response:

Hello. Into my 3rd week with Effexor still lots of side-effects and not much relief. I know my depression is a main reason for my terrible sleeping pattern but Effexor seems to make it worse. Is there any over-the-counter drug that would be good for helping me sleep longer and deeper? TIA.

Response:

Thanks all. I appreciate it. See my pdoc Wednesday and my GP Friday so between the two pill dispensers I should be able to come up with something. Trouble is they might not want to prescribe something too strong as I tried swallowing bucket loads of Endocet and valium only a month or so ago. Maybe  I should take up a "wee hours of the morning" hobby. Maybe painting landscapes on the head of a pin

– Hide quoted text — Show quoted text – spewed forth: Hello. Into my 3rd week with Effexor still lots of side-effects and not much relief. I know my depression is a main reason for my terrible sleeping pattern but Effexor seems to make it worse. Is there any over-the-counter drug that would be good for helping me sleep longer and deeper? TIA. You might want to try Benadryl.  Yes, it’s an anti-histamine.  But it can make you very drowsy.  And by far it’s the only ’sleep aid’ that you might be able to take on any kind of depression medication. Anything else you might take could possibly increase the effects of the anti-depressants you’re on – and in a very bad way.

Response:

- Hide quoted text — Show quoted text – Thanks all. I appreciate it. See my pdoc Wednesday and my GP Friday so between the two pill dispensers I should be able to come up with something. Trouble is they might not want to prescribe something too strong as I tried swallowing bucket loads of Endocet and valium only a month or so ago. Maybe  I should take up a "wee hours of the morning" hobby. Maybe painting landscapes on the head of a pin spewed forth: Hello. Into my 3rd week with Effexor still lots of side-effects and not much relief. I know my depression is a main reason for my terrible sleeping pattern but Effexor seems to make it worse. Is there any over-the-counter drug that would be good for helping me sleep longer and deeper? TIA. You might want to try Benadryl.  Yes, it’s an anti-histamine.  But it can make you very drowsy.  And by far it’s the only ’sleep aid’ that you might be able to take on any kind of depression medication. Anything else you might take could possibly increase the effects of the anti-depressants you’re on – and in a very bad way.

Benadryl isn’t supposed to be taken at the same time. It will effectively make your Effexor dose more potent and longer lasting. Talk to your doctor and make sure they look up drug interactions.

Response:

Question:

A new study found that patient complaints of sexual dysfunction caused by antidepressants are almost two times greater than believed by physicians, according to a report presented at the American Psychiatric Association’s annual meeting. Researchers studied 6,297 patients enrolled at 1,101 primary care offices throughout the U.S. and evaluated 10 different new generation antidepressants. Although selective serotonin reuptake inhibitors (SSRIs) and serotonin and norephinephrine reuptake inhibitors (SNRIs) are associated with a higher rate of sexual dysfunction, newer antidepressants such as bupropion (Wellbutrin) and nefazodone have shown a lower incidence of the problem. "The SSRIs are known to cause sexual dysfunction as a side effect, but until now, there hasn’t been a study to look at all the new generation antidepressants to see how they compare," said Dr. Anita Clayton, associate professor and vice chair of the Department of Psychiatric Medicine at the University of Virginia and lead investigator of the study. "Physicians and patients are generally reluctant to talk about sexual problems. Therefore, physicians often underestimate the prevalence of antidepressant-associated sexual dysfunction and the impact on patients, as shown in this study." Wellbutrin SR (bupropion HCI) Sustained-Release was associated with the lowest rate of sexual dysfunction (25 percent) after Wellbutrin (bupropion HCI) (22 percent), compared with an average of 40 percent with the SSRIs venlafaxine (Effexor) and mirtazapine (Remeron). The prevalence rate of sexual dysfunction ranged from 7 percent of patients receiving Wellbutrin SR to 23 to 30 percent for patients receiving the other antidepressants, including fluoxetine (Prozac), citalopram (Celexa) and venlafaxine XR. This article is brought to you by the "Depression Week" online newsletter. This newletter presents the latest news and views on developments in Depression, it is one of a family of specialized medical newsletters brought to you by Medical Week, LLC. http://www.depressionweek.org/

Response:

I went on 50mgd Zoloft 3 monthes ago and it has helped me.  Before I went on I had no energy of any kind, sexual or otherwise.  Now I’m back to my oldself.  I guess it just depends upon the person. —–= Posted via Newsfeeds.Com, Uncensored Usenet News =—– http://www.newsfeeds.com – The #1 Newsgroup Service in the World! —–==  Over 80,000 Newsgroups – 16 Different Servers! =—–

Response:

Question:

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

Response:

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

Response:

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

Response:

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

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

Response:

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

I would be careful with Zoloft

Question:

"Edee Roche" <Roche…@AOL.COM

wrote in message

news:39.80b5c24.26b3c117@aol.com…

I’m on prozac, which costs between $140  and $156 for 60 caps. Does anyone out there know if meds would be cheaper in Canada? and if so, what iis the procedure to follow to get my meds from Canada?

1)  You bet your *ass* prozac is cheaper here, Edee.   It would run $90-120CDN ($60-80US) for your scrip. 2)  Other than showing up here to buy ‘em, I have no idea how you’d get ‘em from here.  :-( —      (((((((((((((U))))))))))))) Michael <muirh…@island.net

  -=[ Livin' on Island Time ]=-

Response:

In a message dated 07/27/2000 11:57:35 PM Central Daylight Time, ta…@TNS.NET writes:

<< I just downloaded a huge list of pharmacies in Mexico and that’s my  next step.  

I’m on prozac, which costs between $140  and $156 for 60 caps. I take Miacalcin to rebuild  and  strengthen my bones @ about $66 a month. These are two of the 10 meds I take, and the most expensive.  Tammy mentioned Mexico. Does anyone out there know if meds would be cheaper in Canada? and if so, what iis the procedure to follow to get my meds from Canada? Edee

Response:

Shell, I can increase my neurontin if I want too (more $$$$) – I don’t want to go back on morphine as I do travel – it is very difficult to go out of this country with morphine – I went to Tel Aviv (Israel trip) – found out after that if my meds were inspected I dould have been arrested even with Neuro’s lettters etc. That scared me.  Be well Shell Love Barbxx. "Shell" <smin…@epix.com

wrote in message

news:397B4595.FA1F6D1B@epix.com… – Hide quoted text — Show quoted text -

Barb, Won’t your doc give you both (neruontin and morphine) I know I could never

even

ask for morphine and that is why I put up with the awful neuro I currently

see

because I’m scared I will lose my current pain meds. Anyway….. If you have already used Morphine and it helped, wouldn’t your doc give

you some

for break thru pain? I never sleep thru the night. I hate this nasty pain

and I

feel for all of us that have to put up with it ecspecially when there is something that helps. Our only obstacle are getting the docs to do their

jobs.

Take Care Shell Barb Edmiston wrote: Hi Joanne I still get break through pain at times on Neurontin. At the moment I am in a real mess. I can’t sleep – if I try to exercise

I

get into this ‘overdrive’ like tremors and weakness + pain but fast

heart

and nightmares.(Neurontin relief is reduced by eating high protein =

steak

or lean chicken etc.) BUT I need to try to keep fit. Barb – wondering

what

the ****** is going on in my body. Got my first wheelchair last week –

for > > home – but failing badly at everything else.  Hey –  xx be well on both > > meds!! OK? > > "joannek4" <joann…@email.msn.com

wrote in message

> > news:ePKwXo58$GA.420@cpmsnbbsa08… > > > Barb Edmiston <barbedmis…@dingoblue.net.au

wrote in message

> > > news:3977da87$0$11187$7f31c96c@news01.syd.optusnet.com.au… > > > > Shell – I thought morphine worked really well for me – it changed my > > life! > > > > But the Docs are dead against it now as some folk have discovered ho w to

change the content of the capsule and sell it. Hi Barb & Shell, I take Neurontin and Morphine (MS Contin) for severe pain. My Neuro

sent

me to a Pain Clinic because he tried everything he could and didn’t work.

I

deal with nerve pain which in my opinion only Morphine can help calm

the

pain. I well understand anyone dealing with pain its devastating! Take Care, Joanne

Response:

On 29 Jul 2000 08:14:03 +0300, Roche…@AOL.COM (Edee Roche) wrote: }and if so, }what iis the procedure to follow to get my meds from Canada?

I just did a search for any outlets that sold prescription drugs on-line. The only one I found was Guardian Drugs, but you must have a prescription from a physician licensed to practice in the Province of Ontario.  If you want to search further then I suggest http://www.canada.com — jcarter at superaje dot com The next century and the next millennium begin at midnight on December 31,2000.

Response:

Here are some drug comparisons from an article in the OREGONIAN newspaper.  The U.S. insured price is the cost negotiated & paid by the insurance company. Drug       U.S. insured      Canada         Mexico      U.S. uninsured Prilosec     $58.73            $49.80           $37.50        $117.56 Zoloft        115.70            125.00           133.00          223.61 One of the tv stations did a cost comparison between Portland, OR pharmacies and found some of the best prices at small pharmacies. Carole – Hide quoted text — Show quoted text -Michael Muirhead wrote:

"Edee Roche" <Roche…@AOL.COM wrote in message news:39.80b5c24.26b3c117@aol.com… I’m on prozac, which costs between $140  and $156 for 60 caps. Does anyone out there know if meds would be cheaper in Canada? and if so, what iis the procedure to follow to get my meds from Canada? 1)  You bet your *ass* prozac is cheaper here, Edee.   It would run $90-120CDN ($60-80US) for your scrip. 2)  Other than showing up here to buy ‘em, I have no idea how you’d get ‘em from here.  :-( —      (((((((((((((U))))))))))))) Michael <muirh…@island.net   -=[ Livin' on Island Time ]=-

Response:

In a message dated 07/23/2000 3:34:30 PM Central Daylight Time, ms150…@MINDSPRING.COM writes:

<< He  is aware that I cut the pills in half and on good days, have gone up to 11  hours without one…but still afraid that I will get addicted, though my  actions show otherwise.  Isn’t it frustrating?  Really tough when we have  this pain and can barely function, and to add to it, we have to fight the  doctors to get what we need.

I cut mine in half also. I have been taking oxycodone since 1980, about 20 years. I use less now than ever and have had now problems with it at all. Many in the medical field believe that if a medication is used for its intended purpose, addiction is very rare.and unlikely. I have found that stress increases pain, including stress caused by knowing you are in pain and can’t do anything about it or are running low on pain medication with no refills. I told my GP and my neuro both that the only part of MS I can control is the pain and that was a right I was entitled to. Edee

Response:

Joanne, You SAID it girl!  Power to the patient! Susan E

Response:

John P. Husvar <jhus…@apk.net

wrote in message

news:8lhabj$1rh$1@plonk.apk.net…

While addiction can generate its own set of problems additional to the condition causing the pain; which is better, a happy, productive, self-supporting addict or a miserable dependent, but "clean" victim? Is a puzzlement.

I agree…this has been an ongoing issue for me. With sufficient pain meds, I’m up and around, active, working, eating better, and less tired. Funny how my non-MS friends can take a Vicodin and it wipes them out…for me it’s a few hours of respite on bad days and it gets me up and functioning. My HMO disagrees. MS is officially a "painless" disease. I am hoping the MS Society will come out with some official statement at some point that will allow some of the stricter HMO’s (I have Kaiser) to prescribe adequate pain relief. We’re actually looking into going down to Mexico for meds at this point. I spoke to a therapist about meds – she specializes in illness with chronic pain. The whole addiction question. Her questions were "Have you increased your dosage or frequency?" No. "What do you do when you take a pain reliever?" Laundry, play with my child, cook, work, and sleep restfully. Her response made sense to me….that if we are addicted to anything it’s the relief from pain, and that if monitored carefully, the improvement in quality of life far outweighs the risks.  Unfortunately, she can’t write prescriptions Tammy —–= Posted via Newsfeeds.Com, Uncensored Usenet News =—– http://www.newsfeeds.com – The #1 Newsgroup Service in the World! —–==  Over 80,000 Newsgroups – 16 Different Servers! =—–

Response:

That is such an encouraging attitude, Edee…I so know that horrible feeling of no refills and no help in sight. Or counting out what they do give you to parcel them out over a month’s time to make them last. It’s ridiculous, and does increase stress – something none of us need. It feels like a never-ending battle. Tammy Edee Roche <Roche…@AOL.COM

wrote in message

news:44.5bbe4f0.26ade33a@aol.com… – Hide quoted text — Show quoted text -

I cut mine in half also. I have been taking oxycodone since 1980, about 20 years. I use less now than ever and have had now problems with it at all. Many in the medical field believe that if a medication is used for its intended purpose, addiction is very rare.and unlikely. I have found that stress increases pain, including stress caused by knowing you are in pain

and

can’t do anything about it or are running low on pain medication with no refills. I told my GP and my neuro both that the only part of MS I can control is

the

pain and that was a right I was entitled to. Edee

—–= Posted via Newsfeeds.Com, Uncensored Usenet News =—– http://www.newsfeeds.com – The #1 Newsgroup Service in the World! —–==  Over 80,000 Newsgroups – 16 Different Servers! =—–

Response:

I just spoke with my Kaiser pharmacy and my doc (and he IS a specialist) hasn’t gotten around to this month’s refill approval yet (I have to get a new one every month, and it’s about half of what I actually need). It makes me sick. I just downloaded a huge list of pharmacies in Mexico and that’s my next step. This is a huge waste of energy. I though the National MS Society was considering a statement on pain management and MS? Their stance on the ABC drugs is the one and only reason I got approved for Copaxone after a 3-month fight. (I wasn’t "sick enough". For a prophylactic drug.) Tammy <ms150…@mindspring.com

wrote in message

news:8lopl0$r75$1@slb0.atl.mindspring.net… – Hide quoted text — Show quoted text -

I am going through the exact same thing myself!  I take hydrocodone and my neuro is afraid of addiction!!! :O  I too cut them in half and wait as

long

as I possibly can between pills.  My husband told the doc, that stress is our worst enemy and there is not stress to compare with what we go through trying to get our pain pills refilled.  He gave me one more and said ‘no more’!  I am switching to a specialist and hoping that he can help with something else that will work as well.  No one can imagine this pain that

we

go through.  NOT the pain of the occasional spasm!  But feels like being

in

labor 24/7! Karlyn Shell wrote in message <397F4EA9.2E732…@epix.com… It is awful having to worry about the next refill. My spouse and I are constantly wondering whether the cessation will occur and what we will do as I cannot take aspirin or ibuprofen and of course the docs think I’m making

it

up like the one episode of ER where the old lady says she has a migraine and aspirin hurts her ‘tummy’. Then of course, you have the actors who go through their little phase and end up at Betty Ford. I’m sorry just having a bad pain day and so tired of playing the game when  no patient should have to

worry

about living with this awful pain. Take Care Shell Tammy wrote: That is such an encouraging attitude, Edee…I so know that horrible feeling of no refills and no help in sight. Or counting out what they do give

you > to > >> parcel them out over a month’s time to make them last. It’s ridiculous, > and > >> does increase stress – something none of us need. It feels like a > >> never-ending battle. > >> Tammy > >> Edee Roche <Roche…@AOL.COM

wrote in message

> >> news:44.5bbe4f0.26ade33a@aol.com… > >> > I cut mine in half also. I have been taking oxycodone since 1980, about

20 years. I use less now than ever and have had now problems with it at all. Many in the medical field believe that if a medication is used for

its

intended purpose, addiction is very rare.and unlikely. I have found that stress increases pain, including stress caused by knowing you are in pain and can’t do anything about it or are running low on pain medication with no refills. I told my GP and my neuro both that the only part of MS I can control is the pain and that was a right I was entitled to. Edee —–= Posted via Newsfeeds.Com, Uncensored Usenet News =—– http://www.newsfeeds.com – The #1 Newsgroup Service in the World! —–==  Over 80,000 Newsgroups – 16 Different Servers! =—–

—–= Posted via Newsfeeds.Com, Uncensored Usenet News =—– http://www.newsfeeds.com – The #1 Newsgroup Service in the World! —–==  Over 80,000 Newsgroups – 16 Different Servers! =—–

Response:

I am going through the exact same thing myself!  I take hydrocodone and my neuro is afraid of addiction!!! :O  I too cut them in half and wait as long as I possibly can between pills.  My husband told the doc, that stress is our worst enemy and there is not stress to compare with what we go through trying to get our pain pills refilled.  He gave me one more and said ‘no more’!  I am switching to a specialist and hoping that he can help with something else that will work as well.  No one can imagine this pain that we go through.  NOT the pain of the occasional spasm!  But feels like being in labor 24/7! Karlyn – Hide quoted text — Show quoted text -Shell wrote in message <397F4EA9.2E732…@epix.com

… It is awful having to worry about the next refill. My spouse and I are constantly wondering whether the cessation will occur and what we will do

as I

cannot take aspirin or ibuprofen and of course the docs think I’m making it

up

like the one episode of ER where the old lady says she has a migraine and aspirin hurts her ‘tummy’. Then of course, you have the actors who go

through

their little phase and end up at Betty Ford. I’m sorry just having a bad

pain

day and so tired of playing the game when  no patient should have to worry

about

living with this awful pain. Take Care Shell Tammy wrote: That is such an encouraging attitude, Edee…I so know that horrible

feeling

of no refills and no help in sight. Or counting out what they do give you

to

parcel them out over a month’s time to make them last. It’s ridiculous,

and

does increase stress – something none of us need. It feels like a never-ending battle. Tammy Edee Roche <Roche…@AOL.COM wrote in message news:44.5bbe4f0.26ade33a@aol.com… I cut mine in half also. I have been taking oxycodone since 1980, about

20

years. I use less now than ever and have had now problems with it at

all.

Many in the medical field believe that if a medication is used for its intended purpose, addiction is very rare.and unlikely. I have found

that

stress increases pain, including stress caused by knowing you are in

pain

and can’t do anything about it or are running low on pain medication with

no

refills. I told my GP and my neuro both that the only part of MS I can control

is

the pain and that was a right I was entitled to. Edee —–= Posted via Newsfeeds.Com, Uncensored Usenet News =—– http://www.newsfeeds.com – The #1 Newsgroup Service in the World! —–==  Over 80,000 Newsgroups – 16 Different Servers! =—–

Response:

It is awful having to worry about the next refill. My spouse and I are constantly wondering whether the cessation will occur and what we will do as I cannot take aspirin or ibuprofen and of course the docs think I’m making it up like the one episode of ER where the old lady says she has a migraine and aspirin hurts her ‘tummy’. Then of course, you have the actors who go through their little phase and end up at Betty Ford. I’m sorry just having a bad pain day and so tired of playing the game when  no patient should have to worry about living with this awful pain. Take Care Shell – Hide quoted text — Show quoted text -Tammy wrote:

That is such an encouraging attitude, Edee…I so know that horrible feeling of no refills and no help in sight. Or counting out what they do give you to parcel them out over a month’s time to make them last. It’s ridiculous, and does increase stress – something none of us need. It feels like a never-ending battle. Tammy Edee Roche <Roche…@AOL.COM wrote in message news:44.5bbe4f0.26ade33a@aol.com… I cut mine in half also. I have been taking oxycodone since 1980, about 20 years. I use less now than ever and have had now problems with it at all. Many in the medical field believe that if a medication is used for its intended purpose, addiction is very rare.and unlikely. I have found that stress increases pain, including stress caused by knowing you are in pain and can’t do anything about it or are running low on pain medication with no refills. I told my GP and my neuro both that the only part of MS I can control is the pain and that was a right I was entitled to. Edee —–= Posted via Newsfeeds.Com, Uncensored Usenet News =—– http://www.newsfeeds.com – The #1 Newsgroup Service in the World! —–==  Over 80,000 Newsgroups – 16 Different Servers! =—–

Response:

Here in NY- this is a problem as well. Drs. here are paranoid about any pain meds. Their fear is addiction. This is insanity-I know so many are suffering with tremendous pain on a daily basis, but Drs. here refuse to Rx. I guess they are more concerned with how they appear to the HMOs than with the welfare of their patients. Its called CYA.!! Dianne-NY – Hide quoted text — Show quoted text -

While addiction can generate its own set of problems additional to the condition causing the pain; which is better, a happy, productive, self-supporting addict or a miserable dependent, but "clean" victim? Is a puzzlement. joannek4 <joann…@email.msn.com wrote in message news:ea5v0lT9$GA.64@cpmsnbbsa07… Hi Michael, I have to agree with you on getting addicted to  whatever a person takes for pain and it works. We are talking about MS and the severe pain that comes with it. What is more important stopping the pain enough to deal with it or becoming addicted. It is ridiculous for a Doctor to even bring this up to a patient but if it’s a must,well I feel it’s our choice to continue to take it not the Doc. We are the ones in pain not him. Take Care, Joanne

Response:

Hi Michael, I have to agree with you on getting addicted to  whatever a person takes for pain and it works. We are talking about MS and the severe pain that comes with it. What is more important stopping the pain enough to deal with it or becoming addicted. It is ridiculous for a Doctor to even bring this up to a patient but if it’s a must,well I feel it’s our choice to continue to take it not the Doc. We are the ones in pain not him. Take Care, Joanne

Response:

While addiction can generate its own set of problems additional to the condition causing the pain; which is better, a happy, productive, self-supporting addict or a miserable dependent, but "clean" victim? Is a puzzlement. joannek4 <joann…@email.msn.com

wrote in message

news:ea5v0lT9$GA.64@cpmsnbbsa07… – Hide quoted text — Show quoted text -

Hi Michael, I have to agree with you on getting addicted to  whatever a person

takes for

pain and it works. We are talking about MS and the severe pain that

comes

with it. What is more important stopping the pain enough to deal with

it or

becoming addicted. It is ridiculous for a Doctor to even bring this up

to a

patient but if it’s a must,well I feel it’s our choice to continue to

take

it not the Doc. We are the ones in pain not him. Take Care, Joanne

Response:

Barb, Won’t your doc give you both (neruontin and morphine) I know I could never even ask for morphine and that is why I put up with the awful neuro I currently see because I’m scared I will lose my current pain meds. Anyway….. If you have already used Morphine and it helped, wouldn’t your doc give you some for break thru pain? I never sleep thru the night. I hate this nasty pain and I feel for all of us that have to put up with it ecspecially when there is something that helps. Our only obstacle are getting the docs to do their jobs. Take Care Shell – Hide quoted text — Show quoted text -Barb Edmiston wrote:

Hi Joanne I still get break through pain at times on Neurontin. At the moment I am in a real mess. I can’t sleep – if I try to exercise I get into this ‘overdrive’ like tremors and weakness + pain but fast heart and nightmares.(Neurontin relief is reduced by eating high protein = steak or lean chicken etc.) BUT I need to try to keep fit. Barb – wondering what the ****** is going on in my body. Got my first wheelchair last week – for home – but failing badly at everything else.  Hey –  xx be well on both meds!! OK? "joannek4" <joann…@email.msn.com wrote in message news:ePKwXo58$GA.420@cpmsnbbsa08… Barb Edmiston <barbedmis…@dingoblue.net.au wrote in message news:3977da87$0$11187$7f31c96c@news01.syd.optusnet.com.au… Shell – I thought morphine worked really well for me – it changed my life! But the Docs are dead against it now as some folk have discovered how to change the content of the capsule and sell it. Hi Barb & Shell, I take Neurontin and Morphine (MS Contin) for severe pain. My Neuro sent me to a Pain Clinic because he tried everything he could and didn’t work. I deal with nerve pain which in my opinion only Morphine can help calm the pain. I well understand anyone dealing with pain its devastating! Take Care, Joanne

Response:

I have this pain and my neuro prescribed Hydrocodone and it works!  Doesn’t take the pain away completely, but leaves you with a feeling of pressure instead of PAIN.  But now he fears that I will become ‘addicted’ and has tried other things that have not worked and made me violently ill on top of not taking away the pain.  I have some of the hydrocodone left and as this exacerbation has started subsiding, I have been cutting my 10mg tablets in half and that seems to be doing the job…at least now.  I have an appointment with a new neurologist Aug. 1st who specializes in MS and we will see what he has to say.  Only problem is that I have pain meds to last only until the 28th and my current neuro, will not prescribe any more.  He is aware that I cut the pills in half and on good days, have gone up to 11 hours without one…but still afraid that I will get addicted, though my actions show otherwise.  Isn’t it frustrating?  Really tough when we have this pain and can barely function, and to add to it, we have to fight the doctors to get what we need. Karlyn "Laura K." wrote in message <8e.7f85b88.26a64…@aol.com

… Hello Group: For all interested, another prospective on MS pain. use of milder medications containing codeine, if tolerated. I then use=20 hydrocodone, long-acting oxycodone, long-acting morphine, methadone,=20 hydromorphone, meperidine, fentanyl patches or oral fentanyl. I warn

patient=

Response:

Karlyn wrote…

I have this pain and my neuro prescribed Hydrocodone and it works!

Doesn’t

take the pain away completely, but leaves you with a feeling of pressure instead of PAIN.  But now he fears that I will become ‘addicted’ and has tried other things that have not worked and made me violently ill on top

of

not taking away the pain.

Gimme a break.  Your doctor is an idiot.   Don’t fault him too harshly for that, most of them are in this regard. Of *course* you’ll become addicted ("tolerant" and "dependant", to name it properly) if you take any opiate for long enough… so WHAT?   It’s not that hard to become UN-addicted when the time comes to stop taking the stuff. What he’s *really* afraid of is that you’ll become the stereotypical poster-campaign drug fiend that the world has come to know and fear. Doctors aren’t granted some special immunity to social pressure, you know.

He is aware that I cut the pills in half and on good days, have gone up to 11 hours without one…but still afraid that I will get addicted, though

my

actions show otherwise.  Isn’t it frustrating?

Yup.   You’ve given him ample evidence that even if you *did* become addicted, you’re prepared to end your addiction as soon as it’s appropriate. Model behaviour, I’d say.   Tell your new neuro about all this, will you? It might be a good litmus test of how commited he/she is to helping you, rahter than merely *treating* you. —      (((((((((((((U))))))))))))) Michael <muirh…@island.net

  -=[ Livin' on Island Time ]=-

Response:

Barb, I found Neurontin exacerbated all my symptoms. I hated it. The only thing that works for me are narcotics. This is one whacky disease, what works for one of us doesn’t work for another. I’m glad you have found relief with the Neurontin but I never ever want to see it again. Take Care Shell – Hide quoted text — Show quoted text -Barb  wrote:

Thank you – I have only one word to say NEURONTIN beats MORPHINE!!!!!!!! AMEN. Works for me thank goodness – even though the dose goes up – (and price)  thank you for your info! Barb. In respite I think  - I hope………. xxx

Response:

Shell – I thought morphine worked really well for me – it changed my life! But the Docs are dead against it now as some folk have discovered how to change the content of the capsule and sell it. :0( So glad it works for you – keep eating the tinned pears beats prunes….(good for the bowel!!)  Barb..(on Neurontin now)…. Be Well x. "Shell" <smin…@epix.com

wrote in message

news:3975F006.9B920A51@epix.com… – Hide quoted text — Show quoted text -

Barb, I found Neurontin exacerbated all my symptoms. I hated it. The only thing

that

works for me are narcotics. This is one whacky disease, what works for one

of us

doesn’t work for another. I’m glad you have found relief with the

Neurontin but

I never ever want to see it again. Take Care Shell

Response:

Barb Edmiston <barbedmis…@dingoblue.net.au

wrote in message

news:3977da87$0$11187$7f31c96c@news01.syd.optusnet.com.au…

Shell – I thought morphine worked really well for me – it changed my life! But the Docs are dead against it now as some folk have discovered how to change the content of the capsule and sell it.

Hi Barb & Shell, I take Neurontin and Morphine (MS Contin) for severe pain. My Neuro sent me to a Pain Clinic because he tried everything he could and didn’t work. I deal with nerve pain which in my opinion only Morphine can help calm the pain. I well understand anyone dealing with pain its devastating! Take Care, Joanne

Response:

Hi Joanne I still get break through pain at times on Neurontin. At the moment I am in a real mess. I can’t sleep – if I try to exercise I get into this ‘overdrive’ like tremors and weakness + pain but fast heart and nightmares.(Neurontin relief is reduced by eating high protein = steak or lean chicken etc.) BUT I need to try to keep fit. Barb – wondering what the ****** is going on in my body. Got my first wheelchair last week – for home – but failing badly at everything else.  Hey –  xx be well on both meds!! OK? "joannek4" <joann…@email.msn.com

wrote in message

news:ePKwXo58$GA.420@cpmsnbbsa08… – Hide quoted text — Show quoted text -> Barb Edmiston <barbedmis…@dingoblue.net.au

wrote in message

> news:3977da87$0$11187$7f31c96c@news01.syd.optusnet.com.au… > > Shell – I thought morphine worked really well for me – it changed my life!

But the Docs are dead against it now as some folk have discovered how to change the content of the capsule and sell it. Hi Barb & Shell, I take Neurontin and Morphine (MS Contin) for severe pain. My Neuro sent

me

to a Pain Clinic because he tried everything he could and didn’t work. I deal with nerve pain which in my opinion only Morphine can help calm the pain. I well understand anyone dealing with pain its devastating! Take Care, Joanne

Response:

Thank you – I have only one word to say NEURONTIN beats MORPHINE!!!!!!!! AMEN. Works for me thank goodness – even though the dose goes up – (and price)  thank you for your info! Barb. In respite I think  - I hope………. xxx "Laura K.""  <Nygab…@AOL.COM

wrote in message

news:8e.7f85b88.26a6439f@aol.com… – Hide quoted text — Show quoted text -

Hello Group: For all interested, another prospective on MS pain. Intelihealth Rational Polypharmacy In The Treatment Of Chronic Neuropathic Pain Robert L. Knobler, M.D., Ph.D., is the director of the Knobler Institute

of=20

Neurologic Disease, PC, and the K.I.N.D. Clinic. He is professor of

neurolog=

y=20 at Thomas Jefferson University. Dr. Knobler has basic science and

clinical=20

research expertise in multiple sclerosis, viral immunology and the

managemen=

t=20 of chronic pain disorders.=20  =20 In my adult neurology practice, I see many referred patients with

multiple=20

sclerosis and chronic pain disorders. About half of the patients I see

with=20

multiple sclerosis are also affected by chronic neuropathic pain.

Therefore,=

=20 I thought I would discuss some of the clinical issues in the day-to-day=20 management of chronic neuropathic pain. The patients I see have various forms of pain, but their pain is almost=20 always severe. The pain is often rated 7-9/10 before treatment and

interrupt=

s=20 the patients’ activities of daily living. The pain may be a result of

trauma=

=20 or the lesions of multiple sclerosis. The most common component of my patients=E2=80=99 complaint is that of a

bur=

ning=20 dysesthetic sensation. Many of the newer anticonvulsants work

particularly=20

well for this symptom, particularly gabapentin (Neurontin), tiagabine=20 (Gabitril) and topiramate (Topamax). It has been my perception, perhaps influenced by the information I am=20 provided in the history I elicit from the patient, that there is an

effort=20

directed at pushing this class of medication to its limit before

considering=

=20 other medications. Typically, a patient will see me who has been given=20 gabapentin at a dose of 800 milligrams four times daily (2400

milligrams=20

total). The patient is still experiencing sensory dysesthesia as well

as=20

having some confusion and dizziness from the high dose of gabapentin.=20 I have found that patients get the best response from gabapentin by

starting=

=20 at a lower dose of 100 milligrams to start, and then titrating upward to

a=20

higher dose. I start the patient on the medication at bedtime initially,

to=20

be certain that the patient gets to sleep, and then add additional

doses=20

during the daytime, as needed, to get maximal relief. Recognizing that

this=20

is an educational process for the patient, I explain that it will take

time=20

to get the maximum benefit from the medicine, and encourage the patient

to=20

work with me to help find the best dose for them.=20 Older drugs, such as the tricyclics, still will work best in some=20 circumstances. I may choose to use 10 milligrams of amitriptyline to

start,=20

and have the patient titrate up to as much as 40 milligrams at bedtime,

if=20

that much is actually needed. The reasons for using tricyclics such as=20 amitriptyline for the treatment of neuropathic pain include its impact

on=20

improving mood, slowing the urgent bladder, reducing burning pain and

helpin=

g=20 patients get to sleep. Caution is advised in patients with a history of=20 palpitations. Dry mouth and urinary retention can present drawbacks for

this=

=20 class of medication, so I tend to use the newer medications with more=20 specific effectiveness. However, tricyclics sometimes still have great=20 utility and have the added benefit of being relatively inexpensive. With all of these medications, the starting dose is always low, and the=20 titration is always slow. The titration can be accelerated as needed. It

is=20

far more difficult to get a patient to continue a medication that they

have=20

had an adverse reaction to caused from taking too much of the drug, than

to=20

have the patient gradually increase the dose and tolerate the side effects

a=

=20 bit longer until they are adequately treated by the drug. For gabapentin, I start patients with 100 milligrams and increase the dose

i=

n=20 100-milligram increments, generally until reaching three tablets at

bedtime.=

=20 I may then begin to spread the medication throughout the day as needed.

For=20

tiagabine, I start patients with 4 milligrams and escalate at

4-milligram=20

increments to reach a dosing schedule of two 4-milligram tablets four

times=20

per day. This can be reduced to twice daily dosing if needed for

convenience=

.=20 For topiramate, I start patients with 25 milligrams at bedtime and

escalate=20

to two 25-milligram tablets or capsules four times per day. I may have some patients taking more than one type of anticonvulsant at

the=20

same time. I have observed that I can continue to use lower doses of

each=20

type of medication effectively and keep the side effects low while

improving=

=20 efficacy since their mechanisms of action are different (which is beyond

the=

=20 scope of the present discussion, but which is the scientific basis for=20 rational polypharmacy). Other symptoms and side effects may occur in patients and these must also

be=

=20 addressed to provide effective care and management. These symptoms

include=20

aching pain, unresponsiveness to these newer anticonvulsants, reactive=20 depression, muscle spasms, difficulty sleeping, confusion and memory

problem=

s. I have noted that medication and lack of sleep can contribute to the

combine=

d=20 symptoms of sleep disruption, confusion, muscle spasms and memory

problems.=20

To address these issues effectively, I have found that a certain degree

of=20

pain relief is needed for quality sleep to take place. Pain is an

alerting=20

response that will effectively prevent sleep, and lack of sleep can lead

to=20

confusion and memory disturbances. To treat pain, I often prescribe opioids as they are needed. I begin with

th=

e=20 use of milder medications containing codeine, if tolerated. I then use=20 hydrocodone, long-acting oxycodone, long-acting morphine, methadone,=20 hydromorphone, meperidine, fentanyl patches or oral fentanyl. I warn

patient=

s=20 of possible side effects such as nausea, vomiting, delayed swallowing

or=20

delayed gastric emptying, and constipation. I have noted a reduction of pain intensity to the 4-5/10 range in

patients=20

treated with opioids. However, some patients indicate higher pain levels

at=20

their follow-up appointments for several reasons: (1) they have not

taken=20

their medication in order to drive to their appointment; (2) they

over-repor=

t=20 pain in an attempt to ensure continuation of their medication; (3) they=20 purposely don=E2=80=99t take their medication before their appointment in

or=

der to=20 look as if they need more pain medication, or to ensure continuation of

thei=

r=20 pain medication. I put patients taking opioids on a stool softener and a fiber supplement

as=20

well. I caution them about the use of magnesium citrate if they are at

risk=20

of developing fecal impaction because of the potential danger of

perforation=

.=20 Patients usually don=E2=80=99t like to hear that, but they have to know.

If=20=

they=20 develop gastrointestinal pain or rectal bleeding, I send them for an=20 appropriate endoscopic or colonoscopic evaluation. If patients have reactive depression develop, I prescribe an

antidepressant.=

=20 I favor the selective serotonin reuptake inhibitors (SSRIs), and note

that=20

they have been of some use in both relief of depression and treatment

of=20

migraine. This is helpful since there is an element of migraine-like

headach=

e=20 in many of the patients that develop upper extremity pain problems.

Migraine=

=20 may be the response that any of several stimuli yields when triggered,

but=20

whatever the explanation the depression must be treated. Fluoxetine

(Prozac)=

,=20 sertraline (Zoloft) and venlafaxine (Effexor) all have excellent records

of=20

effectiveness. When an SSRI cannot be used because of a potential

conflict=20

due to simultaneous use with an anti-migraine triptan (Serotonin

Syndrome),=20

bupropion (Wellbutrin) can be used effectively. If memory problems persist, donepezil (Aricept) can be used at a dose of 5

t=

o=20 10 milligrams per day, with some improvement. Confusion should subside

as=20

sleep improves and the dose of anticonvulsant adjuvant is reduced.

Improved=20

pain control will also help improve cognition. Finally, perhaps the most important aspect of neuropathic pain control

is=20

that associated with the control of movement-related muscle spasms.

Muscle=20

spasms are made worse by physical activity of even the mildest variety,

a=20

dependent posture and cold ambient temperature. This is important

because=20

treating movement-related spasms is one of the principal ways by which=20 neuropathic pain may be resolved, particularly early after the onset of

the=20

pain, before it has had a chance to become "centralized" pain due to

changes=

=20 secondary to the release of excitatory neurotransmitters within the

dorsal=20

root entry zone. I most often will use tizanidine (Zanaflex) to treat neuropathic pain=20 associated with movement-related muscle spams, beginning with a dose of

1mg=20

at bedtime. I have the patient titrate up to as much as 8 milligrams at=20 bedtime, if needed, and 1 to 4 milligrams at two-hour intervals if so

needed=

,=20 with a maximum of eight full 4-milligram tablets per day (32

milligrams).=20

Tizanidine reduces the spasm of movement and the pain associated with

that=20

spasm,

… read more »

Response:

I hated Neurontin. It exacerbated all my symptoms and I will never take it again. I know it has helped a lot of patients but not me….yuk. As for Zoloft……To each their own. Take Care Shell – Hide quoted text — Show quoted text -"Laura K." wrote:

Hello Group: For all interested, another prospective on MS pain. Intelihealth Rational Polypharmacy In The Treatment Of Chronic Neuropathic Pain Robert L. Knobler, M.D., Ph.D., is the director of the Knobler Institute of=20 Neurologic Disease, PC, and the K.I.N.D. Clinic. He is professor of neurolog= y=20 at Thomas Jefferson University. Dr. Knobler has basic science and clinical=20 research expertise in multiple sclerosis, viral immunology and the managemen= t=20 of chronic pain disorders.=20  =20 In my adult neurology practice, I see many referred patients with multiple=20 sclerosis and chronic pain disorders. About half of the patients I see with=20 multiple sclerosis are also affected by chronic neuropathic pain. Therefore,= =20 I thought I would discuss some of the clinical issues in the day-to-day=20 management of chronic neuropathic pain. The patients I see have various forms of pain, but their pain is almost=20 always severe. The pain is often rated 7-9/10 before treatment and interrupt= s=20 the patients’ activities of daily living. The pain may be a result of trauma= =20 or the lesions of multiple sclerosis. The most common component of my patients=E2=80=99 complaint is that of a bur= ning=20 dysesthetic sensation. Many of the newer anticonvulsants work particularly=20 well for this symptom, particularly gabapentin (Neurontin), tiagabine=20 (Gabitril) and topiramate (Topamax). It has been my perception, perhaps influenced by the information I am=20 provided in the history I elicit from the patient, that there is an effort=20 directed at pushing this class of medication to its limit before considering= =20 other medications. Typically, a patient will see me who has been given=20 gabapentin at a dose of 800 milligrams four times daily (2400 milligrams=20 total). The patient is still experiencing sensory dysesthesia as well as=20 having some confusion and dizziness from the high dose of gabapentin.=20 I have found that patients get the best response from gabapentin by starting= =20 at a lower dose of 100 milligrams to start, and then titrating upward to a=20 higher dose. I start the patient on the medication at bedtime initially, to=20 be certain that the patient gets to sleep, and then add additional doses=20 during the daytime, as needed, to get maximal relief. Recognizing that this=20 is an educational process for the patient, I explain that it will take time=20 to get the maximum benefit from the medicine, and encourage the patient to=20 work with me to help find the best dose for them.=20 Older drugs, such as the tricyclics, still will work best in some=20 circumstances. I may choose to use 10 milligrams of amitriptyline to start,=20 and have the patient titrate up to as much as 40 milligrams at bedtime, if=20 that much is actually needed. The reasons for using tricyclics such as=20 amitriptyline for the treatment of neuropathic pain include its impact on=20 improving mood, slowing the urgent bladder, reducing burning pain and helpin= g=20 patients get to sleep. Caution is advised in patients with a history of=20 palpitations. Dry mouth and urinary retention can present drawbacks for this= =20 class of medication, so I tend to use the newer medications with more=20 specific effectiveness. However, tricyclics sometimes still have great=20 utility and have the added benefit of being relatively inexpensive. With all of these medications, the starting dose is always low, and the=20 titration is always slow. The titration can be accelerated as needed. It is=20 far more difficult to get a patient to continue a medication that they have=20 had an adverse reaction to caused from taking too much of the drug, than to=20 have the patient gradually increase the dose and tolerate the side effects a= =20 bit longer until they are adequately treated by the drug. For gabapentin, I start patients with 100 milligrams and increase the dose i= n=20 100-milligram increments, generally until reaching three tablets at bedtime.= =20 I may then begin to spread the medication throughout the day as needed. For=20 tiagabine, I start patients with 4 milligrams and escalate at 4-milligram=20 increments to reach a dosing schedule of two 4-milligram tablets four times=20 per day. This can be reduced to twice daily dosing if needed for convenience= .=20 For topiramate, I start patients with 25 milligrams at bedtime and escalate=20 to two 25-milligram tablets or capsules four times per day. I may have some patients taking more than one type of anticonvulsant at the=20 same time. I have observed that I can continue to use lower doses of each=20 type of medication effectively and keep the side effects low while improving= =20 efficacy since their mechanisms of action are different (which is beyond the= =20 scope of the present discussion, but which is the scientific basis for=20 rational polypharmacy). Other symptoms and side effects may occur in patients and these must also be= =20 addressed to provide effective care and management. These symptoms include=20 aching pain, unresponsiveness to these newer anticonvulsants, reactive=20 depression, muscle spasms, difficulty sleeping, confusion and memory problem= s. I have noted that medication and lack of sleep can contribute to the combine= d=20 symptoms of sleep disruption, confusion, muscle spasms and memory problems.=20 To address these issues effectively, I have found that a certain degree of=20 pain relief is needed for quality sleep to take place. Pain is an alerting=20 response that will effectively prevent sleep, and lack of sleep can lead to=20 confusion and memory disturbances. To treat pain, I often prescribe opioids as they are needed. I begin with th= e=20 use of milder medications containing codeine, if tolerated. I then use=20 hydrocodone, long-acting oxycodone, long-acting morphine, methadone,=20 hydromorphone, meperidine, fentanyl patches or oral fentanyl. I warn patient= s=20 of possible side effects such as nausea, vomiting, delayed swallowing or=20 delayed gastric emptying, and constipation. I have noted a reduction of pain intensity to the 4-5/10 range in patients=20 treated with opioids. However, some patients indicate higher pain levels at=20 their follow-up appointments for several reasons: (1) they have not taken=20 their medication in order to drive to their appointment; (2) they over-repor= t=20 pain in an attempt to ensure continuation of their medication; (3) they=20 purposely don=E2=80=99t take their medication before their appointment in or= der to=20 look as if they need more pain medication, or to ensure continuation of thei= r=20 pain medication. I put patients taking opioids on a stool softener and a fiber supplement as=20 well. I caution them about the use of magnesium citrate if they are at risk=20 of developing fecal impaction because of the potential danger of perforation= .=20 Patients usually don=E2=80=99t like to hear that, but they have to know. If=20= they=20 develop gastrointestinal pain or rectal bleeding, I send them for an=20 appropriate endoscopic or colonoscopic evaluation. If patients have reactive depression develop, I prescribe an antidepressant.= =20 I favor the selective serotonin reuptake inhibitors (SSRIs), and note that=20 they have been of some use in both relief of depression and treatment of=20 migraine. This is helpful since there is an element of migraine-like headach= e=20 in many of the patients that develop upper extremity pain problems. Migraine= =20 may be the response that any of several stimuli yields when triggered, but=20 whatever the explanation the depression must be treated. Fluoxetine (Prozac)= ,=20 sertraline (Zoloft) and venlafaxine (Effexor) all have excellent records of=20 effectiveness. When an SSRI cannot be used because of a potential conflict=20 due to simultaneous use with an anti-migraine triptan (Serotonin Syndrome),=20 bupropion (Wellbutrin) can be used effectively. If memory problems persist, donepezil (Aricept) can be used at a dose of 5 t= o=20 10 milligrams per day, with some improvement. Confusion should subside as=20 sleep improves and the dose of anticonvulsant adjuvant is reduced. Improved=20 pain control will also help improve cognition. Finally, perhaps the most important aspect of neuropathic pain control is=20 that associated with the control of movement-related muscle spasms. Muscle=20 spasms are made worse by physical activity of even the mildest variety, a=20 dependent posture and cold ambient temperature. This is important because=20 treating movement-related spasms is one of the principal ways by which=20 neuropathic pain may be resolved, particularly early after the onset of the=20 pain, before it has had a chance to become "centralized" pain due to changes= =20 secondary to the release of excitatory neurotransmitters within the dorsal=20 root entry zone. I most often will use tizanidine (Zanaflex) to treat neuropathic pain=20 associated with movement-related muscle spams, beginning with a dose of 1mg=20 at bedtime. I have the patient titrate up to as much as 8 milligrams at=20 bedtime, if needed, and 1 to 4 milligrams at two-hour intervals if so needed= ,=20 with a maximum of eight full 4-milligram tablets per day (32 milligrams).=20 Tizanidine reduces the spasm of movement and the pain associated with that=20 spasm, thus allowing the patient to move more freely. Tizanidine may be used= =20 strictly on an as

… read more »

Response:

Hello Group: For all interested, another prospective on MS pain. Intelihealth Rational Polypharmacy In The Treatment Of Chronic Neuropathic Pain Robert L. Knobler, M.D., Ph.D., is the director of the Knobler Institute of=20 Neurologic Disease, PC, and the K.I.N.D. Clinic. He is professor of neurolog= y=20 at Thomas Jefferson University. Dr. Knobler has basic science and clinical=20 research expertise in multiple sclerosis, viral immunology and the managemen= t=20 of chronic pain disorders.=20  =20 In my adult neurology practice, I see many referred patients with multiple=20 sclerosis and chronic pain disorders. About half of the patients I see with=20 multiple sclerosis are also affected by chronic neuropathic pain. Therefore,= =20 I thought I would discuss some of the clinical issues in the day-to-day=20 management of chronic neuropathic pain. The patients I see have various forms of pain, but their pain is almost=20 always severe. The pain is often rated 7-9/10 before treatment and interrupt= s=20 the patients’ activities of daily living. The pain may be a result of trauma= =20 or the lesions of multiple sclerosis. The most common component of my patients=E2=80=99 complaint is that of a bur= ning=20 dysesthetic sensation. Many of the newer anticonvulsants work particularly=20 well for this symptom, particularly gabapentin (Neurontin), tiagabine=20 (Gabitril) and topiramate (Topamax). It has been my perception, perhaps influenced by the information I am=20 provided in the history I elicit from the patient, that there is an effort=20 directed at pushing this class of medication to its limit before considering= =20 other medications. Typically, a patient will see me who has been given=20 gabapentin at a dose of 800 milligrams four times daily (2400 milligrams=20 total). The patient is still experiencing sensory dysesthesia as well as=20 having some confusion and dizziness from the high dose of gabapentin.=20 I have found that patients get the best response from gabapentin by starting= =20 at a lower dose of 100 milligrams to start, and then titrating upward to a=20 higher dose. I start the patient on the medication at bedtime initially, to=20 be certain that the patient gets to sleep, and then add additional doses=20 during the daytime, as needed, to get maximal relief. Recognizing that this=20 is an educational process for the patient, I explain that it will take time=20 to get the maximum benefit from the medicine, and encourage the patient to=20 work with me to help find the best dose for them.=20 Older drugs, such as the tricyclics, still will work best in some=20 circumstances. I may choose to use 10 milligrams of amitriptyline to start,=20 and have the patient titrate up to as much as 40 milligrams at bedtime, if=20 that much is actually needed. The reasons for using tricyclics such as=20 amitriptyline for the treatment of neuropathic pain include its impact on=20 improving mood, slowing the urgent bladder, reducing burning pain and helpin= g=20 patients get to sleep. Caution is advised in patients with a history of=20 palpitations. Dry mouth and urinary retention can present drawbacks for this= =20 class of medication, so I tend to use the newer medications with more=20 specific effectiveness. However, tricyclics sometimes still have great=20 utility and have the added benefit of being relatively inexpensive. With all of these medications, the starting dose is always low, and the=20 titration is always slow. The titration can be accelerated as needed. It is=20 far more difficult to get a patient to continue a medication that they have=20 had an adverse reaction to caused from taking too much of the drug, than to=20 have the patient gradually increase the dose and tolerate the side effects a= =20 bit longer until they are adequately treated by the drug. For gabapentin, I start patients with 100 milligrams and increase the dose i= n=20 100-milligram increments, generally until reaching three tablets at bedtime.= =20 I may then begin to spread the medication throughout the day as needed. For=20 tiagabine, I start patients with 4 milligrams and escalate at 4-milligram=20 increments to reach a dosing schedule of two 4-milligram tablets four times=20 per day. This can be reduced to twice daily dosing if needed for convenience= .=20 For topiramate, I start patients with 25 milligrams at bedtime and escalate=20 to two 25-milligram tablets or capsules four times per day. I may have some patients taking more than one type of anticonvulsant at the=20 same time. I have observed that I can continue to use lower doses of each=20 type of medication effectively and keep the side effects low while improving= =20 efficacy since their mechanisms of action are different (which is beyond the= =20 scope of the present discussion, but which is the scientific basis for=20 rational polypharmacy). Other symptoms and side effects may occur in patients and these must also be= =20 addressed to provide effective care and management. These symptoms include=20 aching pain, unresponsiveness to these newer anticonvulsants, reactive=20 depression, muscle spasms, difficulty sleeping, confusion and memory problem= s. I have noted that medication and lack of sleep can contribute to the combine= d=20 symptoms of sleep disruption, confusion, muscle spasms and memory problems.=20 To address these issues effectively, I have found that a certain degree of=20 pain relief is needed for quality sleep to take place. Pain is an alerting=20 response that will effectively prevent sleep, and lack of sleep can lead to=20 confusion and memory disturbances. To treat pain, I often prescribe opioids as they are needed. I begin with th= e=20 use of milder medications containing codeine, if tolerated. I then use=20 hydrocodone, long-acting oxycodone, long-acting morphine, methadone,=20 hydromorphone, meperidine, fentanyl patches or oral fentanyl. I warn patient= s=20 of possible side effects such as nausea, vomiting, delayed swallowing or=20 delayed gastric emptying, and constipation. I have noted a reduction of pain intensity to the 4-5/10 range in patients=20 treated with opioids. However, some patients indicate higher pain levels at=20 their follow-up appointments for several reasons: (1) they have not taken=20 their medication in order to drive to their appointment; (2) they over-repor= t=20 pain in an attempt to ensure continuation of their medication; (3) they=20 purposely don=E2=80=99t take their medication before their appointment in or= der to=20 look as if they need more pain medication, or to ensure continuation of thei= r=20 pain medication. I put patients taking opioids on a stool softener and a fiber supplement as=20 well. I caution them about the use of magnesium citrate if they are at risk=20 of developing fecal impaction because of the potential danger of perforation= .=20 Patients usually don=E2=80=99t like to hear that, but they have to know. If=20= they=20 develop gastrointestinal pain or rectal bleeding, I send them for an=20 appropriate endoscopic or colonoscopic evaluation. If patients have reactive depression develop, I prescribe an antidepressant.= =20 I favor the selective serotonin reuptake inhibitors (SSRIs), and note that=20 they have been of some use in both relief of depression and treatment of=20 migraine. This is helpful since there is an element of migraine-like headach= e=20 in many of the patients that develop upper extremity pain problems. Migraine= =20 may be the response that any of several stimuli yields when triggered, but=20 whatever the explanation the depression must be treated. Fluoxetine (Prozac)= ,=20 sertraline (Zoloft) and venlafaxine (Effexor) all have excellent records of=20 effectiveness. When an SSRI cannot be used because of a potential conflict=20 due to simultaneous use with an anti-migraine triptan (Serotonin Syndrome),=20 bupropion (Wellbutrin) can be used effectively. If memory problems persist, donepezil (Aricept) can be used at a dose of 5 t= o=20 10 milligrams per day, with some improvement. Confusion should subside as=20 sleep improves and the dose of anticonvulsant adjuvant is reduced. Improved=20 pain control will also help improve cognition. Finally, perhaps the most important aspect of neuropathic pain control is=20 that associated with the control of movement-related muscle spasms. Muscle=20 spasms are made worse by physical activity of even the mildest variety, a=20 dependent posture and cold ambient temperature. This is important because=20 treating movement-related spasms is one of the principal ways by which=20 neuropathic pain may be resolved, particularly early after the onset of the=20 pain, before it has had a chance to become "centralized" pain due to changes= =20 secondary to the release of excitatory neurotransmitters within the dorsal=20 root entry zone. I most often will use tizanidine (Zanaflex) to treat neuropathic pain=20 associated with movement-related muscle spams, beginning with a dose of 1mg=20 at bedtime. I have the patient titrate up to as much as 8 milligrams at=20 bedtime, if needed, and 1 to 4 milligrams at two-hour intervals if so needed= ,=20 with a maximum of eight full 4-milligram tablets per day (32 milligrams).=20 Tizanidine reduces the spasm of movement and the pain associated with that=20 spasm, thus allowing the patient to move more freely. Tizanidine may be used= =20 strictly on an as needed basis during the day or night. Taken together, the use of medications for the burning pain/allodynia=20 (anticonvulsants); aching pain (analgesic/narcotics); bowel regimen (stool=20 softener/fiber); reactive depression (antidepressants); disturbed memory=20 (memory enhancer); muscle spasm (antispasticity agents) provides the basis=20 for a plan of rational polypharmacy in the clinical management of the patien= t=20 with chronic neuropathic pain. Nygabnet

Response:

Question:

Wait and take the next one when you are suppose. If you missed one dosage it won’t hurt you. You may want to get a pill box and then if you think you have missed a dosage you can look and tell if it missing. Hope your day goes well. K. HAVE A WONDERFULLY FUN FILLED DAY!!!!

Response:

I usually cant remember whether I took my meds or not so I went out and bought one of those cute pill reminder box. Mine is plastic and about 4 in. long and a thumbnail wide.It has 7 little compartments with each one having a snap top and the letter of the week on top. They come in many sizes depending on how many pills a day you have to take. I fill mine once a week. If I am about to run out of a med I see it coming a week in advance. Also if you suffer from OCD it really helps you KNOW that you took that pill, so you wont obsess on that. Or if you just have 10 million things on your plate and cant remeber much of anything anymore, lol, it helps. Chow love Brenda

Response:

- Hide quoted text — Show quoted text – I have to respond to this having made this mistake myself not long ago. DO NOT take the extra dose!!! I did that and overdosed myself. You will be better off waiting until your next scheduled dose and just going from there. Your body will not miss the zoloft if you’ve been on it awhile. Just don’t make a habit of it, ok? Mary That’s good advice. What happened when you overdosed, Mary? Philip (just curious)

Well Philip, I took 250 mgs instead of 150. I spent the whole day sitting on the couch wondering how I could have been so stupid. I also spent the day on the couch because every muscle in my body was vibrating and I had very little motor control. But I wasn’t depressed. How could I be with that much of an ad in my system? I pormised myself never to do it again. (I was sleepy when I took my meds that morning and couldn’t remember taking the one pill, so I took another) I went to the store the next day and bought myself a pill organizer that holds all your meds for every day of the week. Now I take the correct dose everyday while feeling like an alzheimer’s patient because at the age of 31, I can’t remember to take my meds correctly. Mary – Hide quoted text — Show quoted text –  Well, I have been here and lurking…I try to respond privately when I feel I can help…To be honest, the only reason I haven’t been responding on the newsgroup is because I found deja.com…When I discovered all my messages, I felt my privacy was invaded a bit much…Anyway, I now have a question that needs the newsgroup and can’t be dealt with privately, so here it is… Hi Chuck, I’m sorry I can’t be of much help with Zoloft but I do have a solution for this problem.  There are 2 options. If your reader allows it (Agent does) you can have the line "x-no-archive: yes" (without quotes) added to your header. If you can’t find out how to do this, the other option is to make that same line (x-no-archive: yes) the *very first* line of your post.  I took some sleeping meds last night, and this morning I woke up late and don’t recall if I took my Zoloft in the morning (as I usually do)…I fear I have missed it…I have been doing excellent on Zoloft Ok now, you are not sure, you *fear* you’ve forgotten. I would say, don’t try to catch up the dose. AFAIK, it’s not good to ever try to catch up a forgotten AD dose. Just lleave it for what it is and take your regular dose tomorrow morning. I doubt you’ll have a major setback, maybe you’ll be a little uncomfortable but that’s all I would expect. I’ve forgotten my paxil dose several times but it never caused any problems for me. Bye! Inky (^_-)

Response:

I’d quote but the beginning of this thread is gone (yes I’m on AOL)… If it helps you any, try putting your morning meds (for me it’s an SSRI and a hormone) in a container (I use the top of the Nyquil bottle…hey it’s free) and keep that by the bed. Make it a practice to leave your BOTTLE in the living room and only put your morning meds in there before you go to bed (like a routine). I’ve found I can get them in my system faster, which helps me get to sleep earlier that night, in case I just wake up early, take the meds and feel like going back to sleep instead of getting up completely. Keep a small glass of water and the cup and turn the med cup upside down when you’ve taken them. Sometimes my OCD comes in handy  This method sure beats looking at the label and counting and subtracting, blah blah….BTDT and found this helps. All the best. Miriam

Response:

i use a pill box to keep meds straight.before i go to bed i put the next day meds in the pill box,also my husband takes heart meds.he keeps them in a box.when he takes one he turns the bottle up side down.no more guessing or mistakes .let me share something else with you.at times it is hard to swoller pills.use a straw taking pills .you can’t believe how much easier it is. hope some of this helps. good luck. fanny

Response:

- Hide quoted text — Show quoted text – That’s good advice. What happened when you overdosed, Mary? Philip (just curious) Well Philip, I took 250 mgs instead of 150. I spent the whole day sitting on the couch wondering how I could have been so stupid. I also spent the day on the couch because every muscle in my body was vibrating and I had very little motor control. But I wasn’t depressed. How could I be with that much of an ad in my system? I pormised myself never to do it again. (I was sleepy when I took my meds that morning and couldn’t remember taking the one pill, so I took another) I went to the store the next day and bought myself a pill organizer that holds all your meds for every day of the week. Now I take the correct dose everyday while feeling like an alzheimer’s patient because at the age of 31, I can’t remember to take my meds correctly. Mary

I thought it would be somewhat like this. Overdosing on a TCA is worse…. I think in 31 years I have missed a dose twice…and the *idea* brings on panic with me (with a benzo it’s different, I notice that very soon and that’s not just psychological). Many  people need pill organizers or a similar system. We may well all  have Alzheimer’s at ASAP, if that would be the criterion ) Philip – Hide quoted text — Show quoted text –  Well, I have been here and lurking…I try to respond privately when I feel I can help…To be honest, the only reason I haven’t been responding on the newsgroup is because I found deja.com…When I discovered all my messages, I felt my privacy was invaded a bit much…Anyway, I now have a question that needs the newsgroup and can’t be dealt with privately, so here it is… Hi Chuck, I’m sorry I can’t be of much help with Zoloft but I do have a solution for this problem.  There are 2 options. If your reader allows it (Agent does) you can have the line "x-no-archive: yes" (without quotes) added to your header. If you can’t find out how to do this, the other option is to make that same line (x-no-archive: yes) the *very first* line of your post.  I took some sleeping meds last night, and this morning I woke up late and don’t recall if I took my Zoloft in the morning (as I usually do)…I fear I have missed it…I have been doing excellent on Zoloft Ok now, you are not sure, you *fear* you’ve forgotten. I would say, don’t try to catch up the dose. AFAIK, it’s not good to ever try to catch up a forgotten AD dose. Just lleave it for what it is and take your regular dose tomorrow morning. I doubt you’ll have a major setback, maybe you’ll be a little uncomfortable but that’s all I would expect. I’ve forgotten my paxil dose several times but it never caused any problems for me. Bye! Inky (^_-)

Response:

Chuck, I’m one day late on this question, but I’ll give you some advice for the future. Keep a record of whenever you take meds. I have a calender next to my pill bottles and indicate whenever I have taken a med. I started doing this because sometimes I forget what I’ve taken, especially if it’s first thing in the morning and I’m still half asleep. I do lots of crazy stuff in the morning, like making coffee without adding the water. Or putting my shirt on backwards. Or missing the toilet when I pee. In fact, sometimes I sit down to pee. (that way there’s a better chance of hitting the target) One lady at ASAP said she didn’t know why her husband sat down in the AM to pee. She thought he was doing strange things. I didn’t say anything at the time, to keep her in suspence I suppose, or maybe just to keep her on her toes. Chip p.s. missing one day of Zoloft won’t hurt. To all –

Question:

Have your blood pressure checked

Had it checked a few weeks ago.  It was fine.  If anything, it is too low. I’m dealing with the VA!!  Jerks that they are, just got off the phone with a VA pharmacist who told me that "perhaps I was coming down with the flu."  Doc is not in, and nobody seems to know when he WILL be in. <sigh

Luanne

Response:

LuanneP <luan…@aol.comet

wrote: Have your blood pressure checked Had it checked a few weeks ago.  It was fine.  If anything, it is too low.

If it’s a bit on the low side, than it could be orthostatic hypotension. Have it myself as long as I can remember – it’s causing dizzyness after a (rapid) change of position. I experienced  a total _different_ kind of dizzyness due to effexor: it’s like all my limbs and my head are way ahead of me all the time – I can _see_ where my arms and legs are, but I sense them way behind, and it takes a while for the visual and sensoreous input to  catch up.  That leads to a very intruiging kind of drowsiness when I move my head – interesting experience, but I’m glad it’s over now! dagdag, sterre — .nosig

Response:

Luanne, I am on Serzone and I have had slight dizziness recently.  I dont know if its the chemical, but there are other reasons for dizziness.  One is that there is a bug going round at the moment that causes dizziness.  There are other things, like ear infections, low blood sugar, stress etc. best wishes estelle.

Response:

Maybe somebody can help me with this.  I am on 300 mg. Effexor daily, along with 1.5 mgs and 25 mgs desyrel at night (for sleep.)  I have been on this ‘current cocktail’ for three years now.  Just recently, I started to experience extreme dizziness if, for instance, I bend over to pick up something, and stand up again.  Usually happens in the early part of the day, and kind of scary… Does this happen to anyone here, and why, after three years would I start to experience this side effect now?  This morning, I almost fell over, I got so dizzy after picking up some change I dropped on the floor. Sincerely, Luanne

Response:

You’re safest thing to do is to call and speak with your doctor as soon as you can.  It may be something as simple as your body changing as you get older and requiring an adjustment in the medication.

 Thanks, Wall, That’s what I was going to do….call my doc on Monday.  Thing is, I’ve been sneezing all day, so maybe getting a headcold so that would explain the dizziness too.   Now y’all know a Dizzy Blonde! <g

Luanne

Response:

luan…@aol.comet (LuanneP) wrote:

Maybe somebody can help me with this.  I am on 300 mg. Effexor daily, along with 1.5 mgs and 25 mgs desyrel at night (for sleep.)  I have been on this ‘current cocktail’ for three years now.  Just recently, I started to experience extreme dizziness if, for instance, I bend over to pick up something, and stand up again.  Usually happens in the early part of the day, and kind of scary…

Have your blood pressure checked.  One of the possible side effects of Effexor is elevated blood pressure.  While I was on it, I was also taking two blood pressure medications, and still found myself in the ER a few times with blood pressure of 230/150.  It wasn’t pretty.  Now that I’m on Wellbutrin, I only have to take one medication for blood pressure, and it’s under perfect control.  Just one possibility … ask your doctor about the blood pressure thing, though. (BTW, symptoms of blood pressure problems (for me) included:  dizziness, pounding in the head, and I could feel the blood throbbing through my carotid artery (the big ones in the front corners of the neck) and in my chest.) Hope you find whatever is wrong and get it straightened out. Carol ********* The Mercurial Mind ********* The Wonderful World of Bipolar Disorder http://members.xoom.com/merc_mind/

Response:

Question:

Hi everyone, I have not posted to your group in a very long time. I have lost my support group and need your support in dealing with my GAD and life as a fellow sufferer. I have been suffering from GAD for over 3 yr. now and have been under treatment for about 1 and a half years. It’s been a long strange trip indeed Currently I am taking Prozac and Knoplin (misspelled I know) and am having moderate success. I have tried many alternative medicines and pharmaceuticals in dealing with this disease and am anxious to share with the group and get feedback. Feel free to talk to me about anything or get on my ICQ list my ICQ number is 4058408. I would love to share information. Peace, lunarchld

Response:

. Feel free to talk to me about anything or get on my ICQ list my ICQ number is 4058408. I would love to share information.

Hmmmm, never considered our ICQ numbers…….mine is 1569491….anyone else have ICQ numbers to share?? KC

Response:

Hmmmm, never considered our ICQ numbers…….mine is 1569491….anyone else have ICQ numbers to share?? KC What are ICQ numbers? I am really dumb on this one. Yes I would like to share information anyway I can. Lol no disrespect it’s that you blew me away with this one. Warmest Regards Bonnie

Bonnie…..I’ll send you the ICQ program…..just run it while you are already online with AOL…..ICQ is just another communication form……you can see at a glance who is online, send quick messages like IM’s to people with other servers, and chat with people from other servers so you aren’t confined to AOL chat rooms.  And the sound waves are cute! Anyone wanting the little program to run ICQ, drop me your e-mail address and I’ll send the program.  I THINK it’s free…..I’ve had it about 6 months and it was when I logged on. Just send me your e-mail address and I’ll forward the program to you. KC

Response:

. Feel free to talk to me about anything or get on my ICQ list my ICQ number is 4058408. I would love to share information. Hmmmm, never considered our ICQ numbers…….mine is 1569491….anyone else have ICQ numbers to share?? KC

okay, i’m in my ICQ # is 2714295. Just be sure to put ASAP on your request this is a great idea y’all

Response:

. Feel free to talk to me about anything or get on my ICQ list my ICQ number is 4058408. I would love to share information. Hmmmm, never considered our ICQ numbers…….mine is 1569491….anyone else have ICQ numbers to share?? KC

Yeah Cindy, as a matter of fact, I have it written down, somewhere, uuuhhhmmm, where is it??? Oh yes, here it is: 3206250 I have only one problem: I don’t have a clue what I can do with this Now I only hope you don’t come to visit me at night and do spooky things…… bye, Trudy the netherlands Remove "xx" from address when replying.

Response:

as a matter of fact, I have it written down, somewhere, uuuhhhmmm, where is it??? Oh yes, here it is: 3206250

next time you are online Trudy, find the ICQ program and run it. Then "connect"…….you CHOOSE who you want to chat to, or send instant messages to. for instance……if you are online right now reading this…..you might hear a little voice say……"incoming message"…..then you click on receive, and it could be me sending a message to you while I’m online at the same time! I could also initiate a "chat" mode with you…..where a screen comes up and we can talk back and forth in real time.  As I type my message, the letters come up on your screen!!!  And you can answer immediately too! I’m a computer flunky, and if I can figure it out, ANYONE can.  Jus tmake sure you run your program WHILE YOU ARE ALREADY ONLINE WITH YOUR ISP. I’ll add you to my list Trudy and you’ll get a system message! KC Cindy

Response:

Spike, as others, I appreciate all the effort your putting in for me. Thank You Stephanie – Hide quoted text — Show quoted text – Jenwolf may be correct. If you think that is the case do this, off-line; reboot, go to dos, type this: netstat -anc:netstat.txt. press enter, type this: exit press enter, that gets things back to windows. Then look in windows and a file called netstat.txt will be there. (notepad) If you know about ports, check it yourself, if not mail the text to me. With your type of connection you have. I don’t think that is the case, however. Still this little thing is good to know. spike If you believe that someone else is posting to usenet and forging your return e-mail address on their posts, then you too can send a copy of the offending post (with complete headers) to their ISP (and to their NNTP-Posting-Host if they are different).  It is a violation of most ISP’s "acceptable use policy" or "terms of service" to forge someone else’s e-mail address. you might also want to check your machine for trojan horses. . .like netbus or subseven. they could be used to *easily* steal passwords and proceed to post or send email in the name of the person stolen from, *from* that person’s account(s). http://jenwolf.virtualave.net/

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Jenwolf may be correct. If you think that is the case do this, off-line; reboot, go to dos, type this: netstat -anc:netstat.txt.

eh? no no no, you need to do netstat while you are *on* line. that way you can see who is connected to you or, if you’re fast enough who is sending you udp packets. as well as what ports are listening. some trojans listen on a certain port(s), which could be seen with an offline netstat, but i’ve never tried it. the easiest way, for someone who is not really in to the technicalities of networking, is to check the registry. hit the start button, then run, type in "regedit" and go to HKEY_LOCAL_MACHINESOFTWARE<MicrosoftWidowsCurrentVersionRun if there are any files there that end with exe, delete them. this will prevent the blasted thing from starting up every time you reboot. (or just exit the registry, use a virus cleaner to rid your system of them, reboot and check the registry again.) note the name of the file and then search the system for it and delete it. unfortunately there are a lot of rat trojans out there, so this may or may not work for all of them. the *best* way to be rid of the damned things is to lowlevel format the drive, most of the newer bios’ have a utility to do this, but it could be risky for certain hard drives. http://jenwolf.virtualave.net/

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Some of these aliases are suspect as being one and the same person.

Half a dozen people in ASAP can vouch for La Chech. She’s one of the nicest people you’d ever want to meet. Karen – Hide quoted text — Show quoted text –

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Some of these aliases are suspect as being one and the same person.

well, let’s clear up one name…i am not the spammer.  i AM guilty of poor taste and displaying a bad temper…but since i used such poor judgement i have no doubt i am picked as a target…..  unfortunately, it took me about 5 tries with my smart buddy spike just to get the spam proof on my acct, and another 3 or 4 to get the sig line working….. the people in this ng (aar) do know me, and I would hope that even in light of my poor judgement a few might stand up to say that i did not do this aweful thing.  at least i hope so…. — If you can judge a wise man by the color of his skin,  then mister you

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Chandra, Yes, I have been there and done that! I suffer from both severe panic (or anxiety) disorder and chronic depression. I had a wonderful family doctor (younger-around 30ish) that was working with me before I became pregnant and at the time I became pregnant. He was super! He was willing to work in the "gray area" and help give me and my unborn child the best of what there was to offer. New doctor’s seem to be better at this. After I voiced my concerns to him (pretty much the same as your’s) he told me that what it came down to was what was best for both mother and child. Sure we all want to be "medication-free" but is that the best thing- even for the unborn child when the mother is not able to be out in the world, lying in bed day after day, terrified unable to care for herself let alone a new baby that’s going to be born, etc…  We all know what effects STRESS has on the already born! Can medication-which hasn’t been proven to cause ill-effects on the fetus be more dangerous than the illness the mother suffers from? No one can know for sure, but both my doctor and I opted for "me" being HEALTHY with medicine over me being gravely unhealthy without needed medication. During my full-term wonderful pregancy, I was taking Prozac, Effexor(an anti-anxiety medication), and another med. I can’t remember at this time. I delivered a superhealthy boy. He weighed 9lbs.13oz. and was 22&1/2 inches long! I only gained 30 lbs. during my pregnancy. Yes, we did tests every trimester, nothing major `just double checking, and had an ulrasound twice (which are nerve racking like everything when your pregnant-your so scared for your baby, but they are such an unbelieveable experience). We even had to induce-he was late! This all happened FIVE YEARS AGO!!! Technology has come along way since then! The question your doctor, and you, needs to answer is which problem will be worse for your unborn baby—medication or a "mentally" unhealthy mother! You should be with a doctor that allows you to help make decisions that are affecting you and you baby! If he doesn’t agree or understand your concerns , or whatever….remember he is YOUR employee and you can find a different doctor. Lots, if not most, have delt with patients such as yourself! I have NO DOUBTS that you will have a beautiful and healthy baby! NONE!!! God is with you! I’d love to talk to you more about it if you like-all you *Also, as far as "hormones" especially during  pregnancy they increase and make worse any problem I’ve found. *F.Y.I. I was 30 at the time of my delivery and am 36 ( just turned) now. Please let me know how things go!

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Hello,      I am new to this message board, but I have been trying to find ANYBODY who can help me out!  I am two months pregnant and I have panic disorder (diagnosed in March of this year) and severe anxiety.  My doctor is weaning me off my paxil (I was on 20 mg. a day) and I had really bad side effects because of it.  Well now I am having severe relapses of panic, which I hadn’t had one for a few months.  I am also suffering severe depression, which I never had before.  I even think about suicide, which I never did before either.  I’m only 22 and this is my first baby and I’m really scared that I’m gonna loose it and not be able to make it. Can anyone else tell me if there was any drug they took while pregnant that won’t hurt my baby?  Also, I wonder if my symptoms are worse because of hormonal changes.  Has anyone one been there, done that?  Please e-mail me any words of wisdom.  I am really scared and wigged out.  I don’t think I can do this without help!  Thanks!

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