Question:

Can Azmacort cause swelling ankles?  I get at least 40 minutes of exercise a day so it is not inactivity (plus a toddler).

Response:

Can Azmacort cause swelling ankles?  I get at least 40 minutes of exercise a day so it is not inactivity (plus a toddler).

I had a swollen face (moon face) from using High Dose Azmacort for 3 months; so I would think it might be responsible; any such effect is dose dependent and time dependent. Azmacort seems to have more severe side effects than other steroid inhalers; also it’s singled out as the steroid inhaler for pregnant women to avoid, in an article at the JAMA asthma site. So it would be worth trying switching to another steroid inhaler. I find that Vanceril DS doesn’t cause this problem for me. Even better would be the new generation steroid inhalers, Flovent and Pulmicort. There are other things that can cause swollen ankles. Ellis

Response:

Can Azmacort cause swelling ankles?  I get at least 40 minutes of exercise a day so it is not inactivity (plus a toddler).

My son has ankle and other joint pain whenever he is on steroids.  The higher the dose, the more intense the symptoms Hulahoops

Response:

Can Azmacort cause swelling ankles?  I get at least 40 minutes of exercise a day so it is not inactivity (plus a toddler).

You would be wise to check with your doctor.  I don’t mean to alarm you, but swollen ankles and shortness of breath are symptoms of Congestive Heart Failure. It would be a good idea to have this ruled out.

Response:

Question:

Hi all… A week ago Tues I saw my specialist who said to reduce my FloVent to 500 mcg per day and see how it goes.  So Tues I had the reduced dose and Wed I woke with that familar tiggle and congestion in the back of my throat.  I posted a message about this being related to reduced FloVent so fast but no one replied.  Then Wed afternoon my PEF dropped into my yellow zone where it has remained (9 1/2 days total).  During this time, I returned to 1000 mcg (last Fri).  Since I was taking my Bricanyl more frequently, I called my doctor who said to up the dose to 2000 mcg until things calm down then gradually reduce to my regular 1000 mcg.  I can’t figure out what caused this drop in PEF; I’m still very close to my red zone so I’m taking it easy, staying indoors and close to the phone incase my PEF drops to the red zone.  I’m drinking lots of tea and water.  At first I thought I may have a cold but no real cold symptoms have appeared other than feeling quite run down and sluggish.  I don’t have any nasal congestion, excessive coughing, sneezing.  I did notice a low grade transient fever that didn’t last very long.  Does anyone have any ideas what may have caused this?  I sure would like to find out so I can prevent it from happening again. — Janine

Response:

- Hide quoted text — Show quoted text – A week ago Tues I saw my specialist who said to reduce my FloVent to 500 mcg per day and see how it goes.  So Tues I had the reduced dose and Wed I woke with that familar tiggle and congestion in the back of my throat.  I posted a message about this being related to reduced FloVent so fast but no one replied.  Then Wed afternoon my PEF dropped into my yellow zone where it has remained (9 1/2 days total).  During this time, I returned to 1000 mcg (last Fri).  Since I was taking my Bricanyl more frequently, I called my doctor who said to up the dose to 2000 mcg until things calm down then gradually reduce to my regular 1000 mcg.  I can’t figure out what caused this drop in PEF; I’m still very close to my red zone so I’m taking it easy, staying indoors and close to the phone incase my PEF drops to the red zone.  I’m drinking lots of tea and water.  At first I thought I may have a cold but no real cold symptoms have appeared other than feeling quite run down and sluggish.  I don’t have any nasal congestion, excessive coughing, sneezing.  I did notice a low grade transient fever that didn’t last very long.  Does anyone have any ideas what may have caused this?  I sure would like to find out so I can prevent it from happening again. —

Janine (in Canada), I would guess your exacerbation is caused by a virus, this happens often; external symptoms may be minimal but the lung function gets knocked down; another possibility is its one of your other triggers. Have your triggers been identified and exposure to them minimized? Per US Guidelines, fluticasone use above 660 mcg/day, or 3 puffs/day of Flovent 220 constitutes a High Dose. I believe in Canada you use the same MDI inhaler but labeled Flovent 250 since you measure dose at the nozzle whereas in the US its measured at the holder opening; so this translates to 750 mcg/day is a High Dose. It would be desireable to get your dose down to 500 mcg/day per your doctor’s suggestion, after you are over the exacerbation. Are you using any steroid-sparing meds; a long acting bronchodilator is usually recommended, Serevent, 2 pf twice a day; or TheoDur tablets. [I take both.] Another possibility is Accolate. Do you have Sinusitis or Gastroesophageal Reflux, that could be contributing to asthma? If so it needs to be treated. Do you breathe thru your nose most of the time (filters & humdifies air) Here are links on Asthma Triggers: ASTHMA TRIGGERS http://www.aaaai.org/patpub/resource/publicat/tips/tip04.html TRIGGERS OF ASTHMA http://www.njc.org/MFhtml/TRI_MF.html  Identifying Triggers of Asthma, 1994 http://www.ama-assn.org/special/asthma/treatmnt/updates/identify.htm Identifying  Asthma Triggers http://www.mayohealth.org/mayo/9602/htm/trigg_sb.htm Trigger-proofing your  environment http://www.lungusa.org/learn/asthma/astastrig.html  Asthma Triggers http://www.lungusa.org/global/news/medical/medfebaf.html  Ozone Air Pollution, Particulates Ellis

Response:

snip I would guess your exacerbation is caused by a virus, this happens often; external symptoms may be minimal but the lung function gets knocked down

There’s a nasty respiratory bug going around right now. My son, who is normally a Mild Persistant asthmatic, had a horrible time of it last week.  He dropped into his red zone fairly quickly, and when we got to the doctor, he was in bad shape.  He had to go onto oral prednisone for five days–and two days later, had a coughing fit so bad he had problems catching his breath and we did the 911/emergency room run, ending up with another breathing treatment (and a verdict of clear lungs) and a diagnosis of a virus-caused cough triggering bronchospasm.  So he got codeine to go with the prednisone. That same day he had a brief, but intense fever, going from normal to 103 degrees back down to normal in the space of five hours.  We visited the doctor, had x-rays done, because the doctor was worried about the possibility of pneumonia.  Lungs looked good, with only a few mucus plugs remaining in his lungs (the doctor pointed them out to me, saying "this is what an asthmatic’s lung looks like on x-rays)…it’s just an ugly, ugly virus causing coughing which irritates the bronchial tubes. I’m hoping we don’t have to go back on prednisone, because he’s now off–but he’s still blowing in his yellow zone.  It’s borderline yellow/green–but I’d like him to get back to Intal only, not Intal and Ventolin, as we’ve been doing to manage the attack. jrw

Response:

280 is panic time??? Wow, I don’t get worried until I am down below 200. Sharre T.

It depends on what your personal best is.  Obviously if your personal best is 600, your normal lung capicity is more than someone whose personal best is 400. Kim

Response:

- Hide quoted text — Show quoted text – I went to the doctor’s again today since I have been in my yellow zone since the 7th despite increased FloVent (from 1000 mcg to 2000 mcg daily).  A side effect of the FloVent has been thrush so he prescribed medication for that and Prednisone. Funny, I was rinsing after each FloVent inhalation, using tea tree oil toothpaste and using my spacer but still developed thrush! Perhaps I’m a little run down?  I mentioned this to the doctor and he said I should call him Thurs to let him know how I was doing and if things were not improving then he would run some blood tests.  Isn’t asthma fun?  Even when you do everything you are supposed to, things can still go wrong. Janine

Yep, that’s true.   I would suggest that instead of using a tea tree oil toothpaste you use a tea tree oil mouth wash.  You can gargle with it and get the areas of your throat that a toothpast will miss.  Also swishing it around your mouth will cover areas the toothpaste would miss. Hang in there. Sometimes, as you said, you do everything right and things still go wrong. Loki

Response:

I would suggest that instead of using a tea tree oil toothpaste you use a tea tree oil mouth wash.  You can gargle with it and get the areas of your throat that a toothpast will miss.  Also swishing it around your mouth will cover areas the toothpaste would miss.

I’m not familiar with tea tree oil.  Is it an antispetic of some sort? Anyway, I use a standard antispetic mouthwash for the same purpose.  It may not be ‘natural’ but it seems to  do the job just fine (and is probably a lot less expensive).

Response:

I would suggest that instead of using a tea tree oil toothpaste you use a tea tree oil mouth wash.  You can gargle with it and get the areas of your throat that a toothpast will miss.  Also swishing it around your mouth will cover areas the toothpaste would miss. I’m not familiar with tea tree oil.  Is it an antispetic of some sort?

It is an essential oil that has antiseptic and antifungal properties. As an antiseptic it’s ok.  I use it on minor things like paper cuts.  As an antifungal it is extremely good. Anyway, I use a standard antispetic mouthwash for the same purpose.  It may not be ‘natural’ but it seems to  do the job just fine (and is probably a lot less expensive).

As long as it works, that’s all that matters.  I used just plain water for a long time.  I’ve started using the tea tree oil mouthwash mostly because I had begun to get thrush no matter how thoroughly I rinsed.  It seems to be doing the job (at least for now). I’m sure your mouthwash tastes better than mine anyway.  Tea tree oil isn’t exactly the most appetizing thing in the world even when masked with spearmint oil (as mine is).   Oh, I do believe you are correct about the cost.  Someone who is adventurous might try just adding a drop of tea tree oil to their regular mouthwash but I’m uncertain of the correct dilution for that purpose so I wouldn’t.  (I could go do the research but I’m in a hurry.) Now, if you need the dilution for shampoo (dandruff), that I can give you.  <chuckle Loki

Response:

One more note about tea tree–as with any herbal remedy, be cautious with it.  My niece is allergic to it, as she discovered to her horror when she used it on a skin inflammation and made it WORSE.  I may be a bit sensitive to it as well, as I’ve found it irritating to some of the things I’ve tried to treat with it, and pretty much ineffective for me.  Your mileage may vary, but do be careful in testing it. Tea tree oil is also sometimes called "ti tree oil". I understand the tree itself, which was imported into Florida, has become a pest there and is displacing native plants.  Maybe if someone turned Floridians on to the market for the stuff, they’d harvest the interloper trees and the price would go down.  ;-) My sympathies for those who get thrush from Azmacort or other inhalers. Apparently following my doctor’s recommendation of rinsing my mouth (or just drinking something) after use has been enough to prevent it in my case. Kiwi Carlisle

Response:

280 is panic time??? Wow, I don’t get worried until I am down below 200. I only use ventolin, and five mgs methylprenisolone with an antibiotic if I get an infection. I have never really understood peak flow numbers. I didn’t even own one for the first three years of my asthma.  Once when I got an infection that went too long before I got my refill for prednisone, I blew 95.  THEN I was panicked.  I am a half an hour from the hospital. The doctor keeps telling me that there are no definite numbers.  I keep wondering why the hell I have the meter. – Hide quoted text — Show quoted text – Hi all… I talked to my doctor on Thursday after trying to get my PEFs up out of the yellow for the past two weeks.  Despite prednisone, they were still in the yellow.  He referred me back to my specialist who I saw this afternoon at the end of his day. The first few minutes of the visit were disasterous!  I told him that my peak flows were down and he commented that "You are obsessed with you peak flows, we have worse cases of asthma than this…go down to spirometry."  I was stunned, since any other time I had dealt with him there had been no problem.  I went down to spirometry, and the first try produced severe chest tightness and pain.  The respirologist immediately left to talk to the specialist, then came back and asked if I would be ok to try again.  I managed to get through two more tries.  The last two loops could easily fit within the first loop as they were quite a bit smaller.  This was under the influence of prednisone and Bricanyl (within 1 hr of the test).  I headed back to the examining room while he looked over my results.  When he returned, his attitude was significantly changed.  Now he was extremely interested in my peak flow chart and commented that he hadn’t realized that I had been this bad for this long. He said that the FloVent was not depositing in my lungs so he has now put me on Pulmicort turbuhaler (400 ug) and he replaced my SereVent with Foradil aerolizer. He also gave me a renewable prescription for prednisone (5 mg) with instructions to use 4 tablets if my PEF drops to 280.  I now have to go back in three weeks, sooner if things don’t settle down.  He said I definitely had a viral infection which caused my peak flows to drop but I didn’t feel "sick" so I’m still wondering about this.  What I found so interesting was his change in attitude and I am left wondering why the change.  I definitely will make sure that my next visit with him is not at the end of the day though. — Janine

Sharre T.                          Truth is infinite; therefore,                      Truth cannot be known in finite terms                                           – Joel Goldsmith

Response:

Hi all… <snip if things don’t settle down.  He said I definitely had a viral infection which caused my peak flows to drop but I didn’t feel "sick" so I’m still wondering about this.

<snip I feel that quite a low-grade viral infection which I wouldn’t have noticed before asthma, or which would have lead to a slight drippy nose, can affect my chest or possibly increase my sensativity to chemical smells, such as toilet cleaner, which seem to make my asthma worse. — Surfer! http://www.nevis-vieww.demon.co.uk Hopeful anti-spam: alter double ‘w’ to single ‘w’ to view site & send Email.

Response:

Question:

: You could be having an allergic reaction to the medication.  This is : something you should report to both your doctor and pharmacist (IMO a : pharmacist tends to do a better job of keeping track of the : medications you shouldn’t take than a doctor does). : There should be no direct problem from abruptly stopping Accolate, : however Rule #2 for asthmatics is: Never stop taking a medication : without checking with a doctor (unless this is covered by an ‘Asthma : Action Plan’). Except in this case, there is the potential for not stopping to be life-threatening.  I believe that the rule is if you get an allergic reaction to some medication, especially things like antibiotics, that you stop the medication first and find a doctor next, the speed depending on how serious the reaction is. : You should try to find a walk-in clinic in your area and consult with : a doctor. I agree entirely, except that I think that it would be a good idea to stop taking the medication if you suspect that it is causing an allergic reaction, and then get your hands on a doctor ASAP. Cheers, Kin Hoong

Response:

If you break out in an itchy blotchy rash after each dose then you should clearly stop the drug. There is no danger inherent to stopping Accolate abruptly other than worsening asthma. If you don’t feel that you were responding tot he Accolate than this should not be a problem. Keep taking the Zyrtec, it may be the only thing stopping a more severe reaction. If your asthma worsens contact your doctor immediately. — Good Luck, CBI, M.D. – Hide quoted text — Show quoted text – Folks, I need some information.  Both my pharmacist and physician are unavailable for another two weeks [the health center is closed for the XMas holidays]. I have been taking Accolate for just over 2 weeks now; to be honest, I haven’t noticed a significant change in my asthma that can definitely be attributed to the Accolate as opposed to just getting over the stupid virus that I have had; though being sick means judging how well the underlying asthma *itself* is doing has been a challenge [respiratory infections are an almost guaranteed flare-er of my asthma]. HOWEVER, that is not what concerns me.  Last night for the third time or so that I have taken my dose I have broken out in a blotch rash/hives and been *severely* itchy, especiall on my legs.  Last night I finally clued into the fact that I think the Accolate is what is causing it — it started within a half hour of taking it, and the only thing I had was it and some water; nothing else that I can think of could possible have triggered the reaction.  I could have handled the headache that many people get; this kind of itchiness is intolerable. So, I haven’t taken my dose this morning [I am pretending I forgot ], and I want to stop taking it.  But I need to know if it is safe to stop taking it abruptly or not.  So: IS IT SAFE??  I’ve been on 20mg twice a day since the 11th of December, and have rarely forgotten to take it. FWIW, I am also on Zyrtec [aka Reactine in Canada; and have been for about 5 years] 10mg/d, Pulmicort Turbuhaler 1600mcg/d [haven't come off the increased dose from being sick yet; have been on this dose basically since the week before the US Thanksgiving], and Bricanyl as required [in the last few days, not needed at all].  I have been on deltasone 3X in the last month and a half, most recently a 40mg/d X3d, 20mg/d X3d, 10mg/d X3 days taper regimine [finished under week ago]; I have a burst dose Rx for deltasone [40mg/d X 3 d] if I need to use it, which I am allowed to use. So, folks, is it safe to come off of the Accolate abruptly, and if so/not, what should I look for if anything if I do?  I am assuming my asthma may worsen some, but I think I can manage that ok [I am allowed to flex my medications to a certain degree]. Thanks for your help!! SW.

Response:

HOWEVER, that is not what concerns me.  Last night for the third time or so that I have taken my dose I have broken out in a blotch rash/hives and been *severely* itchy, especiall on my legs.  Last night I finally clued into the fact that I think the Accolate is what is causing it — it started within a half hour of taking it, and the only thing I had was it and some water; nothing else that I can think of could possible have triggered the reaction.  I could have handled the headache that many people get; this kind of itchiness is intolerable.

You could be having an allergic reaction to the medication.  This is something you should report to both your doctor and pharmacist (IMO a pharmacist tends to do a better job of keeping track of the medications you shouldn’t take than a doctor does). There should be no direct problem from abruptly stopping Accolate, however Rule #2 for asthmatics is: Never stop taking a medication without checking with a doctor (unless this is covered by an ‘Asthma Action Plan’). You should try to find a walk-in clinic in your area and consult with a doctor.

Response:

- Hide quoted text — Show quoted text – Folks, I need some information.  Both my pharmacist and physician are unavailable for another two weeks [the health center is closed for the XMas holidays]. I have been taking Accolate for just over 2 weeks now; to be honest, I haven’t noticed a significant change in my asthma that can definitely be attributed to the Accolate as opposed to just getting over the stupid virus that I have had; though being sick means judging how well the underlying asthma *itself* is doing has been a challenge [respiratory infections are an almost guaranteed flare-er of my asthma]. HOWEVER, that is not what concerns me.  Last night for the third time or so that I have taken my dose I have broken out in a blotch rash/hives and been *severely* itchy, especiall on my legs.  Last night I finally clued into the fact that I think the Accolate is what is causing it — it started within a half hour of taking it, and the only thing I had was it and some water; nothing else that I can think of could possible have triggered the reaction.  I could have handled the headache that many people get; this kind of itchiness is intolerable. So, I haven’t taken my dose this morning [I am pretending I forgot ], and I want to stop taking it.  But I need to know if it is safe to stop taking it abruptly or not.  So: IS IT SAFE??  I’ve been on 20mg twice a day since the 11th of December, and have rarely forgotten to take it. FWIW, I am also on Zyrtec [aka Reactine in Canada; and have been for about 5 years] 10mg/d, Pulmicort Turbuhaler 1600mcg/d [haven't come off the increased dose from being sick yet; have been on this dose basically since the week before the US Thanksgiving], and Bricanyl as required [in the last few days, not needed at all].  I have been on deltasone 3X in the last month and a half, most recently a 40mg/d X3d, 20mg/d X3d, 10mg/d X3 days taper regimine [finished under week ago]; I have a burst dose Rx for deltasone [40mg/d X 3 d] if I need to use it, which I am allowed to use. So, folks, is it safe to come off of the Accolate abruptly, and if so/not, what should I look for if anything if I do?  I am assuming my asthma may worsen some, but I think I can manage that ok [I am allowed to flex my medications to a certain degree]. SW.

First, I’m not a doctor, but a well informed asthmatic taking Singulair (sometimes), inhaled steroids (just switching from Vanceril DS to Pulmicort; etc. Antileukotrienes like Accolate and Singulair don’t help all asthmatics, maybe half or 2/3. Your main preventor drug is your inhaled steroids, Pulmicort; and 1600ug is a very High Dose. My advice would be to try stopping Accolate for a while; any drug that can cause an allergic reaction like you described could be dangerous; and if it doesn’t help why take it.[The nice thing about asthma drugs is you can tell whether or not they are working] You may want to try Accolate again after your exacerbation is under control; or try the better drug Singulair. Here’s the Prescribing Info on Accolate: http://www.accolateinfo.com/ http://www.rxlist.com/cgi/generic/zafirlukast.htm zafirlukast Excerpt: "Contraindications: Zafirlukast is contraindicated in patients who are hypersensitive  to zafirlukast or any of its inactive ingredients." My personal experience with a similar drug Singulair is initially it increased my personal best peak flow by 10%. Later I noticed I seemed to have signs of fatigue, and it doesn’t seem to help at all during exacerbations. So now I take it about every other day. It seems to work best when my asthma is relatively well controlled. I have recently had to switch to a higher strength steroid inhaler (Pulmicort) I had hoped the antileukotriene would be a steroid sparing drug, but it doesn’t seem to be the case; tho I think it still helps. Ellis

Response:

Folks, I need some information.  Both my pharmacist and physician are unavailable for another two weeks [the health center is closed for the XMas holidays]. I have been taking Accolate for just over 2 weeks now; to be honest, I haven’t noticed a significant change in my asthma that can definitely be attributed to the Accolate as opposed to just getting over the stupid virus that I have had; though being sick means judging how well the underlying asthma *itself* is doing has been a challenge [respiratory infections are an almost guaranteed flare-er of my asthma]. HOWEVER, that is not what concerns me.  Last night for the third time or so that I have taken my dose I have broken out in a blotch rash/hives and been *severely* itchy, especiall on my legs.  Last night I finally clued into the fact that I think the Accolate is what is causing it — it started within a half hour of taking it, and the only thing I had was it and some water; nothing else that I can think of could possible have triggered the reaction.  I could have handled the headache that many people get; this kind of itchiness is intolerable. So, I haven’t taken my dose this morning [I am pretending I forgot ], and I want to stop taking it.  But I need to know if it is safe to stop taking it abruptly or not.  So: IS IT SAFE??  I’ve been on 20mg twice a day since the 11th of December, and have rarely forgotten to take it. FWIW, I am also on Zyrtec [aka Reactine in Canada; and have been for about 5 years] 10mg/d, Pulmicort Turbuhaler 1600mcg/d [haven't come off the increased dose from being sick yet; have been on this dose basically since the week before the US Thanksgiving], and Bricanyl as required [in the last few days, not needed at all].  I have been on deltasone 3X in the last month and a half, most recently a 40mg/d X3d, 20mg/d X3d, 10mg/d X3 days taper regimine [finished under week ago]; I have a burst dose Rx for deltasone [40mg/d X 3 d] if I need to use it, which I am allowed to use. So, folks, is it safe to come off of the Accolate abruptly, and if so/not, what should I look for if anything if I do?  I am assuming my asthma may worsen some, but I think I can manage that ok [I am allowed to flex my medications to a certain degree]. Thanks for your help!! SW.

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Question:

I just started to take 75 mg effexor xr, since the prozac i use to take, wasn’t working very well anymore.  How is this anti-depressant like?  Is it better than the older SSRIs?  Sometimes I feel strange while I am on it. Does this go away with time?  Are there more or less sexual side effects with this one compared to SSRIS like prozac and zoloft? Thanks for any help

I am now on 150 mg of Effexor, but it is only temporary. I have been on 75 mg since a couple of years ago, and there is no side effect which gives me problems. I am also on Risperdal, and recently my pdoc changed it for Zyprexa and I noted an increase of my sexual libido, so I am not sure if Effexor is lowering my libido. What I can say is that when I was married I didn’t find I needed more sexual drive than I actually had. If you find any annoying side effects from Effexor, most surely they’ll disappear in something like a week. — Teilhard Knight The Extraterrestrial Eat the sandwich to email    http://www.newsfeed.com       The #1 Newsgroup Service in the World! —–= Over 100,000 Newsgroups – Unlimited Fast Downloads – 19 Servers =—–

Response:

I just started to take 75 mg effexor xr, since the prozac i use to take, wasn’t working very well anymore.  How is this anti-depressant like?  Is it better than the older SSRIs?  Sometimes I feel strange while I am on it. Does this go away with time?  Are there more or less sexual side effects with this one compared to SSRIS like prozac and zoloft? Thanks for any help

Response:

Question:

Well, I have been on 10mg of Paxil for a couple of weeks and at least I am sleeping better and my anxiety is not rearing its ugly head.  However, these tremors seem to be staying with me.  And when I moved up from 10-20 mgs a couple of days ago they got worse.  Is that probably a side effect?  I am thinking of going back down to 10 but wanted your opinions if it has happened to you…..

Response:

Fishman wrote….. Well, I have been on 10mg of Paxil for a couple of weeks and at least I am sleeping better and my anxiety is not rearing its ugly head.  However, these tremors seem to be staying with me.  And when I moved up from 10-20 mgs a couple of days ago they got worse.  Is that probably a side effect?  I am thinking of going back down to 10 but wanted your opinions if it has happened to you…..

Hi Fishman, Paxil can cause or excerbate tremors. Being your tremors are getting worse, I think it is important you discuss this with your doctor so he can advise you on what to do. Take care Jackie

Response:

- Hide quoted text — Show quoted text – Well, I have been on 10mg of Paxil for a couple of weeks and at least I am sleeping better and my anxiety is not rearing its ugly head.  However, these tremors seem to be staying with me.  And when I moved up from 10-20 mgs a couple of days ago they got worse.  Is that probably a side effect?  I am thinking of going back down to 10 but wanted your opinions if it has happened to you…..

time to change medications-tremors can happen from any medication but are not a good sign nor one you want to tolerate-ask your doc about switching to celexa or luvox or effexor and if they persist get a neuro opinion and or switch to a different class of drugs altogether like serzone, doxepine, or imipramine LM

Response:

he said that there’s no way that an SSRI could be dangerous in causing this neurological effect.

they can be quite dangerous in this regard as can any med. The tca’s are a derivitive of the phenothiazine compounds so initially some tremor is expected and does go away for most people-the ssri’s are a different ball game and when they excert neuronal go signals when they by rights shouldn’t they are reacting in a way that may create damage that may be ireversible if pushed too far-but your pointabout "feeling" jittery or like your trembling is different then essential tremor. Tardive dyskinesias can be permanent so a doc had best be notified and you get examined LM

Response:

- Hide quoted text — Show quoted text –         "Fishman" says… Well, I have been on 10mg of Paxil for a couple of weeks and at least I am sleeping better and my anxiety is not rearing its ugly head.  However, these tremors seem to be staying with me.  And when I moved up from 10-20 mgs a couple of days ago they got worse.  Is that probably a side effect?  I am thinking of going back down to 10 but wanted your opinions if it has happened to you….. There can be confusion with the word "jitters" and "tremors."  If it’s jitters (more a feeling of nervousness, and thus, a feeling of bouncing against the walls), that would most likely be from the dose increase. Going back to 10 mg should relieve that, and discuss with your doctor about increasing in 5 mg increments, rather than 10 mg. Tremor is neurological, and it’s recommended that if this occurs, that your doctor be advised at once.  There’s a rather simple test for tremor, which is placing a piece of paper on the back of your hand, while holding your hand still. It should be noticeable if there’s a tremor (quite different than nervousness or jitters), but the motion (at least to a trained eye). BUT, I had this minor tremor with Celexa (and the insert said to contact doc in case of tremor), and my doctor said to forget about it. It was very slight, and he said that there’s no way that an SSRI could be dangerous in causing this neurological effect. I’m not sure who’s right, but it vanished in time. In either case, I’d suggest calling your doctor, and explaining what (or which) you’re feeling. You’re not alone… — Sloopy:)

A *slight* tremor doesn

Question:

– Hide quoted text — Show quoted text – I recently went off my Zoloft which I have been taking on/off (mostly on) for a couple of years.  I have been at 100 mg for the past six or so months.  I only had side effects in the beginning but they all went away except the lack of libido which I can deal with.  The primary reason I am going off it is that I jsut can’t afford it anymore and am hoping that my depression will not return as bad as before.  Right now I seem emotionally stable   (Not to worry, if it appears that I really *need* to go back on it I will).  I have been off about 4-5 days and am having dizzy spells like crazy.  When I stand up to fast or turn my head too fast.  I know I shouldn’t have gone off cold turkey but hell, the money ran out at the same time the script did.  I am also in one of those situations where I make too much to qualify for any type of medication assistance yet not enough to pay for them.  Yeah, the middle class often gets the shaft too. Anyhow…I digress.  Is this dizziness just possibly a withdrawal thing from the Zoloft and if so, how long can I expect it to go on?  It is quite

annoying. Probably is from withdrawal. When I went off 100 mg of Zoloft cold turkey, I was dizzy 24 hours a day for about 4 weeks. It was then I finally gave in and started taking a very low dose with the goal of weaning myself off gradually. Maybe you can get one more scrip of a low dose from your doc, and wean yourself off? Good luck. Cate

Response:

I recently went off my Zoloft which I have been taking on/off (mostly on) for a couple of years.  I have been at 100 mg for the past six or so months.  I only had side effects in the beginning but they all went away except the lack of libido which I can deal with.  The primary reason I am going off it is that I jsut can’t afford it anymore and am hoping that my depression will not return as bad as before.  Right now I seem emotionally stable   (Not to worry, if it appears that I really *need* to go back on it I will).  I have been off about 4-5 days and am having dizzy spells like crazy.  When I stand up to fast or turn my head too fast.  I know I shouldn’t have gone off cold turkey but hell, the money ran out at the same time the script did.  I am also in one of those situations where I make too much to qualify for any type of medication assistance yet not enough to pay for them.  Yeah, the middle class often gets the shaft too. Anyhow…I digress.  Is this dizziness just possibly a withdrawal thing from the Zoloft and if so, how long can I expect it to go on?  It is quite annoying. SWC

Response:

Question:

Lamictal

Response:

Worn_Out,  you seem to be feeling a little better, are you?  hopefully  

Response:

I am doing better.  My wife says I am talking more & I have started kidding with my 24 year old daughter, again.  I think the tofranil is helping & I am on my third week on testosterone injections. I have decided that bi-polar disorder is forever.  I woke up this morning in very bad shape, but have gotten over it.  Somehow we must all manage to survive because the bad times come and go and if things are bad now, they WILL get better. Thanks Worn_Out,  you seem to be feeling a little better, are you? hopefully

Before you buy.

Response:

What % of manic depressives commit suicide?

I have heard that one in five commit suicide, but I wouldn’t swear by it. I hope you find a treatment that works for you. The future brings us the hope of new drugs and new treatments. Web Page at: www.robertpo.com For email replies remove the ****

Response:

What % of manic depressives commit suicide? I have heard that one in five commit suicide, but I wouldn’t swear by it. I hope you find a treatment that works for you. The future brings us the hope of new drugs and new treatments. Web Page at: www.robertpo.com For email replies remove the ****

I’ve seen studies that showed that 1 in 5 bipolars who refused treatment committed suicide. But…these were bipolars sick enough that they had been hospitalized, that’s where they were found for the study. Also, it stands to reason that those who refuse treatment are sicker with more personality problems than average. Also, these were people who were hospitalized in public hospitals, which again indicates that they were sicker…someone in a private hospital probably has been able to work until recently, and hasn’t alienated or shoved away family and friends yet. Still, taking your meds and working with your doctor is the best way to keep from getting worse…and worse can be very, very bad.

Response:

Paxil worked for me. Not to high though-Reached an even – level of comfort. It sounds like you have to find a MD (preferably, a psychopharmacologist) who knows how to mix different combinations of drugs. Don’t lose hope, though.  If you do you start asking questions about suicide, and you might have to live it all again in the next life.  At this point, paying for drugs is a bigger problem for the long haul than taking them.  Any advice? – Hide quoted text — Show quoted text – After 13 years with BiPolar Disorder I have yet to find effective treatment for its depression. What is the most effective treatment for BiPolar Depression? What % of manic depressives commit suicide? Before you buy.

Response:

At this point, paying for drugs is a bigger problem for the long haul than taking them.  Any advice?

I have been started on Tofranil/Imipramine and my pharmacy dispensed it in its generic form.  Instead of paying a copay of $7.00 for the name brand I pay $2.00 for the generic.  The book, "The Essential Guide to Psychiatric Drugs", shows that the name brand would be $.62/pill and the generic would be $.05/pill (the book was published in 1990). If this is still true, a great deal can be saved by buying generic, if possible. The book, "The Essential Guide to Psychiatric Drugs", by Jack M. Gorman, MD. is the best help in this area that I have found.  If you can find a recent edition, I highly reccomend it. Good luck! Before you buy.

Response:

Drop trou Nihil  You know you get a spanking for saying bad stuff like that. Bend over,  ten whacks with the leather strap. 1   *[SMACK]*      ( oouch) 2   *[WACK]*         (stop) 3   *[CRACK]*        ( I take it back,  please stop) Let those warm yer buns a while,  I’ll fix you a few fresh ones in a bit. – Hide quoted text — Show quoted text – x-no-archive: yes After 13 years with BiPolar Disorder I have yet to find effective treatment for its depression. What is the most effective treatment for BiPolar Depression? Personally, I think that Doctor Kevorkian, whom I consider to be a Saint, has the best treatment.

Response:

Everyone is different.  Tell me what you’ve tried, kay?  Also, let me know what your additional symptoms are, etc.  Have you had partial relief with certain drugs? There may be treatments that are better for BPI and treatments that are better for BPII.  A lot of people take different drug cocktails, as I’m sure you know.  A friend of mine is on lithium AND neurontin, among other things. I’ve been on lots of diff. stuff simultaneously: buspar, trazodone, klonopin, prozac, lithium, depakote, and neurontin are the bulk of the things I’ve been on.  Are you taking an antidepressant and a mood stabilizer? -bpkittycat – Hide quoted text — Show quoted text – After 13 years with BiPolar Disorder I have yet to find effective treatment for its depression. What is the most effective treatment for BiPolar Depression? What % of manic depressives commit suicide? Before you buy.

Response:

I am now on Tofranil and Lithobid. I have had about 35 ECT treatments (unilateral and bilateral). I have been on: Xanax Elavil Dexedrine Anafranil Welbutrin Buspar Tegretol Librium Valium Effexor Prozac Tofranil Librium Eskalith Ritalin Nardil Serzone Pamelor Parnate Paxil Prozac Risperdal Zoloft Xanax Thyroid Hormone Testosterone I appreciate your interest. – Hide quoted text — Show quoted text – Everyone is different.  Tell me what you’ve tried, kay?  Also, let me know what your additional symptoms are, etc.  Have you had partial relief with certain drugs? There may be treatments that are better for BPI and treatments that are better for BPII.  A lot of people take different drug cocktails, as I’m sure you know.  A friend of mine is on lithium AND neurontin, among other things. I’ve been on lots of diff. stuff simultaneously: buspar, trazodone, klonopin, prozac, lithium, depakote, and neurontin are the bulk of the things I’ve been on.  Are you taking an antidepressant and a mood stabilizer? -bpkittycat

Before you buy.

Response:

Worn Out- I can see why you are frustrated I’ve forgotten what Tofranil is for.  Antipsychotic?  Antidepressant?  MAOI or Tricyclic? What symptoms do you have the most trouble with?  I seem to be depressed a lot, and have had depression for most of my life, and "only" a few major manic episodes.  I suffer from migraines as well, and hope that the neurontin that I’ve just started will help in preventing the attacks (mania and migraine). I am wondering what you have tried and what you know about diet and how it affects mood.  I would suggest, if you are not already doing so, to severely cut down on all carbohydrates, have lots of protein, and consume 3T of flax seed oil every day.  Always use olive oil when you can, too (like in salad dressings, for dipping bread in, etc.). These new drugs for seizures are supposed to work for many treatment-resistant patients.  check out the Neurontin facts posted earlier today if you haven’t already. Good luck, and I hope you get some good advice and new ideas from others… -bpkittycat – Hide quoted text — Show quoted text – I am now on Tofranil and Lithobid. I have had about 35 ECT treatments (unilateral and bilateral). I have been on: Xanax Elavil Dexedrine Anafranil Welbutrin Buspar Tegretol Librium Valium Effexor Prozac Tofranil Librium Eskalith Ritalin Nardil Serzone Pamelor Parnate Paxil Prozac Risperdal Zoloft Xanax Thyroid Hormone Testosterone I appreciate your interest. Everyone is different.  Tell me what you’ve tried, kay?  Also, let me know what your additional symptoms are, etc.  Have you had partial relief with certain drugs? There may be treatments that are better for BPI and treatments that are better for BPII.  A lot of people take different drug cocktails, as I’m sure you know.  A friend of mine is on lithium AND neurontin, among other things. I’ve been on lots of diff. stuff simultaneously: buspar, trazodone, klonopin, prozac, lithium, depakote, and neurontin are the bulk of the things I’ve been on.  Are you taking an antidepressant and a mood stabilizer? -bpkittycat Before you buy.

Response:

After 13 years with BiPolar Disorder I have yet to find effective treatment for its depression. What is the most effective treatment for BiPolar Depression? What % of manic depressives commit suicide? Before you buy.

Response:

re: question #1: that’s the question, all right re: question #2: between 15 & 20% (some confusion, apparently, about whether this means *all* people with bipolar or just the untreated ones). What about the undiagnosed ones, then? I interpolate all this to indicate that the figure refers to all bipolars. — Deep – Hide quoted text — Show quoted text – After 13 years with BiPolar Disorder I have yet to find effective treatment for its depression. What is the most effective treatment for BiPolar Depression? What % of manic depressives commit suicide? Before you buy.

Response:

: After 13 years with BiPolar Disorder I have yet to find effective : treatment for its depression. : : What is the most effective treatment for BiPolar Depression?    There is no most effective treatment, it varies with the    circumstances and individual.  Passage of time usually    brings with it some relief of symptoms. : : What % of manic depressives commit suicide?   It is higher for untreated sufferers……15-20% if I recall   correctly.   nm : : : Before you buy. :

Response:

Question:

Hi Charla, Thanks for the response.  Gradual is ok with me, so just getting past some of the things that would otherwise stress me out even while on xanax is an indication the Zoloft may be doing some good? I’m glad you didn’t mind my ‘oh so detailed’ rambling.  I was a great student in creative writing in highschool. little bear–who is feeling better just from writing that post last night; theraputic, it was  to get all my ducks in a row….especially after all of the crap about Zoloft hitting this board recently. – Hide quoted text — Show quoted text – Hi Little Bear, I can not translate sorry. But I find your spirit and strength unbeatable in the face of adversary. IME with Zoloft being the first and only AD Ive taken..I could evaluate it helping me in times of trouble..because I did not react as intensly to the stressors. eg. My husband gets layed off,we were living at my moms,a five month old at the time..Snow piling up outside as high as the fence it dawns on me something is working. I was  relaxed and accepting of the circumstance.. I think when you have found the right mg range with the right AD you gradually see results. For me it did not just happen it was a gradual.I did not know when it started working..I just started feeling better. BTW I like your detailed post..:-) Hope all gets better soon Charla — Being safe is about being seen and heard and allowed to be who you are and to speak your truth.                                    —Rachel Naomi Remen,M.D. Hi Everyone! I have been ready to post this for a couple of days now but with all the b*llshit that’s been going on here (of which I admit to being a part of) along with some personal stuff, I just haven’t gotten around to it. I want to let you know how my meds are doing compared to before and just give you my updated condition, and hope to hear from many of you telling me I’m healed  LOL. No, really, just let me know how you think I’m doing as I am a first timer on the AD thing and a long time xanax friend, as well as pain meds which tend also to produce a false sense of well-being. If it were one or the other, I know it would be much simpler to evaluate my progress so please bear with me. (PUN CERTAINLY INTENDED.  ALL RIGHTY THEN, LET’S GET STARTED <g) As you may remember my problems started about 3yrs ago with horrible back pain. I was temporarily living in a town of about 10,000 after being transferred from a mega-city on the west coast.  I saw any and all available docs but I believe I was clearly out of thier league and a bit of a mystery to boot. I had two kids and was a stay at home mom for the first time in my life. (And I’m old <VBG, more than 20 but less than 42). Eventually, after MRI’s and xrays, and limited bloodwork including thyroid, I was told I had no strength in my back and was sent to PT.  This was a joke indeed.  I might as well have been in a 4th grade P.E. class–no hands on, no direction etc.I had no improvement with my back pain but within about 3mos, I had the first of three consecutive PA’s.  Of course, I had no Idea what was happening to me but the ER diagnosed them and a visit to a GP the next day confirmed it. So, that was that; I was given .25mgs xanax twice daily.  I was given very little info about benzos but I assure you, I was miserable enough with the accompaning symptoms (GAD in a nutshell )-) that I would have gladly taken them anyway.  I would have done anything to escape that awful panic/nervousness I was racked with.  And they did the trick. After a year we moved back to the big city.  I became close to a neighbor whos husband had eerily similar symptoms as mine (back and anxiety) and she recommended a doc that was supposedly the finest in his field so I called.  I was desperate by then with my back pain and the panic escalated accordingly.  I was told he was not taking new patients and I quite literally would not hang up, and I cried on the phone basically begging for an appt. until they set me up for 3mos later.  So, I had something to look forward to finally!  This was the time that I thought I could wean off of the xanax (I had learned more about the dependance issue by this time) and I weaned very slowly-or so I thought but I was hit with a series of PA’s almost exactly like the ones a year earlier. A quick call to the doc in the little town on the prairie got me scolded for going off of them with no direction or support and I was back on them but this time at .5mgs 3/day to get the GAD back under control.  I have since (stupidly) tried to stop them again, but I always had other things going on and the GAD was always present so I don’t know what I was thinking except that I wanted to know that I was in control of my own body (I don’t even want to go there). IOW, it was always a huge mistake. In the year since I started seeing this back specialist (he found 3 buldging dics in my back–two in my neck and one in my upper back. He showed me the MRI I had taken in the little town and even I could see them. So, I have endured about 10 cortisone/lidocaine injections either epidural or facet joint injections and have regained full range of motion in my neck and back but the "knife in the back" pain was still there, as painful as ever. When it was clear the injections had done all they could, I was sent on to PT. BTW, this doc is very particular and insists on specific specialists when he refers me, and I go because he obviously knows what he is doing.  I have been seeing a PT doc for about 2mos now and she is marvelous! (So was the shot guy TTTT) My back has been getting better…so much so that I no longer fear some terminal illness the way I constantly used to.  Between the three of these specialists I was finally finding answers to the pain in the back and even relief!   Now, keep in mind, and you might remember I went on Wellbutrin to quit smoking (when hubby had pneumonia in July) and though I did quit smoking (HOORAY FOR ME!!!) the Wellbutrin just about did me in. I was a screaming, sweaty, panicky mess–24hrs a day for about 9wks I think. To be fair, for those of you who are new to this group, I was warned by some of our veterans about Wellbutrin and that it would not be a good choice for someone already suffering anxiety. But for a few reasons, I took it anyway, quit smoking and proved our experts to be experts.  I reacted word for word the way I was warned I would. It was awful but YMMV when it comes to meds. It just wasn’t right for me.  I was then put on Zoloft 50mgs daily and was still getting better in the back pain department.  I had no bad side effects from the Zoloft (some sweating and a little irritablity at first but was immediately better when I put down the Wellbutrin so it’s difficult to say whether it was getting off the W and on the Z or both.  Anyway, out of the blue during PT, it was discovered I have an internal impingement on my right shoulder.  Off to another specialist who says no more PT until he fixes my shoulder either with cortisone injections or simple surgery. H gave me a shot in the bursa? and my elbow was stuck to my waistline for a week. Right arm too….bummer.  The problem is that while I am away from ‘hands on’ PT, my back muscles go back into spasms and my neck tightens up and all of the progress I’ve made is fading quickly.  I am having a bit more difficulty getting in touch with the shoulder doc so no MRI has been scheduled yet and I’m hanging in limbo.  My PT is frustrated for obvious reasons–things were going so well. Let me be clear on something here: when I say my back got so much better, it is to say that the pain went from unbearable to bearable and I was able to move again and because of that progress, I was mentally more at ease (and I always believed the pain caused the anxiety since I could think of nothing else).  Anyway, during the Wellbutrin phase, I was up to the max xanax dose for me 2.5-3mgs daily. It was awful. With the Zoloft, so far 5-6wks? I am down to .25mgs 3/day. But I can feel the urge to take more while I go through the return of the back pain and watching all that progress go down the drain. I may need to go up another .25 each day–either that or chew my lips off, grit my teeth (Oh yeah, I had 3 crowns done last month-I consider dental work a setback just for existing!) or get angry all the time, etc.  See, I was so looking forward to the AD taking over for the xanax–I just knew that Zoloft was the answer.  I feel sorta good on it; I am cautiously optimistic. Now I don’t know what to expect or how I should proceed. I know I have bored you silly—-I don’t know why my posts are always so long.  I guess I don’t want to miss anything and then I read your posts that are so clear and concise and to the point……But I had so many points <BG I look forward to your observations regarding the Zoloft, how much better do you think I should expect to get. How do I know if it’s the right one for me, and isn’t it a bitch that just when I might be able to pull everything together, half of it falls apart. I’m not going to know if the Zoloft helps my anxiety until I have a normal, calm, regular period of time in my life to evaluate it. What I mean is, the thought of the back pain returning in it’s original form is enough to scare the crap out of me. And then there’s the holidays….OMG, don’t know if I am going to make it. Thanks everyone who took the time to read this in it’s entirety.  I look forward to any responses at all. little bear–who

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Response:

Hi Cheryl, I  have responded in length to other’s posts to this thread and I guess I’ve said all that can be said (hopefully, ASAP is secretely thinking). But thanks for sharing your coffee with me this morning and for your kind words. The "Jim Carrey on Acid:" cracked me up.  See, I can be cracked up. That hasn’t been true for months and months.  Thank you for your prayers, I believe they help–I really do. little bear-who needs a nap now (see you in 6mo) NOT :0} – Hide quoted text — Show quoted text – Little Bear,   I wish I could help you with the Zoloft issue…but I am on Remeron and I have been on Wellbutrin and it made me nuts!  Jim Carrey on Acid so to speak!  Anyway, your story brought tears to my eyes.  I can identify, being chronically ill myself.  I know the vicious vicious cycles it produces, the one illness festering into another into another.  I am on pain meds myself and the "false sense of well being" really hit me.  When I take them it’s the ONLY time I feel "normal."  Little Bear, you have been through so much and I think you have maintained your sense of self, humor and faith. Just know you are not alone…and I am here and we are all here for you. And I love long posts, I kick back with the old cup of coffee and feel like you are right in my living room.  God bless you, friend.  I will keep you in my prayers and mostly in my thoughts. Hi Everyone! I have been ready to post this for a couple of days now but with all the b*llshit that’s been going on here (of which I admit to being a part of) along with some personal stuff, I just haven’t gotten around to it. I want to let you know how my meds are doing compared to before and just give you my updated condition, and hope to hear from many of you telling me I’m healed  LOL. No, really, just let me know how you think I’m doing as I am a first timer on the AD thing and a long time xanax friend, as well as pain meds which tend also to produce a false sense of well-being. If it were one or the other, I know it would be much simpler to evaluate my progress so please bear with me. (PUN CERTAINLY INTENDED.  ALL RIGHTY THEN, LET’S GET STARTED <g) As you may remember my problems started about 3yrs ago with horrible back pain. I was temporarily living in a town of about 10,000 after being transferred from a mega-city on the west coast.  I saw any and all available docs but I believe I was clearly out of thier league and a bit of a mystery to boot. I had two kids and was a stay at home mom for the first time in my life. (And I’m old <VBG, more than 20 but less than 42). Eventually, after MRI’s and xrays, and limited bloodwork including thyroid, I was told I had no strength in my back and was sent to PT.  This was a joke indeed.  I might as well have been in a 4th grade P.E. class–no hands on, no direction etc.I had no improvement with my back pain but within about 3mos, I had the first of three consecutive PA’s.  Of course, I had no Idea what was happening to me but the ER diagnosed them and a visit to a GP the next day confirmed it. So, that was that; I was given .25mgs xanax twice daily.  I was given very little info about benzos but I assure you, I was miserable enough with the accompaning symptoms (GAD in a nutshell )-) that I would have gladly taken them anyway.  I would have done anything to escape that awful panic/nervousness I was racked with.  And they did the trick. After a year we moved back to the big city.  I became close to a neighbor whos husband had eerily similar symptoms as mine (back and anxiety) and she recommended a doc that was supposedly the finest in his field so I called.  I was desperate by then with my back pain and the panic escalated accordingly.  I was told he was not taking new patients and I quite literally would not hang up, and I cried on the phone basically begging for an appt. until they set me up for 3mos later.  So, I had something to look forward to finally!  This was the time that I thought I could wean off of the xanax (I had learned more about the dependance issue by this time) and I weaned very slowly-or so I thought but I was hit with a series of PA’s almost exactly like the ones a year earlier. A quick call to the doc in the little town on the prairie got me scolded for going off of them with no direction or support and I was back on them but this time at .5mgs 3/day to get the GAD back under control.  I have since (stupidly) tried to stop them again, but I always had other things going on and the GAD was always present so I don’t know what I was thinking except that I wanted to know that I was in control of my own body (I don’t even want to go there). IOW, it was always a huge mistake. In the year since I started seeing this back specialist (he found 3 buldging dics in my back–two in my neck and one in my upper back. He showed me the MRI I had taken in the little town and even I could see them. So, I have endured about 10 cortisone/lidocaine injections either epidural or facet joint injections and have regained full range of motion in my neck and back but the "knife in the back" pain was still there, as painful as ever. When it was clear the injections had done all they could, I was sent on to PT. BTW, this doc is very particular and insists on specific specialists when he refers me, and I go because he obviously knows what he is doing.  I have been seeing a PT doc for about 2mos now and she is marvelous! (So was the shot guy TTTT) My back has been getting better…so much so that I no longer fear some terminal illness the way I constantly used to.  Between the three of these specialists I was finally finding answers to the pain in the back and even relief!   Now, keep in mind, and you might remember I went on Wellbutrin to quit smoking (when hubby had pneumonia in July) and though I did quit smoking (HOORAY FOR ME!!!) the Wellbutrin just about did me in. I was a screaming, sweaty, panicky mess–24hrs a day for about 9wks I think. To be fair, for those of you who are new to this group, I was warned by some of our veterans about Wellbutrin and that it would not be a good choice for someone already suffering anxiety. But for a few reasons, I took it anyway, quit smoking and proved our experts to be experts.  I reacted word for word the way I was warned I would. It was awful but YMMV when it comes to meds. It just wasn’t right for me.  I was then put on Zoloft 50mgs daily and was still getting better in the back pain department.  I had no bad side effects from the Zoloft (some sweating and a little irritablity at first but was immediately better when I put down the Wellbutrin so it’s difficult to say whether it was getting off the W and on the Z or both.  Anyway, out of the blue during PT, it was discovered I have an internal impingement on my right shoulder.  Off to another specialist who says no more PT until he fixes my shoulder either with cortisone injections or simple surgery. H gave me a shot in the bursa? and my elbow was stuck to my waistline for a week. Right arm too….bummer.  The problem is that while I am away from ‘hands on’ PT, my back muscles go back into spasms and my neck tightens up and all of the progress I’ve made is fading quickly.  I am having a bit more difficulty getting in touch with the shoulder doc so no MRI has been scheduled yet and I’m hanging in limbo.  My PT is frustrated for obvious reasons–things were going so well. Let me be clear on something here: when I say my back got so much better, it is to say that the pain went from unbearable to bearable and I was able to move again and because of that progress, I was mentally more at ease (and I always believed the pain caused the anxiety since I could think of nothing else).  Anyway, during the Wellbutrin phase, I was up to the max xanax dose for me 2.5-3mgs daily.  It was awful. With the Zoloft, so far 5-6wks? I am down to .25mgs 3/day. But I can feel the urge to take more while I go through the return of the back pain and watching all that progress go down the drain. I may need to go up another .25 each day–either that or chew my lips off, grit my teeth (Oh yeah, I had 3 crowns done last month-I consider dental work a setback just for existing!) or get angry all the time, etc.  See, I was so looking forward to the AD taking over for the xanax–I just knew that Zoloft was the answer.  I feel sorta good on it; I am cautiously optimistic. Now I don’t know what to expect or how I should proceed. I know I have bored you silly—-I don’t know why my posts are always so long.  I guess I don’t want to miss anything and then I read your posts that are so clear and concise and to the point……But I had so many points <BG I look forward to your observations regarding the Zoloft, how much better do you think I should expect to get. How do I know if it’s the right one for me, and isn’t it a bitch that just when I might be able to pull everything together, half of it falls apart. I’m not going to know if the Zoloft helps my anxiety until I have a normal, calm, regular period of time in my life to evaluate it. What I mean is, the thought of the back pain returning in it’s original form is enough to scare the crap out of me. And then there’s the holidays….OMG, don’t know if I am going to make it. Thanks everyone who took the time to read this in it’s entirety.  I look forward to any

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Response:

Hi Chip, Good to hear from you!  First of all, don’t I know how complicated my situation is.  That is why it is so difficult to get a handle on any progress made and being terrified to let any of it go (the back thing). Let me itemize a bit. Smoking-easy as could be to stop, never had an urge since. Can take it or leave it for friends and family–would never preach. I always take my meds as prescribed. Never one for the other or vice versa. I do not drink alcohol at all anymore. I used to love it. Problem is, I take pain meds and xanax from the time I get up in the AM every four hours. I am on a pain mgt program so I don’t wait for the pain.  And I just happen to take the xanax at the same time. So if I were to lack one or the other, it would feel the same I’ve been living with the back and shoulder thing for 3yrs, it is better than it has ever been–and I’m mentally better for it, but I also fear a huge setback if this shoulder thing isn’t taken care of soon. I’m comfortable with all of my docs–no added anxiety there, though the shoulder guy could use a better bedside manner and might have warned me about the shoulder pain that resulted from the injection. Also, I would be less stressed if he would call back so we can get going on this. Ironically, my old insurance runs out end of Nov. and is currently paying 100% due I have met max out of pocket for year (boy, that says something doesn’t it?) Holiday season? Can’t avoid it, can I.  So I’ll just blow them away with gourmet stuffings and mouth watering desserts.  Nothing traditional–I need to occupy my mind and feed my ego <VBG.  I got through my husbands near fatal illness this summer without a scratch. You were all a tremendous help (for the 40th time). My husband is the kind of man who takes me as I am. The other morning (the shoulder morning) I walked into the bathroom when he was showering and said, "you know, I think you may want to trade me in on a newer model with a good warranty program, as it seems I’m falling apart a little more each day".  He said, "yeah, but if I recall, I got a lifetime guarantee when I married you". I bitch about him sometimes but he is head and shoulders above any other man I (personally know). And I love him dearly with never a doubt he feels the same way.  How do I rate my recovery?  Well, I feel real happiness for the first time in a long time. I get through situations normally considered difficult, with much more ease. I can go a bit longer between xanax doses. Yesterday I went 7 1/2 hrs (and though you may think they would, pain meds do not control anxiety at all!) And I no longer feel euphoria when taking my pain meds–that pleasant effect lasted a very short time……so I take them on the theory that if I don’t and my back flares up, we can undo much of what we have accomplished.  Much like the situation I face with the shoulder.  My PT is so upset–she could probably use about .25mgs Well Chip, you said all comments were welcome and I handed you a few to get started with but if I had to grade myself it would probably look something like this:  1996-F   1997-F  1998-F 1999 C+ / B- depending on the day–now that is just for my mental state and anxiety. Unfortunately, since my mental outlook depends so much on my physical health, it’s like a yo-yo.  Oh, yeah, nearly forgot–before the Zoloft, I had constant fears of having cancer or any one of 20 different horrible diseases. I tortured myself with thoughts of ‘who will take care of my family when I go’. That seems silly to me now, but it was very real believe me.  I also think the Zoloft has given me the gift of GAB as it works to control the gift of GAD. little bear Little Bear, I know for my recurrant depression and panic anxiety (with agoraphobia) I need a "cocktail" of meds including Klonopin 2 mg/day, Zoloft 150 mg/day, desipramine 50 mg/day, and p.r.n.  Xanax ranging from 0.5 to 1.5 mg/day. It can take time to find the right mixture of meds to make you feel better. And that mixture can change from time to time as your body adjusts to the chronic administration of your meds. You have the additional problems of back and shoulder pain which makes your situation even more complex than mine. I would advise taking pain meds for pain, and anti-anxiety meds for anxiety. I.E. don’t take more Xanax because you have increased back or shoulder pain! (take pain meds) It’s difficult for me to judge how you are doing because you have introduded so many variables into your equation (panic anxiety, cig smoking, back and shoulder pain, fear of "terminal" illness, stress over husband’s illness this past summer,  multiple care providers, upcoming holiday season, etc). Plus, you are married to a man and I know how difficult we can be to live with sometimes! How would you translate your progress? How are you feeling these days? How do you think you are doing? All comments and observations are welcome!! You seem to be in good spirits. Chip my progress? Hi Everyone! I have been ready to post this for a couple of days now but with all the b*llshit that’s been going on here (of which I admit to being a part of) along with some personal stuff, I just haven’t gotten around to it. I want to let you know how my meds are doing compared to before and just give you my updated condition, and hope to hear from many of you telling me I’m healed LOL. No, really, just let me know how you think I’m doing as I am a first timer on the AD thing and a long time xanax friend, as well as pain meds which tend also to produce a false sense of well-being. If it were one or the other, I know it would be much simpler to evaluate my progress so please bear with me. (PUN CERTAINLY INTENDED. ALL RIGHTY THEN, LET’S GET STARTED <g) As you may remember my problems started about 3yrs ago with horrible back pain. I was temporarily living in a town of about 10,000 after being transferred from a mega-city on the west coast. I saw any and all available docs but I believe I was clearly out of thier league and a bit of a mystery to boot. I had two kids and was a stay at home mom for the first time in my life. (And I’m old <VBG, more than 20 but less than 42). Eventually, after MRI’s and xrays, and limited bloodwork including thyroid, I was told I had no strength in my back and was sent to PT. This was a joke indeed. I might as well have been in a 4th grade P.E. class–no hands on, no direction etc.I had no improvement with my back pain but within about 3mos, I had the first of three consecutive PA’s. Of course, I had no Idea what was happening to me but the ER diagnosed them and a visit to a GP the next day confirmed it. So, that was that; I was given .25mgs xanax twice daily. I was given very little info about benzos but I assure you, I was miserable enough with the accompaning symptoms (GAD in a nutshell )-) that I would have gladly taken them anyway. I would have done anything to escape that awful panic/nervousness I was racked with. And they did the trick. After a year we moved back to the big city. I became close to a neighbor whos husband had eerily similar symptoms as mine (back and anxiety) and she recommended a doc that was supposedly the finest in his field so I called. I was desperate by then with my back pain and the panic escalated accordingly. I was told he was not taking new patients and I quite literally would not hang up, and I cried on the phone basically begging for an appt. until they set me up for 3mos later. So, I had something to look forward to finally! This was the time that I thought I could wean off of the xanax (I had learned more about the dependance issue by this time) and I weaned very slowly-or so I thought but I was hit with a series of PA’s almost exactly like the ones a year earlier. A quick call to the doc in the little town on the prairie got me scolded for going off of them with no direction or support and I was back on them but this time at .5mgs 3/day to get the GAD back under control. I have since (stupidly) tried to stop them again, but I always had other things going on and the GAD was always present so I don’t know what I was thinking except that I wanted to know that I was in control of my own body (I don’t even want to go there). IOW, it was always a huge mistake. In the year since I started seeing this back specialist (he found 3 buldging dics in my back–two in my neck and one in my upper back. He showed me the MRI I had taken in the little town and even I could see them. So, I have endured about 10 cortisone/lidocaine injections either epidural or facet joint injections and have regained full range of motion in my neck and back but the "knife in the back" pain was still there, as painful as ever. When it was clear the injections had done all they could, I was sent on to PT. BTW, this doc is very particular and insists on specific specialists when he refers me, and I go because he obviously knows what he is doing. I have been seeing a PT doc for about 2mos now and she is marvelous! (So was the shot guy TTTT) My back has been getting better…so much so that I no longer fear some terminal illness the way I constantly used to. Between the three of these specialists I was finally finding answers to the pain in the back and even relief!

Question:

Brett- This kind of problem always appeared for me (as for about a million others) if an SSRI was involved at a normally therapeutic dosage. (I’m including Welbutrin here even though I think its action is primarily dopamine-related, but not sure.)

higher doses-but not ejac.(my studied opinion based on reading. – Hide quoted text — Show quoted text – When I was properly diagnosed as bipolar I was taken off all SSRIs and put on tegretol which has no such negative effects on plumbing.  Sometime later a very small, "subtherapeutic" dose of effexor was added to the tegretol/klonopin combo.  It seemed to have positive effect on mood in spite of how small the dose was, and it had no sexual side effects at all. If you are bipolar, why don’t you discuss with a psychopharmacologist the possibility of relying less on SSRIs?  Negative sexual side effects are serious side effects in my opinion, in spite of the triviality with which some people may view them. Shukoku I hate to beat on a dead horse and am sure that this subject has been brought up many times, but I needto bring it up again. I’m on a combo of depekote, wellbutrin, klonopin and prozac and am suffering from serious sexual disfunction. Not to get into too much detail, but I can do all but ejaculate.  I was thinking that maybe "Yohimba" might help….  Anyone tried it?  How about that new drug on the market for impotence??  It would just add one more pill to the many we already take daily, but to have a sex live, it would be worth it. I’ve pretty much come to terms with the fact that this subject will always be a problem for me and a delicate one for my partner as she feels guilty that she cannot "please" me as she would like to.  I would rather live a "normal" life and give up a portion of my sex life…  But will constantly look for a solution. Anyone tried either method??? what is an SSRI? thanks, tom arnall fort washington, md usa

Response:

Well I can pretty well tell you which drug is the major *culprit* in

Don’t be too sure that the problem is solely from Klonopin.  Prozac is also known to cause sexual dysfunction, including inorgasmia.  I am not sure, but that may be a general problem with SSRI’s. This problem should be discussed with your pdoc.  Don’t add any "natural" remedies without checking with the doctor first.  It can be dangerous to mix over-the-counter meds with prescription drugs. Good luck.  

Response:

Brett.. just read your post.. Check this out.. it’s becoming the TOC in SSRI-induced sexual dysfunction.. it’s a great cognitive enhancer too, but make sure you get a quality standardized extract.  Nature’s Way and Eclectic Institute in Oregon have good products, or you can call L & H Vitamins toll free in NYC.. E-mail me if you want tel #’s.                  http://www.publinet.it/pol/pharmol/gingko.htm    (gingko biloba)

Response:

I find Zoloft is just as bad, with a total kill of the sex drive. – Hide quoted text — Show quoted text – Well I can pretty well tell you which drug is the major *culprit* in Don’t be too sure that the problem is solely from Klonopin.  Prozac is also known to cause sexual dysfunction, including inorgasmia.  I am not sure, but that may be a general problem with SSRI’s. This problem should be discussed with your pdoc.  Don’t add any "natural" remedies without checking with the doctor first.  It can be dangerous to mix over-the-counter meds with prescription drugs. Good luck.  

Response:

- Hide quoted text — Show quoted text – Brett- This kind of problem always appeared for me (as for about a million others) if an SSRI was involved at a normally therapeutic dosage. (I’m including Welbutrin here even though I think its action is primarily dopamine-related, but not sure.) When I was properly diagnosed as bipolar I was taken off all SSRIs and put on tegretol which has no such negative effects on plumbing.  Sometime later a very small, "subtherapeutic" dose of effexor was added to the tegretol/klonopin combo.  It seemed to have positive effect on mood in spite of how small the dose was, and it had no sexual side effects at all. If you are bipolar, why don’t you discuss with a psychopharmacologist the possibility of relying less on SSRIs?  Negative sexual side effects are serious side effects in my opinion, in spite of the triviality with which some people may view them. Shukoku I hate to beat on a dead horse and am sure that this subject has been brought up many times, but I needto bring it up again. I’m on a combo of depekote, wellbutrin, klonopin and prozac and am suffering from serious sexual disfunction. Not to get into too much detail, but I can do all but ejaculate.  I was thinking that maybe "Yohimba" might help….  Anyone tried it?  How about that new drug on the market for impotence??  It would just add one more pill to the many we already take daily, but to have a sex live, it would be worth it. I’ve pretty much come to terms with the fact that this subject will always be a problem for me and a delicate one for my partner as she feels guilty that she cannot "please" me as she would like to.  I would rather live a "normal" life and give up a portion of my sex life…  But will constantly look for a solution. Anyone tried either method???

what is an SSRI? thanks, tom arnall fort washington, md usa

Response:

You asked what a SSRI is ? It’s a Serotonin-Specific Reuptake Inhibitor. It means that the Serotonin Reuptake site is blocked and serotonin stays in the synaptic cleft (and seeps out, where it might activate pre-synaptic receptors) where serotonin activates the post-synaptic receptors. In other words. a SSRI is a material that has potenial anti-depressant, stabilizing and anti-anxiety properties, because the brains’ Serotonin system is stabilized (mostly at a higher level of activity). a SSRI, like prozac (fluoxetine), paroxetil/Seroxat (paroxetine) will, because it’s serotonin-specific, therefore exhibit very rarely many side effects. Whether they work better as the classical tricyclics still remains to be seen, but the apparent lack of side effects is VERY NICE! GREETINGS and Keep Sailing The Seas Of High Hopes ! Bas                     DE  DIGITALE  STAD

Response:

                    DE  DIGITALE  STAD Op Wed, 27 May 1998, Chip schreef: I hate to beat on a dead horse and am sure that this subject has been brought up many times, but I needto bring it up again. I’m on a combo of depekote, wellbutrin, klonopin and prozac and am suffering from serious sexual disfunction. Not to get into too much detail, but I can do all but ejaculate.  I was thinking that maybe "Yohimba" might help….  Anyone tried it?  How about that new drug on the market for impotence??  It would just add one more pill to the many we already take daily, but to have a sex live, it would be worth it.

Taking Yohimbe (That’s the dutch name of the inner bark of an african tree) in combination with Prozac is a definite No-NO! Yohimbe containse Yohimbine, which is beside a vasodilator of the genitals (Due to adrenergic

Question:

As I previously posted, I was advised by my PDoc to increase my dosage of Zoloft from 100 mg to 200 mg per day slowly in an attempt to treat my high level of anxiety. I’m up to 125 mg now, and I’m noticing the effect; I wouldn’t exactly describe it as anxiety–more like "antsiness", or agitation.  I feel like I need to be constantly moving, even if it’s drumming my fingers on a table when I’m sitting. Anyone else have a similar experience? Carol

Response:

I’ve been taking Zoloft for almost a month, 50mg and klonopin for anxiety as needed (haven’t yet) and have been very fidgety.  I’m always wiggling but it isn’t bothering me.  We’ll see how things go, I’m feeling tons better than I felt before I got the meds and was depressed/anxious 24/7.  I’ve noticed that I’m very antsy though.   shanti As I previously posted, I was advised by my PDoc to increase my dosage of Zoloft from 100 mg to 200 mg per day slowly in an attempt to treat my high level of anxiety. I’m up to 125 mg now, and I’m noticing the effect; I wouldn’t exactly describe it as anxiety–more like "antsiness", or agitation.  I feel like I need to be constantly moving, even if it’s drumming my fingers on a table when I’m sitting. Anyone else have a similar experience? Carol

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