Question:

says… – Hide quoted text — Show quoted text – A patent does not last 20 or 30 years.  It is something like 7 or 11 years, (I don’t remember exactly). 20 years from the date it was filed with the patent office.  There are a few ways to extend them to a certain extent, if the patent office was really slow, or it took forever to get FDA approval. I thought so. Now, what if they "enhance" the design of the originally patented technology. Does the 20-year clock start over? I’m asking because it sounds like that’s what ALZA did for Concerta. They took their original design and added a coating of med on the outside so that it would release an initial dose of medication.

In that case I suspect that the patent is on the coating technology. — — –John Reply to jclarke at eye bee em dot net

Response:

The Concerta web page says that if you take 15 mg Methylphenidate 2x/day or 15 mg Methylphenidate 3x/day or 60 mg Methylphenidate-SR, then you should take  54 mg of Concerta every morning by taking a 36 mg and an 18 mg at the same time. Daily dosage above 54 mg is not recommended. The URL is http://www.concerta.net/info.html Katswan

– Hide quoted text — Show quoted text – Hello, I am going to my Doctor tomorrow, and he has expressed interest in trying Concerta. I have a question on this, however. I am an adult, 31 years old. I have been on 20mg (non-SR) Ritalin 3 times a day (60 mg total per day) for the past 5 years. Considering this, what dosage of Concerta should I be on? The 60 mg per day worked fine for me, but I dont see how that dose (per day) can be obtained from the size tablets being offered right now for Concerta (only 18mg or 36mg). I am at a total loss as to why there is no good indicators of what an adult should be taking for Concerta, if (s)he is coming from a regular release Ritalin dosage of 60mg per day? Taking 2 x 36mg. Concerta might be considered to be too high of a dose. There is a new 54mg coming out (I am wondering if it is out yet… possibly). But would this be enough for me? Also, I can find no literature that talks about how much (in mg) is released on the outside-coating ‘immediate release’ of Concerta tabs, and then, how much is released in each remaining layer (2 more layers), and at what time are they released? I went to Concerta.net, but cannot find any data that answers these questions. Can anyone provide some answers to these questions? Thanks. Chris

Response:

I just had a thought, they have generic Ritalin SR, do they have it yet for Concerta? <Christopher wrote No, it is brand new, less than one year old. (Curious again) How long does it take for a generic to be approved and shipping? I think only generics are approved for the type of insurance my daughter has, unless there is a good reason she has to take a brand name medication.

When a new med is developed, that company that developed it has exclusive rights to market it, as with any patented invention. After, I think, 20 or 30 years or so, they lose the exclusivity and other products can copy their design/formula. They can also "lease" the right to use the patented formula/design during their exclusive rights period. ALZA’s web site says that their OROS delivery system has been used for 20 years, but that Concerta uses an enhanced OROS system, so the clock may have restarted ticking, it may be like a new patent. Most health/medical insurance policies push generics (list of covered meds). When my daughter was on Ritalin, I had to make certain the doctor put "Brand name medically necessary" on every prescription, or our previous insurance company would only pay for the generic, since it was available. To get our new insurance company to pay for Concerta, we had to jump through some hoops. The doctor had to write a letter (for which I had to provide him information since we’re new to the practice), detailing all the meds daughter has been on, why they weren’t effective or were problematic, and why we think Concerta will be different. Since daughter’s tried everything, they approved our request and are paying for Concerta. They did not approve it for son, however, as he hasn’t tried Ritalin-SR (much cheaper than Concerta and theoretically similar). I won’t put him on Ritalin-SR, however, because I think the dose is too high for him. When he was on Ritalin, he took 5mg 3x/day. He currently takes 5mg Adderall 2x/day. No way do these dosages compare to 20 mg R-SR, which would be expected to dump 20mg of meds into his system in 4 hours less than he got 15mg of meds (and twice as much meds as he’s taking now). He doesn’t need more med, he needs it spread over a longer day. So I paid for his first month’s Rx for Concerta (nearly $70). Now that we know it’s working well for him, the doctor will write another letter requesting approval. Katswan

Response:

<part of reply snipped They did not approve it for son, however, as he hasn’t tried Ritalin-SR (much cheaper than Concerta and theoretically similar). I won’t put him on Ritalin-SR, however, because I think the dose is too high for him. When he was on Ritalin, he took 5mg 3x/day. He currently takes 5mg Adderall 2x/day. No way do these dosages compare to 20 mg R-SR, which would be expected to dump 20mg of meds into his system in 4 hours less than he got 15mg of meds (and twice as much meds as he’s taking now). He doesn’t need more med, he needs it spread over a longer day. So I paid for his first month’s Rx for Concerta (nearly $70). Now that we know it’s working well for him, the doctor will write another letter requesting approval. Katswan

Thanks for the reply. It is something for me to think about.        Norma   <Sigline space for rent

Response:

- Hide quoted text — Show quoted text – I just had a thought, they have generic Ritalin SR, do they have it yet for Concerta? <Christopher wrote No, it is brand new, less than one year old. (Curious again) How long does it take for a generic to be approved and shipping? I think only generics are approved for the type of insurance my daughter has, unless there is a good reason she has to take a brand name medication. When a new med is developed, that company that developed it has exclusive rights to market it, as with any patented invention. After, I think, 20 or 30 years or so, they lose the exclusivity and other products can copy their design/formula.

A patent does not last 20 or 30 years.  It is something like 7 or 11 years, (I don’t remember exactly). Copyrights last longer than patents and can be renewed.  Copyrights don’t cover the same thing; they protect expressions of ideas, like books or pictures. Patents give companies (or people) the exclusive right to construct or sell or use a process or principle of operation. However, to get copyright protection for a period, you must disclose exactly how to do it, and anyone can get copies from the patent office after it has expired. Alternatively, companies can just keep things secret.  These are trade secrets, but if someone else comes up with the same idea, the company has nothing they can legally do about it. -Chris Eliot

Response:

says… – Hide quoted text — Show quoted text – I just had a thought, they have generic Ritalin SR, do they have it yet for Concerta? <Christopher wrote No, it is brand new, less than one year old. (Curious again) How long does it take for a generic to be approved and shipping? I think only generics are approved for the type of insurance my daughter has, unless there is a good reason she has to take a brand name medication. When a new med is developed, that company that developed it has exclusive rights to market it, as with any patented invention. After, I think, 20 or 30 years or so, they lose the exclusivity and other products can copy their design/formula. A patent does not last 20 or 30 years.  It is something like 7 or 11 years, (I don’t remember exactly). Copyrights last longer than patents and can be renewed.  Copyrights don’t cover the same thing; they protect expressions of ideas, like books or pictures. Patents give companies (or people) the exclusive right to construct or sell or use a process or principle of operation. However, to get copyright protection for a period, you must disclose exactly how to do it, and anyone can get copies from the patent office after it has expired.

Well, sorta.  The "game", I am told by folks who have cause to know such things, is to tell enough to get the patent but not enough that someone can reproduce the technology.  Georgia Tech has a course in which you are given a patent and required to design a working device based on that patent.  It very quickly becomes evident how much information is _not_ included in the patent.  Of course this assumes that the device described by the patent will actually work.  One engineer I knew collected whacky patents for stuff that couldn’t possibly work–had his office wallpapered with them. Alternatively, companies can just keep things secret.  These are trade secrets, but if someone else comes up with the same idea, the company has nothing they can legally do about it. -Chris Eliot

– — –John Reply to jclarke at eye bee em dot net

Response:

We switched daughter back to Adderall this morning largely based on what daughter was telling us. It just wasn’t working for her. Now we her taking 30 long however I wonder if she can take another 20 mg dose around 2PM? Is there an Adderall website?? Is anyone taking Adderall this way, three doses a day? Last time we talked to her doctor we found that she was splitting her afternoon dose by taking 10 mg at lunch plus 10 mg later in the afternoon which the the lower split dose. This was one of the reasons he suggested trying Concerta

Response:

A patent does not last 20 or 30 years.  It is something like 7 or 11 years, (I don’t remember exactly).

20 years from the date it was filed with the patent office.  There are a few ways to extend them to a certain extent, if the patent office was really slow, or it took forever to get FDA approval.

Response:

A patent does not last 20 or 30 years.  It is something like 7 or 11 years, (I don’t remember exactly). 20 years from the date it was filed with the patent office.  There are a few ways to extend them to a certain extent, if the patent office was really slow, or it took forever to get FDA approval.

Really?? OK, I didn’t think it was so long.

Response:

A patent does not last 20 or 30 years.  It is something like 7 or 11 years, (I don’t remember exactly). 20 years from the date it was filed with the patent office.  There are a few ways to extend them to a certain extent, if the patent office was really slow, or it took forever to get FDA approval.

I thought so. Now, what if they "enhance" the design of the originally patented technology. Does the 20-year clock start over? I’m asking because it sounds like that’s what ALZA did for Concerta. They took their original design and added a coating of med on the outside so that it would release an initial dose of medication. Katswan

Response:

– Hide quoted text — Show quoted text – Anyone know of a free online PDR reference for Concerta and Adderall? We are at 56 mg/day on a 14yr old and wonder if we have the option of increasing or possibly we may end up going back to the Adderall and try to figure out a better way of managing its level As a medic, I would recommend talking to her Dr first. PDR’s should be available at most libraries. While my USP DI is a bit old (1996, they ain’t cheap), the usual pediatric dose for 6 years of age and older for Adderall, states that the dose does not usually exceed 40 mg daily. Concerta is not listed, as it is newer than my book. I saw a company chart comparing 18 mg concerta with 5 mg Ritalin taken three times a day. My guess is that there is some loss due to the special delivery capsule, and that otherwise you can do very rough dosing estimates by comparing 18 mg concerta to 15 mg Ritalin spread out over a day.  This is only my guess, though; no one who understands about it has told me anything like this.

That’s how our pediatrician explained it to us. — Light, Love, & Laughter, Kitten, Goddess of Mischief "Thousands of years ago, cats were worshipped as gods. Cats have never forgotten this." – Anonymous "Just for today, do not worry;  Just for today, do not anger; Earn your living honestly; Honor your parents, teachers and elders; Show gratitude for every living thing."- Dr. Mikao Usui

Response:

As a medic, I would recommend talking to her Dr first. PDR’s should be available at most libraries.

Concerta does not appear in our Libraries 2000 PDR and of course although I have to talk to her psychiatrist before we increase (ie to get a script) I was wondering if increasing the dose was an option. I don’t think she gets the kick (maybe poor choice of words) that she got from the Adderall. The Concerta is probably much slower and more gradual delivery and change in the blood level.

Response:

I saw a company chart comparing 18 mg concerta with 5 mg Ritalin taken three times a day. My guess is that there is some loss due to the special delivery capsule, and that otherwise you can do very rough dosing estimates by comparing 18 mg concerta to 15 mg Ritalin spread out over a day.  This is only my guess, though; no one who understands about it has told me anything like this. That’s how our pediatrician explained it to us.

I just had a thought, they have generic Ritalin SR, do they have it yet for Concerta?  Curious,            Norma        Norma   <Sigline space for rent

Response:

I got confused about the attributions here.  Sorry if I’m misquoting. I saw a company chart comparing 18 mg concerta with 5 mg Ritalin taken three times a day. My guess is that there is some loss due to the special delivery capsule, and that otherwise you can do very rough dosing estimates by comparing 18 mg concerta to 15 mg Ritalin spread out over a day.  This is only my guess, though; no one who understands about it has told me anything like this.

That’s how we’ve switched dosages here. Son went from 5mg Ritalin 3x/day to 5mg Adderall 2x/day (but really needing a 3rd dose too late to give it to him) to 18mg Concerta 1x/day. Daughter went from 20mg Ritalin-SR in the AM plus 10mg Ritalin regular in the PM (and still never being stable in the meds’ effects) to 10mg Adderall 2x/day (but really needing a third dose too late to give it to her) to 36mg Concerta 1x/day. That’s how our pediatrician explained it to us.

I just had a thought, they have generic Ritalin SR, do they have it yet for Concerta?

Well, the med in Concerta is methylphenidate HCl (a form of Ritalin), so it’s already a generic. The delivery system in the body is what is unique and what makes it so expensive. It’s called OROS and was developed by ALZA. It’s been used to deliver other medications for about 20 years, although it’s been enhanced for Concerta to give an intial "shot" of medication. I’m sure ALZA with hold on to the rights/patents for as long as they can. Here’s ALZA’s Concerta web site URL: http://www.concerta.net/index.htm Katswan

Response:

- Hide quoted text — Show quoted text – I saw a company chart comparing 18 mg concerta with 5 mg Ritalin taken three times a day. My guess is that there is some loss due to the special delivery capsule, and that otherwise you can do very rough dosing estimates by comparing 18 mg concerta to 15 mg Ritalin spread out over a day.  This is only my guess, though; no one who understands about it has told me anything like this. That’s how our pediatrician explained it to us. I just had a thought, they have generic Ritalin SR, do they have it yet for Concerta?

No, it is brand new, less than one year old. – Hide quoted text — Show quoted text –  Curious,            Norma        Norma   <Sigline space for rent

Response:

- Hide quoted text — Show quoted text – I just had a thought, they have generic Ritalin SR, do they have it yet for Concerta? <Christopher wrote No, it is brand new, less than one year old. (Curious again) How long does it take for a generic to be approved and shipping? I think only generics are approved for the type of insurance my daughter has, unless there is a good reason she has to take a brand name medication.

The patents have to expire first, and that takes a number of years. – Hide quoted text — Show quoted text –        Norma   <Sigline space for rent

Response:

Hello, I am going to my Doctor tomorrow, and he has expressed interest in trying Concerta. I have a question on this, however. I am an adult, 31 years old. I have been on 20mg (non-SR) Ritalin 3 times a day (60 mg total per day) for the past 5 years. Considering this, what dosage of Concerta should I be on? The 60 mg per day worked fine for me, but I dont see how that dose (per day) can be obtained from the size tablets being offered right now for Concerta (only 18mg or 36mg). I am at a total loss as to why there is no good indicators of what an adult should be taking for Concerta, if (s)he is coming from a regular release Ritalin dosage of 60mg per day? Taking 2 x 36mg. Concerta might be considered to be too high of a dose. There is a new 54mg coming out (I am wondering if it is out yet… possibly). But would this be enough for me? Also, I can find no literature that talks about how much (in mg) is released on the outside-coating ‘immediate release’ of Concerta tabs, and then, how much is released in each remaining layer (2 more layers), and at what time are they released? I went to Concerta.net, but cannot find any data that answers these questions. Can anyone provide some answers to these questions? Thanks. Chris

Response:

I am going to my Doctor tomorrow, and he has expressed interest in trying Concerta. I have a question on this, however. I am an adult, 31 years old. I have been on 20mg (non-CR) Ritalin 3 times a day (60 mg total per day) for the past 5 years. What dosage of Concerta should I be on? The 60 mg per day worked fine for me, but I dont see how that dose (per day) can be obtained from the size tablets being offered right now for Concerta (18 or 36mg).

From what our pediatrician told us about the conversion from Ritalin to Concerta, you would need 2 36mg caplets in the morning to receive the equivalent of your current 60mg/day of Ritalin.  (18mg Concerta = 15mg {3 5mg doses} Ritalin) I am at a total loss as to why there is no good indicators of what an adult should be taking for Concerta, if (s)he is coming from a regular release Ritalin dosage of 60mg per day? Taking 2 36mg. Concerta might be considered to be too high of a dose. There is a new 54mg coming out (maybe out now, possibly). But would this be enough?

With the conversion above, I don’t see how 2 36mg would be considered too high.  It’s an equivalent dosage to what you are currently taking. Also, I can find no literature that talks about how much (in mg) is released on the outside coating immediate release of Concerta tabs, and then, how much is released in each remaining layer (2 more layers), and at what time are they released? I went to Concerta.net, but cannot find any of this data. Can anyone provide some info on this?

I’ve a pdf on Concerta.  I’m not sure if it has the info you’re looking for, but if you’d like me to email it to you, let me know. — Light, Love, & Laughter, Kitten, Goddess of Mischief "Thousands of years ago, cats were worshipped as gods. Cats have never forgotten this." – Anonymous "Just for today, do not worry;  Just for today, do not anger; Earn your living honestly; Honor your parents, teachers and elders; Show gratitude for every living thing."- Dr. Mikao Usui

Response:

I just had a thought, they have generic Ritalin SR, do they have it yet for Concerta?

<Christopher wrote No, it is brand new, less than one year old.

(Curious again) How long does it take for a generic to be approved and shipping? I think only generics are approved for the type of insurance my daughter has, unless there is a good reason she has to take a brand name medication.        Norma   <Sigline space for rent

Response:

I am going to my Doctor tomorrow, and he has expressed interest in trying Concerta. I have a question on this, however. I am an adult, 31 years old. I have been on 20mg (non-CR) Ritalin 3 times a day (60 mg total per day) for the past 5 years. What dosage of Concerta should I be on? The 60 mg per day worked fine for me, but I dont see how that dose (per day) can be obtained from the size tablets being offered right now for Concerta (18 or 36mg). I am at a total loss as to why there is no good indicators of what an adult should be taking for Concerta, if (s)he is coming from a regular release Ritalin dosage of 60mg per day? Taking 2 36mg. Concerta might be considered to be too high of a dose. There is a new 54mg coming out (maybe out now, possibly). But would this be enough? Also, I can find no literature that talks about how much (in mg) is released on the outside coating immediate release of Concerta tabs, and then, how much is released in each remaining layer (2 more layers), and at what time are they released? I went to Concerta.net, but cannot find any of this data. Can anyone provide some info on this? Thanks. Chris

Response:

- Hide quoted text — Show quoted text – I just had a thought, they have generic Ritalin SR, do they have it yet for Concerta? Well, the med in Concerta is methylphenidate HCl (a form of Ritalin), so it’s already a generic. The delivery system in the body is what is unique and what makes it so expensive. It’s called OROS and was developed by ALZA. It’s been used to deliver other medications for about 20 years, although it’s been enhanced for Concerta to give an intial "shot" of medication. I’m sure ALZA with hold on to the rights/patents for as long as they can. Here’s ALZA’s Concerta web site URL: http://www.concerta.net/index.htm Katswan

Thanks for the info.        Norma   <Sigline space for rent

Response:

Anyone know of a free online PDR reference for Concerta and Adderall? We are at 56 mg/day on a 14yr old and wonder if we have the option of increasing or possibly we may end up going back to the Adderall and try to figure out a better way of managing its level

Response:

Anyone know of a free online PDR reference for Concerta and Adderall? We are at 56 mg/day on a 14yr old and wonder if we have the option of increasing or possibly we may end up going back to the Adderall and try to figure out a better way of managing its level

Have you talked to her doctor?   Nessa — Life’s a dance. You learn as you go. Sometimes you lead, sometimes you follow Don’t worry ’bout what you don’t know, life’s a dance you learn as you go!

Response:

Anyone know of a free online PDR reference for Concerta and Adderall? We are at 56 mg/day on a 14yr old and wonder if we have the option of increasing or possibly we may end up going back to the Adderall and try to figure out a better way of managing its level

As a medic, I would recommend talking to her Dr first. PDR’s should be available at most libraries. While my USP DI is a bit old (1996, they ain’t cheap), the usual pediatric dose for 6 years of age and older for Adderall, states that the dose does not usually exceed 40 mg daily. Concerta is not listed, as it is newer than my book. The dosage info for Adderal is backed by the PDR info at: http://www.healthsquare.com/drugmain.htm You should also be able to find the info on Concerta there. Chewy — Kitten’s Main Squeeze We live in a technological society that creates many illusions of reality…it’s the most irresponsible behaving entity that ever lived on this planet.  This civilization is not about responsibility, it’s about guilt, sin, blame and aggressive bad behavior.  That is the shadow world… The real world is about fulfilling our responsibility to life. — John Trudell

Response:

– Hide quoted text — Show quoted text – Anyone know of a free online PDR reference for Concerta and Adderall? We are at 56 mg/day on a 14yr old and wonder if we have the option of increasing or possibly we may end up going back to the Adderall and try to figure out a better way of managing its level As a medic, I would recommend talking to her Dr first. PDR’s should be available at most libraries. While my USP DI is a bit old (1996, they ain’t cheap), the usual pediatric dose for 6 years of age and older for Adderall, states that the dose does not usually exceed 40 mg daily. Concerta is not listed, as it is newer than my book.

I saw a company chart comparing 18 mg concerta with 5 mg Ritalin taken three times a day. My guess is that there is some loss due to the special delivery capsule, and that otherwise you can do very rough dosing estimates by comparing 18 mg concerta to 15 mg Ritalin spread out over a day.  This is only my guess, though; no one who understands about it has told me anything like this. – Hide quoted text — Show quoted text – The dosage info for Adderal is backed by the PDR info at: http://www.healthsquare.com/drugmain.htm You should also be able to find the info on Concerta there. Chewy — Kitten’s Main Squeeze We live in a technological society that creates many illusions of reality…it’s the most irresponsible behaving entity that ever lived on this planet.  This civilization is not about responsibility, it’s about guilt, sin, blame and aggressive bad behavior.  That is the shadow world… The real world is about fulfilling our responsibility to life. — John Trudell

Response:

Question:

Hey Don, My running partner has asthma and routinely runs Ultra Marathons. If you write me I’ll forward your address with your permission to him. He might

Response:

        Some meds such as Ventolin or sodium chromolyn are often prescriobed to be taken before exercise.  When I do hard runs, I hit the puffer.  On easy days, I usually do not (preference on my part). – Hide quoted text — Show quoted text – Does anyone out there have advice for running with asthma.  I ran in highschool and my best times were around 16:30 for the 5K and 35 for the 10k and continued to run sporadically thru college . I got out of shape later in life and developed asthma, since then I have been running for a year and a half and can’t seem to get in shape or run faster than 7 minute pace, yet I’m only 33.  Mentally I know I’m capable of at least running close to those highschool times as I never really even did any speed work in hs and college, just went for long runs. Any advice please Frustrated runner

Response:

Don, I have asthma and had used Ventolin for years (and Cromolyn and epinephrine and bronkaid and Prednisone and Beclovent and Beclofort and side-stream at the hospital and … on and on and on), since I was 18 (I am now 45), up until last fall. I then consulted another lung specialist. He categorized me as "severely asthmatic" and put me on two new meds; Serevent (2 puffs x 2 daily) and Flovent (2 puffs x 2 daily). Since then, almost 1 year, I have used my Ventolin … once! I used it practically daily up until I started the new meds. I now "never" use Ventolin during my runs (I "always" used it before), my breathing is stronger, my lungs feel stronger and life, overall is that much better. I’ll stop sounding like a shill for pharmaceutical companies now and get on to the … ***SOLICITED ADVICE SECTION*** I’m not saying that these meds will do for you what they do for me … we are all different. What I’m saying is this; There is help out there for asthmatics that wasn’t available even 1 or 2 years ago. Do your homework, see a specialist, get a diagnosis … and get back to running. Geoff *18 days to Seattle Marathon!!* Nash – Hide quoted text — Show quoted text – Does anyone out there have advice for running with asthma

Response:

Does anyone out there have advice for running with asthma.  I ran in highschool and my best times were around 16:30 for the 5K and 35 for the 10k and continued to run sporadically thru college . I got out of shape later in life and developed asthma, since then I have been running for a year and a half and can’t seem to get in shape or run faster than 7 minute pace, yet I’m only 33.  Mentally I know I’m capable of at least running close to those highschool times as I never really even did any speed work in hs and college, just went for long runs. Any advice please Frustrated runner

Response:

Hey there.  There’s another thread here about this same topic, you should check it out.  You didn’t mention being on any medications; there’s some really good ones out there.  For example, there is Ventolin, which is good for stopping your wheezing once you’ve already started.  I can also use it just before easy runs; but it does increase your heart rate so it’s probably not a good idea for those days when you push yourself.  Another really great one is cromolyn, which prevents wheezing in the first place.  Unless it’s cold, what’s probably happening is that your lungs are hypersensitized to pollutants.  Cells in your lungs release nasty stuff that constricts your airways (in case you’re interested); cromolyn stops those cells from ever releasing that stuff. Ventolin opens your airways up afterwards.  Cold weather may be different; I don’t think anybody really knows how that works.  The cromolyn that I’m taking doesn’t really seem to help there.  Ozzie has mentioned breathing through your nose (thanks Ozzie!); I’ve also heard that wrapping a scarf around your mouth helps too. Either way, the air gets warmed before it hits your lungs. Just to be on the safe side, you may want to get your wheezing checked out, just in case it’s heart-related and not lung-related.  It’s much more likely to be asthma than anything else, but I’m quite the hypochrondriac! Good luck! Jo. – Hide quoted text — Show quoted text – Does anyone out there have advice for running with asthma.  I ran in highschool and my best times were around 16:30 for the 5K and 35 for the 10k and continued to run sporadically thru college . I got out of shape later in life and developed asthma, since then I have been running for a year and a half and can’t seem to get in shape or run faster than 7 minute pace, yet I’m only 33.  Mentally I know I’m capable of at least running close to those highschool times as I never really even did any speed work in hs and college, just went for long runs. Any advice please Frustrated runner

Response:

Question:

I took it for about 6 weeks and all I got were headaches. My doctor just prescribed Singulair for my asthama. I was looking forward to taking it to see if it would help, until I read the information sheet from the pharmacy. There are alot of potenital side effects, and it kind of spooked me. Anyone else have any side effects, besides nightmares and headaches? Thanks!

The ONLY side effect I had from taking Singulair, was being a little more emotional than normal.  I have always been a sensitive person, but I would cry at a commercial if it was sentimental at all.  Silly, isn’t it?  Well, once I got on Zoloft (part of my migraine prevention routine), my emotional state has returned to normal.   Just my 2 cents..Good Luck, I hope Singulair works well for you! *hugs* Ash

Response:

I asked my doctor about taking the Singulair in the morning and he thought it would be ok.  He asked the rep. and they didn’t know why it was to be a night time dose. I can tell that it is working because I only need my rescue inhaler a few times a week instead of every day.  I do not like the weird dreams so I will cont. to take in the morning until I receive a "good" reason why I should take in the night.  Pam.

Response:

I take Singulair in the morning also.  I found if taken at night it makes my insomnia much worse.  Taking it in the morning works much better for me. I asked my doctor about taking the Singulair in the morning and he thought it would be ok.  He asked the rep. and they didn’t know why it was to be a night time dose. I can tell that it is working because I only need my rescue inhaler a few times a week instead of every day.  I do not like the weird dreams so I will cont. to take in the morning until I receive a "good" reason why I should take in the night.  Pam.

– Lisa M. DeSavage Hinsbar Laboratories, Inc. www.hinsbarlabs.com

Response:

From the Singular web page: Like all prescription drugs, SINGULAIR may cause side effects. In studies, side effects usually have been mild. They generally have not caused patients to stop taking SINGULAIR. The list below is NOT a complete list of side effects reported with SINGULAIR. Your doctor can discuss with you a more complete list of side effects. The side effects in patients treated with SINGULAIR were similar in type and frequency to side effects in patients who were given a placebo (a pill containing no medication). Some of the side effects reported in studies included: tiredness fever abdominal (stomach) pain stomach or intestinal upset (gastroenteritis) heartburn dizziness headache rash Additionally, the following have been reported:  allergic reactions such as swelling of the face, lips, tongue, and/or throat, which may cause difficulty in breathing or swallowing, hives, and itching; dream abnormalities, drowsiness, irritability, and restlessness. A condition, which includes a combination of certain persistent or worsening symptoms, has been reported rarely in patients given SINGULAIR. These symptoms may include: a flu-like illness, rash, pins and needles or numbness of arms or legs, and severe sinusitis. These have occurred usually, but not always, in patients whose oral corticosteroid medicine for asthma is being reduced. Although SINGULAIR has not been shown to cause this condition, you must tell your doctor immediately if you experience a combination of these symptoms. Remember, anytime you have a medical problem you think may be related to SINGULAIR, talk to your doctor. Tim – Hide quoted text — Show quoted text – Then that’s what it is!  I just started having bizarre dreams — sometimes nightmares — about a month ago.   And it did start about a week or so after I started the Singulair.  The Singulair is definitely helping me.  I don’t feel like I have a bad chest cold all of the time anymore (yeah!).   And I’ve been waking up at least twice every night for about 3 years now, so I guess I can live with the nightmares.  I’ll ask my doctor about it the next time I see him.  Thanx! Regarding nightmares: I think I read in a magazine ad (the part on the back of the ad that contains all the technical information about a drug) that Singulair can cause vivid dreams. You may want to discuss this rare side-effect with your doctor. I regularly have vivid dreams, I did both before and after going on Singulair last spring, but I have noticed an increase in the frequency of these dreams, rarely bad, since starting the med. Because I am used to the dreams anyway, they don’t bother me. Anyone else notice this when they started Singulair? Lisa S. — Starlight Bridals                  TOLL FREE!  888-VEILS-33 Affordable headpieces, veils, and more! Since 1995… http://starlightbridals.com

– Hide quoted text — Show quoted text – My daughter  (20 yr old) is starting to have great relief with singulair. Night time asthma attacks are becoming less severe but she is having nightmares……and she feels there is some connection….anyone else experience this? Anne

Response:

I prefer morning too, so thanks for letting me know. I’ll ask my doc about it.

Response:

I took it for about 6 weeks and all I got were headaches. My doctor just prescribed Singulair for my asthama. I was looking forward to taking it to see if it would help, until I read the information sheet from the pharmacy. There are alot of potenital side effects, and it kind of spooked me. Anyone else have any side effects, besides nightmares and headaches?

Singulair is considered to ba a very safe medication.  The trick when looking for side effects is to compare the medication side effects with the placebo side effects.  The difference in the rates of the side effects suggest the likelihood of an actual side effect of the medication. No electrons were harmed in the posting of this message.

Response:

My doc switched me from Singulair to Accolate because I experienced numbness in my extremities and lips (of all places!) plus I was really disoriented when taking it.  Sort of spaced out feeling. Patrice – Hide quoted text — Show quoted text – I took it for about 6 weeks and all I got were headaches. My doctor just prescribed Singulair for my asthama. I was looking forward to taking it to see if it would help, until I read the information sheet from the pharmacy. There are alot of potenital side effects, and it kind of spooked me. Anyone else have any side effects, besides nightmares and headaches? Thanks!

Response:

i

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.

Response:

Question:

If your depression is due to a seratonin imbalence, yes they can help. If your depression is due to something else, they won’t. Most ssri drugs do have sexual side effects. If you’ve had blood work and your testosterone level is above the midrange, you might try antidepressants for a month or so. If they don’t work for you, try something else. Mike – Hide quoted text — Show quoted text – i am at the point where i think its time to aproach my gp to discuss some help regards anti depressants.from earlier posts i have seen people recomend not to use ssri,s so i will also talk with him regards these.i was just wondering if these will help my wellbeing for i am extremely depressed and really need some help now.everything is a struggle from getting up in the morns to working to well just everything .so could some one with experience in these things help me out by telling me if they r worth taking as things r getting harder day by day.i cant afford to get much worse or things could fall apart and i really need to keep my job thanks to anyone who can shed some light on this for me

Response:

- Hide quoted text — Show quoted text – If your depression is due to a seratonin imbalence, yes they can help. If your depression is due to something else, they won’t. Most ssri drugs do have sexual side effects. If you’ve had blood work and your testosterone level is above the midrange, you might try antidepressants for a month or so. If they don’t work for you, try something else. Mike i am at the point where i think its time to aproach my gp to discuss some help regards anti depressants.from earlier posts i have seen people recomend not to use ssri,s so i will also talk with him regards these.i was just wondering if these will help my wellbeing for i am extremely depressed and really need some help now.everything is a struggle from getting up in the morns to working to well just everything .so could some one with experience in these things help me out by telling me if they r worth taking as things r getting harder day by day.i cant afford to get much worse or things could fall apart and i really need to keep my job thanks to anyone who can shed some light on this for me

I had much more severe form of depression and antidepressants helped me to minimize it. I was not even moving…Here are those I took: Amitriptillin, Zoloft,Xanax, Alprazolam…the good about them – they helped me to ALMOST completely defeat depression, but The bad side…they ALMOST competely removed my sex drive…

Response:

Saint John’s Wort will lower prolactin levels, unlike other SSRI pills. – Hide quoted text — Show quoted text – i am at the point where i think its time to aproach my gp to discuss some help regards anti depressants.from earlier posts i have seen people recomend not to use ssri,s so i will also talk with him regards these.i was just wondering if these will help my wellbeing for i am extremely depressed and really need some help now.everything is a struggle from getting up in the morns to working to well just everything .so could some one with experience in these things help me out by telling me if they r worth taking as things r getting harder day by day.i cant afford to get much worse or things could fall apart and i really need to keep my job thanks to anyone who can shed some light on this for me

Response:

i was just wondering if these will help my wellbeing for i am extremely depressed and really need some help now.everything is a struggle from getting up in the morns to working to well just everything .so could some one with experience in these things help me out by telling me if they r worth taking as things r getting harder day by day.i cant afford to get much worse or things could fall apart and i really need to keep my job

The first thing you need to do is get "The Testosterone Sydrome" by Dr. Eugene Shippen and read it. Find out what the various tests to check you hormone levels and other health issues are before going to antidepressants. I wasted many years on antidepressants before discovering I had a hormone deficiency. You at least owe it to yourself to CHECK OUT ALL OTHER PHYSICAL PROBLEMS FIRST. The symptoms you describe sound like hypogonadism. I had identical symptoms myself for many many years.  I’m surprised I didn’t commit suicide, but I’m extrremely thankful now that I didn’t!

Response:

Like everybody else said, it’s vital to have a complete hormone panel, including prolactin, free testosterone, estradiol, and thyroid. If *any* of those are off, it can cause depression, anxiety, lethargy, etc. If you haven’t had a CBC (complete blood count) and lipid profile (cholesterol) have that checked also. They aren’t related to depression, but it’s just good sense. Also a review of your medical history, drug and alcohol use, and family history of medical and psychiatric problems are all useful. The troubleshooting sequence is actually very simple: hormonal problems can cause depression. You can test for hormone problems, so do that first. You can’t test for depression. If hormones are normal, treat as depression. But don’t take an SSRI if you’re concerned about sexual problems, rather try Wellbutrin, Remeron, or Serzone. One possible exception: the brand-new SSRI Lexapro reportedly causes less sexual problems than other SSRIs; don’t know how true this is. Re your title question, ADs can be very helpful. When they work people often report a fog has lifted, black moods gone, energy and vitality restored, can think clearer, etc. Statistically ADs have about a 70% success rate, but that’s *all* ADs combined. IOW you might need to try several different ones — Drs can’t match an AD to your symptoms, it’s just trial and error. But there’s a good chance it will work if your problem is endogenous depression, not hormonal. — Joe D. – Hide quoted text — Show quoted text – i am at the point where i think its time to aproach my gp to discuss some help regards anti depressants.from earlier posts i have seen people recomend not to use ssri,s so i will also talk with him regards these.i was just wondering if these will help my wellbeing for i am extremely depressed and really need some help now.everything is a struggle from getting up in the morns to working to well just everything .so could some one with experience in these things help me out by telling me if they r worth taking as things r getting harder day by day.i cant afford to get much worse or things could fall apart and i really need to keep my job thanks to anyone who can shed some light on this for me

Response:

Jim, You are absolutely correct! However, there does appear to be a form of depression unlinked to low testosterone levels.   I asked my psychiatrist about that and he agreed.   I posted what my psychiatrist said at http://groups.yahoo.com/group/hypogonadism2. and a fellow member posted that he agreed with that possibility. OR eon

Response:

T, Yes, my email addy works…it’s a real one too.  Feel free to email me anytime. OR eon

Response:

Hi, Before you jump into the deep end of  the pool, have you ever gotten your testosterone level? The symptoms of low T include depression, low energy level and loss of the sense of well being. I have been getting testosterone replacement therapy for  10 years and just recently bought a book on the subject that is fabulous. "The Testosterone Syndrome" by Dr. Eugene Shippen, $14.95, Barnes & Noble. It was a surprise T is used by the vital organs and all thru the body. I guess the brain is a vital organ to, right? He says in the preface, "When deficient, it is at the core of disease and early demise". Pretty strong language I thought but then found out why by reading his book. Ernie – Hide quoted text — Show quoted text – i am at the point where i think its time to aproach my gp to discuss some help regards anti depressants.from earlier posts i have seen people recomend not to use ssri,s so i will also talk with him regards these.i was just wondering if these will help my wellbeing for i am extremely depressed and really need some help now.everything is a struggle from getting up in the morns to working to well just everything .so could some one with experience in these things help me out by telling me if they r worth taking as things r getting harder day by day.i cant afford to get much worse or things could fall apart and i really need to keep my job thanks to anyone who can shed some light on this for me

Response:

i am at the point where i think its time to aproach my gp to discuss some help regards anti depressants.from earlier posts i have seen people recomend not to use ssri,s so i will also talk with him regards these.i was just wondering if these will help my wellbeing for i am extremely depressed and really need some help now.everything is a struggle from getting up in the morns to working to well just everything .so could some one with experience in these things help me out by telling me if they r worth taking as things r getting harder day by day.i cant afford to get much worse or things could fall apart and i really need to keep my job thanks to anyone who can shed some light on this for me

Response:

T, There are four or five anti-depressants with minimal,  negative erectile effects.  One is Wellbutrin. I had clinical depression and in Oct ‘97 my psychiatrist put me on 150 mg Wellbutrin SR/2x/dy. That did not alleviate depressive symptoms and suicidal ideation seemed to intensify…so December ‘97 he added Lithobid 300 mg/2x/dy.   That did it! I’ve been on that combination since then. There was a brief period when depressive symptoms returned…when PCP put me on a diuretic…diuretic was flushing out the lithium and it was easier to eliminate diuretic than find one compatible with lithium. Good luck, Keep us posted as goes it how… Just my experiences…. OR eon

Response:

thanks oreon for the reply.not dealing with this to well and have some pretty bad times .dont like facing a life of ad,s but must try something.hope ur doing well.would like to discuss things more with u on a more private level,so i will see if ur mail addy works if thats ok with u.thanks again

– Hide quoted text — Show quoted text – T, There are four or five anti-depressants with minimal,  negative erectile effects.  One is Wellbutrin. I had clinical depression and in Oct ‘97 my psychiatrist put me on 150 mg Wellbutrin SR/2x/dy. That did not alleviate depressive symptoms and suicidal ideation seemed to intensify…so December ‘97 he added Lithobid 300 mg/2x/dy.   That did it! I’ve been on that combination since then. There was a brief period when depressive symptoms returned…when PCP put me on a diuretic…diuretic was flushing out the lithium and it was easier to eliminate diuretic than find one compatible with lithium. Good luck, Keep us posted as goes it how… Just my experiences…. OR eon

Response:

Question:

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

Response:

William wrote:

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

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

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

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

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

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

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

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

Response:

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

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

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

Response:

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

Is Zoloft the only anti depressant you’ve tried?

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

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

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

Response:

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

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

OK.

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

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

Thanks, -William

Response:

Question:

Hi… My doctor just increased me from 100mg Zoloft a day to 200mg, and I was just wondering how long it would take to feel a difference, if at all.  I’ve been on Zoloft for six weeks and I’ve just gotten worse.  I’m getting pretty desperate and irrational, so I wish things would get sorted out… -Alex

For me it took several weeks for each dose change to take effect. Be sure to talk to your doctor immediately if you start to feel any serious side effects of Zoloft! My body cannot tolerate more than 50 mg/day.

Response:

Hi… My doctor just increased me from 100mg Zoloft a day to 200mg, and I was just wondering how long it would take to feel a difference, if at all.  I’ve been on Zoloft for six weeks and I’ve just gotten worse.  I’m getting pretty desperate and irrational, so I wish things would get sorted out… -Alex  —–  Posted via NewsOne.Net: Free (anonymous) Usenet News via the Web  —–   http://newsone.net/ — Free reading and anonymous posting to 60,000+ groups    NewsOne.Net prohibits users from posting spam.  If this or other posts

Response:

Question:

- Hide quoted text — Show quoted text – Hi all. Overall Im doing better and better. My hyper self seems to be kicking back in and that is some of my problem. Here the main one. Tue will start my 8th week I think or is it my 7th. dont remember. I was weaning on soooooo slow that Im not even up to 50mg yet but heres the ?. Im up to 37mg and cutting the 50mg off at the end. Less and less so I am probably close to 43 now. The day before yesterday I did soooo much stuff. Yesterday I started feeling the tremors like I had 10 cups of coffee. Breathing is ok. Just really jittery and shaky. The emotional stuff is not as bad either. I also have had a headache in my temples…tension..Tue I am going to take the full 50mg Zoloft. I need to get back to work and at a theraputic dose. If this shakyness is from even my increase Tue I can handle it. I still have my Xanax. What do you all think…Like I said I have been doing alot better. The fear to stay around the house has vanished except for yesterday and today. I probably do need to rest. This normal stuff for even 7-8weeks. I guess I thought I would be pretty much back to normal…..but getting there. Thanks Brenda

Brenda, It sounds like great progress. As you say you’re doing a lot better. I think you can take 50 mgs now and go to work and be fine. Slowly things will become more *routine-like* and you won’t notice every small change in your body or at least not in an unpleasant way which keeps you *catastrophizing* over it. There will be good days and not so good days, we all have them, but you have Xanax for when you need it.  Moreover, the Zoloft dose is still low. If this works that’s fantastic, if you have to decide somewhere along the road to take more it would be no problem at all. Enjoy your *new life*! Philip

Response:

Hi all. Overall Im doing better and better. My hyper self seems to be kicking back in and that is some of my problem. Here the main one. Tue will start my 8th week I think or is it my 7th. dont remember. I was weaning on soooooo slow that Im not even up to 50mg yet but heres the ?. Im up to 37mg and cutting the 50mg off at the end. Less and less so I am probably close to 43 now. The day before yesterday I did soooo much stuff. Yesterday I started feeling the tremors like I had 10 cups of coffee. Breathing is ok. Just really jittery and shaky. The emotional stuff is not as bad either. I also have had a headache in my temples…tension..Tue I am going to take the full 50mg Zoloft. I need to get back to work and at a theraputic dose. If this shakyness is from even my increase Tue I can handle it. I still have my Xanax. What do you all think…Like I said I have been doing alot better. The fear to stay around the house has vanished except for yesterday and today. I probably do need to rest. This normal stuff for even 7-8weeks. I guess I thought I would be pretty much back to normal…..but getting there. Thanks Brenda

Response:

– Hide quoted text — Show quoted text – Hi all. Overall Im doing better and better. My hyper self seems to be kicking back in and that is some of my problem. Here the main one. Tue will start my 8th week I think or is it my 7th. dont remember. I was weaning on soooooo slow that Im not even up to 50mg yet but heres the ?. Im up to 37mg and cutting the 50mg off at the end. Less and less so I am probably close to 43 now. The day before yesterday I did soooo much stuff. Yesterday I started feeling the tremors like I had 10 cups of coffee. Breathing is ok. Just really jittery and shaky. The emotional stuff is not as bad either. I also have had a headache in my temples…tension..Tue I am going to take the full 50mg Zoloft. I need to get back to work and at a theraputic dose. If this shakyness is from even my increase Tue I can handle it. I still have my Xanax. What do you all think…Like I said I have been doing alot better. The fear to stay around the house has vanished except for yesterday and today. I probably do need to rest. This normal stuff for even 7-8weeks. I guess I thought I would be pretty much back to normal…..but getting there. Thanks Brenda

Brenda –   It’s a slow process…I am starting week 8 myself (which means you are too I believe )…I noticed the shakes with each increase of Zoloft for a few days…this is probably what you are experiencing…The good part is that the shakes go away, but the feeling better doesn’t…Anyway, hang in there!  We’ll both get there – I know it!!!  I am still at the stage where the fear of having future attacks is a problem…Still need more time…At least my physiological symptoms are much better…Except for the last 2 days (see blood work 2 post) Best, — Charles Phipps

Response:

Question:

- Hide quoted text — Show quoted text – I have been taking Zoloft 100 mg (after starting at 50 mg) since the end of January.  My other meds are doxepin 50 mg at bedtime, diazepam 20 mg, and atenolol 50 mg every day.  I have had chronic severe anxiety and major depression for the past 20 years (been there, done that with just about every AD there is). Tried to start a job last week for the first time in 4 years (my previous job, where I lived previously, I remained full time for 3 years).  I had severe anxiety on the first day, meaning I felt very claustrophobic (I was in a cubicle with another person about 8 feet by 8 feet, for 8 hours, no windows), responsible for answering phones (6 incoming lines), greeting customers.  I had understood that the job was going to be mostly typing from dictation, which I thought I could handle.  Quit the job and made an ASAP appointment with the PDoc, whose associate I saw today. Initially, before I went on the Zoloft, the PDoc (my regular one) had suggested Paxil, which he thought would be more helpful for my anxiety problems.  Now, I’m thinking, maybe he was right, I suggested this to the one I saw today.  This PDoc wants me to raise dosage of the Zoloft from 100 mg to 200 mg per day, in an attempt to get my anxiety under control.  He figures this will bring quicker results than switching meds at this time, since, due to my economic circumstances, I *have* to get a job soon.  The Zoloft has been better for my depression than any other drug I’ve ever taken, and I’ve had *no* problems with side effects.  After being on it for 4 months, I figure it’s reached whatever maximum effect I can expect, at least at 100 mg. Anyone have any experience with Zoloft, does increasing the dose to the maximum 200 mg help anxiety with depression? Any help much appreciated! Carol

Response:

I was taking zoloft for depression, played with the dosage until the anxiety became something that I had no control over…so I changed to aropax and valium

This PDoc wants me to raise dosage of the Zoloft  from 100 mg to 200 mg per day,

Response: