Question:

What is a good starting dose for paxil. doc said start at 20. Does it cause sexual side effects in men? What about drinking alcohol and taking it. What are some side effects that should be called into the doctor over? Sue Before you buy.

Response:

What is a good starting dose for paxil. doc said start at 20. Does it cause sexual side effects in men? What about drinking alcohol and taking it. What are some side effects that should be called into the doctor over? Sue

Hi Sue, People with anxiety disorders should start Paxil at 5mgs, increasing the dose in 5mg increments every week or so. Paxil should kick in around 6 to 8 weeks. Paxil is notorious for sexual dysfunction in men ( I will enlcose a link for a website that has alot of info on med induced sexual dysfunction. http://panicdisorder.about.com/cs/medsdysfunction/index.htm It is always advisable to not drink while taking AD`s. You should always talk to your doctor about this, and do things in moderation. Any side-effect that is causing significant distress should be discussed with your doctor. Take care Jackie

Response:

– Hide quoted text — Show quoted text – What is a good starting dose for paxil. doc said start at 20. Does it cause sexual side effects in men? What about drinking alcohol and taking it. What are some side effects that should be called into the doctor over? Sue Hi Sue, People with anxiety disorders should start Paxil at 5mgs, increasing the dose in 5mg increments every week or so. Paxil should kick in around 6 to 8 weeks. Paxil is notorious for sexual dysfunction in men ( I will enlcose a link for a website that has alot of info on med induced sexual dysfunction. http://panicdisorder.about.com/cs/medsdysfunction/index.htm It is always advisable to not drink while taking AD`s. You should always talk to your doctor about this, and do things in moderation. Any side-effect that is causing significant distress should be discussed with your doctor. Take care Jackie

Thank you very much Jackie. Its apreciated. Sue:-) Before you buy.

Response:

What is a good starting dose for paxil. doc said start at 20.

Sigh…much too high. Start at 5 mg and stay there for a week and then raise the dose in weekly increments of 5 mg or whatever is comfortable. Does it cause sexual side effects in men?

It very often causes sexual dysfunction in men and in women. What about drinking alcohol and taking it.

Every doctor will say it’s a nono but IMO very moderate drinking won;t hurt. What are some side effects that should be called into the doctor over?

What side effects are happening? Sue

Philip – Hide quoted text — Show quoted text – Before you buy.

Response:

Hi Sue, What is a good starting dose for paxil.

About 1/4 the smallest dose tablet. In this case 5mg. Pill cutters available at pharmacies will make cutting easier and less bloody. NOTE1: Okay this with the prescribing doctor first. There may be a good reason why this isn’t okay in some situations, but he/she would need to come up with one.   NOTE2: this doesn’t apply to Paxil, but some antidepressants are available in prolonged release formulations (Effexor XR etc). These should NOT be cut. doc said start at 20.

Doctor needs to be educated about the different needs of anxiety patients compared to those with depression. Antidepressants almost always cause an initial increase in anxiety for purely physical reasons. Most of this can be reduced, though, unfortunately, not completely avoided by starting on small doses and ramping up in similar small doses at 7-10 day intervals. Does it cause sexual side effects in men?

Despite the claims of some manufacturers, all antidepressants may. What about drinking alcohol and taking it.

1)  The biggest problem with alcohol + ADs is that the effect can be unpredictable. Some days you can drink a fair amount of alcohol without greater than usual effect, other days just a small drink will turn your legs to rubber. Alcohol should be treated with caution and no driving etc afterwards. 2) Alcohol can, often does, make anxiety disorders worse. Having 1 or 2 drinks is usually not a problem, indeed may be beneficial, but if it gets to 3-4 then 5-6 etc, you can quickly get into serious trouble because alcohol and anxiety start to feed off each other into a rapid downward spiral. What are some side effects that should be called into the doctor over?

If started at a low dose with small increases, as above, there shouldn’t be any major problems. SSRI meds are very safe, even in huge overdose quantities. Anything that does cause concern should be referred to the prescribing doctor, if only for the re-assurance value. I won’t list all the possible side effects because I can guarantee that half the folk that read it will instantly start experiencing all of them. However, full information about Paxil and other ADs can be found at www.mentalhealth.com  - click the ‘medications’ button and then scroll down the list that appears in the l/h frame. Sue

Good  luck Ian

Response:

Sue, They started me at 20, its now up to 30.  Doc told me not to drink while on the medication, said it’s not a good idea!  Don’t know about the sexual side effects in men, but, with me…well, don’t know if it’s the drug or the problems with my depression and/or anxiety.  Maybe should call doctor if there’s any signs of headaches, fever, dizziness, etc.! Kerri – Hide quoted text — Show quoted text – What is a good starting dose for paxil. doc said start at 20. Does it cause sexual side effects in men? What about drinking alcohol and taking it. What are some side effects that should be called into the doctor over? Sue Before you buy.

Response:

my experience has been that a lower starting dose has fewer side effects.  I can’t drink alcohol with it, either.  (one beer, okay, but it hits me like a brick wall!) It can lessen sex drive, but I didn’t have that problem. – Hide quoted text — Show quoted text – What is a good starting dose for paxil. doc said start at 20. Does it cause sexual side effects in men? What about drinking alcohol and taking it. What are some side effects that should be called into the doctor over? Sue Before you buy.

Response:

What is a good starting dose for paxil. doc said start at 20.

I think it depends on the disorder. I have anxiety mostly but depression also. When I tried paxil, we started at 5mg for a week, then 10 then 20. Does it cause sexual side effects in men?

It did for me, but it won’t effect everyone the same way so it may not affect you that way. What about drinking alcohol and taking it.

Please don’t. It’ll make everything better if you don’t. What are some side effects that should be called into the doctor over?

I had weight loss, extreme tiredness, sexual dysfunction, involuntary muscle movements/tremors, and it made the anxiety actually worse. It all got significantly worse as soon as we went up to 20mg. That was enough for me and doc to try something else, since I don’t normally have such strong reactions to SSRI’s (I took prozac some years ago and had much milder side-effects). OTOH, a friend of mine takes paxil and had hardly any side effects and it seems to be helping him quite a bit. So, as my doc says, it’s like trying on shoes – try a med untilyou find one that "fits". IMO, it’s ok to talk to the doc about any side effects, particularly if they’re strong or really interfering with your life. We’ve recently switched me to zoloft and, although it’s still pretty early, I am not having side effects to that degree. So I’m in the same boat as you, trying different meds to find the right one…. LS Before you buy.

Response:

- Hide quoted text — Show quoted text – What is a good starting dose for paxil. doc said start at 20. Does it cause sexual side effects in men? What about drinking alcohol and taking it. What are some side effects that should be called into the doctor over? Sue Before you buy. Paxil should be started at 5mgs then slowly move up.  20mgs for depression and

30-60mgs for panic.  Also for you men.  paxil is also prescribed for premature ejaculation and TRUST me it works.  Paxil will delay your ejaculation and it wont be near as powerfull. donny Confess your sins.  Turn from your sins.  Believe in your heart.  Ask Jesus to save you.

Response:

What is a good starting dose for paxil. doc said start at 20.

I started at 20mg and quickly rose to 60mg with no problem.  Some people seem to need smaller doses and slower increases as they complain about various annoying side effects when starting Paxil. Does it cause sexual side effects in men?

It sure does.  One of Paxil’s off label uses is for the treatment of premature ejaculation and let me tell you this drug does a fantastic job of delaying orgasm.  At 60mg I was totally unable to orgasm even after hours of trying and would just have to give up due to exhaustion and boredom. Before you buy.

Response:

I’d ask your doctor for 20 mg "plain" Paxil tablets, and start with 10 mgs every day with dinner, after a couple weeks, raise the dose to the full 20 mg tablet.  Paxil CR is nothing more than a patent ploy used by that drug manufacturer to keep making a brand name product, because their patent ran out on Paxil – subsequently there are generic brands of plain Paxil available.   I’m hearing rumblings amonst paxil patients that some of the generics are lesser than…. You may want to try brand name Paxil.  I have no use for Paxil CR personally, as you can probably tell by my "thoughts", which you asked for. Gary   I just started Paxil CR for panic disorder. 12.5 and increasing weekly up to 37.5 hopefully.  Over the last 3 days I’ve noticed more sedation than the other SSRI’s I’ve taken.  So, I’m trying to decide if I should take it at night or daytime.  Any thoughts and how has it worked for anyone?   Thanks   Scott

Response:

I’ve been on Paxil CR since 2003. I started at the 12.5 dosage and i’ve been at 37.5 for over a year now. It’s helped me a great deal and it’s gotten my panic disorder under control. I’m going to be coming down off of it this year actually. You know alot of people always think they need to be at the highest dosage possible. I think that you should not fall into that trap. See how the 12.5 works for you if you are okay then maybe you don’t need to increase. I went up gradually going from the 12.5 for a few months, to the 25 for a few months, and the 37.5 for over a year, and that’s where i’ve been at and it’s worked great for me. It takes time to kick in though it took about four weeks or so for it to really do the trick for me. Some of the side effects of waiting for it to kick in are dry mouth and lack of libido. While taking Paxil you may also experience weight gain. So hang in there. I’ll let you know however that Paxil does not work for everyone. It worked for me though and i’m happy about that.

Response:

I just started Paxil CR for panic disorder. 12.5 and increasing weekly up to 37.5 hopefully.  Over the last 3 days I’ve noticed more sedation than the other SSRI’s I’ve taken.  So, I’m trying to decide if I should take it at night or daytime.  Any thoughts and how has it worked for anyone? Thanks Scott

Response:

- Hide quoted text — Show quoted text – I switched about 16 months ago from Paxil to Celexa. It was a pretty seamless transition. Celexa has proven very effective for my panic and anxiety (like Paxil), without the sleepiness. I gained lots of weight on Paxil, but have stabilized on Celexa. And I stopped falling asleep at my desk at work every afternoon, which was happening on Paxil! I also have felt for some time that the Celexa actually gave me a better lift for my depression than the Paxil did, especially over the long haul. (I had to increase my Paxil dose after about 6 months, as it was beginning to "poop out" for the depression; I have not had to do this with Celexa.) Hello Anne How did you switch from paxil to celexa. Weaning of paxil,or just a change overnight ? Just wondering,cause I do feel the sedating effect from paxil. Would be glad with some information about the transition Love from Anna I can

Question:

I read somewhere that the NPS considers invasive plants and animals to be a greater threat to the integrity of the park environments then the crush of human visitors.

This is one of the areas where full protection gets very hard to even define. For example, the Great Smokies area parks and some of the national forests nearby, are all either already allowing or considering unlimited fishing of rainbow trout. Why? Because the rainbow isn’t a native species, and they hope that eliminating it from some streams will preserve the native trout (which is technically a char anyway). Park service people are busily figuring out which streams have waterfalls high enough to keep rainbows from returning if fished out (as rainbows are mediocre jumpers compared to the native species), and which ones can’t be kept cleared. It may be ecologically sound overall, but it results in a crazy quilt pattern of fishing policies. I’m waiting for someone to suggest ‘improving’ a few waterfalls to make more streams ‘native species only’. Then there’s the asiatic brown trout, which is also non-native, but is unfortunately an excellent jumper…      Meanwhile, efforts continue to restore once native elk and wolves. Elk seem to be working, but keeping released red wolves alive when they stray out of the park area is highly doubtful, and if they can’t be established as a stable population, then the only way left to control the elk is to allow hunting. There’s also the question of whether red wolves count as a native species, since they all seem to have some domestic canine genes mixed in. Wolves may also help reduce the numbers of wild boar (again a non-native species). But nobody seriously thinks the wild boar can be eliminated by wolf predation…       The situation makes one thing clear. Once you let invasive plants and animals in, and hunt out a few native species, you have a seriously unstable ecosystem on your hands, and every step you take to restore a ‘normal’ ecology is a step into the unknown. All the likelyest scenarios involve other problems developing, and fixes for the fixes for the fixes being required. ‘Full protection’ becomes ‘full protection for native species’, with native usually meaning ‘before the white man came’. Planners don’t generally like to admit it, but they are not even trying to preserve the full diversity of the park’s wildlife, they are trying to set a higher threshold for the coming crash. They don’t expect to have a thousand species of wildflowers in the park in 30 years, but they think that proper management can cut diebacks to 20% or so, or in some areas 50%, and not taking these steps could leave us with 80 or 90% losses to some phyla. – Hide quoted text — Show quoted text – Yup and we also have to worry about plans to "localize" control of other areas of wilderness.  This is one of the few instances I can think of where National control of land is far better than state or local control.  Once local control is involved, local, economic concerns, logging, etc. takes over.  Then we all lose what we’ve been lucky enough as a nation to have had in the past. Jerry

Response:

 I still believe we have to recognize that National Parks are, by their very design, places where we have to balance the needs of recreation and protection. – Bob C.

snipped all sorts of agreeable stuff… Here’s the crux of the problem, not all people agree on what the "balance" should be. leads to healthy debate…too bad that’s about as far as it can go in this forum. — Paul Schnettler

Response:

     Don’t know if many have been following a previous post on protections for our National Parks but it seems by the responses that various animals and objects within our parks are not fully protected!  I was always under the assumption that our National Parks were these "Cathedrals" set aside, forever for the people and also for preservation. I think I agree with your sentiments in general, but disagree with the notion that National Parks should be set aside as "Cathedrals".

This was not a suggestion of mine——-simply an observation I had personally made and thought was true! This is more the purpose of other types of protected areas. A National Park is not the same thing as a wilderness area, although it may contain such areas. The mission of the NPS is stated as: "…to promote and regulate the use of the…national parks…which     purpose is to conserve the scenery and the natural and historic objects     and the wild life therein and to provide for the enjoyment of the same in     such manner and by such means as will leave them unimpaired for the     enjoyment of future generations."

Unimpaired for the enjoyment of future generations is a key phrase here. And as was stated in other posts, changing times, habitat loss and other factors may change the general "mission" of the park in future years. A key to the statement is the "enjoyment" aspect. Most of our parks have been created around scenic wonders of the landscape, scenic wonders which people naturally want to go see. (Everglades NP, designated in 1947, was the first park created purely because of the plant and animal life, with supporters admitting that many would consider the scenery to be "confused and monotonous" – having been there twice, however, I can tell you that the abundance of plants and animal life is itself a scenic wonder!). Personally, I think it makes sense to try to make the parks as accessible as possible (within the bounds of leaving them "unimpaired"). The reason I say this is that our National Parks are probably the best school room we have for educating people on the need for protecting our wilderness.

Exactly.  Even though I don’t like the idea of seeing animals in cages in zoos, I agree with the reasons——to educate, inform and enlighten the public on the issues of preservation.  Somewhere along the line, man may have to face the choice of either restricting events that may lead to the complete loss of a species, etc. or lose the species alltogether.  That’s a drastic statement and we as a nation are at this cross road with some species now but will we value our National Parks enough to restrict certain activities in a park that will cause negative affects by overuse? I read somewhere that the NPS considers invasive plants and animals to be a greater threat to the integrity of the park environments then the crush of human visitors.

I somewhat agree.  Vast numbers of visitors can be controlled, after all, you’re dealing with an "intelligent" being.  :-)  But mindless, foreign plants that may have no, local preditors but thrive in their new homes can choke out resident plants because these plants have to contend with the native insects, diseases, etc. I don’t know if this is true, but I can easily believe it given the the human visitation is mostly limited to very small areas of the park and is completely within our control. So bring as many people as possible to the park and give them that environmental education.

Yes.  The vast majority of visitors to the parks never see the "back country". Yes, we do have to be always wary of many of the privatization schemes and other ways in which those hostile to environmental concerns would like to "Disnify" our parks, but I still believe we have to recognize that National Parks are, by their very design, places where we have to balance the needs of recreation and protection.

Yup and we also have to worry about plans to "localize" control of other areas of wilderness.  This is one of the few instances I can think of where National control of land is far better than state or local control.  Once local control is involved, local, economic concerns, logging, etc. takes over.  Then we all lose what we’ve been lucky enough as a nation to have had in the past. Jerry

Response:

Jerry, I know where you’re going with your plea, and I respect that. But why attempt to turn something that was once and is no longer…wilderness, into what it cannot revert back to? It’s an oxymoron… congregating mass quantities of people into an area like Yellowstone renders it no longer a "wilderness" experience.

Well, the way I look at it is that the vast majority of visitors to the park don’t even get into the "back country"!  Many just drive the loops then stay in a motel for the night then head home.  So not that many people are spoiling the parks.  And the few who do make it back into the "wilderness" tend to take care of it.  It’s not a lost cause. Why not keep the truly unmolested areas as wilderness areas for all to see and experience, while leaving other areas not so pristine? Experiencing the wilderness is more of a mindset rather than an event. One (IMHO) cannot expect to funnel people in cars or any other form of mass transportation into an area and then proclaim it as a "wilderness past" experience. In almost every preserve…(I like that word better) type of area I’ve visited, it takes a day of hard paddling or strenuous hiking to get past the day trip mentality people, back to the areas where you really want to spend time exploring. In other words, you put the effort forth to find the "walden" that you seek, each seeker has his/her own expectations.

That’s exactly what I’m talking about. Again, IMHO the mere presence of people threatens the protections afforded the animals in the parks. Any man vs/ animal situation puts the animal at a disadvantage with regards to protections…it’s the human psyche that upsets the balance.

You’re right but just by having people present, doesn’t necessarily have to degrade the immediate environment for animals living there.  That’s where and why we have certain rules to follow to insure a quality experience in our parks.  Somethin’ worth fighting for. Jerry – Hide quoted text — Show quoted text – — Paul Schnettler

Response:

     Don’t know if many have been following a previous post on protections for our National Parks but it seems by the responses that various animals and objects within our parks are not fully protected!  I was always under the assumption that our National Parks were these "Cathedrals" set aside, forever for the people and also for preservation.  

I think I agree with your sentiments in general, but disagree with the notion that National Parks should be set aside as "Cathedrals". This is more the purpose of other types of protected areas. A National Park is not the same thing as a wilderness area, although it may contain such areas. The mission of the NPS is stated as: "…to promote and regulate the use of the…national parks…which     purpose is to conserve the scenery and the natural and historic objects     and the wild life therein and to provide for the enjoyment of the same in     such manner and by such means as will leave them unimpaired for the     enjoyment of future generations." A key to the statement is the "enjoyment" aspect. Most of our parks have been created around scenic wonders of the landscape, scenic wonders which people naturally want to go see. (Everglades NP, designated in 1947, was the first park created purely because of the plant and animal life, with supporters admitting that many would consider the scenery to be "confused and monotonous" – having been there twice, however, I can tell you that the abundance of plants and animal life is itself a scenic wonder!). Personally, I think it makes sense to try to make the parks as accessible as possible (within the bounds of leaving them "unimpaired"). The reason I say this is that our National Parks are probably the best school room we have for educating people on the need for protecting our wilderness. People who would dismiss me as a tree-hugger and not listen to anything I say will stop and take notice when they’re in a national park listening to a park ranger say the exact same thing. People of all political ideologies seem to have a great deal of respect for park rangers, and I don’t think I ever met a ranger who wasn’t a great deal concerned about protecting the environment. I read somewhere that the NPS considers invasive plants and animals to be a greater threat to the integrity of the park environments then the crush of human visitors. I don’t know if this is true, but I can easily believe it given the the human visitation is mostly limited to very small areas of the park and is completely within our control. So bring as many people as possible to the park and give them that environmental education. Yes, we do have to be always wary of many of the privatization schemes and other ways in which those hostile to environmental concerns would like to "Disnify" our parks, but I still believe we have to recognize that National Parks are, by their very design, places where we have to balance the needs of recreation and protection. – Bob C.

Response:

     Don’t know if many have been following a previous post on protections for our National Parks but it seems by the responses that various animals and objects within our parks are not fully protected!  I was always under the assumption that our National Parks were these "Cathedrals" set aside, forever for the people and also for preservation.  Not so.  So, when you see lobbyists trying to further degrade the only public place that should be held in trust for preservation AND public use that does not degrade your park, speak up.  All Americans have the right to get a glimpse of what the American wilderness used to be.  And future generations should also have the same expectations.      There is plenty of public land outside our National Parks where people can use the land for something other than preservation.  Here’s a "timely" quote from John Muir that perfectly fits various "These temple-destroyers, devotees of ravaging commercialism, seem to have a perfect contempt for Nature, and instead of lifting their eyes to the God of the mountains, lift them to the Almighty Dollar". Jerry

Response:

- Hide quoted text — Show quoted text –      Don’t know if many have been following a previous post on protections for our National Parks but it seems by the responses that various animals and objects within our parks are not fully protected!  I was always under the assumption that our National Parks were these "Cathedrals" set aside, forever for the people and also for preservation.  Not so.  So, when you see lobbyists trying to further degrade the only public place that should be held in trust for preservation AND public use that does not degrade your park, speak up.  All Americans have the right to get a glimpse of what the American wilderness used to be.  And future generations should also have the same expectations.      There is plenty of public land outside our National Parks where people can use the land for something other than preservation.  Here’s a "timely" quote from John Muir that perfectly fits various "These temple-destroyers, devotees of ravaging commercialism, seem to have a perfect contempt for Nature, and instead of lifting their eyes to the God of the mountains, lift them to the Almighty Dollar". Jerry

Jerry, I know where you’re going with your plea, and I respect that. But why attempt to turn something that was once and is no longer…wilderness, into what it cannot revert back to? It’s an oxymoron… congregating mass quantities of people into an area like Yellowstone renders it no longer a "wilderness" experience. Why not keep the truly unmolested areas as wilderness areas for all to see and experience, while leaving other areas not so pristine? Experiencing the wilderness is more of a mindset rather than an event. One (IMHO) cannot expect to funnel people in cars or any other form of mass transportation into an area and then proclaim it as a "wilderness past" experience. In almost every preserve…(I like that word better) type of area I’ve visited, it takes a day of hard paddling or strenuous hiking to get past the day trip mentality people, back to the areas where you really want to spend time exploring. In other words, you put the effort forth to find the "walden" that you seek, each seeker has his/her own expectations. Again, IMHO the mere presence of people threatens the protections afforded the animals in the parks. Any man vs/ animal situation puts the animal at a disadvantage with regards to protections…it’s the human psyche that upsets the balance. — Paul Schnettler

Response:

Question:

Justin,     Depression is a bummer, in and of itself. Have you asked your doc to check other things out? I have a thyroid problem and one of the things that surfaces with it is depression and a tendency to sleep 14 hours a day ( really ), skin problems, other health problems can accompany it. Most docs blow us off because, as men, we are in the minority with this, and so they seldom screen for it. Having checked a few things back for about 20 years or more, it is highly probable I’ve had for some time. A couple of simple blood tests and you’ll have a good idea if it is or isn’t, but it is not normal to be depressed and it would be one less worry. It could be something so simple but life changing as this that it would be prudent to discuss it with your doc.     A good place to ask for more question on this might be Alt.Support.Thyroid , as they are good, gentle folks with a lot of answers pertaining to what you’ve described, and it is quite possible to have a life changing event cause a temporary health issue. If that isn’t the case, feel free to vent, rant, or rave here. We’ll listen.

– Hide quoted text — Show quoted text – This post is not divorce, but I do need help. I have posted at other ng some have been helpful others have not. I’m looking for advice, I will be preprared to take it. Which can be hard for me. I have posted here before. My name is Justin, I’m 22/m I feel like my life is a real mess, I don’t know how to get out of this rut. Most days I rather be dead then go on. I don’t feel like I will neber ever, ever get better It starts here. Im upset because I feel like I  disappointed my parents at many levels. After graduating high school in 98′ I went off to the University Of Toledo. I stayed 5 days. I left because I was paranoid about some stuff from high school, which I rather not mention. Upon coming home I worked several jobs. I didn’t stay at many because I was too paranoid. I eventually became house bound. The only time I left was to see my doctor. Its almost like my mom hated my mom for not understanding my problems. I wasn’t a perfect kid, but most of my problems stemed from this issue. I finally moved in with my father. I did get better. I started doing the phones at his office and became confident. But living with my father was hell. He made me ill and I became aneroxic at some level. I’m about 5′11" I dropped down to 135Ib. Eventually I moved out. I couldn’t  stand the asshole. I did it overnight without hi knowing (If you ask my father he will tell you what a rotten kid I was) I then moved into an apartment. In a good neighborhood. But even in good areas there are some real nuts. The lady who lived across from me was a cocaine addict. She even proposition me for sex in the middle of the night. I didn’t touch the skank. Eventually, I moved out of that apartment and one across the street. I then met up with this dude, while working at the movie theatre. That was a bad sitution. He never took showers. He left meatloaf out for weeks, he had cereal all over the floor in his room. The list goes on and on. The apartment managers let me break my lease. I now live by myself(boy, im glad I don’t live with anyone) Then 7 months ago. I was so depressed I hooked up with some guy I met on the net. I regret doing this, one because Im not gay. But I was so unhappy. I would do anything to relieve stress. Lately, I look at porn on the net because Im miserable. Then last week I got fired from my job at Nordstroms as a dishwasher.. I was only there for about 5 weeks. So it wasn’t a big deal. The reason is I don’t know how  to do washes. I also put the trash in the wrong place a few times. I know this was my fault. I got a little lazy. The last day I was there this dude got in my face and was yelling at me about how I don’t know how to do dishes. He put his finger in my face. I dont look weak now. I now weigh abou 170 5′11" medium build. Im pissed another dude got in my face. I told my grandfather what happened he said i "fucked up" and on the wrong track in life. Today, its 5:30 am. I feel like shit. I’m thinking about cutting school. I sleep like 14 hrs a day. Im so depressed, and even a little suicidal. I have bad obsessions. I’m always concerned with my looks. I always think Im ugly, but I’m not I’m actually good looking. I stand in the mirrors for awhile picking at whats wrong with my face, and how i could correct it. I’m seething about some other things. I was talking to this kid I know from one of the ng. I told him how sometimes I read posts with advice and I get upset. He told me im too emotional, and then he said im as emotional as a woman. After he said that I started insulting him like crazy. I usually feel bad when Im brutally mean to people this time, I wasn’t. I could barley sleep last  night because of this comment. I don’t feel like I will get over this comment. Boy, am I angry. Then last night I read a helpful post on here. Anyway, I took it the wrong way and got upset. I was then obsessing about it all last night and still am. The comment was just how relationships are 50/50 nothing bad. Well, I then started to worry that Im just a totaly self-absorbed dude. Which Im not, except when it comes to my problems.  I see myself being absorbed in them. After I read that post I was got all paranoid that when Im not absorbed in my own problems Im not interested in others. I dont want people to see me like this, so now im very worried. So I traced back to all the people I talk to at school and wondered if I seemed interested in them. And I did. But now I fear that I will worry if  I seem interested in people and watch everything I say, and maybe say things just so I seem interested. Maybe ask them questions that I might not normally do. I once did this before and I felt fake. I rather be mother fucking dead then to have this obsession return and thats what its fucking doing. To some this may seem like nothing to me this is a huge deal. I rather stay home then bare this worry. What’s funny is people do REALLY like me. People ask me where the parties are, boy if they only knew how horrible my life is. I once took a survery at the mall while I had some extra time. The kid doing the survey was in high school. He said I bet your a frat boy. Its funny because I see myself as an ugly, loser fuck. Will I get better? I have been going through hell for the last 5 years I see a doc, take meds, do everything. nothin works Justin

Response:

 But now I fear that I will worry if  I seem interested in people and watch everything I say, and maybe say things just so I seem interested. Maybe ask them questions that I might not normally do. I once did this before and I felt fake. I rather be mother fucking dead then to have this obsession return and thats what its fucking doing. To some this may seem like nothing to me this is a huge deal. I rather stay home then bare this worry.

Ask your doc if you can get into some sort of support group for obsessives.   I think obsessions can be an offshoot from anxiety disorders, and are not exactly the same as depression.  But ask a pro, i really don’t know.  I do know from experience that medications made obsessions worse for me.  I still deal with them but they’re more under control, and even channeled into positive things sometimes…  I wonder if your past anorexia is related to that, also?  I was told it was all related.  Congrats on getting past that part, that’s a big step that shouldn’t go unnoticed. Good luck.  

Response:

Justin, I am sorry you are feeling so depressed and going through sucha horrible time of it. But As you say this is a divorce support group and I don;t know how much good posting here will do, have you tried posting on the Alt. Support Depressed or depression NG? Have you tired talking to people, to friends to the doctor even?

Response:

This post is not divorce, but I do need help. I have posted at other ng some have been helpful others have not. I’m looking for advice, I will be preprared to take it. Which can be hard for me. I have posted here before. My name is Justin, I’m 22/m Will I get better? I have been going through hell for the last 5 years SNIP, SNIP, SNIP I see a doc, take meds, do everything. nothin works Justin

Will you get better?  Sure you will!  It’s obvious to me that you are TOO HARD ON YOURSELF.  When I was 22 years old I felt the same way…which is pitiful because very few people have found themselves at such an early age…meanwhile a lot of your friends have graduated from college and look like they had all the self-direction in the world.  Don’t believe it. You need to send a cheap little greeting card to your parents every now and then.  Falling out of contact is not very good psychology….even if you’re at a place in life when you don’t like them and think their values stink. I’m going to sing a song… listen to the words… DESYREL, LITHIUM, ZOLOFT, XANAX, LORAZAPAM, NORTRIPTOLEAN, PROZAC and PAXIL. It took over seven years of trial and error to get the right medication before life began to be bearable.   You want advice?  Contruct a diary of your moods and chart the highs and lows.  Write a lil’ story about your past history of abuse and addiction. 2. Go back to your medical doctor and tell him you want to visit a psychiatrist.  He’ll give you a medical referral 3.   A good psychiatrist will ask you 50-100 questions…in rapid fire… He’ll then construct a baseline on where you are right now verses where you ought to be.  4) You’ll have routine visits with him– adjusting medication. PS You know you’re not a loser…just take better care of yourself.

Response:

This post is not divorce, but I do need help. I have posted at other ng some have been helpful others have not. I’m looking for advice, I will be preprared to take it. Which can be hard for me. I have posted here before. My name is Justin, I’m 22/m I feel like my life is a real mess, I don’t know how to get out of this rut. Most days I rather be dead then go on. I don’t feel like I will neber ever, ever get better It starts here. Im upset because I feel like I  disappointed my parents at many levels. After graduating high school in 98′ I went off to the University Of Toledo. I stayed 5 days. I left because I was paranoid about some stuff from high school, which I rather not mention. Upon coming home I worked several jobs. I didn’t stay at many because I was too paranoid. I eventually became house bound. The only time I left was to see my doctor. Its almost like my mom hated my mom for not understanding my problems. I wasn’t a perfect kid, but most of my problems stemed from this issue. I finally moved in with my father. I did get better. I started doing the phones at his office and became confident. But living with my father was hell. He made me ill and I became aneroxic at some level. I’m about 5′11" I dropped down to 135Ib. Eventually I moved out. I couldn’t  stand the asshole. I did it overnight without hi knowing (If you ask my father he will tell you what a rotten kid I was) I then moved into an apartment. In a good neighborhood. But even in good areas there are some real nuts. The lady who lived across from me was a cocaine addict. She even proposition me for sex in the middle of the night. I didn’t touch the skank. Eventually, I moved out of that apartment and one across the street. I then met up with this dude, while working at the movie theatre. That was a bad sitution. He never took showers. He left meatloaf out for weeks, he had cereal all over the floor in his room. The list goes on and on. The apartment managers let me break my lease. I now live by myself(boy, im glad I don’t live with anyone) Then 7 months ago. I was so depressed I hooked up with some guy I met on the net. I regret doing this, one because Im not gay. But I was so unhappy. I would do anything to relieve stress. Lately, I look at porn on the net because Im miserable. Then last week I got fired from my job at Nordstroms as a dishwasher.. I was only there for about 5 weeks. So it wasn’t a big deal. The reason is I don’t know how  to do washes. I also put the trash in the wrong place a few times. I know this was my fault. I got a little lazy. The last day I was there this dude got in my face and was yelling at me about how I don’t know how to do dishes. He put his finger in my face. I dont look weak now. I now weigh abou 170 5′11" medium build. Im pissed another dude got in my face. I told my grandfather what happened he said i "fucked up" and on the wrong track in life. Today, its 5:30 am. I feel like shit. I’m thinking about cutting school. I sleep like 14 hrs a day. Im so depressed, and even a little suicidal. I have bad obsessions. I’m always concerned with my looks. I always think Im ugly, but I’m not I’m actually good looking. I stand in the mirrors for awhile picking at whats wrong with my face, and how i could correct it. I’m seething about some other things. I was talking to this kid I know from one of the ng. I told him how sometimes I read posts with advice and I get upset. He told me im too emotional, and then he said im as emotional as a woman. After he said that I started insulting him like crazy. I usually feel bad when Im brutally mean to people this time, I wasn’t. I could barley sleep last  night because of this comment. I don’t feel like I will get over this comment. Boy, am I angry. Then last night I read a helpful post on here. Anyway, I took it the wrong way and got upset. I was then obsessing about it all last night and still am. The comment was just how relationships are 50/50 nothing bad. Well, I then started to worry that Im just a totaly self-absorbed dude. Which Im not, except when it comes to my problems.  I see myself being absorbed in them. After I read that post I was got all paranoid that when Im not absorbed in my own problems Im not interested in others. I dont want people to see me like this, so now im very worried. So I traced back to all the people I talk to at school and wondered if I seemed interested in them. And I did. But now I fear that I will worry if  I seem interested in people and watch everything I say, and maybe say things just so I seem interested. Maybe ask them questions that I might not normally do. I once did this before and I felt fake. I rather be mother fucking dead then to have this obsession return and thats what its fucking doing. To some this may seem like nothing to me this is a huge deal. I rather stay home then bare this worry. What’s funny is people do REALLY like me. People ask me where the parties are, boy if they only knew how horrible my life is. I once took a survery at the mall while I had some extra time. The kid doing the survey was in high school. He said I bet your a frat boy. Its funny because I see myself as an ugly, loser fuck. Will I get better? I have been going through hell for the last 5 years I see a doc, take meds, do everything. nothin works Justin

Response:

Question:

- Hide quoted text — Show quoted text – You gotta remember I live in Oklahoma USA….cattle is king around here…although I know Aussies are serious contributors.  I even have Kayla trained…"what’s for dinner Kayla?"  she replies "oh I don’t know, something with hamburger meat"  It’s cheap and versitile…do I sound like a commercial for the beef trade yet? LOL R Just kidding.  I hope to heck no one ever tells me to refrain from eating meat…we live on hamburger meat…LOL On behalf of the Australian cattle producers who supply most of it, I thank you.   Ian Robin When your unemployed hamburger meet comes in handy.

Confess your sins.  Turn from your sins.  Believe in your heart.  Ask Jesus to save you.

Response:

Listen freak…no one yanked your chain.  YOU are unemployed.  Neither I or my husband are.  Get this through your thick head.  I do NOT want you to reply to me, antagonize me or harass me.  I would like for you to go away.  I do NOT understand how you can even log on here every day…then again it is between here and a few other choice places that you do…been visiting a lot of alt.sex ng’s lately haven’t you donny? Oh and there was that one…what was it?  Hmmm…somewhere to do with computers for sale, and then a few I figure must not have been you since they were normal sites.  Don’t think just because you don’t use the same screen name and such that we can’t figure out where you have been.  I wonder though?  Is it cable, DSL or just boredom that keeps your ip the same for so long? R Robin When your unemployed hamburger meet comes in handy.

Robin "Anyone who thinks they’re important is usually just a pompous moron who can’t deal with his or her own pathetic insignificance and the fact that what they do is meaningless and inconsequential…"   William Thomas

Response:

We also eat lots of sandwiches to.  When you have only one paycheck its tough. dc Confess your sins.  Turn from your sins.  Believe in your heart.  Ask Jesus to save you.

Response:

You gotta remember I live in Oklahoma USA….cattle is king around here…although I know Aussies are serious contributors.  I even have Kayla trained…"what’s for dinner Kayla?"  she replies "oh I don’t know, something with hamburger meat"  It’s cheap and versitile…do I sound like a commercial for the beef trade yet? LOL R

I doubt they would be grinding up good USA prime beef when they can use cheap old rogue bull meat from central Oz. <G Always ask for 3RT grade. That means that the carcass has been run over and tenderised by at least 3 road trains (prime mover pulling Ian

Response:

Just kidding.  I hope to heck no one ever tells me to refrain from eating meat…we live on hamburger meat…LOL

On behalf of the Australian cattle producers who supply most of it, I thank you.   Ian

Response:

- Hide quoted text — Show quoted text – You gotta remember I live in Oklahoma USA….cattle is king around here…although I know Aussies are serious contributors.  I even have Kayla trained…"what’s for dinner Kayla?"  she replies "oh I don’t know, something with hamburger meat"  It’s cheap and versitile…do I sound like a commercial for the beef trade yet? LOL R Just kidding.  I hope to heck no one ever tells me to refrain from eating meat…we live on hamburger meat…LOL On behalf of the Australian cattle producers who supply most of it, I thank you.   Ian Robin

Jeez, Robin, you’re not afraid of Mad Cow Disease?? Thats my newest paranoia now…last year it was Ecoli….it’s gotta be something, you know      lorri

Response:

You gotta remember I live in Oklahoma USA….cattle is king around here…although I know Aussies are serious contributors.  I even have Kayla trained…"what’s for dinner Kayla?"  she replies "oh I don’t know, something with hamburger meat"  It’s cheap and versitile…do I sound like a commercial for the beef trade yet? LOL R Just kidding.  I hope to heck no one ever tells me to refrain from eating meat…we live on hamburger meat…LOL On behalf of the Australian cattle producers who supply most of it, I thank you.   Ian

Robin

Response:

– Hide quoted text — Show quoted text -Hello friends: It is almost time for my visit with my pdoc. Actually I must call and confirm the date, some time at the end of November. I’m going to get in shit by him but who cares!!! He wanted me to walk 3 – 5 miles a day and fill up on salad and refrain from eating meat. I’ll tell ya, if I did those 3 – 5 miles I would not be around for my next appointment. He would be treating me from the ditch on the side of the road. LOL I’m going to be making the Zoloft for three years and I am on the highest dosage. I wonder if I will suffer any withdrawal symptoms, I also wonder how this switch will take place. All I know is I will no longer be hungry 24 hours a day and the love will return, if ya know what I mean. LOL Hey, that is my excuse! That damn Zoloft was making me so hungry that is why I couldn’t cut back. HEHEHE So, I should have a wonderful Christmas. What a shitty time to switch meds! No doubt I will not be feeling the full effects of Celexa until after Christmas. Oh well I will just stay sedated on benzo’s. HEHEHE If 200mg is the maximum allowable dosage for Zoloft, what is the equivalent in Celexa? Going to bed. Hopefully I’ll sleep. That’s another thing, I cannot sleep on Zoloft. I’m tired but cannot fall asleep. I guess the dose is too high. I used to be able to sleep on 100 and 150mg. Anyway, GOOD NIGHT ALL! Paula

Hi Paula, As I understand it you’re changing to Celexa mainly because of the hunger pangs that Zoloft produces and the weight increase that results. That may help, I don’t know, its probably a very individual thing. However, I am concerned that you seem to need the max Zoloft dose to treat your anxiety. ADs seem to have a dose ‘window’ range at which they produce the maximum effect. Taking more than this ‘window’ range can be just as counterproductive as taking too little. Celexa seems to affect basically the same receptors as Zoloft, so you shouldn’t get much of a withdrawal effect because of compatibility issues. It should begin working virtually immediately. I don’t know of any dose equivalency tables, but I assume you doctor wouldn’t want you to start out on the max dose (60mg), but probably will suggest 40mg/day, which is the usual therapeutic dose. That may mean that there is a slight withdrawal effect, but you probably won’t notice too much. The benzos will help if needed. Celexa isn’t particularly sedating, so you might not get any direct benefit, but once its working it may alleviate whatever is causing your insomnia. Good luck Ian

Response:

I thought I would put a plus by your name since you brought it up before LOL Just kidding.  I hope to heck no one ever tells me to refrain from eating meat…we live on hamburger meat…LOL Anyhow…good luck with your med switch…~  It might not be as bad as you think changing over….they have changed Wes’ meds from high doses of one to what seems like a low dose of another and not had serious side effects because of the differences in the meds.  Stay positive about it!  I bet you make it through with flying colors R – Hide quoted text — Show quoted text -Hello friends: It is almost time for my visit with my pdoc. Actually I must call and confirm the date, some time at the end of November. I’m going to get in shit by him but who cares!!! He wanted me to walk 3 – 5 miles a day and fill up on salad and refrain from eating meat. I’ll tell ya, if I did those 3 – 5 miles I would not be around for my next appointment. He would be treating me from the ditch on the side of the road. LOL I’m going to be making the Zoloft for three years and I am on the highest dosage. I wonder if I will suffer any withdrawal symptoms, I also wonder how this switch will take place. All I know is I will no longer be hungry 24 hours a day and the love will return, if ya know what I mean. LOL Hey, that is my excuse! That damn Zoloft was making me so hungry that is why I couldn’t cut back. HEHEHE So, I should have a wonderful Christmas. What a shitty time to switch meds! No doubt I will not be feeling the full effects of Celexa until after Christmas. Oh well I will just stay sedated on benzo’s. HEHEHE If 200mg is the maximum allowable dosage for Zoloft, what is the equivalent in Celexa? Going to bed. Hopefully I’ll sleep. That’s another thing, I cannot sleep on Zoloft. I’m tired but cannot fall asleep. I guess the dose is too high. I used to be able to sleep on 100 and 150mg. Anyway, GOOD NIGHT ALL! Paula

Robin

Response:

I’m sorry you have to switch meds Paula.  I  know I really hate being on these meds, although they have gotten me through some rough times.  I hope the transition goes smoothly for you. Hugs, Di

– Hide quoted text — Show quoted text – Hello friends: It is almost time for my visit with my pdoc. Actually I must call and confirm the date, some time at the end of November. I’m going to get in shit by him but who cares!!! He wanted me to walk 3 – 5 miles a day and fill up on salad and refrain from eating meat. I’ll tell ya, if I did those 3 – 5 miles I would not be around for my next appointment. He would be treating me from the ditch on the side of the road. LOL I’m going to be making the on Zoloft for three years and I am on the highest dosage. I wonder if I will suffer any withdrawal symptoms, I also wonder how this switch will take place. All I know is I will no longer be hungry 24 hours a day and the love will return, if ya know what I mean. LOL Hey, that is my excuse! That damn Zoloft was making me so hungry that is why I couldn’t cut back. HEHEHE So, I should have a wonderful Christmas. What a shitty time to switch meds! No doubt I will not be feeling the full effects of Celexa until after Christmas. Oh well I will just stay sedated on benzo’s. HEHEHE If 200mg is the maximum allowable dosage for Zoloft, what is the equivalent in Celexa? Going to bed. Hopefully I’ll sleep. That’s another thing, I cannot sleep on Zoloft. I’m tired but cannot fall asleep. I guess the dose is too high. I used to be able to sleep on 100 and 150mg. Anyway, GOOD NIGHT ALL! Paula

Response:

Hello friends: It is almost time for my visit with my pdoc. Actually I must call and confirm the date, some time at the end of November. I’m going to get in shit by him but who cares!!! He wanted me to walk 3 – 5 miles a day and fill up on salad and refrain from eating meat. I’ll tell ya, if I did those 3 – 5 miles I would not be around for my next appointment. He would be treating me from the ditch on the side of the road. LOL I’m going to be making the Zoloft for three years and I am on the highest dosage. I wonder if I will suffer any withdrawal symptoms, I also wonder how this switch will take place. All I know is I will no longer be hungry 24 hours a day and the love will return, if ya know what I mean. LOL Hey, that is my excuse! That damn Zoloft was making me so hungry that is why I couldn’t cut back. HEHEHE So, I should have a wonderful Christmas. What a shitty time to switch meds! No doubt I will not be feeling the full effects of Celexa until after Christmas. Oh well I will just stay sedated on benzo’s. HEHEHE If 200mg is the maximum allowable dosage for Zoloft, what is the equivalent in Celexa? Going to bed. Hopefully I’ll sleep. That’s another thing, I cannot sleep on Zoloft. I’m tired but cannot fall asleep. I guess the dose is too high. I used to be able to sleep on 100 and 150mg. Anyway, GOOD NIGHT ALL! Paula

Response:

Question:

"Edee Roche" <Roche…@AOL.COM

wrote in message

news:39.80b5c24.26b3c117@aol.com…

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

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

  -=[ Livin' on Island Time ]=-

Response:

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

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

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

Response:

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

wrote in message

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

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

even

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

see

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

you some

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

and I

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

jobs.

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

I

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

heart

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

steak

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

what

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

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

wrote in message

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

wrote in message

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

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

sent

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

I

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

the

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

Response:

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

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

Response:

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

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

Response:

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

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

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

Response:

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

Response:

John P. Husvar <jhus…@apk.net

wrote in message

news:8lhabj$1rh$1@plonk.apk.net…

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

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

Response:

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

wrote in message

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

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

and

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

the

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

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

Response:

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

wrote in message

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

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

long

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

we

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

in

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

it

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

worry

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

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

wrote in message

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

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

its

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

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

Response:

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

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

as I

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

up

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

through

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

pain

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

about

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

feeling

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

to

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

and

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

20

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

all.

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

that

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

pain

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

no

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

is

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

Response:

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

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

Response:

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

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

Response:

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

Response:

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

wrote in message

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

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

takes for

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

comes

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

it or

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

to a

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

take

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

Response:

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

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

Response:

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

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

patient=

Response:

Karlyn wrote…

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

Doesn’t

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

of

not taking away the pain.

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

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

my

actions show otherwise.  Isn’t it frustrating?

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

  -=[ Livin' on Island Time ]=-

Response:

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

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

Response:

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

wrote in message

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

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

that

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

of us

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

Neurontin but

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

Response:

Barb Edmiston <barbedmis…@dingoblue.net.au

wrote in message

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

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

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

Response:

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

wrote in message

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

wrote in message

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

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

me

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

Response:

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

wrote in message

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

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

of=20

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

neurolog=

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

clinical=20

research expertise in multiple sclerosis, viral immunology and the

managemen=

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

multiple=20

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

with=20

multiple sclerosis are also affected by chronic neuropathic pain.

Therefore,=

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

interrupt=

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

trauma=

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

bur=

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

particularly=20

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

effort=20

directed at pushing this class of medication to its limit before

considering=

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

milligrams=20

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

as=20

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

starting=

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

a=20

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

to=20

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

doses=20

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

this=20

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

time=20

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

to=20

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

start,=20

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

if=20

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

on=20

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

helpin=

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

this=

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

is=20

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

have=20

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

to=20

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

a=

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

i=

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

bedtime.=

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

For=20

tiagabine, I start patients with 4 milligrams and escalate at

4-milligram=20

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

times=20

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

convenience=

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

escalate=20

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

the=20

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

each=20

type of medication effectively and keep the side effects low while

improving=

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

the=

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

be=

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

include=20

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

problem=

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

combine=

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

problems.=20

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

of=20

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

alerting=20

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

to=20

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

th=

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

patient=

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

or=20

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

patients=20

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

at=20

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

taken=20

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

over-repor=

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

or=

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

thei=

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

as=20

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

risk=20

of developing fecal impaction because of the potential danger of

perforation=

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

If=20=

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

antidepressant.=

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

that=20

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

of=20

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

headach=

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

Migraine=

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

but=20

whatever the explanation the depression must be treated. Fluoxetine

(Prozac)=

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

of=20

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

conflict=20

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

Syndrome),=20

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

t=

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

as=20

sleep improves and the dose of anticonvulsant adjuvant is reduced.

Improved=20

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

is=20

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

Muscle=20

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

a=20

dependent posture and cold ambient temperature. This is important

because=20

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

the=20

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

changes=

=20 secondary to the release of excitatory neurotransmitters within the

dorsal=20

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

1mg=20

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

needed=

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

milligrams).=20

Tizanidine reduces the spasm of movement and the pain associated with

that=20

spasm,

… read more »

Response:

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

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

… read more »

Response:

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

Response:

Question:

: Hi, I am new here and I am grateful that there are newsgroups available : to share these panic and anxiety experiences.   : I have been diagnosed with having a severe depression episode and also : am having panic and anxiety attacks.  Primarily while I am driving : to work.  My doctor gave me some medication called effexor to try and : it made me sick to my stomach and really spaced out.  Needless to say : I only took those once. When I went back and told him that they were awful : he gave me some zoloft.  I took one of those and I got a dry mouth, : and felt ’speedy’ and not really like myself. I also felt sick to : my stomach and frankly I didn’t like it at all.  Is this the way : antidepressants are?  Do you always have to feel like a glassy eyed : sick zombie?  I guess I am just wondering if this is normal? The : thought of taking medication in the first place is troubling to me, : let alone having myself turn in to some space cadet. Hi Kelly, I’m currently taking Luvox and desipramine for panic disorder and depression. I too was reluctant to take meds at first but now I’m so relieved to be on them. The Luvox made me very sleepy and nauseated, but that subsided within a couple of weeks. With desipramine I was definitely "spacey" (prob. due to lowered blood pressure) but that went away pretty quickly as well. Most side effects go away within a couple of weeks. I like to think of them as signs that the drugs are working–i.e. they’re starting to change my body chemistry. I’m probably completely off base but it works for me. Please try to ride out the side effects if you can–I have some ideas on how to make them better. You’ll feel a lot better, and knowing the SEs are temporary will give you incentive to stick with them. Going on and off meds is going to do you more harm than good, IMHO. Feel free to email anytime. Doris —                         Doris Ostendorf "Show me a sane man and I will cure him for you."                                                   C.G. Jung

Response:

You might want to look in Imipramine. It is pretty mild and works very good. You will notice dry mouth but hey that is why we have water. Thomas

Response:

- Hide quoted text — Show quoted text – Hi, I am new here and I am grateful that there are newsgroups available to share these panic and anxiety experiences.   I have been diagnosed with having a severe depression episode and also am having panic and anxiety attacks.  Primarily while I am driving to work.  My doctor gave me some medication called effexor to try and it made me sick to my stomach and really spaced out.  Needless to say I only took those once. When I went back and told him that they were awful he gave me some zoloft.  I took one of those and I got a dry mouth, and felt ’speedy’ and not really like myself. I also felt sick to my stomach and frankly I didn’t like it at all.  Is this the way antidepressants are?  Do you always have to feel like a glassy eyed sick zombie?  I guess I am just wondering if this is normal? The thought of taking medication in the first place is troubling to me, let alone having myself turn in to some space cadet. The good thing was I was definitely not depressed anymore.  I was too sick and stoned to feel anything!!!  thanks for listening — kel

Antidepressants work differently for different people. Unfortunately, doctors sometimes have to try different drugs on some people to find the right one. I was diagnosed as being severly depressed and an accompanying anxiety disorder to boot. I was given Prozac first which made me feel MUCH worse (I literally "crashed" and had horrible anxiety problems as well). After being admitted to the hospital, I was given Luvox (a close cousin of Prozac and was almost brand new on the market at the time) which seemed to do the trick after a few weeks. Mind you I was a virtual zombie since I was on way too high a dose! Doctors don’t seem to pay too much attention to psychiatric patients in the hospital. I was mostly just very, very tired from the Luvox and a bit of a dry mouth. The dry mouth went away pretty quickly but since I was on other meds as well, it may or may not have been the Luvox. My guess is that it was. After my hospital stay, another psychitrist (who actually listened!) saw that I was zombified by the dose and cut it down from 150mg to 100mg. It’s been just over a year and I’m now down to 50mg (so far so good!) and I take an Ativan (.5mg) once in a while when I need it. So it may just be a case of finding the right drug for you. It’s bizarre how greatly the side effects are from drug to drug even though they are all very similar (Prozac, Luvox, Zoloft, Effexor). The dose your doctor gave you might be a bit too high – but i guess you have to be on them for a while for them to consider that. I don’t know if this helps you at all other than the fact that many of us here have gone through/going through the same thing! Take heart – you’ll get better! And the crap wears off – really! Thomas

Response:

My doctor gave me some medication called effexor to try and it made me sick to my stomach and really spaced out.  Needless to say I only took those once….

Many side effects can be reduced by s*l*o*w*l*y increasing dosages to the desired level.  Discuss this with your doctor. I guess I am just wondering if this is normal?

Many people have trouble (real or imagined) with "normal" drug dosing. Mike Creswick Practical Software Solutions Member Association of Online Professionals Member HTML Writers’ Guild

Response:

l.  Is this the way   antidepressants are?  Do you always have to feel like a glassy eyed sick zombie?  I guess I am just wondering if this is normal?  

Hi Kelly, Usually, one starts with a very low (subtherapeutic) dose of these meds in order to minimize the side effects, and gradually increase it as your body gets more comfortable with the medicine.  Yes…it is kind of rough in the beginning, but usually these side effects go away after a week or two, and the dosage can be gently increased to a therapeutic level. I had the same problem with Zoloft, and after a few weeks I felt fine and am able to things I haven’t done in 8 years. Good luck! Andy

Response:

Hi, I am new here and I am grateful that there are newsgroups available to share these panic and anxiety experiences.   I have been diagnosed with having a severe depression episode and also am having panic and anxiety attacks.  Primarily while I am driving to work.  My doctor gave me some medication called effexor to try and it made me sick to my stomach and really spaced out.  Needless to say I only took those once. When I went back and told him that they were awful he gave me some zoloft.  I took one of those and I got a dry mouth, and felt ’speedy’ and not really like myself. I also felt sick to my stomach and frankly I didn’t like it at all.  Is this the way antidepressants are?  Do you always have to feel like a glassy eyed sick zombie?  I guess I am just wondering if this is normal? The thought of taking medication in the first place is troubling to me, let alone having myself turn in to some space cadet. The good thing was I was definitely not depressed anymore.  I was too sick and stoned to feel anything!!!   thanks for listening — kel

Response:

I have been diagnosed with having a severe depression episode and also am having panic and anxiety attacks.  Primarily while I am driving to work.  My doctor gave me some medication called effexor to try and it made me sick to my stomach and really spaced out.  Needless to say I only took those once. When I went back and told him that they were awful he gave me some zoloft.

Hmm, sounds to me like your doctor didnt explain things fully too you. Anti-depresssents are renown for making you feel really grotty for the first few days however the key is to bear with them and things should sort themselves out in a week or so. The amount of grottyness you experience depends on the family of anti-depressants your particular one belongs too. I am taking  Seroxat 20mg ( Peroxatine) which I admit I have never heard mentioned here. My current specialist is one of the most senior psycotherapists in London (he’s on the NHS too, for all you UK chaps out there.. a miricle!!) and he was telling me that this is now the leading drug used to combat anxiety and panic disorders.Apparently for all the hype Prozac is in fact as he put it " a pretty crude" drug and though good at treating depression is not so good at treating anxiety and panic disorder. Anyway he fully explained the side effects and though a bit like having  hangover because I expected them I coped ok and now I take them without any problems. Thankfully they seem to be having the desired effect. What was more imprsssive and actually helped me have faith in my therapist and the drugs was the fact that when I returned to see him after a couple of weeks he suggested how I should have felt day by day and indeed myu own personal notes mirrored this. It’s  3 months on now and I have to admit I’m in much better shape and closer to my old self after 2 years of hell. Try to stick with the drugs if you can. About a year after my first panic attack my own local doctor gave me Seroxat to take while I waited for my fisrt appointment with a behavioural therapist. Unfortuantely he didnt describe the side effects properly and of course  I became even more panicy when they started and stopped taking them. I wish I’d stayed with them …perhaps I could have saved myself another 12 months of grief. Good luck….things do get better…eventually..just keep on fighting Paul

Response:

- Hide quoted text — Show quoted text – I just started taking zoloft for my panic attacks, I have been on xanax for three months, I was just wondering if anyone has experienced the feeling of not really feeling like your in your right mind, almost like your peering through a glass at the rest of the world when you first started taking anti-depressant medications and does it get better with time? It almost feels like I’m in my mind but I’m really not,, Oh well sorry to take up your time on a stupid question, it just kinda worries me, any help or support would be greatly appreciated….. Thanks Paul Florida

Yes, I have experienced that.  Many of us call it the "Zombie" brain feeling. Clouded thinking is a beginning side-effect that many Zoloft users experience. It does go away for some.  You just have to stay on it for awhile to see if the sun gets brighter or dimmer.  If you don’t feel better, like say after 8 weeks on a therapeutic dose, talk to your doctor.  Matter of fact, it’s always a good plan to call your doctor or pharmacist for any side-effects. Mel

Response:

Not a stupid question at all.  I get that brain-fogged feeling from a lot of medications; indeed, it it also a symptom of anxiety in the first place.  If you only get it as a medication side effect, I would give it a couple of weeks to see if it goes away, as many side effects disappear or become more tolerable as one adjusts to the medication.  If on the other hand it is unbearable, perhaps you should try something different.  

Response:

I just started taking zoloft for my panic attacks, I have been on xanax for three months, I was just wondering if anyone has experienced the feeling of not really feeling like your in your right mind, almost like your peering through a glass at the rest of the world when you first started taking anti-depressant medications and does it get better with time? It almost feels like I’m in my mind but I’m really not,, Oh well sorry to take up your time on a stupid question, it just kinda worries me, any help or support would be greatly appreciated…..

Hi Paul, Do you feel like things around you are unreal, or that you are in a dream? It sounds to me like you *might* be having some derealization/depersonalization, which is frightening, but not dangerous. Derealization/depersonalization is the feeling that one is living in a dream, feeling that nothing is real, feeling detached from oneself. It is another symptom of anxiety and I have heard people that start anti-depressants complain of this also. I had this symptom toward the end of my last setback and it is quite frightening. Since being on Paxil I don`t have this symptom except when having a migraine. How much Zoloft are you taking and how many days have you been on Zoloft? This feeling is probably a side-effect of the Zoloft and more than likely will diminish over the next few weeks as your body gets accustomed to the Zoloft. Have you noticed if the Xanax helps this symptom? If you are concerned about this, don`t hesitate to call your doctor. I know that you are worried, but I can assure you that it is not dangerous, just very uncomfortable. It will get better. Take care. Jackie

Response:

I just started taking zoloft for my panic attacks, I have been on xanax for three months, I was just wondering if anyone has experienced the feeling of not really feeling like your in your right mind, almost like your peering through a glass at the rest of the world when you first started taking anti-depressant medications and does it get better with time? It almost feels like I’m in my mind but I’m really not,, Oh well sorry to take up your time on a stupid question, it just kinda worries me, any help or support would be greatly appreciated….. Thanks Paul Florida

Response:

Question:

HI ITS ME AMY AGAIN, THANKS TO ALL  WHO HELPED ME BEFORE THIS CHAT LINE IS A GOD SENT, ANYWAY IM NOW ON ZOLOFT AND STILL WEENING OFF PROZAC, I FEEL SOOOO SHITTY TIRED, HEART PALPS AND DIZZY, IS THIS NORMAL AND HAS ANYONE ELSE HAD THESE   SYMTOMS  AMD WHEN DOES IT GET BETTER THANKS TO ALL

Response:

HI ITS ME AMY AGAIN, THANKS TO ALL  WHO HELPED ME BEFORE THIS CHAT LINE IS A GOD SENT, ANYWAY IM NOW ON ZOLOFT AND STILL WEENING OFF PROZAC, I FEEL SOOOO SHITTY TIRED, HEART PALPS AND DIZZY, IS THIS NORMAL AND HAS ANYONE ELSE HAD THESE   SYMTOMS  AMD WHEN DOES IT GET BETTER THANKS TO ALL

Are you taking a benzo…I got tired from Xanax, but not Zoloft…The heart palps and dizziness are signs of anxiety…I would suspect that perhaps you have  the classic additional anxiety that you get when starting a new AD…I had tremors and other side-effects with Zoloft that increased my anxiety…This went away for the most part inside of a week, and continued to disapear in the following weeks… Best, — Charles Phipps

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Question:

Hello everyone i have not posted in a while but just wanted to let everyone know that i went for my first psych visit, she started me on 0.5mg of xanax and gave me the zoloft starter kit, she said start with the 25mg and cut them in have so that i will only be taking 12 1/2 mg for 4 days then take 25mg for a week then start on the 50mg. so i dont have many side effects she wants my body to adjust slowley. I  really like her my family doc wanted to start me on 50mg my psych doc says thats to much to start on so thats why she is starting my slowly. Has anyone else started slow like this, I am in a wedding in 3 weeks and i am hoping that i wont have one of my attacks while standing up there for 1 hr. ok well i guess i am done. Talk to everyone soon Diana

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Hello everyone i have not posted in a while but just wanted to let everyone know that i went for my first psych visit, she started me on 0.5mg of xanax and gave me the zoloft starter kit, she said start with the 25mg and cut them in have so that i will only be taking 12 1/2 mg for 4 days then take 25mg for a week then start on the 50mg. so i dont have many side effects she wants my body to adjust slowley. I  really like her my family doc wanted to start me on 50mg my psych doc says thats to much to start on so thats why she is starting my slowly. Has anyone else started slow like this, I am in a wedding in 3 weeks and i am hoping that i wont have one of my attacks while standing up there for 1 hr. ok well i guess i am done. Talk to everyone soon Diana

Hi Diana! I’m glad to hear that you actually found a pdoc who seems to be doing everything right! Starting Zoloft at 12,5 mgs and then weaning on slowly with Xanax on the side is absolutely the best way to avoid or minimize initial side effects. Such docs are rare and as you also like her as a person you’ve been very lucky. About the wedding: maybe Zoloft will not yet be at therapeutic dose after three weeks, but Xanax will keep PA’s at bay. If necessary you could take some more Xanax that day – Xanax works very fast and will take care of an upcoming PA or prevent one from manifesting itself at all within 15-20 minutes for many people -but you should talk this over with your doctor. Philip

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Hello everyone i have not posted in a while but just wanted to let everyone know that i went for my first psych visit, she started me on 0.5mg of xanax and gave me the zoloft starter kit, she said start with the 25mg and cut them in have so that i will only be taking 12 1/2 mg for 4 days then take 25mg for a week then start on the 50mg. so i dont have many side effects she wants my body to adjust slowley. I  really like her my family doc wanted to start me on 50mg my psych doc says thats to much to start on so thats why she is starting my slowly. Has anyone else started slow like this, I am in a wedding in 3 weeks and i am hoping that i wont have one of my attacks while standing up there for 1 hr. ok well i guess i am done. Talk to everyone soon Diana

 That is exactly the right way to start and if you DO experience any increase in anxiety while starting ask your doctor for a temporary amount of a benzo, for example Xanax to help you get past that, and to help you in the period where you are waiting for the real effects of the Paxil. I would surely want a bit for the wedding on hand just in case, as your Paxil wont probably be at full therapeutic levels at that time. Best of Luck! May — "Believe me! The secret of reaping the greatest fruitfulness and the greatest enjoyment from life is to live dangerously!"      -                Nietzsche

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DynaSoft66 wrote – Hide quoted text — Show quoted text -Hello everyone i have not posted in a while but just wanted to let everyone know that i went for my first psych visit, she started me on 0.5mg of xanax and gave me the zoloft starter kit, she said start with the 25mg and cut them in have so that i will only be taking 12 1/2 mg for 4 days then take 25mg for a week then start on the 50mg. so i dont have many side effects she wants my body to adjust slowley. I  really like her my family doc wanted to start me on 50mg my psych doc says thats to much to start on so thats why she is starting my slowly. Has anyone else started slow like this, I am in a wedding in 3 weeks and i am hoping that i wont have one of my attacks while standing up there for 1 hr. ok well i guess i am done. Talk to everyone soon Diana

Hi Diana, glad to hear you found a good pdoc, sounds like she is on top of things. You definitely want to start slow to minimize initial side effects, don’t try taking more to rush yourself into being ready for the wedding, this probably won’t help. You may see some improvement in the next three weeks, let’s hope so. Good luck with the Zoloft/Xanax combo. Ray

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snipped Hmmmmmmmmmmmm  now see here, after 3 years of hindsight, continuing weirdness in the monthly department, (Just now missing my second in a row and having predictable hot flashes,) I stand to tell you that there MUST be a strong connection for me between hormone levels and my state of mind. Depression, panic attacks and anxiety are ALWAYS worse around my menstrual time.   sue

Hi Sue, Emotional disorders (anxiety/panic/depression etc) are believed to be centered in the parts of our brain that make up the Limbic system. This is, in the main, our primitive brain, that which we share with most animals, incl reptiles and probably dinosaurs. Oestrogen receptors are prevelant in the Limbic, particularly the Hypothalamus. Indeed many hormones are neurotransmitters, so hormonal fluctuations can, and almost certainly do, trigger many PAs etc. All part of the joy of being female, I guess!   Ian (who is glad he isn’t) Phobias:  Menophobia- Fear of menstruation.

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Hi Blue, Thanks for your words of encouragement! I am feeling better today, and am taking off work to go see my Doc re the hormone bit. Am also going to sit in my Attys office until he has the time to see me re the fact that I am going to have to declare bankruptcy. This is all a bit much for me. So many issues to deal with, so confused and upset. So, if all you fine folks here at ASAP start hearing me "shout" a bit more, please do not be surprised, or offended. Just riding the rollercoaster for awhile. Hope to get off it, someday soon..Thank you all, for your love and support. I do so appreciate it  (((((ASAP GROUP HUG)))))))) Take Care   Stephanie  :-)

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- Hide quoted text — Show quoted text – Hi Blue, Thanks for your words of encouragement! I am feeling better today, and am taking off work to go see my Doc re the hormone bit. Am also going to sit in my Attys office until he has the time to see me re the fact that I am going to have to declare bankruptcy. This is all a bit much for me. So many issues to deal with, so confused and upset. So, if all you fine folks here at ASAP start hearing me "shout" a bit more, please do not be surprised, or offended. Just riding the rollercoaster for awhile. Hope to get off it, someday soon..Thank you all, for your love and support. I do so appreciate it  (((((ASAP GROUP HUG)))))))) Take Care   Stephanie  :-)

Well, Steph, if it makes you feel any better to know YOU’RE NOT ALONE, I can tell you that I’ve been contemplating taking bankruptcy myself.  It’s not been much fun, and I’m trying to figure out a way that I can avoid it.   Now that I am once again able to feel hopeful, it isn’t such a depressing topic for me to consider — or for that matter, to talk about!  Just do what you think is best, and remember that sometimes we project the worse and then discover it wasn’t as bad as we imagined.  (I’ll not add the inverse of that statement, at this time ) Best Wishes — Blue (maybe I should change my name to Green? )

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No!! Don’t change your name! I rather like it. The best therapist I ever had once told me: Ask yourself what is the worst thing that can happen, and can you live with that? I have often had to ask myself this! Thank you for your kind words. You are a very caring and supportive person. We here on ASAP are lucky to have you with us! Hope your situation works out ok..Thinking of you  :-) Stephanie

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- Hide quoted text — Show quoted text – Hi all, I just need to get this out, so please be patient, ok? I am going through early menopause (40) And I swear to god…I almost lost it today!!!! My body…is so out of whack, I do not even know myself, anymore. This ALWAYS happens, one week before my…"monthly". I needed to go and buy cigarretes, it took all I could muster, to go get in my jeep, and drive…1 Mile!!!!!! I go there everyday….After work…..So..why was it so hard?  The hormones! They will kill me yet! Before the PA/Phobia!!!  Crying all weekend…..Sorry to unload…  I cannot stop the tears. Dread going to work in the AM….But..is good for me….. Thank you all for listening  :-)  Stephanie

Hi, Steph — Gosh, it sounds like you had a really rough time.  Please, here is your apology returned, as it is not necessary.  Were it not for the times that I unloaded to ASAP, I feel I might have run too dangerously close to the point of no return.  So, I, for one, am extremely sympathetic to anyone who feels the urge to post about what they’re feeling or experiencing — and it doesn’t always have to be a pretty picture, as often times what we feel is NOT *pretty* — at times our pictures may look quite ugly. Today I listened as someone told three others of us a story about a guy who had been a client at the place I work.  This person relayed that this man said he suffered from anxiety, and then the story was told of the must-have-been-at-least-twenty meds that the guy was on.  The story teller said they had not heard of any of the meds the guy was taking, but figured they must be psych meds.  Sure ’nuff, they were.  Story Teller then said, "The guy’s not working, he’s too *anxious* to do anything," and Story Teller felt that the guy just needed to be working and then not have time for such nonsense — to paraphrase in a major way. And I sat there and listened to Story Teller speak, and listened to the quiet of the others who were there also,  as each of us there — excluding Story Teller, apparently — have had or are continuing to have encounters with anxiety and or depression and/or whatnot.  I managed to keep my mouth shut, as it was the politically expedient thing to do, but it hit me hard as I thought of ASAP and those of us here now, and those who have been here in times past, and those that will surely be here in times to come…  I consoled myself with the thought that a wise person knows when to speak, and perhaps more importantly, when not to.  There’s comfort to be found hanging out with others who have been where you are now, or who are, yes, there WITH you now — knowing of the feelings you are experiencing. {{{ ASAP }}}  I just know you’ll be feeling better after having unloaded a bit (so I hope ) Best to Steph — Blue (I can see clearly now, my tears have dried…;)

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Hey Sue, Thanks for the words of encouragement! And a good laugh! Ifeel much better today (the cycle began) GOD!!! The feeling is right up there…right with the PA….I wanted to kill myself yesterday! I curled up, in a ball, wishing to be rid of it. I know that this is because I bore a child, at the age of 17..I had been forewarned. But, with my PA/ Agoraphobic  condition, it is pure hell!!!! Thank You, for understanding  :-) Stephanie  Glad you are here too!

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Hi all, I just need to get this out, so please be patient, ok? I am going through early menopause (40) And I swear to god…I almost lost it today!!!! My body…is so out of whack, I do not even know myself, anymore. This ALWAYS happens, one week before my…"monthly". I needed to go and buy cigarretes,   it took all I could muster, to go get in my jeep, and drive…1 Mile!!!!!!    I go there everyday….After work…..So..why was it so hard?  The hormones! They will kill me yet! Before the PA/Phobia!!!  Crying all weekend…..Sorry to unload…  I cannot stop the tears. Dread going to work in the AM….But..is good for me….. Thank you all for listening  :-)  Stephanie

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- Hide quoted text — Show quoted text – Hi all, I just need to get this out, so please be patient, ok? I am going through early menopause (40) And I swear to god…I almost lost it today!!!! My body…is so out of whack, I do not even know myself, anymore. This ALWAYS happens, one week before my…"monthly". I needed to go and buy cigarretes,   it took all I could muster, to go get in my jeep, and drive…1 Mile!!!!!! I go there everyday….After work…..So..why was it so hard?  The hormones! They will kill me yet! Before the PA/Phobia!!!  Crying all weekend…..Sorry to unload…  I cannot stop the tears. Dread going to work in the AM….But..is good for me….. Thank you all for listening  :-)  Stephanie

Hi Stephanie!  My mom is beginning menopause and is having a bad time also.  I would strongly recommend going to your doctor–there are many options, and I’m certain there is something that could even things out for you.  (I wish my mom would go to her doctor, but that is another story!) I believe there are also some newsgroups that discuss menopause, and that might be something worth checking out too.  Hormones can really be a pain in the a**! Tammy

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Hi all, I just need to get this out, so please be patient, ok? I am going through early menopause (40) And I swear to god…I almost lost it today!!!! My body…is so out of whack, I do not even know myself, anymore. This ALWAYS happens, one week before my…"monthly". I needed to go and buy cigarretes,   it took all I could muster, to go get in my jeep, and drive…1 Mile!!!!!!    I go there everyday….After work…..So..why was it so hard?  The hormones! They will kill me yet! Before the PA/Phobia!!!  Crying all weekend…..Sorry to unload…  I cannot stop the tears. Dread going to work in the AM….But..is good for me….. Thank you all for listening  :-)  Stephanie

wonderful, isn’t it, especially the "erotic" hot flashes <VBG CAthy P.H.O.B.I.A. People Helping Others Become Independent Again Panic/anxiety Support Group, New Jersey http://community.nj.com/cc/phobia

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oooooohhhhhh  Stephanie!!  I hear ya woman!!!! <<<<Hi all, I just need to get this out, so please be patient, ok? I am going through early menopause (40) And I swear to god…I almost lost it today!!!! My body…is so out of whack, I do not even know myself, anymore. This ALWAYS happens, one week before my…"monthly". I just turned 46, and I have a running dialog with my doc about the effects of hormones.  I had my FIRST PA in the fall of 95 after a long string of <sh*t happens life events.  Loss was the key word that year.  My DH and I had spent five years building up a restaruant business for our mutual employer, and that was the year her health problems were found to be advanced colon cancer.  In the course of 9 months, we lost her, then MY job, in October MY DH was hospitalized with a ruptured appendix (no insurance), during which he was permanently replaced at HIS job, and I was only just working parttime myself.  Panic attacks started in November of that year, right around my 43rd birthday.  Life was soooo very difficult for me, I had lots of worries, debts, anger, grief, fear…….  and my monthlies started to get <weird as well. I was taking Xanax, weaning on Zoloft……  monthly crap was tossed off by the doc as—-  well—–  stress. Hmmmmmmmmmmmm  now see here, after 3 years of hindsight, continuing weirdness in the monthly department, (Just now missing my second in a row and having predictable hot flashes,) I stand to tell you that there MUST be a strong connection for me between hormone levels and my state of mind. Depression, panic attacks and anxiety are ALWAYS worse around my menstrual time.  My last visit to the ER, in August of ‘98,  happened in the morning, I came home around noon with a new RX for Xanax and Zoloft, and started my period around 2 pm that very same day.    Hmmmm. sez I, indeed, did I really need a swift kick in the head to FINALLY get the connection? My doc is unwilling to start me on ANY hormne therapy until I have been period free for a year.  Her feeling is that tinkering with the  whore-moans <g could be a LOT worse than continuing the Zoloft.  What <I would  really like is to lose the Zoloft and have Xanax for the BAD times, but she doesn’t go for that either.  So we are in a constant tug of war  watching and waiting to see what will happen next, and where this journey will go. ASAP has been extremely helpful for me in dealing with the PA’s.  I also lurk on Alt.support.menopause, where there is NOTHING NEW about depression, anxiety and panic attacks surrounding the whole Menopause woman. Feel free to e-mail anytime, whether it is to vent or to have a shoulder to cry on.   We can compare notes, and crib on each other’s experiences. BOY this is another time I can say < I am glad I came here because someone ELSE feels this way too!!!! sue

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Question:

Hi, From how I understand it, it is the degree of the movement and the length they last.  Like with myoclonus, is fast quick jerky movememts.  I know there is a site that describes each movement much better, but do not have that address. I know someone will add that info. (Thanks). Hope that helps alittle. Cathy

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Thanks. Just trying to figure out just what it is exactly that I have, besides Essential Tremor. Trevor – Hide quoted text — Show quoted text – Hi, From how I understand it, it is the degree of the movement and the length they last.  Like with myoclonus, is fast quick jerky movememts.  I know there is a site that describes each movement much better, but do not have that address. I know someone will add that info. (Thanks). Hope that helps alittle. Cathy

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Hi all. I’m new here. I’ve had Essential Tremor for 23 years (since I was 13) and now my doc has told me I have Myoclonus too. I’ve looked into that, and it seems to me that Myoclonus and dystonia are very similar. I don’t understand much medical terminology, so if anyone would be kind enough to explain the difference in plain English, I’d appreciate it. T

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