Question:

Dear Joan, I am a Candida biologist. Candida albicans, a dimorphic fungus with yeast and hyphal (like other fungi) phases, is the major causative agent of thrush, followed by some other Candida species. WHile all organisms grow on sugars, Candida albicans thrives well on serum (which does have glucose in it of course as well) and on human tissues. Indeed if you stop cells from making the hyphal form, they are no longer infective. Serum in the absence of added sugars, promotes this invasive hyphal form. I think adding more sugar may stimulate the yeast form a bit-( hmm I never tried that experiment – adding more glucose to the serum plates). Candida is not like bakers yeast, and bakers yeast does not encourage the growth of Candida albicans. You can also consume sugar in normal quantities (if you’re not diaetic of course). The books that deal with candida cleansing diets are not supported by scientific studies. The scientific Candida community has analysed the theories and treatments proposed in these books (diets and the claims they make) They are unfounded. I have looked the studies up on medline myself- and I see that the authors of several books on the subject have made huge assumptions based on very very little data, and actually have thwarted the truth. A complete if not outdated book on Candida infections which even reviews the book "the yeast connection" is "Candida and Candidosis: A review and bibliography" (1989-I think) by FC Odds who was at Leeds in the UK for many years and is now at Jaansen (ie also own J&J) in belgium. He refuses to write a new edition. But his book  remains the most complete and unbiased medical book on the subject. It is out of print. I do have a photocopy of it, or libraries should be able to get you a copy. Medical Schools should have a copy or access to one. Every single study on Candida up to the pub. date is covered in that book- very factual. I have looked over all of the alternative suggestions proposed on this thread. None of them have proven to my knowledge. Definitely do not use any mouthwashs or treatments that kill the bacteria in you mouth. The bacteria help you to fight off thrush.  Gingivitiis is bacterial in origin- do not use washes that treat this. I even asked my pharmacist to confirm this when I had recurrent thrush. Lots of healthy garlic has been shown to kill candida and bacteria- but yikes (yes the scientific community acknowkedges this)- but actualy the studies are in vitro. No proof that consuming garlic helps -to my knowledge. Unfortunately, steroid inhalers I believe affect the same immune cells in the mouth that keep Candida at bay.  I had to switch from flovent (a stronger steroid) to azmacort (which does not work as well for me). Fungal infections are stubborn. 1) you want to treat the underlying cause if possible causes can include: being on antibiotics, diabetes immune disorders (i.e.AIDS) treatment with immunosuppressive agents (ie. us asthmatics) Chemotherapy dentures 2) You need to stick to the antifungal treatment until the thrush clears up, and also solve the underlying cause or it will just recur.  Why? The antifungals being used, do not kill the candida too well, but do stop them from growing (they can’t make their cell membranes). There may be some nongrowing cells that stick around and thus the infection can recur. You need to make sure those immune cells in the mouth are ok. So rinsing with water and using a spacer are critical with the steroid inhalers. Good Luck! Chilla ps. you could also have a drug resisitant strain of candida in your mouth . You could try other classes of antifungals. Nystatin vs. the azoles (like clortrimazole). These belong to different chemical classes

Response:

I didn’t intend to sound critical.  Just wanted to add to the pool of information.   SJ – Hide quoted text — Show quoted text – Cleaning your inhalation paraphenalia is important but not enough, supplimenting that with scrupulous oral hygiene is at least as or more important.  Ask your doctor to prescribe "Chlorhexidine Gluconate" (oral rinse), generally prescribed by dentists for treating gingivititus and other infectious oral abnormalities, use both before and after inhaling meds.   Be aware, though, of the following information on the chlorhexidine box: "Chlorhexidine Gluconate Oral Rinse may cause some tooth discoloration, or increases in tarter (calculus) formation, particularly in areas where stain and tartar usually form.  It is important to see your dentist for removal of any stain or tartar at least every six months, or more frequently if your dentist advises." "Both stain and tartar can be removed by your dentist or hygientist. Chlorhexidine gluconate may cause permanent discoloration of some front-tooth fillings." I noticed definite tooth staining and filling discoloration after using it once a day for 2 weeks. SR That’s why I suggested frequent brushing and flossing, particularly with the Sensonic.  I’ve been adhereing to the aformentioned regimen for more than 3 years now, with no indication of out of the ordinary staining… and of course Clorhexidine gluconate, like any other prescription drug, would be used under the supervison of a physician, with all the same admonishments about reporting back immediately when any adverse conditions begin to occur.  Clorohexidine gluconate works for me, besides, it’s only a suggestion.   Sheldon On a recent Night Court rerun, Judge Harry Stone had a wonderful line: "I try to keep an open mind, but not so open that my brains fall out."

Response:

joan, i don’t know of anything else that you can take that would help prevent thrush. I do have a lot of patients on prednisone and steroid inhalers, but i have not seen as much problem with thrush as it is in your case. Just make sure that you don’t have diabetes or steroid induced hyperglycemia (elevated blood sugars). yatin j patel md http://md4lungs.com – Hide quoted text — Show quoted text – Is there any remedy for thrush other than prescriptions like Mycelex or Nystatin? Does acidophilus really act as a preventative? I use a spacer with my inhaled Flovent and I rinse faithfully but keep getting thrush over and over again. Somebody must be buying a lot of acidophilus for some reason as even the pharmacies in my area are out of it. I am on Prednisone now, and I know it’s only a matter of days before I will have thrush once again. Can anybody offer any suggestions? If not, I guess it’s back to the doctor for another prescription drug. Joan

– Yatin J Patel MD http://md4lungs.com If you have asthma, this is your home. Join Dr. Patel every wednesday 7 PM Indiana Time for online chats. Before you buy.

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* also try and keep your sugar and yeast intake as low as possible.. these help grow the yeast.

I do not think that this is accurate. It’s a terrible responsibility – but somebody has to be the Americans.

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I had thrush and my doctor told me that it was probably a result of the inhaled steroids rather than oral (I was on flovent too.)  What you need to do is rinse your mouth and throat after using your inhaler so the steroid is not sticking to the membranes in your mouth. Hope this helps. – Hide quoted text — Show quoted text – Is there any remedy for thrush other than prescriptions like Mycelex or Nystatin? Does acidophilus really act as a preventative? I use a spacer with my inhaled Flovent and I rinse faithfully but keep getting thrush over and over again. Somebody must be buying a lot of acidophilus for some reason as even the pharmacies in my area are out of it. I am on Prednisone now, and I know it’s only a matter of days before I will have thrush once again. Can anybody offer any suggestions? If not, I guess it’s back to the doctor for another prescription drug. Joan

Response:

i work in a health food store, and have tried a few natural remidies…(with all the other prescriptions i’m on, i don’t want another!) here are a few suggestions that i have found to work.. *Acidophilus.. i prefer PB8 but any with 10 billion or more active cultures is good *gargling with tea tree oil mouthwash or vinegar and water.. i actually do both sometimes, after i use my inhalers and after i brush my teeth. * also try and keep your sugar and yeast intake as low as possible.. these help grow the yeast.  these are more preventitive than a cure… but i have found that it does help, i have very infrequent problems now instead of every month or so… good luck!

Response:

Cleaning your inhalation paraphenalia is important but not enough, supplimenting that with scrupulous oral hygiene is at least as or more important.  Ask your doctor to prescribe "Chlorhexidine Gluconate" (oral rinse), generally prescribed by dentists for treating gingivititus and other infectious oral abnormalities, use both before and after inhaling meds.  

Be aware, though, of the following information on the chlorhexidine box: "Chlorhexidine Gluconate Oral Rinse may cause some tooth discoloration, or increases in tarter (calculus) formation, particularly in areas where stain and tartar usually form.  It is important to see your dentist for removal of any stain or tartar at least every six months, or more frequently if your dentist advises." "Both stain and tartar can be removed by your dentist or hygientist. Chlorhexidine gluconate may cause permanent discoloration of some front-tooth fillings." I noticed definite tooth staining and filling discoloration after using it once a day for 2 weeks. SR

Response:

- Hide quoted text — Show quoted text – Cleaning your inhalation paraphenalia is important but not enough, supplimenting that with scrupulous oral hygiene is at least as or more important.  Ask your doctor to prescribe "Chlorhexidine Gluconate" (oral rinse), generally prescribed by dentists for treating gingivititus and other infectious oral abnormalities, use both before and after inhaling meds.   Be aware, though, of the following information on the chlorhexidine box: "Chlorhexidine Gluconate Oral Rinse may cause some tooth discoloration, or increases in tarter (calculus) formation, particularly in areas where stain and tartar usually form.  It is important to see your dentist for removal of any stain or tartar at least every six months, or more frequently if your dentist advises." "Both stain and tartar can be removed by your dentist or hygientist. Chlorhexidine gluconate may cause permanent discoloration of some front-tooth fillings." I noticed definite tooth staining and filling discoloration after using it once a day for 2 weeks. SR

That’s why I suggested frequent brushing and flossing, particularly with the Sensonic.  I’ve been adhereing to the aformentioned regimen for more than 3 years now, with no indication of out of the ordinary staining… and of course Clorhexidine gluconate, like any other prescription drug, would be used under the supervison of a physician, with all the same admonishments about reporting back immediately when any adverse conditions begin to occur.  Clorohexidine gluconate works for me, besides, it’s only a suggestion.   Sheldon On a recent Night Court rerun, Judge Harry Stone had a wonderful line: "I try to keep an open mind, but not so open that my brains fall out."

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I’m just guessing here but would yogurt (With live cultures) help?  How about a vinegar and water mouthwash?  Just trying to remember what the natural remedies for yeast problems are. While they don’t usually work well as a cure, maybe as a preventive? Jo An Firey * Sent from RemarQ http://www.remarq.com The Internet’s Discussion Network * The fastest and easiest way to search and participate in Usenet – Free!

Response:

Is there any remedy for thrush other than prescriptions like Mycelex or Nystatin? Does acidophilus really act as a preventative? I use a spacer with my inhaled Flovent and I rinse faithfully but keep getting thrush over and over again. Somebody must be buying a lot of acidophilus for some reason as even the pharmacies in my area are out of it. I am on Prednisone now, and I know it’s only a matter of days before I will have thrush once again. Can anybody offer any suggestions? If not, I guess it’s back to the doctor for another prescription drug.

Cleaning your inhalation paraphenalia is important but not enough, supplimenting that with scrupulous oral hygiene is at least as or more important.  Ask your doctor to prescribe "Chlorhexidine Gluconate" (oral rinse), generally prescribed by dentists for treating gingivititus and other infectious oral abnormalities, use both before and after inhaling meds.  Also, Colgate Palmolive’s "Peroxyl" (nonprescription) is a very good oral antiseptic, with the benefit of being pleasant-tasting, especially effective when used right before bedtime, after you’re brushed and flossed.  You might also want to seriously consider treating yourself to Teledyne Water Pik’s "SENSONIC" tooth brush, an excellent product, leagues ahead of any ordinary toothbrush, even the other mundane electric toothbrushes. I used to really suffer with constant bouts of thrush but no more after adopting the above regimen, a much better alternative to guzzling liter after liter of Nystatin, BLECH! Sheldon On a recent Night Court rerun, Judge Harry Stone had a wonderful line: "I try to keep an open mind, but not so open that my brains fall out."

Response:

Is there any remedy for thrush other than prescriptions like Mycelex or Nystatin? Does acidophilus really act as a preventative? I use a spacer with my inhaled Flovent and I rinse faithfully but keep getting thrush over and over again. Somebody must be buying a lot of acidophilus for some reason as even the pharmacies in my area are out of it. I am on Prednisone now, and I know it’s only a matter of days before I will have thrush once again. Can anybody offer any suggestions? If not, I guess it’s back to the doctor for another prescription drug. Joan

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Question:

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

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

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

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

Response:

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

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Question:

Does anyone have experience with taking Celexa vs. Prozac?  Thanks so much.

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Does anyone have experience with taking Celexa vs. Prozac?  Thanks so much.

I tried Prozac once a long time ago, but I had to stop after a few days. Prozac made me extremely anxious. Celexa is the best SSRI I have taken. I just switched from Zoloft to Celexa, and Celexa is equally or more effective as an anti-depressant with fewer and milder side effects than Zoloft, which is already a lot better than Prozac.

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Question:

— Andy

– Hide quoted text — Show quoted text – Hi Andy, I’ve seen three "shrinks" and all three give me something different to work with. Each one though fizzled out, couldn’t get much more after the first few visits. YMMV and IME Charla Hi Guy’s I’m starting to think that maybe I should find a new shrink. I pretty much have everything sorted out now, I can deal with the PA’s if I have to, and if I don’t have to, or don’t feel like sitting through one I go home….. to easy. I’ve got off the Xanax and Zoloft which was only making me worse and am now on Luvox and serapax, which works great. So everything is pretty cruzzy apart from the odd up and down. The problem I’m stuck with now I guess is best described as mild depression / mild constant background anxiety / mild emotional distress, no big problem, just slightly annoying. The thing is, I go to the Pdoc every week and go "this is how I feel and this is what’s going on ect" , but I don’t seem to be getting any new answers. Its always, take the meds, go to places for exposure and desensitisation of the PA’s, CBT, exercise, meditate and stop yourself as soon as you start getting in to any negative thought patterns. I feel like I talk, he listens, but doesn’t say much and what he does say I already know, and am doing it. Should I be getting more answers, and more response from him? or is that about all there is to it…. just keep going as I am and give things more time? The reason I’m asking is because I don’t want to spend more time and money building a repour with new Pdoc’s if the answers are going to be the same. Thanks. — Andy

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- Hide quoted text — Show quoted text – Its always, take the meds, go to places for exposure and desensitisation of the PA’s, CBT, exercise, meditate and stop yourself as soon as you start getting in to any negative thought patterns. I feel like I talk, he listens, but doesn’t say much and what he does say I already know, and am doing it. Should I be getting more answers, and more response from him? or is that about all there is to it…. just keep going as I am and give things more time? The reason I’m asking is because I don’t want to spend more time and money building a repour with new Pdoc’s if the answers are going to be the same. Thanks. — Andy

dump him therapy is a collaborative event that is involving and goal oriented-listening is not productive to getting things done-the goal is to learn coping techniques and various ways to recover. LM

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     Dear Andy,            In my experience  it has always been the same. I went to this one shrink. 12 visits and each time it was the same. I listened to him describe HIS phobias. I’d love to splash his name all over the place, but i won’t. What did help me was group therapy. Have you tried this? If not you may want to check it out Debbie

Response:

- Hide quoted text — Show quoted text – Hi Guy’s I’m starting to think that maybe I should find a new shrink. I pretty much have everything sorted out now, I can deal with the PA’s if I have to, and if I don’t have to, or don’t feel like sitting through one I go home….. to easy. I’ve got off the Xanax and Zoloft which was only making me worse and am now on Luvox and serapax, which works great. So everything is pretty cruzzy apart from the odd up and down. The problem I’m stuck with now I guess is best described as mild depression / mild constant background anxiety / mild emotional distress, no big problem, just slightly annoying. The thing is, I go to the Pdoc every week and go "this is how I feel and this is what’s going on ect" , but I don’t seem to be getting any new answers. Its always, take the meds, go to places for exposure and desensitisation of the PA’s, CBT, exercise, meditate and stop yourself as soon as you start getting in to any negative thought patterns. I feel like I talk, he listens, but doesn’t say much and what he does say I already know, and am doing it. Should I be getting more answers, and more response from him? or is that about all there is to it…. just keep going as I am and give things more time? The reason I’m asking is because I don’t want to spend more time and money building a repour with new Pdoc’s if the answers are going to be the same. Thanks. — Andy

I agree with his referral to CBT. It seems just what you need now. I am glad that you

Question:

Richard: My psychiatrist just increased my Prozac to 30MG per day.  He’s reluctant to switch me to anything else since I had previously had a good response from Prozac.  Just be careful in increasing doses….. I was told that as doses of SSRIs increase, so does the risk of seizures.  I would assume that the doses would have to be tremendously high, but it may be worth it to have your serum levels of Prozac tested.  Finally, you may have to pay out of pocket for the test as most insurance companies still consider testing serum levels of Prozac to be experimental.  I haven’t had my blood drawn yet, so I’ll find out if United will or will not pay. Jeff

– Hide quoted text — Show quoted text – Jeff,      Thank you. I take 3×20mg Prozac with oxycontin and dilaudid. I thought that I was not getting the same relief from depression as when I use to take only 20 mg Prozac before I was hurt. Very interesting. I hate to switch to a tri-cyclic a-d,  but I might have to. I’ll check with my doc. Thanks Peace,   Richard Sullivan

Response:

  There is a question that I need to find out from any of you (inyour experiences – or any pain mgmt. MDs out there) about what I can expectfrom the Oxycontin.  I am currently taking 20MG twice a day.  It makes thepain tolerable, but doesn’t really erase it.  Is this the best that I should expect?

Your doc could titrate your meds up til you get the relief you need.  Also, he could prescribe something for breakthru pain, such as MSIR,or  OXYir.

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Richard: Thank you SO much for taking the time to write.  To add to this information that seems to be little discussed, my Psychiatrist told me about some of the downsides to pain meds: ravenous appetite decreased libido dry mucus membranes (from the anticholinergic <sp? effects) personality change (anywhere from mild to severe) Plus, anyone out there on any anti-depressants, particularly the SSRI (Prozac, Effexor, etc), you may want to have your doc have serum levels for all meds taken.  Evidently, Oxycontin and these SSRI meds use the SAME liver enzyme pathway (P450) for metabolism.  Depending on the individual person, you may not receive the full benefits from one of the meds as the other one is "winning" out for dominance in the bloodstream.  Also, I was cautioned NOT to take Elavil (Amytriptoline) as an adjunct for pain mgmt as Oxycodone will increase the serum levels of Elavil as much as 400%. I’m not an MD, nor a pharmacist, but I thought that I’d share this info from personal experience. Thanks again for your help! Jeff

– Hide quoted text — Show quoted text – Jeff,      I guess it depends on what is ailing us, but on my first visit to my pain clinic, the evaluating Doc told me I would always have pain. He told me I would have remissions where the pain is so low it is like there is none. Not to be a downer but as someone recently said, that’s why we are called chronic. As far as Oxycontin, I have had good luck with it 6 months as my main med. I have never found it to be much longer lasting than 4 or 5 hours, but I like the fact it is clean of additives. After being moved up to where I could take 80 mg 4/day, I still wake up with a pain " alarm clock ". Right know I am shooting for a reduction in my average daily pain. Something we don’t talk alot about is something you brought up. I have gained over 40lbs since I got hurt. One of my meds has given me a sweet tooth, and my suspicion has always been on the oxycontin. Good luck. Peace, Richard

Response:

Jeff,      Thank you. I take 3×20mg Prozac with oxycontin and dilaudid. I thought that I was not getting the same relief from depression as when I use to take only 20 mg Prozac before I was hurt. Very interesting. I hate to switch to a tri-cyclic a-d,  but I might have to. I’ll check with my doc. Thanks Peace,   Richard Sullivan

Response:

Jeff, I too was started on 20mg. Within 6 months I was taking 160 mg. every 6 to 8 hours (and even that wasn’t holding me, when the Dr. asked me  to tell him Honestly was it holding) I soon saw that in the end it came to taking the pain medicine same rate as I was taking short acting meds.I went off of oxycontin when I had to take 560mg. a day. My Doc.. believes in giving what it takes and knows  it’s not some personal vendetta towards him that my tolerance is high. For some Oxycontin works very, very well. For me I was put on 300mg of methadone a day along with 16 mg. of daludid(?) up to every 4 hours.(which is to much for me, knocks me out. (My docs say I have a system the size of a large You WILL find the right dose for yourself. Just be honest with your pain doc. Let us know how you are doing – Hide quoted text — Show quoted text – Dear all: After 3 years of chronic pain, 2 failed back surgeries at L4/5 and a herniated disc at C5/6, I finally took my physical therapist’s advise and went to my neurologist for pain management.  He’s a super MD and is willing to work with me with the meds.  I am going to have a last stab at epidurals with a new, top-notch anesthesiologist at a private hospital where I live. At any rate, it looks as though I will have to be on opiate pain meds for a LONG time.  There is a question that I need to find out from any of you (in your experiences – or any pain mgmt. MDs out there) about what I can expect from the Oxycontin.  I am currently taking 20MG twice a day.  It makes the pain tolerable, but doesn’t really erase it.  Is this the best that I should expect?  Or, should I be expecting total relief from pain?  I am reluctant to take high doses due to the "lovely" side-effects that I already have – weight gain, sleep disturbance, etc. Any advice or suggestions would be greatly appreciated. TIA, Jeff

Response:

Thank you for taking the time to write a response….  just to give additional info, a neurosurgeon did the second operation at the lumbar area. The MRI and Myelogram showed that there is considerable scar tissue not only on the disc, but also on the nerve root itself.  When they did an EMG study, it showed the first level of nerve damage.  I have a feeling that’s why they’re reluctant to do any further surgeries.  If you know of any websites that would be useful in my researching new and cutting-edge procedures, I would REALLY appreciate it as my docs are grateful that I take an active part in my treatment and welcome the research that I find. Thanks again, Jeff

– Hide quoted text — Show quoted text – Jeff, If Oxycontin completely erased pain, I think it would be touted as the "Miracle Drug"!  It helps me greatly, but never totally takes the pain away. When you say that you are going to be on Opiates for a long, long time, –may I make a suggestion?  Do with it what you please, but, I had one failed surgery before I met my neuro-surgeon (an orthopaedic surgeon did the failed surgery) and at that time had the same opinion as you, "I am NEVER having surgery again" and "I will just take the pills for the rest of my life"…although taking them again at some point in time may be inevitable, I think you owe yourself a chance at letting your neuro take a shot at fixing it.  I did and what a difference!  It has been 5 weeks now since I have had surgery, and the difference was noticed the same day that I had surgery.  My back is not yet perfect, it may never be, but I am not having to take opiates at this time, I feel like I have my brain back. I don’t know, I just thought to myself, I don’t want to be "ruled" by a little pill for the rest of my life if at all possible, if this operation works, yay! if it helps, good! and well, if it does not make the difference, well, then I am no worse off than I was before. Food for thought, I hope this helps, good luck! Cfische Dear all: After 3 years of chronic pain, 2 failed back surgeries at L4/5 and a herniated disc at C5/6, I finally took my physical therapist’s advise and went to my neurologist for pain management.  He’s a super MD and is willing to work with me with the meds.  I am going to have a last stab at epidurals with a new, top-notch anesthesiologist at a private hospital where I live. At any rate, it looks as though I will have to be on opiate pain meds for a LONG time.  There is a question that I need to find out from any of you (in your experiences – or any pain mgmt. MDs out there) about what I can expect from the Oxycontin.  I am currently taking 20MG twice a day.  It makes the pain tolerable, but doesn’t really erase it.  Is this the best that I should expect?  Or, should I be expecting total relief from pain?  I am reluctant to take high doses due to the "lovely" side-effects that I already have – weight gain, sleep disturbance, etc. Any advice or suggestions would be greatly appreciated. TIA, Jeff

Response:

Jeff,      I guess it depends on what is ailing us, but on my first visit to my pain clinic, the evaluating Doc told me I would always have pain. He told me I would have remissions where the pain is so low it is like there is none. Not to be a downer but as someone recently said, that’s why we are called chronic. As far as Oxycontin, I have had good luck with it 6 months as my main med. I have never found it to be much longer lasting than 4 or 5 hours, but I like the fact it is clean of additives. After being moved up to where I could take 80 mg 4/day, I still wake up with a pain " alarm clock ". Right know I am shooting for a reduction in my average daily pain. Something we don’t talk alot about is something you brought up. I have gained over 40lbs since I got hurt. One of my meds has given me a sweet tooth, and my suspicion has always been on the oxycontin. Good luck. Peace, Richard

Response:

Jeff, If Oxycontin completely erased pain, I think it would be touted as the "Miracle Drug"!  It helps me greatly, but never totally takes the pain away. When you say that you are going to be on Opiates for a long, long time, –may I make a suggestion?  Do with it what you please, but, I had one failed surgery before I met my neuro-surgeon (an orthopaedic surgeon did the failed surgery) and at that time had the same opinion as you, "I am NEVER having surgery again" and "I will just take the pills for the rest of my life"…although taking them again at some point in time may be inevitable, I think you owe yourself a chance at letting your neuro take a shot at fixing it.  I did and what a difference!  It has been 5 weeks now since I have had surgery, and the difference was noticed the same day that I had surgery.  My back is not yet perfect, it may never be, but I am not having to take opiates at this time, I feel like I have my brain back. I don’t know, I just thought to myself, I don’t want to be "ruled" by a little pill for the rest of my life if at all possible, if this operation works, yay! if it helps, good! and well, if it does not make the difference, well, then I am no worse off than I was before. Food for thought, I hope this helps, good luck! Cfische

– Hide quoted text — Show quoted text – Dear all: After 3 years of chronic pain, 2 failed back surgeries at L4/5 and a herniated disc at C5/6, I finally took my physical therapist’s advise and went to my neurologist for pain management.  He’s a super MD and is willing to work with me with the meds.  I am going to have a last stab at epidurals with a new, top-notch anesthesiologist at a private hospital where I live. At any rate, it looks as though I will have to be on opiate pain meds for a LONG time.  There is a question that I need to find out from any of you (in your experiences – or any pain mgmt. MDs out there) about what I can expect from the Oxycontin.  I am currently taking 20MG twice a day.  It makes the pain tolerable, but doesn’t really erase it.  Is this the best that I should expect?  Or, should I be expecting total relief from pain?  I am reluctant to take high doses due to the "lovely" side-effects that I already have – weight gain, sleep disturbance, etc. Any advice or suggestions would be greatly appreciated. TIA, Jeff

Response:

Dear all: After 3 years of chronic pain, 2 failed back surgeries at L4/5 and a herniated disc at C5/6, I finally took my physical therapist’s advise and went to my neurologist for pain management.  He’s a super MD and is willing to work with me with the meds.  I am going to have a last stab at epidurals with a new, top-notch anesthesiologist at a private hospital where I live. At any rate, it looks as though I will have to be on opiate pain meds for a LONG time.  There is a question that I need to find out from any of you (in your experiences – or any pain mgmt. MDs out there) about what I can expect from the Oxycontin.  I am currently taking 20MG twice a day.  It makes the pain tolerable, but doesn’t really erase it.  Is this the best that I should expect?  Or, should I be expecting total relief from pain?  I am reluctant to take high doses due to the "lovely" side-effects that I already have – weight gain, sleep disturbance, etc. Any advice or suggestions would be greatly appreciated. TIA, Jeff

Response:

Question:

I told my doctor today that the zoloft was not doing anything for me after the initial dosage of 25mg. (I did feel a little better) and after a month he uped the dosage to 50mg– which I felt no different and if anything more anxious. (Xanax aslo perscribed) After taking the 50 mg for a month –I asked him today should I switch to Paxil? He told me don’t believe all the advertizing you read, paxil won’t work any better than zoloft. Just thought you might like mto hear this from what I consider a good  P doctor.

Response:

I told my doctor today that the zoloft was not doing anything for me after the initial dosage of 25mg. (I did feel a little better) and after a month he uped the dosage to 50mg– which I felt no different and if anything more anxious. (Xanax aslo perscribed) After taking the 50 mg for a month –I asked him today should I switch to Paxil? He told me don’t believe all the advertizing you read, paxil won’t work any better than zoloft. Just thought you might like mto hear this from what I consider a good  P doctor.

  I think that your doctor just means that Paxil and Zoloft are just as effective percentage wise in treating PA…However, this does not mean that you don’t fit into the 30% that don’t find help with Zoloft…Nor does it mean that you won’t be sucessful with Paxil because you weren’t with Zoloft…All the SSRI’s may have different effects on you…All that being said I agree with what’s been said here…I felt a little better with 50 mg…A lot better at 100 mg…You have a long way to go before giving up on Zoloft…And some improvement at 25 mg likely means a lot more later…Therefore switching to Paxil may just cost you time (since it’ll take just as long to be effective most likely)… — Charles Phipps

Response:

Philip,     I just wanted to chime in an opinion.  I’ve been on both paxil and zoloft. Zoloft made me like a zombie.  Paxil did wonders in preventing attacks.  I’m on Effexor XR 75 mg right now and it has actually let me make some improvements in my life.  Plus it doesn’t make me feel drowsy like most of the others do. Craig Mangrum – Hide quoted text — Show quoted text – I told my doctor today that the zoloft was not doing anything for me after the initial dosage of 25mg. (I did feel a little better) and after a month he uped the dosage to 50mg– which I felt no different and if anything more anxious. (Xanax aslo perscribed) After taking the 50 mg for a month –I asked him today should I switch to Paxil? He told me don’t believe all the advertizing you read, paxil won’t work any better than zoloft. Just thought you might like mto hear this from what I consider a good  P doctor. The truth is, though, that our reactions to different SSRI’s are very personal and that some may do well on Zoloft and worse on Paxil or vice versa etc. If all SSRI’s had the same results with everybody there wouldn’t have to be more than one. Regarding the Zoloft I believe that you haven’t given it a fair trial yet. Philip

Response:

I told my doctor today that the zoloft was not doing anything for me after the initial dosage of 25mg. (I did feel a little better) and after a month he uped the dosage to 50mg– which I felt no different and if anything more anxious. (Xanax aslo perscribed) After taking the 50 mg for a month –I asked him today should I switch to Paxil? He told me don’t believe all the advertizing you read, paxil won’t work any better than zoloft. Just thought you might like mto hear this from what I consider a good  P doctor.

The truth is, though, that our reactions to different SSRI’s are very personal and that some may do well on Zoloft and worse on Paxil or vice versa etc. If all SSRI’s had the same results with everybody there wouldn’t have to be more than one. Regarding the Zoloft I believe that you haven’t given it a fair trial yet. Philip

Response:

I told my doctor today that the zoloft was not doing anything for me after the initial dosage of 25mg. (I did feel a little better) and after a month he uped the dosage to 50mg– which I felt no different and if anything more anxious. (Xanax aslo perscribed) After taking the 50 mg for a month –I asked him today should I switch to Paxil? He told me don’t believe all the advertizing you read, paxil won’t work any better than zoloft. Just thought you might like mto hear this from what I consider a good  P doctor.

Hi Dan, Get a new doctor, or educate him His statement is false. We have many people here that did awful on Zoloft but did well on Paxil and vice  versa. Even though the two are SSRI anti-depressants, they are still quite different. All the meds in the SSRI family are different from each other. Some are more sedating than others, and some are more stimulating. If you feel that strongly about trying a new med, demand it or find a new doctor. You might want to think of upping the Zoloft dose, your dose might be a bit low, and that is why you are still experiencing anxiety. 50mgs of Zoloft is a low therapeutic dose. Use your Xanax to help you deal with the anxiety.  Take care!! Jackie ~~On earth, an angel’s wings are inside~~

Response:

I agree to educate this MD or get a new one.  Very poor answer.  I have been on paxil about 5 years and it has been a life saver, Zoloft did nothing for me.

Response:

(Dan Littleton) writes: I told my doctor today that the zoloft was not doing anything for me after the initial dosage of 25mg. (I did feel a little better) and after a month he uped the dosage to 50mg– which I felt no different and if anything more anxious.

Hi Dan. I think you might want to give the Z more of a chance. 25mg *really* isn’t much and if it was helping a little bit, that’s a good sign. Some people need 200mg or even more, but your doctor is right to increase it gradually. The increased anxiety as you raise the dose is a common side effect – if you’re able to tolerate it for a little while, the extra anxiety will go away as your body gets used to the drug. I don’t remember if you are taking other meds as well, but if not, you might ask for a benzo such as Klonopin, Xanax, or Ativan, to smooth things out while you’re increasing the dose of Zoloft. Paxil doesn’t work better than Zoloft in general (statistically), but it does work better for some people. For others, Zoloft works better – it averages out the same. You have no way of knowing which will be better for you unless you try them both – which is a pain in the a**, admittedly! If I were in your place, though, I’d stay with the Zoloft, since you’ve already put so much time into it and had a bit of an improvement even at a very low dose. I hope things continue to get better! -elizabeth

Response:

Question:

The antidepressant venlafaxine (Effexor) is similar in its pharmacology to Meridia, yet it isn’t scheduled.  The antidepressant bupropion Wellbutrin) is arguably more of a "stimulant" than sibutramine, yet isn’t scheduled.  (I’m not arguing that either *should* be, of course.) Both butorphanol (Stadol) and tramadol (Ultram) are so-called "non-narcotic" analgesics which can cause dependence and abuse, yet they aren’t scheduled.  It’s clear that an indication of obesity is enough of a bogeyman to the DEA that they’ll schedule first and worry about it later.

It was clear to Knoll that obesity was enough of a bogeyman. I spoke to some of their folks just before the press conference announcing the market date. They knew they couldn’t fight the Schedule 4 classification. If they could have, it would have been much easier to market. For one thing, they could have given physicians samples. This is a no-no in scheduled drugs. Barbara Barbara Hirsch, Publisher Obesity Meds and Research News OMR Web Site: http://www.obesity-news.com

Response:

Perhaps once enough experience is gained with it, it will be removed from the DEA Schedules.

Has anything ever been unscheduled?  I recall a bunch of unscheduled going scheduled (clonipin, soma, etc), but none going the other way. — dc potts biologist at large (pull the nospam out of my email address to respond)

Response:

Do you have any idea why Meridia is scheduled?  It isn’t addictive, is it?

There’s no evidence that sibutramine has any abuse potential, but the fact that it is psychoactive and that it has (in some individuals) somewhat of a stimulating action AND that it is prescribed for obesity, was enough for the DEA to classify it as C-IV.  Their thinking is obviously to be as careful and restrictive as possible at the drug’s introduction, rather than risk the possibility of releasing a drug unscheduled, only to find that it has a degree of abuse potential. Perhaps once enough experience is gained with it, it will be removed from the DEA Schedules. The antidepressant venlafaxine (Effexor) is similar in its pharmacology to Meridia, yet it isn’t scheduled.  The antidepressant bupropion Wellbutrin) is arguably more of a "stimulant" than sibutramine, yet isn’t scheduled.  (I’m not arguing that either *should* be, of course.) Both butorphanol (Stadol) and tramadol (Ultram) are so-called "non-narcotic" analgesics which can cause dependence and abuse, yet they aren’t scheduled.  It’s clear that an indication of obesity is enough of a bogeyman to the DEA that they’ll schedule first and worry about it later. — Steve Dyer

Response:

Now the DEA isn’t going to know whether a doctor sees the patient or not by the prescription, but if a doctor is prescribing huge amounts of a drug, that could trigger an investigation. Then if the DEA investigates and finds irregularities in records, the doctor has a problem.

Wow. I wish we could get rid of this whole stupid prescription system. Vigara is not scheduled, but Meridia is (not that it should be, but that’s another post).

Stupid inconsistencies like this are one reason. What’s the big deal about going to a doctor a couple of times a year and getting a prescription? That’s what I do.

Why should we have to? Why should I have to ask someone else, and pay them, for permission to put something into my own body? And the people who make the laws that dictate what I can and cannot take often have no more medical knowledge than what I scoop out of the cat box. J — Tonight we’re going to party like it’s 1899. Remove the X to email me.

Response:

Vigara is not scheduled, but Meridia is (not that it should be, but that’s another post). I wondered why I see Viagra offered everywhere, and not Meridia.  That explains it. Do you have any idea why Meridia is scheduled?  It isn’t addictive, is it?

Another reason you don’t see Meridia everywhere is that it’s expensive, and not a very effective drug. It’s scheduled, because there is no anorectic drug with any CNS stimulating qualities at all which the FDA will approve without scheduling it. Meridia isn’t that different than Effexor and Wellbutrin which aren’t scheduled. Per Glen Rickards’ post, Meridia isn’t all that similar to fenflruamine. Fen both releases and inhibits the reuptake of serotonin, Meridia is just a serotonin uptake inhibitor. It also works on norepinephrine. Barbara Barbara Hirsch, Publisher Obesity Meds and Research News OMR Web Site: http://www.obesity-news.com

Response:

I have heard, but have not independently verified, that Meridia is chemically similar to fenfluramine. – Hide quoted text — Show quoted text – Vigara is not scheduled, but Meridia is (not that it should be, but that’s another post). I wondered why I see Viagra offered everywhere, and not Meridia.  That explains it. Do you have any idea why Meridia is scheduled?  It isn’t addictive, is it? AB

Response:

Vigara is not scheduled, but Meridia is (not that it should be, but that’s another post).

I wondered why I see Viagra offered everywhere, and not Meridia.  That explains it. Do you have any idea why Meridia is scheduled?  It isn’t addictive, is it? AB

Response:

Yes, that is exactly what I am looking for. Meridia totally online. Viagra is available through www.Focus-Medical.com

It is not wise to get medications without an exam (especially the first time), and it is questionable whether it is legal. Very few doctors would be willing to prescribe schedule 4 drugs without seeing patients first, since the physician must submit his DEA identification number with each prescription. If the DEA sees irregularities it can rip the license. Now the DEA isn’t going to know whether a doctor sees the patient or not by the prescription, but if a doctor is prescribing huge amounts of a drug, that could trigger an investigation. Then if the DEA investigates and finds irregularities in records, the doctor has a problem. Vigara is not scheduled, but Meridia is (not that it should be, but that’s another post). The only doctor I’m aware of who ever prescribed drugs on-line is now undergoing a DEA investigation after a raid on his office last year. And he doesn’t prescribe Meridia anyway. Most states have regulations allowing doctors to prescribe without seeing a patient, but the intent of the law is so that a physician can prescribe something to an existing patient who for one reason or another cannot come into the office. The intent of the law is not for doctors to become "drug stores", for writing a prescription for a fee. My guess is that states will begin clarifying their laws, and the DEA case mentioned above will probably bring some direction as well. What’s the big deal about going to a doctor a couple of times a year and getting a prescription? That’s what I do. I’ve been taking phentermine for over two years, so there probably wouldn’t be any danger if my doctor didn’t see me. But I still think it’s worth it to get checked out once in a while. Barbara Barbara Hirsch, Publisher Obesity Meds and Research News OMR Web Site: http://www.obesity-news.com

Response:

Yes, that is exactly what I am looking for. Meridia totally online. Viagra is available through www.Focus-Medical.com – Hide quoted text — Show quoted text – I think what they are looking for is a doctor that will give them a script after a phone consulation. I saw a news story on people getting viagra this way, they find these places on the net, they call and talk to a doc, or maybe they call you, ask you a few questions and then give you a ’script. without ever seeing a doc in person. and it’s all perfectly legal. Tricia C. 322/276/159   (new scale –adjusted numbers) 46 lbs lost on Atkins since May 26, 1998 <<I am looking for an online source for a prescription and fill for Meridia. I have been told that Viagra is available online with a Doctors consultation and a prescription. I am looking for the same service for Meridia. Thanks **Well..if you had a doctors consultation..wouldnt you have a doctors perscription..??** Just Me,  Lisa. "I’m not fat..I’m big boned!" -Eric Cartman- *SouthPark* PCOS the silent Disease << http://www.pcosupport.org

Response:

I think what they are looking for is a doctor that will give them a script after a phone consulation. I saw a news story on people getting viagra this way, they find these places on the net, they call and talk to a doc, or maybe they call you, ask you a few questions and then give you a ’script. without ever seeing a doc in person. and it’s all perfectly legal. Tricia C. 322/276/159   (new scale –adjusted numbers) 46 lbs lost on Atkins since May 26, 1998 – Hide quoted text — Show quoted text – <<I am looking for an online source for a prescription and fill for Meridia. I have been told that Viagra is available online with a Doctors consultation and a prescription. I am looking for the same service for Meridia. Thanks **Well..if you had a doctors consultation..wouldnt you have a doctors perscription..??** Just Me,  Lisa. "I’m not fat..I’m big boned!" -Eric Cartman- *SouthPark* PCOS the silent Disease << http://www.pcosupport.org

Response:

<<I am looking for an online source for a prescription and fill for Meridia. I have been told that Viagra is available online with a Doctors consultation and a prescription. I am looking for the same service for Meridia. Thanks **Well..if you had a doctors consultation..wouldnt you have a doctors perscription..??** Just Me,  Lisa. "I’m not fat..I’m big boned!" -Eric Cartman- *SouthPark* PCOS the silent Disease << http://www.pcosupport.org

Response:

I am looking for an online source for a prescription and fill for Meridia. I have been told that Viagra is available online with a Doctors consultation and a prescription. I am looking for the same service for Meridia. Thanks

Response:

The antidepressant venlafaxine (Effexor) is similar in its pharmacology to Meridia, yet it isn’t scheduled.  The antidepressant bupropion Wellbutrin) is arguably more of a "stimulant" than sibutramine, yet isn’t scheduled.  (I’m not arguing that either *should* be, of course.) Both butorphanol (Stadol) and tramadol (Ultram) are so-called "non-narcotic" analgesics which can cause dependence and abuse, yet they aren’t scheduled.  It’s clear that an indication of obesity is enough of a bogeyman to the DEA that they’ll schedule first and worry about it later.

A couple of corrections, here.  In two states, Wellbutrin (bupropion), in its regular release form (not SR or the Zyban formulation), IS scheduled, the equiavlent of Schedule IV (Utah & Washington states).  The reason Ultram & Stadol aren’t scheduled because the formulations have such strong narcotic antagonist properties (give either to an opiate/opioid addict and watch them go into withdrawal). Basically, Meridia is schedule IV for the same reason Redux was — because somewhere someone mentioned that these drugs are essentially amphetamine deriviatives, and the FDA/DEA has it’s standard reaction – over-regulation. Of course, if you look at the federal schedules, you’ll see a much stronger trend toward controlling stimulants that depressants (Morphine notwithstanding).  I mean we’ve got drugs like Valium at Schedule IV, but a useful stimulant like phentermine at schedule III.  Typical. I think most of this will become academic in the next five years as the newer anti-obsesity drugs come out that have absolutely no relationship to stimulants or any stimulant activity.  Zenical, and it’s close relatives merely change the way fat is processed in the body, so hopefully access to these drugs won’t be limited by unnecessary regulation. — Rob Bowling, PharmD      (and Meridia patient)

Response:

I had written that I had seen a report indicating CHEMICAL similarity between fen and Meridia.  You appear to be talking about differences in the pharmacological effect.  Chemical similarity doesn’t always imply identical pharmacology, but rather, relates to the structure and composition of the molecule.

Well, sibutramine is not particularly chemically similar to fenfluramine. — Steve Dyer

Response:

I had written that I had seen a report indicating CHEMICAL similarity between fen and Meridia.  You appear to be talking about differences in the pharmacological effect.  Chemical similarity doesn’t always imply identical pharmacology, but rather, relates to the structure and composition of the molecule. – Hide quoted text — Show quoted text -Per Glen Rickards’ post, Meridia isn’t all that similar to fenflruamine. Fen both releases and inhibits the reuptake of serotonin, Meridia is just a serotonin uptake inhibitor. It also works on norepinephrine. Barbara Barbara Hirsch, Publisher Obesity Meds and Research News OMR Web Site: http://www.obesity-news.com

Response:

There’s no evidence that sibutramine has any abuse potential, but the fact that it is psychoactive and that it has (in some individuals) somewhat of a stimulating action AND that it is prescribed for obesity, was enough for the DEA to classify it as C-IV.

What does psychoactive mean, exactly?  When I hear the word I think of LSD, or similar drugs, but it must have a broader definition. AB

Response:

        Just a couple of corrections to your corrections                 Stadol IS scheduled (C-IV). That’s correct.  But this is relatively recent, so I can be excused for having old information. In fact, my original comments which this guy tried to correct were made a while ago; I didn’t see his article in the newsgroup.     Speaking of Stadol, the mixed agonist/antagonist dezocine (Dalgan) is not     scheduled at all, and it is the most morphine-like (highest mu-opioid     activity) of any of the mixed agonist-antagonists.  Dezocine makes Stadol     look like Tylenol. Stadol would never have been scheduled if it hadn’t been made available in a non-injected dosage form (nasal spray) which caused it to be prescribed more widely than it had been been in the previous 15 years.  Mixed agonist/antagonists which must be injected are almost by definition rarely misused, because they’re infrequently found outside hospitals, and the population of outpatients prescribed them is very small. There’s nothing like lack of use to promote lack of abuse.  I’m sure that dezocine follows this same pattern. In fact, the whole idea of a mixed agonist/antagonist being less abusable than, say, codeine, a C-II drug, is a thoroughly discredited 1960’s-era notion.  But it lives on in the current DEA schedules (only recently has this caught up to Stadol, but only after hoardes of formerly respectable people prescribed the drug started to like it a bit too much.)     The scheduling of Meridia, which has absolutely no abuse potential (or IMO     any effect at all, for that matter) is really hysterical, especially in     light of the fact that it’s pharmacodynamically identical to venlafaxine. Which shows you just how much the DEA cares about pharmacology.     What amazes me is how little is understood about     bupropion’s mechanism even after years of research. Yup.  And I’m astonished that any state would think of placing it under any controls at all.  It really doesn’t have any abuse potential.   Since this is a weight loss med newsgroup, it’s probably worth pointing out   that bupropion causes anorexia and weight loss in a pretty high percentage   of subjects.  It’s actually vastly superior to sibutramine or venlafaxine in   this regard. I’ve tried it, and really didn’t notice any anorectic effect worth getting excited over.  The ones who lose their appetite on bupropion are usually 95 lb. grandmothers, not those of us who would benefit from such an effect!    BTW, Ultram is not an antagonist.  Both tramadol and its primary metabolite    are pure, albeit weak, agonists. Correct.  This guy is a Pharm. D.? — Steve Dyer

Response:

Since this is a weight loss med newsgroup, it’s probably worth pointing out that bupropion causes anorexia and weight loss in a pretty high percentage of subjects.  It’s actually vastly superior to sibutramine or venlafaxine in this regard.

Hmmm, that would explain why I didn’t have the urge to stuff my face when I was using Zyban to quit smoking.  In fact, some folks I know even lost weight while quitting smoking on Zyban. Of course, once I went off of it, my weight started going up rapidly … — KC 196/189 (again)/135 Eating smarter since 8/8/98 — exercising since 9/15/98 (reduced calorie/reduced fat/increased protein/low-glycemic/high-fiber/vegetarian WOE)

Response:

The scheduling of Meridia, which has absolutely no abuse potential (or IMO any effect at all, for that matter) is really hysterical, especially in light of the fact that it’s pharmacodynamically identical to venlafaxine.

A few people have commented on their weight loss success using Effexor. Does the above statement indicate that someone who’s tried Meridia and not seen any effect would not benefit from Effexor either?

Response:

Just a couple of corrections to your corrections Stadol IS scheduled (C-IV).  Phentermine is C-IV, not C-III.  C-III anorexiants include phendimetrazine and benzphetamine, which are rarely prescribed.  Both are more effective than phentermine. Speaking of Stadol, the mixed agonist/antagonist dezocine (Dalgan) is not scheduled at all, and it is the most morphine-like (highest mu-opioid activity) of any of the mixed agonist-antagonists.  Dezocine makes Stadol look like Tylenol. The scheduling of Meridia, which has absolutely no abuse potential (or IMO any effect at all, for that matter) is really hysterical, especially in light of the fact that it’s pharmacodynamically identical to venlafaxine. With respect to bupropion (Wellbutrin), even though animal models intended to screen for "abusability" (self-administration, drug discrimination, etc.) show that it has this property, in humans, it doesn’t seem to have that effect.  In blind studies comparing 30 mg d-amphetamine, 200 mg bupropion (immediate release), and placebo, experienced stimulant abusers could not distinguish bupropion from placebo, while they reliably picked d-amphetamine every time.  The structural similarity to diethylpropion is well known, but bupropion apparently does not provoke transmitter release as amphetamine analogs generally do.  What amazes me is how little is understood about bupropion’s mechanism even after years of research. Since this is a weight loss med newsgroup, it’s probably worth pointing out that bupropion causes anorexia and weight loss in a pretty high percentage of subjects.  It’s actually vastly superior to sibutramine or venlafaxine in this regard. BTW, Ultram is not an antagonist.  Both tramadol and its primary metabolite are pure, albeit weak, agonists.

– Hide quoted text — Show quoted text – The antidepressant venlafaxine (Effexor) is similar in its pharmacology to Meridia, yet it isn’t scheduled.  The antidepressant bupropion Wellbutrin) is arguably more of a "stimulant" than sibutramine, yet isn’t scheduled.  (I’m not arguing that either *should* be, of course.) Both butorphanol (Stadol) and tramadol (Ultram) are so-called "non-narcotic" analgesics which can cause dependence and abuse, yet they aren’t scheduled.  It’s clear that an indication of obesity is enough of a bogeyman to the DEA that they’ll schedule first and worry about it later. A couple of corrections, here. In two states, Wellbutrin (bupropion), in its regular release form (not SR or the Zyban formulation), IS scheduled, the equiavlent of Schedule IV (Utah & Washington states).  The reason Ultram & Stadol aren’t scheduled because the formulations have such strong narcotic antagonist properties (give either to an opiate/opioid addict and watch them go into withdrawal). Basically, Meridia is schedule IV for the same reason Redux was — because somewhere someone mentioned that these drugs are essentially amphetamine deriviatives, and the FDA/DEA has it’s standard reaction – over-regulation. Of course, if you look at the federal schedules, you’ll see a much stronger trend toward controlling stimulants that depressants (Morphine notwithstanding).  I mean we’ve got drugs like Valium at Schedule IV, but a useful stimulant like phentermine at schedule III.  Typical. I think most of this will become academic in the next five years as the newer anti-obsesity drugs come out that have absolutely no relationship to stimulants or any stimulant activity.  Zenical, and it’s close relatives merely change the way fat is processed in the body, so hopefully access to these drugs won’t be limited by unnecessary regulation. — Rob Bowling, PharmD     (and Meridia patient)

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Question:

  I just changed my 9 yr old son’s dr…..he was on 75mg luvox and 1-1/2 mg risperdal for OCD/ADD/anxiety.    The meds were great for a few months but then it seemed he needed to change (had alot of tantrums, frustration, very impulsive etc) and the old doc wasn’t cooperative and very hard to talk to. Went yesterday to a new one and she changed him from Luvox to Zoloft (we’re reducing Luvox for a week and slowly adding Zoloft).  Also she split up the Risperdal so he takes some in the morning and some at night instead of all at once.  I hope the Zoloft works for him.  Does anyone have any comments about any of these meds, specifically for children?  Thank you Debbie

Response:

  I just changed my 9 yr old son’s dr…..he was on 75mg luvox and 1-1/2 mg risperdal for OCD/ADD/anxiety.    The meds were great for a few months but then it seemed he needed to change (had alot of tantrums, frustration, very impulsive etc) and the old doc wasn’t cooperative and very hard to talk to. Went yesterday to a new one and she changed him from Luvox to Zoloft (we’re reducing Luvox for a week and slowly adding Zoloft).  Also she split up the Risperdal so he takes some in the morning and some at night instead of all at once.  I hope the Zoloft works for him.  Does anyone have any comments about any of these meds, specifically for children?  Thank you Debbie

Sounds like your child is in good hands now. However, no-one wants to do research on the use of psych meds in children and pregnant women, so how these meds are used in these specific patient populations is taken from research done on nonpregnant adults. Chip Before you buy.

Response:

Hello everyone!! just wondering if anyone had this happen to them.  My doc put me on zoloft started at 12 1/2mg for a week then 25mg for 2 weeks then 50mg when i started taking the 50mg it made my heart flutter, so she put me back on 25mg again but it is not doing much for me now she wants me to try the 50mg again and i am scared she said try 25 in the morning then 25mg at night i am scared to do that also any suggestions? I just didnt like my heart doing that and i am scared it is going to happen again HELP Thanks Diana

I must say that your doc isn’t doing this as badly as some other docs do. She realizes that you have to wean on Zoloft slowly and that’s a good thing. Still, between 25 mg and 50 mg there is 37,5 mg. I think it’s advisable to try that first. Moreover it seems advisable to ask for a benzo (Xanax) on the side *as needed* which may help avoid or minimize initial Zoloft side effects like a fluttering heart. I hope you will hang in there as it takes about 8 weeks to be able to properly assess Zoloft’s value for you (but beneficial effect may be felt much earlier). Philip

Response:

Hello everyone!! just wondering if anyone had this happen to them.  My doc put me on zoloft started at 12 1/2mg for a week then 25mg for 2 weeks then 50mg when i started taking the 50mg it made my heart flutter, so she put me back on 25mg again but it is not doing much for me now she wants me to try the 50mg again and i am scared she said try 25 in the morning then 25mg at night i am scared to do that also any suggestions? I just didnt like my heart doing that and i am scared it is going to happen again HELP Thanks Diana

Diana –   I experienced a return of side-effects for a few days with each increased dose of Zoloft…One side effect for me was the shakes, which increased my anxiety and led to a racing heart…I suspect that you perhaps are having a similar experience…You may have to go through a few days of side-effects like this to reach a theraputic dose…And I checked the PDR, heart attack is not listed as a possible side-effect of Zoloft so don’t worry! Later, — Charles Phipps

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WOW!!  My Dr. started me off at 50mg right away..he did not work me up to 50mg..At any rate I had NO side effects at all from Zoloft.. ~But there’s one thing I know…the blues they send to meet me won’t defeat me, it won’t be long till happiness is out to greet me~

Response:

Hello everyone!! just wondering if anyone had this happen to them.  My doc put me on zoloft started at 12 1/2mg for a week then 25mg for 2 weeks then 50mg when i started taking the 50mg it made my heart flutter, so she put me back on 25mg again but it is not doing much for me now she wants me to try the 50mg again and i am scared she said try 25 in the morning then 25mg at night i am scared to do that also any suggestions? I just didnt like my heart doing that and i am scared it is going to happen again HELP Thanks Diana

Response:

Hello everyone!! just wondering if anyone had this happen to them.  My doc put me on zoloft started at 12 1/2mg for a week then 25mg for 2 weeks then 50mg when i started taking the 50mg it made my heart flutter, so she put me back on 25mg again but it is not doing much for me now she wants me to try the 50mg again and i am scared she said try 25 in the morning then 25mg at night i am scared to do that also any suggestions? I just didnt like my heart doing that and i am scared it is going to happen again HELP Thanks Diana

Hi Diana, I have been dealing with those heart flutters on and off for years. I get mine when I am anxious, drink too much coffee, and have PMS. I don`t like them, but they are harmless. You won`t know if you will get  those flutters, unless you try the 50mgs again. There may be a way to lessen that possibility. Instead of going from 25mgs to 50mgs, go to 37.5mgs. Getting to your prescribed dose is not a race. You want to be as comfortable as possible, and if it means going at a slower pace, so then be it. Watch your caffeine consumption too, it can trigger the heart flutters. And if you should get them , remember they will pass and are harmless. Asking your doctor for a benzo might help too. Jackie "Behold the turtle. He makes progress only when he sticks out his head."

Response:

I was started on 25mg of zoloft daily about two weeks ago for anxiety and panic disorder.  The first few days I took it I had some crazy mood swings but those went away after a while.  Lately I’ve had two episodes of depression that I wonder about.  I know that most side effects are supposed to go away but is this something I should talk to my doctor about immediately or should I just try to tough it out and hope that it goes away.  So far it’s been pretty bearable so I think I could get through it.  Any comments on this would be appreciated and any information on zoloft in general would be great.

15 mg if Zoloft is a subtherapeutic dose, it must be raised. The best way to do that is by weekly increments of 12.5 mg to avoid unpleasant side effects: *start low, go slow*. It may take a few weeks but your depression should disappear. So yes, ask your doctor to raise the dose 37.5 mg etc. Philip

Response:

Hi, Jack, I take Zoloft and Clonazepam for depression and anxiety.  25 mg is low so maybe you could call your pdoc and see about a slight increase.  It never hurts to check in with your pdoc and let them know how you are feeling. smiles, Elise

– Hide quoted text — Show quoted text – I was started on 25mg of zoloft daily about two weeks ago for anxiety and panic disorder.  The first few days I took it I had some crazy mood swings but those went away after a while.  Lately I’ve had two episodes of depression that I wonder about.  I know that most side effects are supposed to go away but is this something I should talk to my doctor about immediately or should I just try to tough it out and hope that it goes away.  So far it’s been pretty bearable so I think I could get through it.  Any comments on this would be appreciated and any information on zoloft in general would be great.

Response:

I was started on 25mg of zoloft daily about two weeks ago for anxiety and panic disorder.  The first few days I took it I had some crazy mood swings but those went away after a while.  Lately I’ve had two episodes of depression that I wonder about.  I know that most side effects are supposed to go away but is this something I should talk to my doctor about immediately or should I just try to tough it out and hope that it goes away.  So far it’s been pretty bearable so I think I could get through it.  Any comments on this would be appreciated and any information on zoloft in general would be great.

Response:

Hi I have often had tinitus.  On and off.  The doctor once gave me a long story about how it was just a disease.  Its been quite bad lately and I found out in the last few weeks maybe from this newsgroup ( if so I apologize ) that it is caused by aspirin. I have been taking lots of painkillers to help with paxil withdrawals love Moira – Hide quoted text — Show quoted text – I took Zoloft last fall for anxiety for 2 and 1/2 months. (I got off it because it began to give me night tremors).  However, only after a month on it, my ears started ringing/hissing.  I also had a bad sinus infection at the time and I assumed it was related to that, never thinking the medication would do such a thing (HA–looks like the joke was on me!).  When I related this to my doctor, she never let on that she KNEW some antidepressants caused tinnitus (why not, I am now asking myself) and continued to let me take the drug for 6 more weeks! I’ve been off the Zoloft for 6 weeks now, and I STILL have the ringing/hissing in my ears.  Has anyone ever had this happen?  Is this EVER going to go away?. It drives you crazy and I fear now I’ll have it forever.

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Hi I have often had tinitus.  On and off.  The doctor once gave me a long story

about how it was just a disease.  Its been quite bad lately and I found out

in the last few weeks maybe from this newsgroup ( if so I apologize ) that it is caused by

aspirin. I have been taking lots of painkillers to help with paxil withdrawals

love Moira   Hi Moira, You say you are taking painkillers… what kind?  I have taken many, many different kinds (due to my headaches) and found that Midrin effected my ears horribly.  Could be an additional cause.. Lee feeling silly lately…must be a side effect

Response:

I took Zoloft last fall for anxiety for 2 and 1/2 months. (I got off it because it began to give me night tremors).  However, only after a month on it, my ears started ringing/hissing.  I also had a bad sinus infection at the time and I assumed it was related to that, never thinking the medication would do such a thing (HA–looks like the joke was on me!).  When I related this to my doctor, she never let on that she KNEW some antidepressants caused tinnitus (why not, I am now asking myself) and continued to let me take the drug for 6 more weeks! I’ve been off the Zoloft for 6 weeks now, and I STILL have the ringing/hissing in my ears.  Has anyone ever had this happen?  Is this EVER going to go away?. It drives you crazy and I fear now I’ll have it forever.

For what it’s worth, I, too, suffered from tinnitus while on Zoloft (for a similar period of time as you) before switching to Prozac.  In my case, the tinnitus went away within days of stopping Zoloft.  I wouldn’t give up hope that yours will fade with time too. Good luck, Bob

Response:

I’ve been off the Zoloft for 6 weeks now, and I STILL have the ringing/hissing in my ears.  Has anyone ever had this happen?  Is this EVER going to go away?. It drives you crazy and I fear now I’ll have it forever.

For what it’s worth, I, too, suffered from tinnitus while on Zoloft (for

a similar period of time as you) before switching to Prozac.  In my

case, the tinnitus went away within days of stopping Zoloft.  I wouldn’t

give up hope that yours will fade with time too.  (piggybacking on Bob)  I had a similar problem with a different med altogether.  I think it was Midrin.  It went away for the most part.  It still happens occasionally, but not on a constant basis.   If it keeps up, you should mention it to your doctor, or go to a specialist. Lee feeling silly lately…must be a side effect

Response:

I took Zoloft last fall for anxiety for 2 and 1/2 months. (I got off it because it began to give me night tremors).  However, only after a month on it, my ears started ringing/hissing.  I also had a bad sinus infection at the time and I assumed it was related to that, never thinking the medication would do such a thing (HA–looks like the joke was on me!).  When I related this to my doctor, she never let on that she KNEW some antidepressants caused tinnitus (why not, I am now asking myself) and continued to let me take the drug for 6 more weeks!   I’ve been off the Zoloft for 6 weeks now, and I STILL have the ringing/hissing in my ears.  Has anyone ever had this happen?  Is this EVER going to go away?. It drives you crazy and I fear now I’ll have it forever.  

Response:

– Hide quoted text — Show quoted text – Hi Tom,     Welcome to ASAP. I’m 21 and diagnosed with manic depression, anxiety, panic attacks, ocd.. and now I’m beginning to wonder about something else, but anyways, the reason for your post and mine.     I’ve been on Zoloft since mid-October. I started on 25mg, two weeks later increased to 50mg, and then two weeks after that 100mg. I finally gained some control over my "problems." I was taken off Zoloft and put on Celexa for a 6 week rollercoaster. I’m back on the Zoloft, and have been since February. I’m up to 200mg a day.     Now, I have little side effects. In the beginning I had a lot of side effects, those you listed, extreme dry mouth, but not the rash and I still have a hard time getting out of bed at a decent hour, I have to keep myself on a very strict sleep pattern, or when I get off of it, I don’t go to bed until 2,3,4am, then never make it up in time to make it to work by 8:30am. And yes, the decreased sex drive is a pain.     Are you taking anything with the Zoloft? I was taking 100mg Zoloft and 4mg Xanax daily, now I’m on 200mg Zoloft and 3mg Klonopin daily. That might also explain the rash, and the waking up thing.     Hope this is of some help for you. Much Love, Brooke Hi Brooke, Do you take anything for the manic depression? Chip

No, because it rarely rears its ugly head, the manic side at least.. it’s often usually just regular old depression, however, we are keeping an eye on it (Daily journal of what’s going on and keeping track of how often the manic side rears up). The pdoc is really concerned with me hiding my depression from people as well as I do, so he wants to try and get that and the anxiety all under control. Much Love, Brooke PS I think the Klonopin helps with the manic too… that’s just my thought. Since I’ve switched from xanax to Klonopin I’ve had a lot fewer manic episodes. B.

Response:

Hi Tom,     Welcome to ASAP. I’m 21 and diagnosed with manic depression, anxiety, panic attacks, ocd.. and now I’m beginning to wonder about something else, but anyways, the reason for your post and mine.     I’ve been on Zoloft since mid-October. I started on 25mg, two weeks later increased to 50mg, and then two weeks after that 100mg. I finally gained some control over my "problems." I was taken off Zoloft and put on Celexa for a 6 week rollercoaster. I’m back on the Zoloft, and have been since February. I’m up to 200mg a day.     Now, I have little side effects. In the beginning I had a lot of side effects, those you listed, extreme dry mouth, but not the rash and I still have a hard time getting out of bed at a decent hour, I have to keep myself on a very strict sleep pattern, or when I get off of it, I don’t go to bed until 2,3,4am, then never make it up in time to make it to work by 8:30am. And yes, the decreased sex drive is a pain.     Are you taking anything with the Zoloft? I was taking 100mg Zoloft and 4mg Xanax daily, now I’m on 200mg Zoloft and 3mg Klonopin daily. That might also explain the rash, and the waking up thing.     Hope this is of some help for you. Much Love, Brooke

– Hide quoted text — Show quoted text – I am new to the group and am interpreted if people can give me any feed back on Zoloft. I started on Zoloft and two months ago after about of panic and depressive episodes. Though the attacks had seemed to be lessening, it seemed to make sense at the time to treat them to prevent a reoccurrence. The first two weeks were difficult on Xanax and brought back the panic as well as diarrhea, stomach upset, heart palpitations, but these went away and I began to increase my dosage from 25mg to the doctor recommended 50mg. I can’t say I feel that much better and am wondering whether these are side effects. I knew about the decreased sex drive and can probably handle that. One major difference is that I used to wake up early in the morning with a feeling of anxiety and now I can hardly drag myself out of bed at a normal time. I also experience frequent headaches as if my head and nose is pinched. I also am putting on weight. Also wondering about the rash that appeared unexpectedly on my arms (though this could be from something else; it is pretty mild.) Do these sound familiar to anyone? I also am wondering about the dosage of 50mg since I felt pretty good on 25mg and have heard that is a standard dosage. Any thoughts about decreasing dosage? — Tom Semmes 301-530-9586 Fax 301-530-9587

Response:

– Hide quoted text — Show quoted text – Hi Tom,     Welcome to ASAP. I’m 21 and diagnosed with manic depression, anxiety, panic attacks, ocd.. and now I’m beginning to wonder about something else, but anyways, the reason for your post and mine.     I’ve been on Zoloft since mid-October. I started on 25mg, two weeks later increased to 50mg, and then two weeks after that 100mg. I finally gained some control over my "problems." I was taken off Zoloft and put on Celexa for a 6 week rollercoaster. I’m back on the Zoloft, and have been since February. I’m up to 200mg a day.     Now, I have little side effects. In the beginning I had a lot of side effects, those you listed, extreme dry mouth, but not the rash and I still have a hard time getting out of bed at a decent hour, I have to keep myself on a very strict sleep pattern, or when I get off of it, I don’t go to bed until 2,3,4am, then never make it up in time to make it to work by 8:30am. And yes, the decreased sex drive is a pain.     Are you taking anything with the Zoloft? I was taking 100mg Zoloft and 4mg Xanax daily, now I’m on 200mg Zoloft and 3mg Klonopin daily. That might also explain the rash, and the waking up thing.     Hope this is of some help for you. Much Love, Brooke

Hi Brooke, Do you take anything for the manic depression? Chip – Hide quoted text — Show quoted text – I am new to the group and am interpreted if people can give me any feed back on Zoloft. I started on Zoloft and two months ago after about of panic and depressive episodes. Though the attacks had seemed to be lessening, it seemed to make sense at the time to treat them to prevent a reoccurrence. The first two weeks were difficult on Xanax and brought back the panic as well as diarrhea, stomach upset, heart palpitations, but these went away and I began to increase my dosage from 25mg to the doctor recommended 50mg. I can’t say I feel that much better and am wondering whether these are side effects. I knew about the decreased sex drive and can probably handle that. One major difference is that I used to wake up early in the morning with a feeling of anxiety and now I can hardly drag myself out of bed at a normal time. I also experience frequent headaches as if my head and nose is pinched. I also am putting on weight. Also wondering about the rash that appeared unexpectedly on my arms (though this could be from something else; it is pretty mild.) Do these sound familiar to anyone? I also am wondering about the dosage of 50mg since I felt pretty good on 25mg and have heard that is a standard dosage. Any thoughts about decreasing dosage? — Tom Semmes 301-530-9586 Fax 301-530-9587

Response:

I am new to the group and am interpreted if people can give me any feed back on Zoloft. I started on Zoloft and two months ago after about of panic and depressive episodes. Though the attacks had seemed to be lessening, it seemed to make sense at the time to treat them to prevent a reoccurrence. The first two weeks were difficult on Xanax and brought back the panic as well as diarrhea, stomach upset, heart palpitations, but these went away and I began to increase my dosage from 25mg to the doctor recommended 50mg. I can’t say I feel that much better and am wondering whether these are side effects.

Yes, these are common side effects from weaning on Zoloft and should be temporary. I knew about the decreased sex drive and can probably handle that. One major difference is that I used to wake up early in the morning with a feeling of anxiety and now I can hardly drag myself out of bed at a normal time. I also experience frequent headaches as if my head and nose is pinched. I also am putting on weight. Also wondering about the rash that appeared unexpectedly on my arms (though this could be from something else; it is pretty mild.) Do these sound familiar to anyone?

These can all be side effects, the headaches should be temporary. I also am wondering about the dosage of /50mg since I felt pretty good on 25mg and have heard that is a standard dosage. Any thoughts about decreasing dosage?

On the contrary you may not have noticed much positive change because you’re on a subtherapeutic dose. I think you should consult your doctor (hopefully a psychiatrist with some knowledge of anxiety disorders and not a GP…) about raising the dose. However, the best way to do this is in increments of 12.5 mg in order to avoid or minimize side effects caused by the dose increase. Having a benzo like Xanax or Ativan on the side to take *as needed* may be helpful too. Philip – Hide quoted text — Show quoted text — Tom Semmes 301-530-9586 Fax 301-530-9587

Response:

I am new to the group and am interpreted if people can give me any feed back on Zoloft. I started on Zoloft and two months ago after about of panic and depressive episodes. Though the attacks had seemed to be lessening, it seemed to make sense at the time to treat them to prevent a reoccurrence. The first two weeks were difficult on Xanax and brought back the panic as well as diarrhea, stomach upset, heart palpitations, but these went away and I began to increase my dosage from 25mg to the doctor recommended 50mg. I can’t say I feel that much better and am wondering whether these are side effects. I knew about the decreased sex drive and can probably handle that. One major difference is that I used to wake up early in the morning with a feeling of anxiety and now I can hardly drag myself out of bed at a normal time. I also experience frequent headaches as if my head and nose is pinched. I also am putting on weight. Also wondering about the rash that appeared unexpectedly on my arms (though this could be from something else; it is pretty mild.) Do these sound familiar to anyone? I also am wondering about the dosage of 50mg since I felt pretty good on 25mg and have heard that is a standard dosage. Any thoughts about decreasing dosage? — Tom Semmes 301-530-9586 Fax 301-530-9587

Response:

– Hide quoted text — Show quoted text -I am new to the group and am interpreted if people can give me any feed back on Zoloft. I started on Zoloft and two months ago after about of panic and depressive episodes. Though the attacks had seemed to be lessening, it seemed to make sense at the time to treat them to prevent a reoccurrence. The first two weeks were difficult on Xanax and brought back the panic as well as diarrhea, stomach upset, heart palpitations, but these went away and I began to increase my dosage from 25mg to the doctor recommended 50mg. I can’t say I feel that much better and am wondering whether these are side effects. I knew about the decreased sex drive and can probably handle that. One major difference is that I used to wake up early in the morning with a feeling of anxiety and now I can hardly drag myself out of bed at a normal time. I also experience frequent headaches as if my head and nose is pinched. I also am putting on weight. Also wondering about the rash that appeared unexpectedly on my arms (though this could be from something else; it is pretty mild.) Do these sound familiar to anyone? I also am wondering about the dosage of 50mg since I felt pretty good on 25mg and have heard that is a standard dosage. Any thoughts about decreasing dosage?

Hi Tom, Welcome to ASAP! Alot of the symptoms you mentioned liked headache, weight gain and fatigue are side-effects of Zoloft. You could try going down to 25mgs ( ask your doctor first)  to see if the side-effects decrease but there is a good chance that 25mgs would not be enough to control your anxiety. The therapeutic dose of Zoloft is 100 to 200mgs, although there are people that do well on lower doses. It is also possible that better. Only you know what side-effects you are willing to tolerate or not tolerate. It is important that you talk to your doctor about what is going on so something can be done to help you. Take care Jackie ~*~When you get to the end of all the light you know and it’s time to step into the darkness of the unknown, faith is knowing that one of two things shall happen: either you will be given something solid to stand on, or you will be taughhow to fly~*~

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My friend has an anxiety disorder-was recently prescribled 50 mg of Zoloft to take in the a.m.  She finds that she is very tired and ready for sleep around 2:30 p.m.   Is 50mg of Zoloft/day normally prescribed?  She’s complains of feeling too sedated. Thanks in advance for your response.  :0) Jennifer

Response:

: :My friend has an anxiety disorder-was recently prescribled 50 mg of Zoloft to :take in the a.m.  She finds that she is very tired and ready for sleep around :2:30 p.m.   : :Is 50mg of Zoloft/day normally prescribed?  She’s complains of feeling too :sedated. : :Thanks in advance for your response.  :0) Dear Jennifer, Welcome to ASAP! Some people do well on 50mgs of Zoloft, others do well on 100mgs and then person to person. Sedation and feeling tired are common side-effects of antidepressants which is why it`s so important for people with anxiety disorder to start antidepressants at a low dose (zoloft would be12.5 or 25mgs) and to wean slowly (with Zoloft increasing the dose in 12.5 or 25 mg increments once a week or so). We tend to be sensitive to the side-effects of medication. Had your friend started Zoloft at 12.5 mg or even 25mgs the sedation may not have been so bad. She could try to stick this side-effect out, it might start to diminish once her body adjusts to the 50mgs. If she finds this side-effect is just too much for her, she should call her doctor and ask to lower her dose. Take care Jackie ~*~Do unto others as though you were the others~*~

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My friend has an anxiety disorder-was recently prescribled 50 mg of Zoloft to take in the a.m.  She finds that she is very tired and ready for sleep around 2:30 p.m. Is 50mg of Zoloft/day normally prescribed?  She’s complains of feeling too sedated. Thanks in advance for your response.  :0) Jennifer

If her sleepiness is due to the Zoloft, she could try 25 mg/day for awhile, and then raise the dose. Chip

Response:

I definitely agree with lowering the dose initially. She could also try taking the 50mg at bedtime. Zoloft is one of those medications that usually must build up in the system over at least two weeks and it doesn’t really matter if you take it in the morning or at bedtime. Often it is just trial and error to find the regime that works best. Good luck, Russ,  M.D.

– Hide quoted text — Show quoted text – My friend has an anxiety disorder-was recently prescribled 50 mg of Zoloft to take in the a.m.  She finds that she is very tired and ready for sleep around 2:30 p.m. Is 50mg of Zoloft/day normally prescribed?  She’s complains of feeling too sedated. Thanks in advance for your response.  :0) Jennifer

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WHATS the story with Zoloft.Ive been on it for a week and still don,t feel any better.Please email me your xperiences with zoloft.Does it take a long time to work.  I DON,T want to give up on it yet I am taking 150mg a day Time wounds all heels!! Generally it takes up to 6 weeks for antidepressants to work.  Some though are fortunate that feel "something" happening by the end of the first week. Don’t give up.  Keep it up. I thought you might have written in another post about difficulty getting an orgasm.  This is experienced with SSRIs, and when it comes so soon after initiation of treatment it is more than likely due to that.  Let your MD know and he may want to change to another SSRI or some other antidepressant that does not have this side effect. kksoo

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Major Impact schreef: WHATS the story with Zoloft.Ive been on it for a week and still don,t feel any better.Please email me your xperiences with zoloft.Does it take a long time to work.  I DON,T want to give up on it yet I am taking 150mg a day Time wounds all heels!!

Alkthough I don’t have experiences with Zoloft I did take three other meds from the same (SSRI) group of antidepressants. These have in common that it may take awhile (anything up from 2-10 weeks) to take effect. So take that time to give the med a chance. After a week it’s already a very good sign that you experienced no side effects or heightened anxiety. This may well be the right med for you! Philip Peters – Hide quoted text — Show quoted text –                                                                                                                                                l

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WHATS the story with Zoloft.Ive been on it for a week and still don,t feel any better.Please email me your xperiences with zoloft.Does it take a long time to work.  I DON,T want to give up on it yet I am taking 150mg a day Time wounds all heels!!                                                                                                                                                    l        

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  my 9 yr old son is taking zoloft..he started at 25mg the first week, now the 2nd week is up to 50 mg.  A little while after he takes it he says he feels hot and his head feels funny.  The whole day he is fine and it is really helping his impulsiveness, frustration and tantrums…these traits have nearly disappeared.  I am going to ask the doctor about it but is this normal?  He just was weaned off of Luvox at the same time he started the Zoloft. Debbie

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my 9 yr old son is taking zoloft..he started at 25mg the first week, now the 2nd week is up to 50 mg.  A little while after he takes it he says he feels hot and his head feels funny.  The whole day he is fine and it is really helping his impulsiveness, frustration and tantrums…these traits have nearly disappeared.  I am going to ask the doctor about it but is this normal?  He just was weaned off of Luvox at the same time he started the Zoloft. Debbie

Hi Debbie, Zoloft can cause sweating and headaches and that could be what your son is experiencing. I would mention this to the doctor, it should go away in a few weeks and appears to be mild, so I wouldn`t worry. That is wonderful that Zoloft has helped your son so much ) Take care!! Jackie

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Hopefully the side effects will go away. I had a really bad time on zoloft. Things did get better but I only took it for two days becuase I could not go to work. So mabe I’ll give a go when I have some space. Incidentally my doc said that the minumum dose was 50mg and that’s what I started on. I am in the UK, but this cannot be right. I think I may purchase myself a pill cutter — And god said. Let there be light. And there was light. But the darkness crept over me. – Hide quoted text — Show quoted text –  my 9 yr old son is taking zoloft..he started at 25mg the first week, now the 2nd week is up to 50 mg.  A little while after he takes it he says he feels hot and his head feels funny.  The whole day he is fine and it is really helping his impulsiveness, frustration and tantrums…these traits have nearly disappeared.  I am going to ask the doctor about it but is this normal?  He just was weaned off of Luvox at the same time he started the Zoloft. Debbie

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I had the same symptoms the first couple of days after switching from Paxil. went to 50 the second week. Felt it for a while the first day of 50, but not since. Good luck to your son. Lee

– Hide quoted text — Show quoted text – my 9 yr old son is taking zoloft..he started at 25mg the first week, now the 2nd week is up to 50 mg.  A little while after he takes it he says he feels hot and his head feels funny.  The whole day he is fine and it is really helping his impulsiveness, frustration and tantrums…these traits have nearly disappeared.  I am going to ask the doctor about it but is this normal?  He just was weaned off of Luvox at the same time he started the Zoloft. Debbie Hi Debbie, Zoloft can cause sweating and headaches and that could be what your son is experiencing. I would mention this to the doctor, it should go away in a few weeks and appears to be mild, so I wouldn`t worry. That is wonderful that Zoloft has helped your son so much ) Take care!! Jackie

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Hopefully the side effects will go away. I had a really bad time on zoloft. Things did get better but I only took it for two days becuase I could not go to work. So mabe I’ll give a go when I have some space. Incidentally my doc said that the minumum dose was 50mg and that’s what I started on. I am in the UK, but this cannot be right. I think I may purchase myself a pill cutter

Oh yes, the UK where psychiatry still has to be invented…. 12.5 mg is the recommended starting dose (half a 25 mg tab), 25 mg may be managed but 50 mg is cruelty! Philip – Hide quoted text — Show quoted text – — And god said. Let there be light. And there was light. But the darkness crept over me.  my 9 yr old son is taking zoloft..he started at 25mg the first week, now the 2nd week is up to 50 mg.  A little while after he takes it he says he feels hot and his head feels funny.  The whole day he is fine and it is really helping his impulsiveness, frustration and tantrums…these traits have nearly disappeared.  I am going to ask the doctor about it but is this normal?  He just was weaned off of Luvox at the same time he started the Zoloft. Debbie

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Oh yes, the UK where psychiatry still has to be invented…. Philip —

Not true!!! My shrink has a certificate of competence signed by no less a person than Noah (of Ark fame).  Must admit though I was a bit worried by the Thioridazine he gave me.  I could just make out on the label that it was best before 3000 BC — Jon Guite Live support and chat for anxiety and panic disorders at the #anx/pan chat room in Dalnet.  For details see http://www.skcldv.demon.co.uk/anxpanw.htm

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LEJ351 schreef: how long did it take for you to start feeling better?  I am only at 2 weeks and am still strugggling with insomnia, lack of appetite and  an acidic stomach.  I also use ativan as needed

Hopefully the Ativan will take you through these weeks as your body is adjusting to Zoloft. You should give Zoloft between 6-8 weeks to be able to evaluate its effect, but it’s entirely possible that you will feel better sooner than that. Philip

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I recently began taking zoloft and have never felt better.  I am curious why it seem many people take zoloft and xanax combo.  Does this help to alleviate some side effects?

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I recently began taking zoloft and have never felt better.  I am curious why it seem many people take zoloft and xanax combo.  Does this help to alleviate some side effects?

It does but when you don’t need it, so much the better! Glad it works! Philip – Hide quoted text — Show quoted text –

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how long did it take for you to start feeling better?  I am only at 2 weeks and am still strugggling with insomnia, lack of appetite and  an acidic stomach.  I also use ativan as needed

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how long did it take for you to start feeling better?  I am only at 2 weeks and am still strugggling with insomnia, lack of appetite and  an acidic stomach.  I also use ativan as needed

Hi: I am on ZOloft 25mg a day, and klonipin 3mg a day (all at bedtime)  I take benadryl 50mg PRN if I can’t get to sleep. For your stomach acidity, I had the same problem, and a simple dose of Zantac 75 (available without prescription) works wonders for the acid problem..in fact..NO problem!!!..It also doesn’t have any side effects. My pdoc lowered my Zoloft prescription after I found it caused too many side effects. At 25 mg’s at bedtime, it works wonders. I’ve been on it about a month now. Again, the benadryl as per needed, (even if I have to take it every second night!!) works great to knock off to sleep. Most impotantly, it keeps my sleep pattern regular.(ie. don’t sleep all day, and stay awake all night, which was my problem before I took the benadryl) Also, Gravol is simular to Benadryl, but a little bit milder, so may also want to consider this. These are non-prescription drugs, so you can take a shot yourself, and if they work..GREAT!! They’ve worked for me, and I’ve heard they worked well for many other, but, just try, as YMMV… Best of luck.. James — "All of us get lost in the darkness… Dreamers learn to stear by the stars.." Neil Peart, Rush, "The Pass"

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Question:

You are right: you are best judge of what your body is up to. I now insist my doctor let me titrate. I leave each session with an upper dose I cannot exceed. There is also a suggested rate of increase I should not exceed (fat chance). Then I increase at the rate which is comfortable for me. (Reverse holds true for going off meds.) I note you’ve been on the new stuff only. Is there a reason you haven’t tried tricyclics or MAOIs? Some people report mircles from them, when the new SSRIs and variation are unsuccessful. Good luck. Stuck

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Well…..I’ve tried eight AD’s …..First was zoloft..did that for 8 months, and for a time added trazodone along with it.  It worked so-so…. Next was paxil…did that for about 3 months.  I didn’t have energy to do much of anything.  The withdrawl was 2 weeks of misery.   Next I went without anything for about 2 months.  Signed up for a 10 week self esteem class which used a workbook on Cognitive Behavioral Therapy.  I felt worse about myself at the end than I did when I started.   Then I tried prozac for 4 months….helped some (any improvement was better than I was).  Started having significant side effects after the dose went beyond 50mg.  Started feeling more depressed as the dose increased. Started effexor…almost stopped it cuz I felt so yucky, but I think it was due to coming off the prozac.  Effexor worked real well for me for about 15 months.  Added wellbutrin for a time, supposedly to help the sexual dysfunction, but it didn’t help. **SOAP BOX TIME** I really don’t think that doctors who work in the field of prescribing antidepressant medications fully appreciate how powerful these drugs are, and how strongly they affect the body.  My doctor, for instance, tends to believe that you can just taper a person (me) off one drug for a week or so and add a new drug at the same time or immediately thereafter, and everything will be hunky dory.  WRONG!!!!  As far as I am concerned, there is always some sort of withdrawl the body goes through when stopping one antidepressant, even if you start another at the same time.  I have gone through this a number of times, and I hope I have been instrumental in helping my doctor learn more about this.  Still, there is that transition period where my life sucks even more when I have changed meds. **END OF SOAP BOX** Anyway, coming off the prozac made it seem like the effexor was giving me a bad reaction at first, but I hung in and after about a week things were ok.   After about 15 months, I was feeling sort of down, more depressed than I had been in a while.  I was also feeling "chemicalized" and kind of wanted to stop.  My pdoc was gonna have me start serzone, but I tapered off the effexor (again with a two week withdrawl) and stopped. So, I then went 3 months taking St. John’s Wort.  It helped some, but I gradually sank down badly again, and when work took a stressful turn, I went down fast.  Back to Depression City. Then I took serzone for 4 months.  It is supposed to make most people a little drowsy, but it had the opposite effect on me.  I felt wired.  It leveled out a bit over time, but during this period I did not sleep very soundly.  It was just moderately effective for the depression. At the beginning of february I started remeron.  Again, in changing meds, I had the usual nausea and stuff associated with withdrawl, but man o man that remeron!! It was like Night of the Living Dead!!  I slept HARD for the 3 weeks I took that stuff.  Supposedly the higher the dose, the more that symptom of sleepiness goes away, but I was still a space cadet even after increasing the dose. So I practically begged my pdoc to let me go back on effexor, which I started again this week.  Right now I’m going through the remeron withdrawls, nausea, diarhea and such, but I feel human again. **THEORY** I believe in my case, having taken antidepressants off and on now for over 3 years, that whatever my depression is, drugs only help it to a moderate degree.  It has been my experience that continually increasing the dosage yields diminishing returns.  It does appear, at least at this time in my life, that I need the help of the antidepressants to handle life.  I am working in other ways on "handling life," and perhaps someday I will obtain some results that will make it unnecessary to take antidepressants. I really don’t know.   But, I think I do best if I take the lowest dose that gives any decent effect. And, I am beginning to believe that my system needs a periodic chemical free period.  So my plan at this point is to take the lowest dose of effexor that will stabilize my mood, which from past experience I think is either 150mg or 225mg.  I think that I will also try to go about a month a year chemical free. I guess to summarize, at least maybe to summarize to myself, it takes a long period of trial and error to find out what works and what doesnt.  The hard part is to somehow hang in there while going through all the ups and downs. Best wishes, Patrick *** To reply by email, remove the zzz from my email address ***

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Question:

If I understand you correctly, I tend to agree.  I am tired of hearing the opinions of people who simply cannot understand and appreciate what anxiety disorders can do to a person’s life and what medical treatments can do as coping mechanisms.  If those who oppose the medical treatment for anxiety (or anything else) could sway the medical community, THEIR day-to-day lives would remain largely unaffected, whereas OURS would become much more difficult.  And what would they care?

<snipped for space I doubt they would – they’d continue to bask in the happy glow of their neo-puritanism. I realise this thread is cross-posted to Hades and back, but I’m responding to it via alt.support.anxiety-panic and over here we have a steady stream of people breezing in with anti-medication rants. Some of them are so strange they defy comprehension, like the noted anti-benzodiazepine troller who posed as a doctor so as to slander a qualified psychiatrist who frequents the group. When unmasked and pilloried, he simply carried on under his own name, spreading the usual lies and distortions of this type of campaigner without skipping a beat. Sadly, here in the UK, the ‘tough it out’ school seems to have gained quite a sway in the medical profession too. Presumably, no one has stopped to count the suicides and wrecked lives caused by this. — Gary Cooper

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I just want to start of by saying that I agree wholeheartedly with the person who stated that drug therapy is a crutch. I just can’t resist putting in my two cents worth.  I’ll tell you one thing, if I break my leg you can bet your a… I mean you can be sure that I will use a crutch…..Hmmm… of course, I just may also want to get my leg set somewhere along the way?  What do you think?  I told you it was just two cents worth

If I understand you correctly, I tend to agree.  I am tired of hearing the opinions of people who simply cannot understand and appreciate what anxiety disorders can do to a person’s life and what medical treatments can do as coping mechanisms.  If those who oppose the medical treatment for anxiety (or anything else) could sway the medical community, THEIR day-to-day lives would remain largely unaffected, whereas OURS would become much more difficult.  And what would they care? As you pointed out, even a crutch in the literal sense is a necessity — sometimes a temporary one, and unfortunately, sometimes a long-term one.  I’d dare say that there’s not a single one among us who wouldn’t like to free him/herself from anxiety and toss the pills out forever.  But we don’t always have that luxury. — Halifax, N.S.     (The "ra" has been added to preclude junk mail)

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- Hide quoted text — Show quoted text –         I just want to start of by saying that I agree wholeheartedly with the person who stated that drug therapy is a crutch.         The notion that brings up for me is that crutches are for crippled people.  And therefore the appropriateness of said crutch would depend mightily on the view the individual took of themselves, whether they saw themselves as broken or not.         I don’t pass judgement on anyone’s self view – I simply do not, personally, see any people as broken.  Those of you who do think you are broken – this post is not for you. For the rest of you, here is a brief story about what works:         Friend of mine had multiple phobias.  Basically, she was raped many years ago, and had panic attacks following the rapes, and the panic got generalized to lots of various things – and all those things ended up acting as anchors – triggering phobic attacks.  Pretty messy stuff.

From what you describe, it would seem that your friend did not have phobias or SP, but rather was suffering from PTSD. G.M.

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   I just want to start of by saying that I agree wholeheartedly with the person who stated that drug therapy is a crutch.  

Of course drugs are crutches. Such drugs as insulin act as a crutch for a lame pancreas (Ok, Else of Langerhands or some such…). Others seem to assist lame brains… In the latter category however there seems to be an attitude of the general popluation that ‘well I don’t need Prosac, or older Valium, or older yet some set of herbals, or perhaps their industrial strength distilates, such as Heroin, so why does anyone else?’. On the other hand, it seems to be in vogue in certain psychotherapy settings that the watchword is ‘Drugs not Hugs’, as ‘Hugs’ could be interpreted wrongly, whereas drugs have a pretty unequivical meaning, ‘I want you sedated, or at least managable, and this can in no way be interpreted as a sexual overture, so we can maintain our strictly contained positions as therapist and patient.’

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– Hide quoted text — Show quoted text –        I just want to start of by saying that I agree wholeheartedly with the person who stated that drug therapy is a crutch.   Of course drugs are crutches. Such drugs as insulin act as a crutch for a lame pancreas (Ok, Else of Langerhands or some such…). Others seem to assist lame brains… In the latter category however there seems to be an attitude of the general popluation that ‘well I don’t need Prosac, or older Valium, or older yet some set of herbals, or perhaps their industrial strength distilates, such as Heroin, so why does anyone else?’. On the other hand, it seems to be in vogue in certain psychotherapy settings that the watchword is ‘Drugs not Hugs’, as ‘Hugs’ could be interpreted wrongly, whereas drugs have a pretty unequivical meaning, ‘I want you sedated, or at least managable, and this can in no way be interpreted as a sexual overture, so we can maintain our strictly contained positions as therapist and patient.’

I just can’t resist putting in my two cents worth.  I’ll tell you one thing, if I break my leg you can bet your a… I mean you can be sure that I will use a crutch…..Hmmm… of course, I just may also want to get my leg set somewhere along the way?  What do you think?  I told you it was just two cents worth wiz

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- Hide quoted text — Show quoted text – It should be noted that I have tried NLP with no luck (actually it was effective for about 30 mins and then I was back to normal), Just a thought if you are willing to listen. The first time you rode a bike did you succeed 100%??  Or did you try and then have to make another attempt before you rode successfully?? Maybe even several or dozens on attempts!!  Did all go to plan the very first or did you have to see what went right, what went wrong, assess, re-adjust and then take the good bits and try something slightly new to see it that worked better. My point is this.  Discover what is was about NLP that made it work for 30 minutes.  Take that knowledge and work on it….get some new info and try it to see if it works.  Keep building on that.  I’m sure, as much as you also know in yourself, that you will be riding that NLP bike fluently very soon and be over your anxiety.  If it worked to 30 minutes there is NOTHING stopping it working for 1 hour, or maybe 1 day, or maybe even a year.  Hey…here is an idea….why not the rest of your life.  Now isn’t that a possibility or moreso a reality. I would first like to point out that social phobia and agoraphobia are not like the usual ("specific") phobia, which is a strong fear response to a specific stimulus.  (For that matter, neither is fear of flying.)   The NLP phobia cure may not be completely successful with social phobia, if at all.  

        Which NLP phobia cure?  Far as I know, there are several.           Myself, I have used kinesthetic swishes very effectively with social phobia (after checking for ecological things, as I believe swishing kinesthetically can lead to problems if not done carefully).         I did the flying one with myself using a visual swish, did it with a client using a visual swish and some future-pacing stuff.         I can’t reclal using the "watching yourself watching yourself in a theatre" one very often – maybe once, with a spider phobia.  Mostly just to see if it worked, which it did.  I really prefer swishing myself – particularly cuz of the generative aspects. My personal opinion is that a very good NLP practitioner would probably be successful in curing social phobia, although it might take several sessions.  However, it’s important to realize that this is not a matter of using some standard technique such as the phobia cure, so the skill and experience of the practitioner will probably be very crucial.

        I would hope that it is NEVER a matter of simply using techniques. Techniques are like brushes and paints, they’re just the tools the artists uses in creating the art. Secondly, I have to say that, unlike for the case of specific phobias, my opinion is not backed by personal experience in dealing with social phobias or reports from other practitioners of successful experience. It’s simply based on the fact that I know that NLP is very good for a lot of other problems, so it ought to be good for this too.

        Try a few, Lee.  They’re not all that difficult.  It’s pretty c00l.         For me, I didn’t have any idea that any phobia was different from any other.  Maybe that’s why I just tried stuff and it worked.  It’s rare that the first thing I try always works, but if ya got an hour or two, that’s plenty of times to run through a few things till you find the one that does.         I’ve even done ‘em online – is amazing how folks will just let ya do therapy on them on the net.  I’ve posted previously both about a kid on a BBS who I lead through his panic attacks upon talking to girls, and also a heights phobia I did with a woman online on an adult BBS.   For this reason, although I would encourage the poster to remain open to the possibility that some day he may find someone who can use NLP to help him, I am reluctant to give him advice that may result in his going to practitioner after practitioner, spending lots of time and emotional energy without finding one who is competent to give him real help.  

        I see your point.  And I disagree.           I know darned well, have no doubt whatsoever, that *I* could fix this d00d’s problem.  I know a number of other folks I would recommend unhesitatingly.  One session most likely, at the most two.         And you, Lee, from what I have read of your posts and some in your archives – I wonder how someone as skilled as you have become can find a way to believe that he might not be able to do this too.  I find that it makes me curious.  Atlanta, GA                      http://www.instatek.com/nlp/

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Standard disclaimers apply.  I’m not a physician, but I’ve been through this stuff and am basing my statements on my experience. Hi All,   Some time ago I was diagnosed as having anxiety, panic attacks and social phobias. Over the past year or so I have been on Clonazepam (1 tablet, twice a day) with some results but I don’t feel I’m cured. As a result, I have been looking into other options, one which has been recommended to me is Sertraline (Zoloft?). As a result, I am going off the Clonazepam (I’m down to half a tablet, once a day) and I am experiencing quite a bit of anxiety/panic, as much as if not more than I originally started with. I have a couple questions regarding the above: 1 – Is this return of anxiety normal?

Yes. 2 – Any chance that it’s just temporary?

Who knows?  Only time will tell.  I wouldn’t count on it, though. 3 – How successful is this Sertralinbe? 4 – Any known long term side effects of Sertraline?

It’s a completely different class of drug.  Clonazepam is a benzodiazepine, which is specifically an anxiolytic.  Zoloft is an antidepressant. Frankly, I found Zoloft completely useless, and I didn’t like the side-effects.  Prozac is much better for me, though I don’t take it now. I’m not sure whether Sertraline is Zoloft or Serzone, but it’s one of them, and I’ve tried both.  Serzone didn’t do anything for me either, but at least there were no side-effects. I’m bipolar, and as far as I can tell, Neurontin is the fruit of the gods.  It’s an anticonvulsant like Tegretol, and it hasn’t even been approved for psychiatric use yet, so I had to sign all these "I will not sue you" papers.  They tell you that it takes so-and-so-many weeks to work, but in my experience, it works fast enough that it could even be used PRN.  One tablet and 30 minutes can pull me out of a very dark depression. 5 – Is Sertraline addictive or can it cause dependancy?

It shouldn’t, but it’s relatively new, of course. 6 – Are there any other options I should consider?

There are lots of other benzos.  Ativan, I’ve found, is much more effective than Klonipin.  Sublingual Ativan is great.  Some people swear by Xanax, which is pretty strong stuff.  With the benzos, though, there’s the potential of getting addicted. Also, there’s a non-benzodiazepine anxiolytic called Buspar.  I took it for a couple of years.  I noticed significant anxiolytic effect for a while, but it wore off.  This is a much more benign drug than the benzos and has no addictive potential.  There’s some evidence that long-term use of Buspar can cause depression, which is why I stopped taking it. There’s also a blood-pressure medication called Enderol which can be very effective in panic for an unusual reason: it stops the physical symptoms. There seems to be a feedback loop involved where the physical symptoms make one even more anxious. It should be noted that I have tried NLP with no luck (actually it was effective for about 30 mins and then I was back to normal),

One thing I’ve found useful was to work myself up (I usually use hypnosis, because it seems to last for a couple of hours, but NLP should be fine) and then go do a challenge.  Once I did the challenge and reverted to normal, I’d celebrate and reward myself. — Eric Pepke Supercomputer Computations Research Institute Florida State University

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Newsgroups: alt.support.anxiety-panic,sci.med.psychobiology,alt.support.depression,alt. support.social-phobia,alt.support.shyness,alt.psychology.nlp,sci.psychology .psychotherapy Followup-To: alt.support.anxiety-panic,sci.med.psychobiology,alt.support.depression,alt. support.social-phobia,alt.support.shyness,alt.psychology.nlp,sci.psychology .psychotherapy Organization: Netcom On-Line Services Distribution: hi Glen,

: Hi All, :   :   Some time ago I was diagnosed as having anxiety, panic attacks and social : phobias. Over the past year or so I have been on Clonazepam (1 tablet, : twice a day) with some results but I don’t feel I’m cured. As a result, I have : been looking into other options, one which has been recommended to me is : Sertraline (Zoloft?). As a result, I am going off the Clonazepam (I’m down to : half a tablet, once a day) and I am experiencing quite a bit of anxiety/panic, : as much as if not more than I originally started with. I have a couple : questions regarding the above: Your anti-anxiety med is working by increasing the sensitivity to some receptors in your brain that bind with GABA.  GABA is an inhibitory neurotransmitter, meaning its use is to inhibit the "firing" of neurons – neurons that have GABA receptors, that is.  Thus it is generally thought of as a "quieting" or "calming" neurotransmitter.  And benzodiazapines enhance those receptors, thereby augmenting the effects of that calming neurotransmitter. Zoloft, on the other hand, is a selective seretonin reuptake inhibitor (as you probably know) and it works by increasing the time that the neurotransmitter seretonin is active in the synapse, and thereby increasing the time that the post-synaptic neuron can be triggered by seretonin.  Seretonin is generally thought to be connected somehow with depression and happiness, and there are studies that show that very aggressive people have lower seretonin activity.  Animal studies show that increases in seretonin are found in the dominant male, and correspondingly that the dominance hierarchy can be changed by increasing the seretonin in an otherwise non-dominant male.  Seretonin increase is also associated with a decrease in REM sleep.  I personally would like more info on this particular feature; it’s my feeling that a decrease in REM will be harmful in the long run, but I also think that anti-depressants do not increase seretonin enough to cause a harmful decrease in REM.  I am not sure, and I’ve not done any literature search but a professor in psychobiology said that she thinks no studies have been done on REM sleep and how it’s affected in people taking an anti-depressant at the usual doses. So, ssri anti-depressants (as well as some tricyclics) are used for panic disorders, especially in children, since traditional anti-anxiety medications are not usually the first choice for kids, due to their psychological withdrawl symptoms (as you are experiencing now.)  I can give you two anecdotes, one about me and one about my daughter.  I had depression with anxiety, and had one panic attack.  I was not given Prozac but was given Zoloft instead, because it’s been said, based on anecdotal evidence, that Prozac can have an anxiety-increasing action in people already prone to anxiety.  I was fine on Zoloft; calm, not depressed, not anxious.  My daughter has panic disorder and post traumatic stress disorder; she’s done wonderfully on both a tricyclic and also on Paxil, another ssri like Prozac and Zoloft which is considered somewhat more calming than Prozac.  However, lately I’m debating whether or not this is the correct medication for her since she has become somewhat manic and is still experiencing anxiety.  She is not acting out as much and is not having any actual panic attacks, but she says she still "feels" anxious and that her "brain" still "talks too much about scary things."   Some people take an anti-depressant and an anti-anxiety at the same time; one suggestion is to add BuSpar for my daughter to hopefully help the anxiety.  BuSpar is in a class of medicines all by itself; it has anti-anxiety properties but it does not work like benzodiazapines.  In fact its exact method is unknown at present time, but that’s not unusual for a relatively new drug. : 1 – Is this return of anxiety normal? Unfortunately, yes.  I hope you are being taken off very slowly? : 2 – Any chance that it’s just temporary? Yes, sure.  As your body adjusts to not having the medicine anymore, you might return to a lower level of anxiety than prior to the start of the medication.  I’ve read that getting off those kinds of meds can be very, very bad and hard.   : 3 – How successful is this Sertralinbe? Ssri’s are considered very effective medicines for depression, and there are some docs that will use them for anything and will report success.  I think there’s no harm at all in giving it a try, to see how it works for you.  Keep in mind that ssri’s can take a very long time to have noticable effects.  I *think* it’s been reported to take, sometimes, a month or even two.  My daughter shaped right up on the 3rd day, but she might have been experiencing some placebo effect. : 4 – Any known long term side effects of Sertraline? The ssri’s are very safe.  They have some side effects that are just nuisances, but that are not dangerous.  As for taking a medication that increases the seretonin in your brain, there are some questions about that.  These questions apply to any anti-depressant, not just to Zoloft.   Your neurons that release seretonin also have receptors that can bind with seretonin; these autoreceptors are believed to function like a feedback loop, giving the neuron information on how much seretonin is needed based on how much it "sees" floating in the synapse.  It’s thought that the autoreceptor would sense the increased seretonin and thereby inform the neuron not to make any more, or at least not to make as much or not to make as much right now.  So basically, it’s not really known whether these anti-depressants are actually increasing seretonin overall or decreasing it.  You need to remember that the medicines only work to increase the time that the seretonin is active in the synapse; they don’t actually increase seretonin production.  So if your neurons aren’t making any, the medicine won’t be increasing the activity. : 5 – Is Sertraline addictive or can it cause dependancy? Well, lots of people have to increase their dose.  It can become ineffective after a while, probably due to what’s described in the above paragraph.  I wish there were studies that showed us how long this takes in the average person…   : 6 – Are there any other options I should consider? Well.  There’s BuSpar, although it’s been said to be less effective on people who’ve already been on another anti-anxiety med.  There’s also beta blockers.  Beta blockers work to block the action of some neurotransmitters, namely norepinephren, seretonin and dopamine.  Those are all "excitatory" neurotransmitters, so beta blockers block that excitment that they would cause.  I haven’t heard of beta blockers being prescribed for chronic anxiety all that much, although they are listed as an option in a few books I have for people who are not getting much relief from other methods.  They can be taken on an as-needed basis; that’s a big benefit if you have certain situations that really make you anxious.  Like, maybe before you need to do anything socially, you could pop a beta blocker?  *smile*  However, it sounds like you need something that works continuously, and I don’t know enough about beta blockers to know if they are ever prescribed in such a manner. You could also try a tricyclic anti-depressant.  Those are older and they work very well, for the most part.  Usually nowadays they are tried after an ssri fails, instead of before an ssri.  They do have slightly worse potential side effects though; they can have cardiac involvement and regular ECG’s are recommended to monitor your heart.  In my daughter’s case, the tricyclic imipramine completely cured her of all her anxiety/ptsd symptoms (I mean, it was like a miracle) but they aggravated a previously minor and insignificant heart problem she had and in fact made the heart problem quite troublesome for a while.  Quitting the medicine did reverse the problem, but I don’t know if all potential cardiac effects are reversable.  ??? : It should be noted that I have tried NLP with no luck (actually it was : effective for about 30 mins and then I was back to normal), group therapy has : not worked thus far (probably because I can’t get into the habit of following : the excercises and doing the homework) although another group has been offered : to me by the Clarke Institute of Psychiatry, and if I can avoid drugs I would : prefer to. That’s a noble standpoint, I think.  Have you tried any desensitization therapy?  I’ve heard that’s the latest thing with phobias and that some people are achieving great success.  The idea, I believe, is to expose yourself (with your therapist’s help and guidance) to increasingly longer involvement with your phobia.  I think it’s got some basis in cognitive work; if you can only re-train your brain to understand that these things that feel like they will kill you, really will not kill you, you supposedly can get some relief.  Maybe that type of work, with the help of a medication, would be possible for you?   One more consideration:  all the benzodiazapines have different characteristics and therefore slightly different experiences in an individual’s body, given the individual’s circumstances and whatnot.   Have you tried any other of the other medicines of this class? Well, just a … read more »

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Hi All,   Some time ago I was diagnosed as having anxiety, panic attacks and social phobias. Over the past year or so I have been on Clonazepam (1 tablet, twice a day) with some results but I don’t feel I’m cured. As a result, I have been looking into other options, one which has been recommended to me is Sertraline (Zoloft?). As a result, I am going off the Clonazepam (I’m down to half a tablet, once a day) and I am experiencing quite a bit of anxiety/panic, as much as if not more than I originally started with. I have a couple questions regarding the above: 1 – Is this return of anxiety normal? 2 – Any chance that it’s just temporary? 3 – How successful is this Sertralinbe? 4 – Any known long term side effects of Sertraline? 5 – Is Sertraline addictive or can it cause dependancy? 6 – Are there any other options I should consider? It should be noted that I have tried NLP with no luck (actually it was effective for about 30 mins and then I was back to normal), group therapy has not worked thus far (probably because I can’t get into the habit of following the excercises and doing the homework) although another group has been offered to me by the Clarke Institute of Psychiatry, and if I can avoid drugs I would prefer to. your time.

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        I just want to start of by saying that I agree wholeheartedly with the person who stated that drug therapy is a crutch.           The notion that brings up for me is that crutches are for crippled people.  And therefore the appropriateness of said crutch would depend mightily on the view the individual took of themselves, whether they saw themselves as broken or not.         I don’t pass judgement on anyone’s self view – I simply do not, personally, see any people as broken.  Those of you who do think you are broken – this post is not for you. For the rest of you, here is a brief story about what works:         Friend of mine had multiple phobias.  Basically, she was raped many years ago, and had panic attacks following the rapes, and the panic got generalized to lots of various things – and all those things ended up acting as anchors – triggering phobic attacks.  Pretty messy stuff.         She tried therapy a few times, but got rather annoyed at the therapists’s insistence on going back to her childhood.  I mean, she knew where the phobias came from, knew why she had them, she just couldn’t get rid of them.         Over time, because she’s a rather strong-willed and stubborn personality, she had gotten rid of a lot of them through a process of gradual desenstiziation that she worked with herself.  Still a lot remained.         So after about two years of me studying NLP and hypnosis, she asked me to work with her on them.  And we did – spent about 1 1/2 hours.         It was fun actually, rather interesting the stuff I learned about how her brain works.  We’d been very close friends for six years, but I hadn’t known what an interesting place her brain is.         She enjoyed it too – said it was completely different than any form of therapy she’d ever heard of, where the therapist’s seem rather determined to make you feel bad stuff from the past again.  She learned a lot about how her brain worked also – and since it’s a highly creative brain, the whole thing was just delightfully entertaining for both of us.         And the phobias… ummm, what phobias?   Oh yeah, there was something about massive phobic reactions being triggered by multiple anchors – I’d almost forgotten.  Well, that’s in the past.  Period.         THAT is what NLP does, when it’s done well, and elegantly, by a highly-skilled and exquisite practicioner.           Or at least, that’s been my experience.  And hers.

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I don’t know if anyone has addressed this yet, but I’ve had success with some of my supervised clientelle using a combination of in vivo desensitization to situational fear hierarchies and limited social skills training.  Of the five clients I have seen with this condition or a combination thereof (i.e., avoidant personality disorder, agoraphobia, etc.), only one was receiving psychopharmicotherapy in conjunction with treatment. David Barlow has an excellent treatment manual that may be useful (Managing Anxiety and Panic), and Zimbardo (1977) has a treatment mileau for the social skills training that I’ve found useful.  I should add that the social skills training is best conducted in a group format. Jeff Browndyke Jeffrey N. Browndyke Ph.D. Student in Medical/Clinical Psychology                     Department of Psychology        Fax: (504) 388-4125 236 Audubon Hall                URL: http://www.premier.net/~cogito   Baton Rouge, LA. 70803           *Neuropsychology Central  -  http://www.premier.net/~cogito/neuropsy.html *Psycresearch-Online – http://www.premier.net/~cogito/psycresearch-online/main.html  

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Some of you might want to check out the new website for individual herbal programs. It is designed for those who would rather go a natural route for their disorders and ailments. http://members.aol.com/doherbs/index.htm

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- Hide quoted text — Show quoted text – It should be noted that I have tried NLP with no luck (actually it was effective for about 30 mins and then I was back to normal), Just a thought if you are willing to listen. The first time you rode a bike did you succeed 100%??  Or did you try and then have to make another attempt before you rode successfully?? Maybe even several or dozens on attempts!!  Did all go to plan the very first or did you have to see what went right, what went wrong, assess, re-adjust and then take the good bits and try something slightly new to see it that worked better. My point is this.  Discover what is was about NLP that made it work for 30 minutes.  Take that knowledge and work on it….get some new info and try it to see if it works.  Keep building on that.  I’m sure, as much as you also know in yourself, that you will be riding that NLP bike fluently very soon and be over your anxiety.  If it worked to 30 minutes there is NOTHING stopping it working for 1 hour, or maybe 1 day, or maybe even a year.  Hey…here is an idea….why not the rest of your life.  Now isn’t that a possibility or moreso a reality. I would first like to point out that social phobia and agoraphobia are not like the usual ("specific") phobia, which is a strong fear response to a specific stimulus.  (For that matter, neither is fear of flying.)   The NLP phobia cure may not be completely successful with social phobia, if at all.   My personal opinion is that a very good NLP practitioner would probably be successful in curing social phobia, although it might take several sessions.  However, it’s important to realize that this is not a matter of using some standard technique such as the phobia cure, so the skill and experience of the practitioner will probably be very crucial. Secondly, I have to say that, unlike for the case of specific phobias, my opinion is not backed by personal experience in dealing with social phobias or reports from other practitioners of successful experience. It’s simply based on the fact that I know that NLP is very good for a lot of other problems, so it ought to be good for this too. For this reason, although I would encourage the poster to remain open to the possibility that some day he may find someone who can use NLP to help him, I am reluctant to give him advice that may result in his going to practitioner after practitioner, spending lots of time and emotional energy without finding one who is competent to give him real help.   — Only by riveting one’s attention on the past is it possible to prevent those occasional changes of perspective that would reveal that the present offers not only the potential for more unhappiness, but also of un-unhappiness, not to mention something entirely new.  –Paul Watzlawick

That is very interesting….thankyou.  I agree that NLP is not the do all and end all.  As NLP teaches you within itself…..variety and flexibility to new ideas and opinion are a healthy and productive way of living.  Gathering the best information and ideas from all around the world on any topic and study or even just the ear of a friendly person is a new approach that should always be considered.   With a smile, Dean Crabb         "The meeting of Preparation with Oppurtunity generates                      the offspring we call LUCK"

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- Hide quoted text — Show quoted text – In our society there is that immediate urge to take a pill and make everything better and, unfortunately, many people are quite disappointed when that doesn’t happen. On the other hand, there are also those who refuse any medication believing it to be nonsense. I used to be very anti-medication. That is, I wanted to be cured of anxiety and depression without any medication at all. Looking back, I see this was a misinformed and stupid attitude. The fact is that the right medication prescribed correctly can be invaluable in getting better. Certainly, one should not rely wholly on medication. Rather it should be a crutch. Jan

        I agree completely with your post. I am using meds (Klonopin & Zoloft, with occasional use of Xanax when immediate relief is necessary) and I also am working with a psychotherapist in individual and group therapy sessions. I think a balanced approach of meds and therapy is good, for me at least.         I was just commenting on the completely med oriented threads and the relative lack of attention to other therapies. I would like to hear more about NLP as I don’t know much about it. There is also EMDR which seems to work for some but is used mostly for PTSD.         I think anyone who has suffered for a significant length of time with panic/phobia, etc., has developed a variety of defence/coping mechanisms which do not disappear when symptoms are reduced with meds. People with SP, myself included, seem to have a difficult time picking up on social cues, with anxiety resulting from a feeling of not quite knowing what is going on. The tendency of SPs to "fill in the blanks" can result in some rather irrational thinking. G.M.

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I used to be very anti-medication. That is, I wanted to be cured of anxiety and depression without any medication at all. Looking back, I see this was a misinformed and stupid attitude. The fact is that the right medication prescribed correctly can be invaluable in getting better. Certainly, one should not rely wholly on medication. Rather it should be a crutch.

I completely agree with you, Jan. For the first year or so of this group’s existence I was scared *stiff* of using benzodiazepines and, as a consequence, was floundering with no treatment at all – neither antidepressants nor psychological treatments having helped me. I was even quite vocal in my concerns about some medications. Eventually, reading what people had to say here changed my mind and I started using Xanax prn. Since then, the change in my life has been little short of miraculous. As you say, meds. are only there to help but, without that help, no behavioural therapy in the world was having any effect at all. Now it is possible to use other therapies because the meds. have given them room to operate. — Gary Cooper

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In our society there is that immediate urge to take a pill and make everything better and, unfortunately, many people are quite disappointed when that doesn’t happen. On the other hand, there are also those who refuse any medication believing it to be nonsense. I used to be very anti-medication. That is, I wanted to be cured of anxiety and depression without any medication at all. Looking back, I see this was a misinformed and stupid attitude. The fact is that the right medication prescribed correctly can be invaluable in getting better. Certainly, one should not rely wholly on medication. Rather it should be a crutch. Jan

Hi Jan, I couldn’t agree with you more… I was anti-medication, big time!!  I spent months on this ng discussing the pros and cons of using meds to help me with my Panic Disorder.  All the time that I was discussing it, I was house bound, unable to do anything out side of my home, and having 4-5 panic attacks a day. I finally found a doctor that specializes in Panic Disorder who prescribed meds for me.  At first I resisted, and wanted to be "cured" without using "drugs."  What a lonely place it is to be so right that I wouldn’t even listen to an expert in the field of PD. I finally, after a few more months, ended up taking Paxil and Klonopin (Clonazepam); I feel like my old self again.  I’m out of the house, going to job interviews, hey, I even go to Wal-Mart  some times (shiver)!!   Taking medications have given me my life back.  I’m still waiting to hear from a therapist (behavioral therapy, I hope), waiting lists are very long in the public and private sector here in Maine.  But once I’ve got a therapist that knows what he/she is doing, and couple that with my meds, and I feel I’ve got half the battle won–the rest is up to me. — Chuck

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In our society there is that immediate urge to take a pill and make everything better and, unfortunately, many people are quite disappointed when that doesn’t happen.

On the other hand, there are also those who refuse any medication believing it to be nonsense. I used to be very anti-medication. That is, I wanted to be cured of anxiety and depression without any medication at all. Looking back, I see this was a misinformed and stupid attitude. The fact is that the right medication prescribed correctly can be invaluable in getting better. Certainly, one should not rely wholly on medication. Rather it should be a crutch. Jan

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- Hide quoted text — Show quoted text – It should be noted that I have tried NLP with no luck (actually it was effective for about 30 mins and then I was back to normal), Just a thought if you are willing to listen. The first time you rode a bike did you succeed 100%??  Or did you try and then have to make another attempt before you rode successfully?? Maybe even several or dozens on attempts!!  Did all go to plan the very first or did you have to see what went right, what went wrong, assess, re-adjust and then take the good bits and try something slightly new to see it that worked better. My point is this.  Discover what is was about NLP that made it work for 30 minutes.  Take that knowledge and work on it….get some new info and try it to see if it works.  Keep building on that.  I’m sure, as much as you also know in yourself, that you will be riding that NLP bike fluently very soon and be over your anxiety.  If it worked to 30 minutes there is NOTHING stopping it working for 1 hour, or maybe 1 day, or maybe even a year.  Hey…here is an idea….why not the rest of your life.  Now isn’t that a possibility or moreso a reality.

I would first like to point out that social phobia and agoraphobia are not like the usual ("specific") phobia, which is a strong fear response to a specific stimulus.  (For that matter, neither is fear of flying.)   The NLP phobia cure may not be completely successful with social phobia, if at all.   My personal opinion is that a very good NLP practitioner would probably be successful in curing social phobia, although it might take several sessions.  However, it’s important to realize that this is not a matter of using some standard technique such as the phobia cure, so the skill and experience of the practitioner will probably be very crucial. Secondly, I have to say that, unlike for the case of specific phobias, my opinion is not backed by personal experience in dealing with social phobias or reports from other practitioners of successful experience. It’s simply based on the fact that I know that NLP is very good for a lot of other problems, so it ought to be good for this too. For this reason, although I would encourage the poster to remain open to the possibility that some day he may find someone who can use NLP to help him, I am reluctant to give him advice that may result in his going to practitioner after practitioner, spending lots of time and emotional energy without finding one who is competent to give him real help.   — Only by riveting one’s attention on the past is it possible to prevent those occasional changes of perspective that would reveal that the present offers not only the potential for more unhappiness, but also of un-unhappiness, not to mention something entirely new.  –Paul Watzlawick

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It should be noted that I have tried NLP with no luck (actually it was effective for about 30 mins and then I was back to normal),

Just a thought if you are willing to listen. The first time you rode a bike did you succeed 100%??  Or did you try and then have to make another attempt before you rode successfully?? Maybe even several or dozens on attempts!!  Did all go to plan the very first or did you have to see what went right, what went wrong, assess, re-adjust and then take the good bits and try something slightly new to see it that worked better. My point is this.  Discover what is was about NLP that made it work for 30 minutes.  Take that knowledge and work on it….get some new info and try it to see if it works.  Keep building on that.  I’m sure, as much as you also know in yourself, that you will be riding that NLP bike fluently very soon and be over your anxiety.  If it worked to 30 minutes there is NOTHING stopping it working for 1 hour, or maybe 1 day, or maybe even a year.  Hey…here is an idea….why not the rest of your life.  Now isn’t that a possibility or moreso a reality. Tell me please…..do you have to even think about riding a bike now or does it just come naturally?? All the best….the journey down this road will be easier than you think.  Just get on that bike and start riding one hour at a time. The hours will become days, and the days will become weeks and the weeks will flow smoothly into years.  Start enjoying your new found happiness….now…. Warmest Regards, Dean Crabb           "The meeting of Preparation with Oppurtunity generates                      the offspring we call LUCK"

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Glen: What NLP techniques did you use? Nick – Hide quoted text — Show quoted text – Hi All,   Some time ago I was diagnosed as having anxiety, panic attacks and social phobias. Over the past year or so I have been on Clonazepam (1 tablet, twice a day) with some results but I don’t feel I’m cured. As a result, I have been looking into other options, one which has been recommended to me is Sertraline (Zoloft?). As a result, I am going off the Clonazepam (I’m down to half a tablet, once a day) and I am experiencing quite a bit of anxiety/panic, as much as if not more than I originally started with. I have a couple questions regarding the above: 1 – Is this return of anxiety normal? 2 – Any chance that it’s just temporary? 3 – How successful is this Sertralinbe? 4 – Any known long term side effects of Sertraline? 5 – Is Sertraline addictive or can it cause dependancy? 6 – Are there any other options I should consider? It should be noted that I have tried NLP with no luck (actually it was effective for about 30 mins and then I was back to normal), group therapy has not worked thus far (probably because I can’t get into the habit of following the excercises and doing the homework) although another group has been offered to me by the Clarke Institute of Psychiatry, and if I can avoid drugs I would prefer to. you for your time.

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It should be noted that I have tried NLP with no luck (actually it was effective for about 30 mins and then I was back to normal), Well, that’s a start, isn’t it? Just because this particular bit of NLP wasn’t permanent doesn’t mean that other attempts won’t be…

what’s nlp?

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It should be noted that I have tried NLP with no luck (actually it was effective for about 30 mins and then I was back to normal),

Well, that’s a start, isn’t it? Just because this particular bit of NLP wasn’t permanent doesn’t mean that other attempts won’t be…

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- Hide quoted text — Show quoted text – Well, just a disclaimer, I am certainly not a doctor nor a therapist; I’m just a 3rd year biological psychology major who’s also done a lot of reading, especially due to my daughter’s condition.  Please please please take everything I say with a healthy dose of skepticism and use it just as a jumping-off place for you to do your own research and/or to ask questions of your doc.  And for a sort of opposite-of-disclaimer, try to make sure your doc knows what she’s/he’s talking about.  I’ve found that the psychiatrists I’ve seen for myself or my daughter have all had somewhat deficient (in my opinion) knowledge about the latest research, including a lack of knowledge even of what’s being reported in the popular media.  Take care of yourself. Cindi

no need for a disclaimer, thank you for the informative post. Don’t forget the "talk therapy" angle on panic/phobia, etc. behavior. You mentioned desensitization, which works for a lot of people, but there are quite a range of psychotherapeutic approaches to the subject. In our society there is that immediate urge to take a pill and make everything better and, unfortunately, many people are quite disappointed when that doesn’t happen.         Again, thank you for the very informative post. G.M.

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- Hide quoted text — Show quoted text – Hi All,   Some time ago I was diagnosed as having anxiety, panic attacks and social phobias. Over the past year or so I have been on Clonazepam (1 tablet, twice a day) with some results but I don’t feel I’m cured. As a result, I have been looking into other options, one which has been recommended to me is Sertraline (Zoloft?). As a result, I am going off the Clonazepam (I’m down to half a tablet, once a day) and I am experiencing quite a bit of anxiety/panic, as much as if not more than I originally started with. I have a couple questions regarding the above: 1 – Is this return of anxiety normal? 2 – Any chance that it’s just temporary? 3 – How successful is this Sertralinbe? 4 – Any known long term side effects of Sertraline? 5 – Is Sertraline addictive or can it cause dependancy? 6 – Are there any other options I should consider? It should be noted that I have tried NLP with no luck (actually it was effective for about 30 mins and then I was back to normal), group therapy has not worked thus far (probably because I can’t get into the habit of following the excercises and doing the homework) although another group has been offered to me by the Clarke Institute of Psychiatry, and if I can avoid drugs I would prefer to. your time.

I’ll try and answer your questions, as I take both Zoloft and Klonopin (clonazepam). you say you take 1 tablet twice a day but you don’t say what the strength of the tablet is. I take 0.5 mg. three times a day and 200 mg. Zoloft once a day. First let me say that your statement " I have been on clonazepam…with some results…but I don’t feel I’m cured" is odd. Was it promoted to you as a "cure"? I don’t know that there is any cure for social phobia, just medication and cognitive techniques for lessening the symptoms and learning to live with it. 1. yes, the return to an anxious state when reducing an anti-anxiety med is normal. BTW, go off clonazepam *slooowly*. There can be dangerous side-effects when terminating any benzodiazepine quickly. 2.temporary? if you really are socially phobic….not likely. 3. Zoloft? it has been a life-saver (literally) for me in the area of depression, which is what it is generally prescribed for. Some people say that Zoloft also has anti-anxiety properties. I have not found that to be so, though I imagine, some people have. It is quite common to be on an anti-depressant and an anti-anxiety med at the same time. I find that Zoloft increases my anxiety, though not as much as Prozac did. 4. side effects of Zoloft. You can check the PDR for the entire list. The only two I have noticed is lethargy (which has lessened over time) and a longer period of stimulation required to reach orgasm ( which also has lessened over time) Zoloft is a pretty benign drug (as drugs go…they all have side-effects and not everyone has the same ) 5. dependance? No. Not in the least. It is the benzodiazepines (Klonopin, though especially Xanax and Ativan) that are quite addictive. 6. Yes. Find a good Psychiatrist and trust him/her and follow the advice. Also, educate yourself about your condition. Take risks. (like group therapy) Be so interested in your condition that you know more about it than your M.D., be your own therapist, leave no stone unturned…..after all, it’s our lives we’re talking about here, and as far as I know, you only get one. Hope this helps G.M.

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Hi All,   Some time ago I was diagnosed as having anxiety, panic attacks and social phobias. Over the past year or so I have been on Clonazepam (1 tablet, twice a day) with some results but I don’t feel I’m cured. As a result, I have been looking into other options, one which has been recommended to me is Sertraline (Zoloft?). As a result, I am going off the Clonazepam (I’m down to half a tablet, once a day) and I am experiencing quite a bit of anxiety/panic, as much as if not more than I originally started with. I have a couple questions regarding the above: 1 – Is this return of anxiety normal?

It happens quite frequently in the folks I’ve worked with who are in your position. 2 – Any chance that it’s just temporary?

There’s a chance.  My sense is that they work by different mechanisms and that zoloft takes longer to kick in.  Could be that you will continue to experience some anxiety by the quality of the anxiety will be different. 3 – How successful is this Sertralinbe?

I’m not familliar with research using zoloft for these anxiety disorders (not to say there’s none there–just that I haven’t seen it).  I’ve seen it work for OCD which has anxiety as its base…. 4 – Any known long term side effects of Sertraline?

Some people claim that the serotonin receptors become either destroyed or desensitized to 5-HT and thus reducing the efficacy of the meds.  I don’t know if the sexual "problems" associated with prozac are also associated with the other SSRIs. 5 – Is Sertraline addictive or can it cause dependancy?

Probably not in the same way that a benzodiazapine is addictive. 6 – Are there any other options I should consider?

Have you read anything by David Barlow.  His book "Anxiety and its disorders" is a good starting point.  I have had very good luck using traditional behavioral techniques with an emphasis on exposure. Good Luck Mark – Hide quoted text — Show quoted text – It should be noted that I have tried NLP with no luck (actually it was effective for about 30 mins and then I was back to normal), group therapy has not worked thus far (probably because I can’t get into the habit of following the excercises and doing the homework) although another group has been offered to me by the Clarke Institute of Psychiatry, and if I can avoid drugs I would prefer to. your time.

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