Question:

WHAT IS ANYONES EXPERIENCE WITH FLOVENT # OF PUFFS/# OF TIMES PER DAY? ARE YOU MILD/MODERATE ASHTMATIC?  USE OF PROVENTIL HFA AND ACCOLATE.  Have been trying to cut back on flovent 110 mg 4 puffs/2x’s per day.  Have great success with accolate but upsets stomach.  Nee Proventil for exercise and in addition to flovent on bad days/ times. Thank you

Response:

WHAT IS ANYONES EXPERIENCE WITH FLOVENT # OF PUFFS/# OF TIMES PER DAY? ARE YOU MILD/MODERATE ASHTMATIC?  USE OF PROVENTIL HFA AND ACCOLATE.  Have been trying to cut back on flovent 110 mg 4 puffs/2x’s per day.  Have great success with accolate but upsets stomach.  Nee Proventil for exercise and in addition to flovent on bad days/ times. Thank you

I checked your meds against the 1997 Asthma Guidelines/Expert Panel Report. Your dose of Flovent, 880 ug/day, puts you in the Moderate-to-High category with Moderate to Severe asthma. The Guidelines recommend you also use a long-acting bronchodilator (either Serevent, or sustained-release theophylline, or long-acting beta2-agonist tablets). Proventil as needed. I’m suprised you get an upset stomach from Accolate. The product information sheet doesn’t seem to indicate this is a significant problem. I haven’t tried Accolate yet. My steroid inhaler is Vanceril DS 84. I tried to switch to Flovent 44 but my HMO won’t pay for it. I also use Serevent & Intal inhalers; and low dose Theo-Dur, 200 mg/day. Note that Flovent is twice as strong as Vanceril per ug; 1 puff Flovent 44 = 1 puff Vanceril DS 84 or 2 puffs Vanceril 42. Ellis

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I use Flovent 220 mcg, two puffs 2/day. I am doing well on this dosage. Previously I was taking 500 mcg beclomethasone 2/day. I had to buy the stronger puffer in Mexico as it was never sold here. I began that treatment in France which made a world of difference in my condition. I have been told that Flovent is stronger than what I was taking and I should only need one puff twice a day, but it doesn’t seem to work that way. I need the four puffs/day. Sue

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Bill, regarding your questions on Flovent, I use a combinaaation of Flovent/Serevent.  My M.D. feels the combination is better than just Flovent on its own.  I am now trying Accolate in order to reduce inhalants.  We shall see……. at least the combination above has gotten me off of prednisone for the first time in 4 years!!!  I use 2 puffs of the long-term bronchodilator twice daily and 8 puffs of the steroid inhalant daily in the afternoon (works as well as 4 puffs twice daily). My M.D. believes that Merck will have something even better than Zyflo or Accolate available in Sept.   Keep breathing!!! Jan

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Bill, regarding your questions on Flovent, I use a combinaaation of Flovent/Serevent.  My M.D. feels the combination is better than just Flovent on its own.  I am now trying Accolate in order to reduce inhalants.  We shall see……. at least the combination above has gotten me off of prednisone for the first time in 4 years!!!  I use 2 puffs of the long-term bronchodilator twice daily and 8 puffs of the steroid inhalant daily in the afternoon (works as well as 4 puffs twice daily). Jan

Regarding the 8 puffs of Flovent/day in a single dose, the manufacturer, Glaxo, recommends divided doses, twice a day. See www.industryreport.com/glaxo/glaxo.html There is evidence that this can reduce the total number of puffs/day required, since the medication is designed to work for about 12 hr. If you took the Flovent at the same time as the Serevent, you would only be using inhalers twice a day instead of 3 times/day. Also it is beneficial to use a steroid inhaler in the evening because asthma is usually worst at nite with symptoms peaking around 3 am. Perhaps you could work back to 3 puffs twice a day. Of course you would need to monitor symptoms and peak flows. Congratulations on getting off the prednisone. Just a suggestion, Ellis

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Question:

I had told the nurse I wanted to do the CT scan today and she said she would schedule it and call with a time.  I let the time get away from me and before I knew it, it was after 5pm.  I guess I will call this morning and see what is up. I have a question for anyone who may know.  I have been taking Bidex, Singulair and Histussin HC for the past week for my breathing and chest congestion.  Do any of these cause a depressing or down-feeling effect?  I have felt like crying a lot the last couple of days.  Of course, when I have felt bad for too long I feel that way also.  I was just wondering if any of these meds could have that side-effect? Vicki — The charter is available at:

Question:

I read an article about people taking Zyban (a quit smoking drug) to treat depression and panic. Anyone ever try it?

Response:

Zyban, which is sold to help people quit smoking, is actually the same drug as Wellbutrin, which is used to treat depression.  Wellbutrin SR (slow release) is now available.  But Wellbutrin *can* cause jitteriness, so it is not often prescribed as a first-course anti-depressant for someone with anxiety.  However, after using the SSRI’s for years and finally getting tired of the sexual side effects, I began using Wellbutrin SR over a year ago.  I have had no heightened sense of anxiety.  Your Mileage May Vary….. I also take Xanax 0.5mg three times a day.   It is more likely that a psychiatrist would prescribe one of the SSRI drugs (Prozac, Effexor, Celexa, among others) before prescribing Wellbutrin to treat someone with a combo of depresison *and* anxiety attacks. When I began taking Prozac, it was as if my world change completely… I became more self-confident, and I was able to confront some of my long-held fears.  I too, Prozac for about 10 years before converting to the Wellbutrin. Best wishes! MikeH

– Hide quoted text — Show quoted text – I read an article about people taking Zyban (a quit smoking drug) to treat depression and panic. Anyone ever try it?

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Question:

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

Response:

William wrote:

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

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

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

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

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

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

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

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

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

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

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

Response:

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

Is Zoloft the only anti depressant you’ve tried?

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

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

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

Response:

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

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

OK.

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

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

Thanks, -William

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Question:

I wrote a previous post but have not seen it here yet.  I am going to post again. The autoimmune diseases are another class of diseases where the allopaths have no idea of what

Question:

I hope someone will soon, Glenn. If you know what I mean. <Hubba,Hubba Gloria

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I only lost 3 pounds last week but the total for two weeks is 11 pounds. It’s still reasonable to lose 50 pounds by my birthday Nov. 28th. Some of the weight I didn’t lose became lean,toned muscle and I’m still detoxing from the med.s which makes it slow going. I had to make a minor call Saturday to Dr.Tom but the no med.s thing is going well. The future’s so bright I have to wear shades. :^) Gloria Thanks for the support!!

Gotta love this girl… — "I do not know" – GlennT Learning to let go… http://people.A2000.nl/gthomas/GlennHome.htm

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Hey girlfriend!! Just under two months until my move to Athens Ga. Life is good! I hope you’re doing well too. G

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Thanks Mary Beth!! It’s good to have your support. G

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Thank you Aware1!! G

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I found a cabbage soup/veggies/fruit diet that I really enjoy. On the fifth and sixth day you can eat up to 20 oz. of steak!! :^) YUM! I’m also off med.s, to make a long story short I may have been sicker on them than I am off. Beside a side-effect of Zoloft for me was midnight eatting binges and Zyprexa helped me gain 80 pounds. I feel great and have had only a few withdrawl events. Week three of the diet and a little over three weeks off Zyprexa. I’ve been off Zoloft for a week and a half and normal sleep cycles are back!! Life is good when I let it be. :^) Gloria

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What is your diet plan?  I know, I know, I’m behind, and probably missed you explaining it all in a previous post. –Tez (fat, and I don’t mean phat) – Hide quoted text — Show quoted text -I only lost 3 pounds last week but the total for two weeks is 11 pounds. It’s still reasonable to lose 50 pounds by my birthday Nov. 28th. Some of the weight I didn’t lose became lean,toned muscle and I’m still detoxing from the med.s which makes it slow going. I had to make a minor call Saturday to Dr.Tom but the no med.s thing is going well. The future’s so bright I have to wear shades. :^) Gloria Thanks for the support!!

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I only lost 3 pounds last week but the total for two weeks is 11 pounds.

Hey, this is great! Congrats on your weight loss! Mary Beth

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Heyhi! Congratulations! Lean, mean, UGA-bound machine chica, eh? -Amber

– Hide quoted text — Show quoted text -I only lost 3 pounds last week but the total for two weeks is 11 pounds. It’s still reasonable to lose 50 pounds by my birthday Nov. 28th. Some of the weight I didn’t lose became lean,toned muscle and I’m still detoxing from the med.s which makes it slow going. I had to make a minor call Saturday to Dr.Tom but the no med.s thing is going well. The future’s so bright I have to wear shades. :^) Gloria Thanks for the support!!

Response:

I only lost 3 pounds last week but the total for two weeks is 11 pounds. It’s still reasonable to lose 50 pounds by my birthday Nov. 28th. Some of the weight I didn’t lose became lean,toned muscle and I’m still detoxing from the med.s which makes it slow going. I had to make a minor call Saturday to Dr.Tom but the no med.s thing is going well. The future’s so bright I have to wear shades. :^) Gloria Thanks for the support!!

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Question:

Hi, There is no physical test (blood, etc.) that can determine if you have OCD.  The only way is to describe your symptoms and feelings to the pdoc.  You may want to schedule a normal exam with your regular doctor to rule out any other physical problems. That would be up to you. A Zoloft/Xanax combination would be a good first choice for someone with OCD or OCD like tendencies. Why do you think you may have OCD? The symptoms you describe below could be OCD, or they might be a lot of other things.  Are your thoughts consistently about "bad" things that may happen, or are they "going over" everyday events and worries?  Do you repeat the same thought over and over or do you think about a lot of different things? Do you have any physical compulsions like checking and rechecking things, or hoarding things? I’m kind of interested in this sort of stuff, because I have OC tendencies a lot of times, but I don’t believe I have OCD. I believe I may have a personality disorder that is kind of similar to OCD but is not the same. – Hide quoted text — Show quoted text – I have what i though was anxiety attacks.  as i have read up on things it appears i have many similarities with OCD.  i have been going to a phsychiatrist but he wasn’t really the one for me.  he imediatly put me on Zoloft, with out any tests or checkups.  I have reaccurring thoughts about everything.  i just can’t seem to "get over things". i constantly concentrate on physical flaws i feel i have.  i think the biggest problem is dealing with things.  i can’t seem to think clearly or objectively.  my thoughts are constantly crowded with the same thoughts over and over.  the phsychiatrist also gave me xanax, which helps alot, but i have heard bad things about the drug like depression and dependance.  can someone please give me some insight.  anything would be good right now. — Posted via Talkway – http://www.talkway.com Exchange ideas on practically anything ™.

Response:

I have what i though was anxiety attacks.  as i have read up on things it appears i have many similarities with OCD.  i have been going to a phsychiatrist but he wasn’t really the one for me.

Find another pdoc if you aren`t happy with this one. Only a pdoc can diagnosis you. OCD is a anxiety disorder, and you can have panic disorder and OCD at the same time, that is why you need to see a new doctor and get diagnosed. he imediatly put me on Zoloft, with out any tests or checkups.

A pdoc is not going to test you or do a checkup on you. He will diagnosis you by what you tell him. It is always a good idea to go to a medical doctor for a complete physical and to make sure there is no physical reason for your symptoms. A Pdoc will not do this for you. Zoloft can be quite effective for anxiety and OCD. It does take 6 to 8 weeks to become effective though. I have reaccurring thoughts about everything.  i just can’t seem to "get over things". i constantly concentrate on physical flaws i feel i have.  i think the biggest problem is dealing with things.  i can’t seem to think clearly or objectively.  my thoughts are constantly crowded with the same thoughts over and over.  the phsychiatrist also gave me xanax, which helps alot, but i have heard bad things about the drug like depression and dependance.  can someone please give me some insight.  anything would be good right now.

It is good to take the Xanax while weaning on the Zoloft. I haven`t seen many people here complain of depression while on Xanax, and if that were to happen there are other benzo`s you can take. You will become dependent on the Zoloft as well as the Xanax, and all that means is you will have to stop the meds slowly when the time comes. Many meds cause a physical dependency and this shouldn`t be confused with *addiction*. If you use the Xanax as prescribed by your doctor you will not get addicted to it. Take care!!!! Jackie

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I have what i though was anxiety attacks.  as i have read up on things it appears i have many similarities with OCD.  i have been going to a phsychiatrist but he wasn’t really the one for me.  he imediatly put me on Zoloft, with out any tests or checkups.  I have reaccurring thoughts about everything.  i just can’t seem to "get over things". i constantly concentrate on physical flaws i feel i have.  i think the biggest problem is dealing with things.  i can’t seem to think clearly or objectively.  my thoughts are constantly crowded with the same thoughts over and over.  the phsychiatrist also gave me xanax, which helps alot, but i have heard bad things about the drug like depression and dependance.  can someone please give me some insight.  anything would be good right now. — Posted via Talkway – http://www.talkway.com Exchange ideas on practically anything ™.

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- Hide quoted text — Show quoted text -I have what i though was anxiety attacks.  as i have read up on things it appears i have many similarities with OCD.  i have been going to a phsychiatrist but he wasn’t really the one for me.  he imediatly put me on Zoloft, with out any tests or checkups.  I have reaccurring thoughts about everything.  i just can’t seem to "get over things". i constantly concentrate on physical flaws i feel i have.  i think the biggest problem is dealing with things.  i can’t seem to think clearly or objectively.  my thoughts are constantly crowded with the same thoughts over and over.  the phsychiatrist also gave me xanax, which helps alot, but i have heard bad things about the drug like depression and dependance.  can someone please give me some insight.  anything would be good right now. — Posted via Talkway – http://www.talkway.com Exchange ideas on practically anything ™.

Hi, How long have you been on the zoloft? I’m pretty sure that SSRI’s are standard treatment for OCD as well as anxiety. I think luvox is used frequently for OCD. Sometimes it takes weeks for an AD to kick in.  I don’t think I have OCD, but being on an SSRI has eliminated 99% of my worries, and ruminations. Haven’t heard of too many people here depressed from xanax. It didn’t affect me that way.   If you are worried about dependence on xanax, there are ways to taper off of it.  If your still having the recurring thoughts/anxiety while on zoloft after 8 weeks, it might not be the correct med for you. Maria

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OCD is an anxiety disorder.  Panic disorder,  post-traumatic stress disorder, phobias, generalized anxiety disorder are all ANXIETY DISORDERS.

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Question:

Hi Jim,     When I lived in the City I saw an excellent pdoc. Her name is Dr. Lauren Gorman, she was at Central Park West. Just wanted to mention a positive Pdoc in the Crazy Crazy City … hummingbrd

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there are  many great doctors in NYC…VERY inexpensive is this place: http://www.nyspi.cpmc.columbia.edu/ Located as part of Columbia,they  offer the newest ideas and most openminded help! Offen for free! ALSO: when I lived on Wooster in  TriBeCa, I often had to work hard to feel clean,bright,special…one of my favorite things to do was the Met. of Art another was to pack a beautiful lunch and  take the ferry to  Statue of Liberty Park…a national Park that over looks a beautiful skyline and ocean scenery,take no alcohol,maybe peaceful tapes and ood food!!Ellis Island gets more crowds, the land around the statue is a delite!maryg Hi Jim,     When I lived in the City I saw an excellent pdoc. Her name is Dr. Lauren Gorman, she was at Central Park West. Just wanted to mention a positive Pdoc in the Crazy Crazy City … hummingbrd

Share what you know. Learn what you don’t.

Response:

Hi Jim, So it’s Saturday morning and I have a talk therapy appointment at 11. Went to the hospital yesterday to see my psychiatrist, and toughed out the (very) brief meeting with him, not wanting to appear too needy. I’ve been feeling very very crazy & suicidal all week and on Wednesday we upped my Effexor dose to 300mg per day.

Are you still taking Depakote? I had prepared a long logical argument with graphs to convince him that the antidepressant side effects were actually causing more depression than they were treating, but he wanted to try more instead of less (I suggested sliding down from 225mg to 150mg). OK. One of my past bad habits has been becoming so upset & mistrustful of my mental health caregivers that I just bail out. I’m trying to trust this young guy (I’ve been taking SSRIs longer than he’s prescribing them). I think this 300mg dose is starting to undercut the good effects of the Depakote (1250mg).

It may be….I guess only time will tell. Has he considered the possibility of adding a 2nd adjunct MS to the Depakote? But then I had to deal with the billing process and the Medicaid office and the damn back & forth (I’m broke & have no money so the clinic will offer me a sliding scale, but because I need meds I applied for Medicaid, but because I applied for Medicaid the clinic won’t offer me a sliding scale and I won’t find out for 2 weeks whether I’ve been approved for Medicaid und so weiter). It was real bad, very Stanislaw Lem.

The bureaucratic run around is so frustrating….and IMO unnecessary. This is a stressor you definitely don’t need (nor does anyone for that matter)!! I feel like I’m failing, like I’ve failed, like there is nothing ahead of me but decline. I’ve applied for SS Disability but have been denied once and the case is up for review. I haven’t paid rent yet this month, and although my sister has offered financial support, I can’t bring myself to actually avail myself of her help.

Please accept her offer. She wants to help and you can use assistance right now. When I first checked out this newsgroup, I saw a very long and angry rant about (text in quotes roughly from memory) "whiners who expect a handout…should get up off their butts and go out and work for a living…" or something to that effect.

Some of us can, and some cannot…through no fault of our own. I have an internal Republican who also says that kind of stuff to me all day long. He’s also an adamant Social Darwinist who tells me that if I don’t have money I’m worthless and that I should just get off the planet.

You are NOT worthless Jim. Just try to let that thought go!!! I dunno. My history is pretty checkered, but I did manage to keep various jobs for about 27 years. My last job was a vice-presidency. I would really like to get back to work sometime soon, but I feel so sick all the time now…this has been the worst 5 years of my life. SSD would provide a little cushion so I could eat better, not worry so much about turning into one of the myriad homeless, and get back on my feet and put myself back into the world.

I do hope you recieve it soon. Most of the time I think suicide is my only option. I’m so tired of all the pain I live with and I can’t imagine things ever getting any better. Maybe I am just a drain on the resources of others and getting out of everyone’s way would be for the best. If only I could just stop my heart….

I share similar sentiments Jim. I’m so tired of the "med go round." It is neverending. I am filled with hoplessness too <sigh. Mostly what I’m doing is just enduring. Plodding through another miserable day. No suicide, just torture. I have no other tools…. Sorry for the long rant.

Please never apologize for sharing your feelings with us. That is why we exist here. You are a worthwhile person…please  try not to succumb to the negative tapes in your head. I will keep you in my thoughts and prayers. (((((((((((((((((((((((((((((((Jim)))))))))))))))))))))))))))))))) Yours,

Response:

So it’s Saturday morning and I have a talk therapy appointment at 11. Went to the hospital yesterday to see my psychiatrist, and toughed out the (very) brief meeting with him, not wanting to appear too needy. I’ve been feeling very very crazy & suicidal all week and on Wednesday we upped my Effexor dose to 300mg per day. I had prepared a long logical argument with graphs to convince him that the antidepressant side effects were actually causing more depression than they were treating, but he wanted to try more instead of less (I suggested sliding down from 225mg to 150mg). OK. One of my past bad habits has been becoming so upset & mistrustful of my mental health caregivers that I just bail out. I’m trying to trust this young guy (I’ve been taking SSRIs longer than he’s prescribing them). I think this 300mg dose is starting to undercut the good effects of the Depakote (1250mg). But then I had to deal with the billing process and the Medicaid office and the damn back & forth (I’m broke & have no money so the clinic will offer me a sliding scale, but because I need meds I applied for Medicaid, but because I applied for Medicaid the clinic won’t offer me a sliding scale and I won’t find out for 2 weeks whether I’ve been approved for Medicaid und so weiter). It was real bad, very Stanislaw Lem. I feel like I’m failing, like I’ve failed, like there is nothing ahead of me but decline. I’ve applied for SS Disability but have been denied once and the case is up for review. I haven’t paid rent yet this month, and although my sister has offered financial support, I can’t bring myself to actually avail myself of her help. When I first checked out this newsgroup, I saw a very long and angry rant about (text in quotes roughly from memory) "whiners who expect a handout…should get up off their butts and go out and work for a living…" or something to that effect. I have an internal Republican who also says that kind of stuff to me all day long. He’s also an adamant Social Darwinist who tells me that if I don’t have money I’m worthless and that I should just get off the planet. I dunno. My history is pretty checkered, but I did manage to keep various jobs for about 27 years. My last job was a vice-presidency. I would really like to get back to work sometime soon, but I feel so sick all the time now…this has been the worst 5 years of my life. SSD would provide a little cushion so I could eat better, not worry so much about turning into one of the myriad homeless, and get back on my feet and put myself back into the world. Most of the time I think suicide is my only option. I’m so tired of all the pain I live with and I can’t imagine things ever getting any better. Maybe I am just a drain on the resources of others and getting out of everyone’s way would be for the best. If only I could just stop my heart…. Mostly what I’m doing is just enduring. Plodding through another miserable day. No suicide, just torture. I have no other tools…. Sorry for the long rant. Jim

Response:

Question:

Individual is a 48 year old male who underwent chemotherapy and concurrent radiation for squamous cell carcinoma of the anal canal.  The exquisite pain was treated with high dose oxycontin for the past 12 weeks.  He withdrew it gradually, but is experiencing panic symptoms, acute anxiety of every type and is being treated with Zoloft, Xanax and for nightime, Klonopin.  His symptoms are still not relieved and his fears and he is concerned he may never live normally again although the cancer treatment is completed and that appears done.  Any suggestions as to how to treat this panic and relatied withdrawl from the Oxycontin? Paradocs

Response:

Individual is a 48 year old male who underwent chemotherapy and concurrent radiation for squamous cell carcinoma of the anal canal.  The exquisite pain was treated with high dose oxycontin for the past 12 weeks.  He withdrew it gradually, but is experiencing panic symptoms, acute anxiety of every type and is being treated with Zoloft, Xanax and for nightime, Klonopin.  His symptoms are still not relieved and his fears and he is concerned he may never live normally again although the cancer treatment is completed and that appears done.  Any suggestions as to how to treat this panic and relatied withdrawl from the Oxycontin? Paradocs

My first reaction is "why hasn’t this guy been referred to a psychiatrist"!! However, there seem to be two issues here. One the problems (incl. possibly anxiety) being caused by withdrawal from a pain killer, and the anxiety being experience as a result of having been confronted by his immortality. It seems that he is on a standard medication treatment regime for anxiety. It may not be working for several reasons. Most antidepressants, incl. Zoloft, take time to work, usually 4 to 8 weeks, so if he has been taking this med for a lesser time, then patience is needed. And it is very probable that his anxiety has been made worse by Zoloft. Most of the SSRI meds seem to produce this affect in the first few weeks. It can be minimised by starting at a small dose (1/4 the lowest dose tab is a good starting point) and ramping up slowly. However, both the Xanax and Klonopin should be relieving most of his anxiety. Perhaps, the dosage of both needs to be reassessed, docs being notoriously benzo phobic often prescribe doses that are next to useless. And Cognitive Behaviour Therapy may help this person a great deal, both in dealing with the anxiety of "loosing" his protection against the pain, and also in coming to terms with the wider issue of having faced a life threatening illness. Ian

Response:

Hi Paradocs, I want you to know that I did at one time have to be put on pain meds for a period of six months.  My doctor cut my doses gradually and then put me on xanax 1mg five times a day.  I am female, 5′ 8 and did weight about 120 at the time.  The xanax really did the trick for me.  Of course I am still on the xanax because of anxiety and panic, but kicking the pain killers is really a tough thing to do.  All I can say is to hang in there.  I would definatly go back to your doctor and have him boost up your xanax intake.  You can be weined (sorry about the spelling) off the xanax a lot easier then the pain meds.  I am now taking 1mg of xanax three times a day.  I wish you the very best in luck and just remember, We care!! Take Care & God Bless Clandery   (e-mail  www.Clandery.com)

Response:

Question:

WebfootVA schreef: – Hide quoted text — Show quoted text – BTW, though you said you take it at night.  Do you eat dinner late or do you take it with a snack?  If I started to eat my dinner at 9pm I would not only have bad indigestion, I’d probably weigh about 10 pounds more than I do now! Hi Iris, I do both.  I used to eat late dinners when I worked until 9pm so I could eat with my husband in the past.  For me, this was never a big deal.  I either eat a very light dinner at 5pm with my kids and a big snack later on, or I just have a late dinner, but I always eat before the meds. I also work out 5-6 times a week in the mornings at the gym as I’ve tended to gain weight with any of the meds in the past and I didn’t want to go that route again.  It also helps a lot with the everyday stress and gives me exposure to the rapid heart rate….rapid breathing symptoms, which I’m hoping will eventually help me prevent relapse once this goes into remission again. take care, Lene Well, I’ll probably have to take it in the morning then, or at least with my dinner around 7pm.  If I eat much later, I feel queasy when I go to bed. I need to start working out again.  I don’t have a weight problem but I am noticing a growing flab problem!  Exercise was my salvation when I had PA’s 10 years ago, but now I’ve developed a bit of a phobia–also, I suspect tied to the rapid heart rate, sweating, etc. BTW, the doc wants me to start out on 25 mg for a week then increase to 50mg where I’ll stay if the drug is successful.  Is 25 mg a low enough dose to start? Should I ask him for a lower dose?  I only weigh about 112, although I have a friend who doesn’t even tip the scales at 100 lbs and she started at 50 mg with no problem. Ever more questions. Iris —

  Iris, I feel your doctor knows about your fear of meds (which I recognize completely) and therefore starts your medication on a very low dose indeed. You should have no problems taking this at any time of the day. And: the proof of the pudding is in the eating. Try it and do it asap because you’ve been torturing yourself for too long now. Just do it! You’ll survive. Just as I did, so many times now (and still fraking out over every new med but having learnt to take it. If I can do it, you certainly can! I wish you knew me better to discover how true this is… Philip Peters

Response:

– Hide quoted text — Show quoted text – WebfootVA schreef: BTW, though you said you take it at night.  Do you eat dinner late or do you take it with a snack?  If I started to eat my dinner at 9pm I would not only have bad indigestion, I’d probably weigh about 10 pounds more than I do now! Hi Iris, I do both.  I used to eat late dinners when I worked until 9pm so I could eat with my husband in the past.  For me, this was never a big deal.  I either eat a very light dinner at 5pm with my kids and a big snack later on, or I just have a late dinner, but I always eat before the meds. I also work out 5-6 times a week in the mornings at the gym as I’ve tended to gain weight with any of the meds in the past and I didn’t want to go that route again.  It also helps a lot with the everyday stress and gives me exposure to the rapid heart rate….rapid breathing symptoms, which I’m hoping will eventually help me prevent relapse once this goes into remission again. take care, Lene Well, I’ll probably have to take it in the morning then, or at least with my dinner around 7pm.  If I eat much later, I feel queasy when I go to bed. I need to start working out again.  I don’t have a weight problem but I am noticing a growing flab problem!  Exercise was my salvation when I had PA’s 10 years ago, but now I’ve developed a bit of a phobia–also, I suspect tied to the rapid heart rate, sweating, etc. BTW, the doc wants me to start out on 25 mg for a week then increase to 50mg where I’ll stay if the drug is successful.  Is 25 mg a low enough dose to start? Should I ask him for a lower dose?  I only weigh about 112, although I have a friend who doesn’t even tip the scales at 100 lbs and she started at 50 mg with no problem. Ever more questions. Iris —   Iris, I feel your doctor knows about your fear of meds (which I recognize completely) and therefore starts your medication on a very low dose indeed. You should have no problems taking this at any time of the day. And: the proof of the pudding is in the eating. Try it and do it asap because you’ve been torturing yourself for too long now. Just do it! You’ll survive. Just as I did, so many times now (and still fraking out over every new med but having learnt to take it. If I can do it, you certainly can! I wish you knew me better to discover how true this is… Philip Peters

Philip: What a nice reply!  I’m going to print it out and tape it to the mirror, ’cause I’ve decided I’m going to start tonight! Iris (hoping to be successful…) —

Response:

– Hide quoted text — Show quoted text – BTW, though you said you take it at night.  Do you eat dinner late or do you take it with a snack?  If I started to eat my dinner at 9pm I would not only have bad indigestion, I’d probably weigh about 10 pounds more than I do now! Hi Iris, I do both.  I used to eat late dinners when I worked until 9pm so I could eat with my husband in the past.  For me, this was never a big deal.  I either eat a very light dinner at 5pm with my kids and a big snack later on, or I just have a late dinner, but I always eat before the meds. I also work out 5-6 times a week in the mornings at the gym as I’ve tended to gain weight with any of the meds in the past and I didn’t want to go that route again.  It also helps a lot with the everyday stress and gives me exposure to the rapid heart rate….rapid breathing symptoms, which I’m hoping will eventually help me prevent relapse once this goes into remission again. take care, Lene

Well, I’ll probably have to take it in the morning then, or at least with my dinner around 7pm.  If I eat much later, I feel queasy when I go to bed. I need to start working out again.  I don’t have a weight problem but I am noticing a growing flab problem!  Exercise was my salvation when I had PA’s 10 years ago, but now I’ve developed a bit of a phobia–also, I suspect tied to the rapid heart rate, sweating, etc. BTW, the doc wants me to start out on 25 mg for a week then increase to 50mg where I’ll stay if the drug is successful.  Is 25 mg a low enough dose to start? Should I ask him for a lower dose?  I only weigh about 112, although I have a friend who doesn’t even tip the scales at 100 lbs and she started at 50 mg with no problem. Ever more questions. Iris —

Response:

BTW, though you said you take it at night.  Do you eat dinner late or do you take it with a snack?  If I started to eat my dinner at 9pm I would not only have bad indigestion, I’d probably weigh about 10 pounds more than I do now! Hi Iris,

I do both.  I used to eat late dinners when I worked until 9pm so I could eat with my husband in the past.  For me, this was never a big deal.  I either eat a very light dinner at 5pm with my kids and a big snack later on, or I just have a late dinner, but I always eat before the meds. I also work out 5-6 times a week in the mornings at the gym as I’ve tended to gain weight with any of the meds in the past and I didn’t want to go that route again.  It also helps a lot with the everyday stress and gives me exposure to the rapid heart rate….rapid breathing symptoms, which I’m hoping will eventually help me prevent relapse once this goes into remission again. take care, Lene – Hide quoted text — Show quoted text –

Response:

Okay, after taking Zoloft for the first time last night, I felt so wired up today. How long are the side effects going to take? Why do some people have more side effects at first than others? PS make sure you eat with it.  I noticed a BIG difference in severity of side effects depending on whether I had a full stomache or not.

Good advice Lene.  I’m still working on starting my Zoloft (sigh…) and the reason I was leaning toward taking it at breakfast was to lessen the side effect possibility.  I’ve had this reaction with several other drugs. If I take them with food (if it’s an option), I always tolerate them better.  I’m not a scientist, but I think food slows the absorbtion rate, so your body can better adjust. BTW, though you said you take it at night.  Do you eat dinner late or do you take it with a snack?  If I started to eat my dinner at 9pm I would not only have bad indigestion, I’d probably weigh about 10 pounds more than I do now! Iris —

Response:

Okay, after taking Zoloft for the first time last night, I felt so wired up today. How long are the side effects going to take?

<snipped for space I’m not a doctor but I do believe that, while there is a possibility that you are experiencing a reaction to Zoloft, it’s an infinitessimal one. Most likely you have hyped yourself up over it with anticipation. ISTM a little too early for any reaction at all, good or bad… Sad to say, we anxiety types do this all too easily — Gary Cooper

Response:

Okay, after taking Zoloft for the first time last night, I felt so wired up today. How long are the side effects going to take? Why do some people have more side effects at first than others?

Side effects with zoloft at first are extremely common.  I’ve been on it for 10 weeks, My side effects lasted about four weeks.  However, my husband who is also on zoloft for chronic pain management had few side effects and none of the ones that I did.    I found that I had to work a bit with the time I took it, to manage the side effects better at first. Some people are just more sensitive to meds.  Myself included.  I usually have side effects to everything.  Try and keep in mind that that the side effects are a temporary situation and well worth getting through in order to give it a chance and see if this is the answer for you. PS make sure you eat with it.  I noticed a BIG difference in severity of side effects depending on whether I had a full stomache or not. take care Lene – Hide quoted text — Show quoted text –

Response:

Okay, after taking Zoloft for the first time last night, I felt so wired up today. How long are the side effects going to take? Why do some people have more side effects at first than others? Is it kind of a Riddlin effect.  Kids who take it and don’t need it tend to react to it differently and get hyped up.  and whereas kids who need the medication the most feel the effect immediately.    mmm.  in that case  is it true that if you’re feeling overanxious when initially using Zoloft   that you’re closer to healthy than you are sick?    just a hopeful thought

Response: