Question:

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

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

Response:

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

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

Response:

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

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

Response:

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

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

Response:

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

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

Response:

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

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

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

Response:

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

Response:

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

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

Response:

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

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

Response:

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

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

Response:

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

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

Response:

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

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

Response:

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

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

Response:

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

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

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

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

Response:

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

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

Response:

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

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

Response:

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

Response:

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

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

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

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

Response:

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

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

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

Response:

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

Response:

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

Thanks for the info.        Norma   <Sigline space for rent

Response:

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

Response:

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

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

Response:

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

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

Response:

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

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

Response:

Question:

Hi, new here. A little background first: I was diagnosed with mild asthma in August and was given an Rx for albuterol 2 puffs as needed. At first I was hardly using it, maybe once a week, then I started going to the gym and as advised by my Dr I’d use it prior to working out to prevent an exercise induced attack  I stopped going to the gym for awhile and just started up again 3 weeks ago. In the last week and a half I’ve been getting chest pains much like what sent me to the Dr. in the first place as well as "flutters" in my chest. I noticed that my inhaler use has gone way up, its almost daily now and some days twice and most of the time I use it and it does nothing. I plan on calling the Dr. in the morning to make an appointment, but I’m just wondering if this is normal? Other then being constantly sleepy (which I think is in part due to being unable to breathe well and part due to jitteryness from the inhaler) and the chest tightness I feel fine, no fever or anything… Sheila Marie

Response:

Hi, new here. A little background first: I was diagnosed with mild asthma in August and was given an Rx for albuterol 2 puffs as needed.

If you’re having ongoing problems, one option is to discuss other medication with your doctor, such as Singulair, Intal, Tilade, or Pulmicort. Joan Joan Marie Verba http://www.sff.net/people/Joan.Marie.Verba

Response:

Hi, new here. A little background first: I was diagnosed with mild asthma in August and was given an Rx for albuterol 2 puffs as needed. At first I was hardly using it, maybe once a week, then I started going to the gym and as advised by my Dr I’d use it prior to working out to prevent an exercise induced attack  I stopped going to the gym for awhile and just started up again 3 weeks ago. In the last week and a half I’ve been getting chest pains much like what sent me to the Dr. in the first place as well as "flutters" in my chest. I noticed that my inhaler use has gone way up, its almost daily now and some days twice and most of the time I use it and it does nothing. I plan on calling the Dr. in the morning to make an appointment, but I’m just wondering if this is normal? Other then being constantly sleepy (which I think is in part due to being unable to breathe well and part due to jitteryness from the inhaler) and the chest tightness I feel fine, no fever or anything…

You need to see your doctor ASAP. — We make war so we may live in peace. Aristotle

Response:

Hi, new here. A little background first: I was diagnosed with mild asthma in August and was given an Rx for albuterol 2 puffs as needed. If you’re having ongoing problems, one option is to discuss other medication with your doctor, such as Singulair, Intal, Tilade, or Pulmicort.

I have both Pulmicort and Singulair now. The Dr. is hoping we can get the attack under control and drop the Pulmicort in a month or so. Sheila Marie, still not quite right, but feeling better.

Response:

- Hide quoted text — Show quoted text – Hi, new here. In the last week and a half I’ve been getting chest pains much like what sent me to the Dr. in the first place as well as "flutters" in my chest. I noticed that my inhaler use has gone way up, its almost daily now and some days twice and most of the time I use it and it does nothing. I plan on calling the Dr. in the morning to make an appointment, but I’m just wondering if this is normal? You need to see your doctor ASAP.

Went today, I was scared last night, I’ve never felt anything like that before. I almost thought for sure I was having a heart attack at 28, but it wasnt. The Dr sent me home all sorts of medicine. He said we need to be more aggressive in my treatment. Seems exercise is a major trigger for me, though its one I need to find a way to get past or something. That’s the goal though, to get to a point where exercise doesn’t trigger this sort of thing. Sheila Marie

Response:

When I first started going downhill with my asthma my main complaint was being extremely tired all the time and the inhaler just sustained me but did not make me feel better. You probably need to be on a low dose of Flovent to start and probably Accolate. Go see your doc! And if he doesn’t change your meds than go to another doctor b/c your asthma will only worsen w/o proper treatment!! Dana

Response:

I’m glad to hear your doctor gave you some preventive meds instead of just rescue meds like albuterol. You should feel better soon! Dana

Response:

Question:

- Hide quoted text — Show quoted text – After this I tried Celexa, Effexor and Zoloft.  Each helped for a week or two and then the irritability and aggression began to steadily increase until it became urgent that I stop the drug. Hi Louise, I had feelings and thoughts of aggression for a few weeks after starting to raise the Zoloft dose to high levels. What I did was take a little bit of Benadryl, about a few grains from a broken store-brand capsule, to settle the agitation.  Eventually after a few days of the Benadryl the agitation stopped and never came back again. I also started raising the dose very gradually. I have a family history of bipolar (called manic depressive back then), and my pdoc concluded that I should NEVER take any more SSRIs because I have the biological tendency to become manic from them. Are you sure you are manic on them permanently? Some of us get manic on them for a while, but only for a while. I was euphorically hypomanic from Zoloft for four months, with some jitters thrown in.  Eventually all that left. How long were you on any of the SSRIs? So, does anyone know whether the Klonopin would prevent the irritable, agitated and aggressive symptoms that I always get after a few weeks on an SSRI?  Would it be worth trying an SSRI now that I am solidly on Klonopin or is it likely that the same thing will happen? Well, I took Benadryl for a few days to calm down the agitation. It wasn’t much–just a few grains once or twice a day–not enough to make one sleepy. It worked for me.  It is used to help those who go through akathisia/ agressiveness when having starting SSRIs.  It may or may not work for you.

I was never on an SSRI for more than a month or two because my I and my pdoc and my therapist became fearful that my anger and irritation were so intense that I would lose control and they felt I should get off of them. I guess I was wondering whether the Klonopin would be like the Benedryl. Louise — The charter is available at: http://readystump.algebra.com/~asapm

Response:

- Hide quoted text — Show quoted text – ::Two people I was very close to have passed away in the last ::6 months and another is moving far away in about 6 weeks. ::The moving has thrown me over the line and I am becoming ::more and chronically depressed, hopeless and it’s getting ::real hard to function in the mornings. <gently snipped Dear Louise, Sorry about all the loss in your life. (((((Louise))))) You seem so sensitive to lots of medication. Have you thought about getting some therapy to help deal with your feelings of loss? It could help you a lot. Healing thoughts being sent your way. Jackie ~*~If you don’t like something, change it. If you can’t change it, change your attitude~*~  ~~ Maya Angelou quote

I’m sorry, I should have said that I am in therapy.  In fact, in January, my therapist of 10 years suddenly had a stroke and died – that is one of the "losses". I have started with someone else….but it’s not the same and I don’t know if it ever will be. Louise — The charter is available at: http://readystump.algebra.com/~asapm

Response:

::I’m sorry, I should have said that I am in therapy.  In ::fact, in January, my therapist of 10 years suddenly had a ::stroke and died – that is one of the "losses". I’m so sorry (((((Louise))))) Jackie ~*~Life is not the way it’s supposed to be. It’s the way it    is. The way you deal with it is what makes the difference~*~   ~~ Virginia Satir   — The charter is available at: http://readystump.algebra.com/~asapm

Response:

Over the last 10+ years, I’ve tried several SSRIs to treat a chronic low level, lifelong depression.  I have also suffered from a lot of anxiety and panic attacks and have usually been thought to have an "agitated depression" when I’ve sought psychiatric help. The only ADs that ever helped were the ones that put me to sleep and made me just able to function, but not "live", because I’d rather be sleeping, almost no matter what.  That was Luvox.  But when the dose of Luvox was raised, I didn’t become more sleepy, I became more agitated, argumentative and intolerably irritable.  I was on the verge of destruction – myself and others. After this I tried Celexa, Effexor and Zoloft.  Each helped for a week or two and then the irritability and aggression began to steadily increase until it became urgent that I stop the drug. I have a family history of bipolar (called manic depressive back then), and my pdoc concluded that I should NEVER take any more SSRIs because I have the biological tendency to become manic from them. I used Lamictal for several years with minimal success.  I need to take lots of benzos to counter the panic attacks and eventually began getting them in a variety of ways because the pdoc didn’t want me to take them every day (ativan mostly). Then I stopped the lamictal and felt better, as I suspected I would.  I was off all medication except for ativan prn for about 8 months. Then, last May (06), there were some serious changes in my life and I became extremely anxious.  I went to see a new pdoc who suggested that we focus on the panic attacks and the anxiety and see what happens.  I am now taking 2mg Klonopin daily and it has definitely helped to level me out and yet, to leave me able to feel and think clearly and have good judgment.  It has provided a lot of relief with minimal side effects.  I don’t really care that it might be addictive. Two people I was very close to have passed away in the last 6 months and another is moving far away in about 6 weeks. The moving has thrown me over the line and I am becoming more and chronically depressed, hopeless and it’s getting real hard to function in the mornings. Seroquel was suggested but I refused it because of its potential to cause diabetes.  This is a disease I dread and I will not take a drug that makes it happen to some people and they don’t know why! So, does anyone know whether the Klonopin would prevent the irritable, agitated and aggressive symptoms that I always get after a few weeks on an SSRI?  Would it be worth trying an SSRI now that I am solidly on Klonopin or is it likely that the same thing will happen? Thanks for reading this long post and for any experiences and/or suggestions you have. Louise — The charter is available at: http://readystump.algebra.com/~asapm

Response:

– Hide quoted text — Show quoted text – Over the last 10+ years, I’ve tried several SSRIs to treat a chronic low level, lifelong depression.  I have also suffered from a lot of anxiety and panic attacks and have usually been thought to have an "agitated depression" when I’ve sought psychiatric help. The only ADs that ever helped were the ones that put me to sleep and made me just able to function, but not "live", because I’d rather be sleeping, almost no matter what.  That was Luvox.  But when the dose of Luvox was raised, I didn’t become more sleepy, I became more agitated, argumentative and intolerably irritable.  I was on the verge of destruction – myself and others. After this I tried Celexa, Effexor and Zoloft.  Each helped for a week or two and then the irritability and aggression began to steadily increase until it became urgent that I stop the drug. I have a family history of bipolar (called manic depressive back then), and my pdoc concluded that I should NEVER take any more SSRIs because I have the biological tendency to become manic from them. I used Lamictal for several years with minimal success.  I need to take lots of benzos to counter the panic attacks and eventually began getting them in a variety of ways because the pdoc didn’t want me to take them every day (ativan mostly). Then I stopped the lamictal and felt better, as I suspected I would.  I was off all medication except for ativan prn for about 8 months. Then, last May (06), there were some serious changes in my life and I became extremely anxious.  I went to see a new pdoc who suggested that we focus on the panic attacks and the anxiety and see what happens.  I am now taking 2mg Klonopin daily and it has definitely helped to level me out and yet, to leave me able to feel and think clearly and have good judgment.  It has provided a lot of relief with minimal side effects.  I don’t really care that it might be addictive. Two people I was very close to have passed away in the last 6 months and another is moving far away in about 6 weeks. The moving has thrown me over the line and I am becoming more and chronically depressed, hopeless and it’s getting real hard to function in the mornings. Seroquel was suggested but I refused it because of its potential to cause diabetes.  This is a disease I dread and I will not take a drug that makes it happen to some people and they don’t know why! So, does anyone know whether the Klonopin would prevent the irritable, agitated and aggressive symptoms that I always get after a few weeks on an SSRI?

Klonopin isn’t a mood stabilizer, so my guess is that it wouldn’t prevent a mood swing to hypomania/mania. Our resident psychiatrist Margrove might be able to suggest a good med combo. Bupropion (Wellbutrin) is used for depression in bipolars cause it is thought it is less likely than other antidepressants to result in a mood swing . Chip — The charter is available at: http://readystump.algebra.com/~asapm

Response:

::Two people I was very close to have passed away in the last ::6 months and another is moving far away in about 6 weeks. ::The moving has thrown me over the line and I am becoming ::more and chronically depressed, hopeless and it’s getting ::real hard to function in the mornings. <gently snipped Dear Louise, Sorry about all the loss in your life. (((((Louise))))) You seem so sensitive to lots of medication. Have you thought about getting some therapy to help deal with your feelings of loss? It could help you a lot. Healing thoughts being sent your way. Jackie ~*~If you don’t like something, change it. If you can’t change it, change your attitude~*~  ~~ Maya Angelou quote — The charter is available at: http://readystump.algebra.com/~asapm

Response:

After this I tried Celexa, Effexor and Zoloft.  Each helped for a week or two and then the irritability and aggression began to steadily increase until it became urgent that I stop the drug.

Hi Louise, I had feelings and thoughts of aggression for a few weeks after starting to raise the Zoloft dose to high levels. What I did was take a little bit of Benadryl, about a few grains from a broken store-brand capsule, to settle the agitation.  Eventually after a few days of the Benadryl the agitation stopped and never came back again. I also started raising the dose very gradually. I have a family history of bipolar (called manic depressive back then), and my pdoc concluded that I should NEVER take any more SSRIs because I have the biological tendency to become manic from them.

Are you sure you are manic on them permanently? Some of us get manic on them for a while, but only for a while. I was euphorically hypomanic from Zoloft for four months, with some jitters thrown in.  Eventually all that left. How long were you on any of the SSRIs? So, does anyone know whether the Klonopin would prevent the irritable, agitated and aggressive symptoms that I always get after a few weeks on an SSRI?  Would it be worth trying an SSRI now that I am solidly on Klonopin or is it likely that the same thing will happen?

Well, I took Benadryl for a few days to calm down the agitation. It wasn’t much–just a few grains once or twice a day–not enough to make one sleepy. It worked for me.  It is used to help those who go through akathisia/ agressiveness when having starting SSRIs.  It may or may not work for you. — The charter is available at: http://readystump.algebra.com/~asapm

Response:

Question:

- Hide quoted text — Show quoted text – My anxiety/panic attacks are actually a lot better than they use to be.  My depression isn’t as intense as it was say a couple of months ago either.  Right now, my biggest problem seems to be obsessive thoughts that I cannot get out of my mind.  For example, I called a lady friend of mine night before last and she still hasn’t called me back.  She normally calls be back shortly after I call her.  This evening I have gotten myself all worked up about her not calling, thinking that she doesn’t like me anymore or is mad at me about something.  Does anyone else experience this obsessive type of thinking?  Is it part of anxiety or is it possibly a deeper problem?  Take care and happy Easter. Yes. A thought goes through my mind and it circulates and intensifies and it becomes very hard to get rid of. At times the thoughts are very positive obsessions (now that the Zoloft is lifting the depression); other times they are negative obsessions. It could be part of anxiety or depression IMO. The Zoloft has merely transferred them more often to the "positive zone." Of course, you constantly have to work to break those negative cycles. Don’t simmer on anything but positive obsessions.

Hello Marie, Thanks for your reply.  Obsessing about things is a big problem with me.  It seems everyday I am obsessing about some new thought or worry. I have been really bad for this for about six years now.  Sometimes I’ll get so worked up I’ll be just beside myself and don’t know what to do.  When I get like this Seroquel PRN seems to be really helpful. Anyways, thanks again for your reply.  Take care. Chris Hecker

Response:

Hello group, I have been struggling with anxiety pretty much my entire adult life. In addition to anxiety I also suffer from depression, possibly bi-polar.  The meds that I am curently on are Effexor XR- 150 mg Seroquel – 50 mg HS Inderal (to counteract shaking caused by my meds) 40 mg Lithium carbonate – 600 mg HS My anxiety/panic attacks are actually a lot better than they use to be.  My depression isn’t as intense as it was say a couple of months ago either.  Right now, my biggest problem seems to be obsessive thoughts that I cannot get out of my mind.  For example, I called a lady friend of mine night before last and she still hasn’t called me back.  She normally calls be back shortly after I call her.  This evening I have gotten myself all worked up about her not calling, thinking that she doesn’t like me anymore or is mad at me about something.  Does anyone else experience this obsessive type of thinking?  Is it part of anxiety or is it possibly a deeper problem?  Take care and happy Easter. Chris H. Internet Security 101 – http://www.internetsecurity101.net

Response:

My anxiety/panic attacks are actually a lot better than they use to be.  My depression isn’t as intense as it was say a couple of months ago either.  Right now, my biggest problem seems to be obsessive thoughts that I cannot get out of my mind.  For example, I called a lady friend of mine night before last and she still hasn’t called me back.  She normally calls be back shortly after I call her.  This evening I have gotten myself all worked up about her not calling, thinking that she doesn’t like me anymore or is mad at me about something.  Does anyone else experience this obsessive type of thinking?  Is it part of anxiety or is it possibly a deeper problem?  Take care and happy Easter.

Yes. A thought goes through my mind and it circulates and intensifies and it becomes very hard to get rid of. At times the thoughts are very positive obsessions (now that the Zoloft is lifting the depression); other times they are negative obsessions. It could be part of anxiety or depression IMO. The Zoloft has merely transferred them more often to the "positive zone." Of course, you constantly have to work to break those negative cycles. Don’t simmer on anything but positive obsessions.

Response:

Question:

I am not a doctor. All medications work differently but Celexa has a good reputation for not having many side effects. NK "Tati" <azevedobor…@planet.nl

wrote in message

news:339dd1ca.0401121648.9a00fa3@posting.google.com… – Hide quoted text — Show quoted text -

hi, after a post natale depression with some agravations (like bad relationships and such) i started taking antidepressants and found out that i felt better with them then without them. even so, i didnt take any for 7 years and started with paroxetine 4 years ago. since then i am able to have a very good relation with my lovely son, able to cope with life, lead a happy life and have a job that is on my level for the first time in my life ( i am 44!, 2 universities and several low education – low pay jobs) because of some worries about the side effects of the paroxetine i was taking, like heart palpitations, head eaches and weight gain, i consulted a psychiatrist in brazil (where i came from ) and asked him to give me some lighter stuff. so, he prescribed Ixel/ milnacipran. back in the netherlands: this is a medicine that is not registered here. i simply cannot get it here! the doctor here told me to take effexor instead. well, effexor’s nick name is " side effexor" what does not inspire me. what then? zoloft? Celexa? someone has some nice idea? and: i just started with Ixel/ milnacipran 4 days ago. i am taking it instead of paroxetine. well, i can hardly stand up because of dizzyness…. i just dont know what to do now…. txs 4 any help! claudia

Response:

Hi Claudia, I’m sorry that you’re seeing the side effects.  Hopefully, they’ll get better with time. Of the SSRI’s, I’ve found that Celexa and Lexapro to be low on side effects and effective.   YMMV. Welcome to the group. Erik – Hide quoted text — Show quoted text -Tati wrote:

hi, after a post natale depression with some agravations (like bad relationships and such) i started taking antidepressants and found out that i felt better with them then without them. even so, i didnt take any for 7 years and started with paroxetine 4 years ago. since then i am able to have a very good relation with my lovely son, able to cope with life, lead a happy life and have a job that is on my level for the first time in my life ( i am 44!, 2 universities and several low education – low pay jobs) because of some worries about the side effects of the paroxetine i was taking, like heart palpitations, head eaches and weight gain, i consulted a psychiatrist in brazil (where i came from ) and asked him to give me some lighter stuff. so, he prescribed Ixel/ milnacipran. back in the netherlands: this is a medicine that is not registered here. i simply cannot get it here! the doctor here told me to take effexor instead. well, effexor’s nick name is " side effexor" what does not inspire me. what then? zoloft? Celexa? someone has some nice idea? and: i just started with Ixel/ milnacipran 4 days ago. i am taking it instead of paroxetine. well, i can hardly stand up because of dizzyness…. i just dont know what to do now…. txs 4 any help! claudia

Response:

Hi Claudia I am on 150mg Efexor, venlafaxine. I have heard about its side effects but havent really had any. When I first started taking it I got weird dreams but they went after a while. I am told thats true for most of the side effects of Effexor, they go after your body gets used to it. Efexor has helped me alot and i feel much happier. Previously i was on prozac and it did nothing for me at all ( Lawrence "Tati" <azevedobor…@planet.nl

wrote in message

news:339dd1ca.0401121648.9a00fa3@posting.google.com… – Hide quoted text — Show quoted text -

hi, after a post natale depression with some agravations (like bad relationships and such) i started taking antidepressants and found out that i felt better with them then without them. even so, i didnt take any for 7 years and started with paroxetine 4 years ago. since then i am able to have a very good relation with my lovely son, able to cope with life, lead a happy life and have a job that is on my level for the first time in my life ( i am 44!, 2 universities and several low education – low pay jobs) because of some worries about the side effects of the paroxetine i was taking, like heart palpitations, head eaches and weight gain, i consulted a psychiatrist in brazil (where i came from ) and asked him to give me some lighter stuff. so, he prescribed Ixel/ milnacipran. back in the netherlands: this is a medicine that is not registered here. i simply cannot get it here! the doctor here told me to take effexor instead. well, effexor’s nick name is " side effexor" what does not inspire me. what then? zoloft? Celexa? someone has some nice idea? and: i just started with Ixel/ milnacipran 4 days ago. i am taking it instead of paroxetine. well, i can hardly stand up because of dizzyness…. i just dont know what to do now…. txs 4 any help! claudia

Response:

Hey Loz, How exactly do you feel effexor helps you? With the thoughts? the mood? the anxiety? or a bit of everything? I am finding it useless for the ocd..great for the depression and the withdrawal effects are awful.. Thanks for any help you can give! Am. xxx "Loz" <lawrence.whale@ntlworld-REMOVE_THIS-.com

wrote in message

news:CZTMb.2666$YV1.214@newsfep4-winn.server.ntli.net… – Hide quoted text — Show quoted text -

Hi Claudia I am on 150mg Efexor, venlafaxine. I have heard about its side effects but havent really had any. When I first started taking it I got weird dreams

but

they went after a while. I am told thats true for most of the side effects of Effexor, they go after your body gets used to it. Efexor has helped me alot and i feel much happier. Previously i was on prozac and it did

nothing > for me at all ( > Lawrence > "Tati" <azevedobor…@planet.nl

wrote in message

> news:339dd1ca.0401121648.9a00fa3@posting.google.com… > > hi, > > after a post natale depression with some agravations (like bad > > relationships and such) i started taking antidepressants and found out > > that i felt better with them then without them. > > even so, i didnt take any for 7 years and started with paroxetine 4 > > years ago. > > since then i am able to have a very good relation with my lovely son, > > able to cope with life, lead a happy life and have a job that is on my > > level for the first time in my life ( i am 44!, 2 universities and > > several low education – low pay jobs) > > because of some worries about the side effects of the paroxetine i was > > taking, like heart palpitations, head eaches and weight gain, i > > consulted a psychiatrist in brazil (where i came from ) and asked him > > to give me some lighter stuff. > > so, he prescribed Ixel/ milnacipran. > > back in the netherlands: this is a medicine that is not registered > > here. i simply cannot get it here! > > the doctor here told me to take effexor instead. > > well, effexor’s nick name is " side effexor" what does not inspire me. > > what then? > > zoloft? > > Celexa? > > someone has some nice idea? > > and: > > i just started with Ixel/ milnacipran 4 days ago. i am taking it > > instead of paroxetine. well, i can hardly stand up because of > > dizzyness…. > > i just dont know what to do now…. > > txs 4 any help! > > claudia

Response:

Am. Hi, Effexor has mainly helped me with my depression. 3 months ago I felt terrible and today I feel more like my old self, generally feel fairly happy ) I think it has helped my anxiety a little but I still get quite anxiuos at times. I dont think that it has helped with the OCD thoughts much. Thankfully I dont get any effexor side effects now. I think I will be sticking with this AD for the time being. It would be nice to be able to take a pill that gets rid of the OCD but in my case, mostly pure OCD, I dont think this will happen. I have just got to learn to control my mind through CBT which will be quite an effort but worth it in the end. Maybe another drug to help with my nerves/anxiety/worry might be useful, I will be asking my pdoc next week. Take care Lawrence "Pola_Pink" <pola_pin…@no.spam.hotmail.com

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news:Qk5Pb.212$Jc6.4668@nnrp1.ozemail.com.au… – Hide quoted text — Show quoted text -

Hey Loz, How exactly do you feel effexor helps you? With the thoughts? the mood?

the

anxiety? or a bit of everything? I am finding it useless for the

ocd..great > for the depression and the withdrawal effects are awful.. > Thanks for any help you can give! > Am. > xxx > "Loz" <lawrence.whale@ntlworld-REMOVE_THIS-.com

wrote in message

> news:CZTMb.2666$YV1.214@newsfep4-winn.server.ntli.net… > > Hi Claudia > > I am on 150mg Efexor, venlafaxine. I have heard about its side effects but

havent really had any. When I first started taking it I got weird dreams but they went after a while. I am told thats true for most of the side

effects

of Effexor, they go after your body gets used to it. Efexor has helped

me > > alot and i feel much happier. Previously i was on prozac and it did > nothing > > for me at all ( > > Lawrence > > "Tati" <azevedobor…@planet.nl

wrote in message

> > news:339dd1ca.0401121648.9a00fa3@posting.google.com… > > > hi, > > > after a post natale depression with some agravations (like bad > > > relationships and such) i started taking antidepressants and found out > > > that i felt better with them then without them. > > > even so, i didnt take any for 7 years and started with paroxetine 4 > > > years ago. > > > since then i am able to have a very good relation with my lovely son, > > > able to cope with life, lead a happy life and have a job that is on my > > > level for the first time in my life ( i am 44!, 2 universities and > > > several low education – low pay jobs) > > > because of some worries about the side effects of the paroxetine i was > > > taking, like heart palpitations, head eaches and weight gain, i > > > consulted a psychiatrist in brazil (where i came from ) and asked him > > > to give me some lighter stuff. > > > so, he prescribed Ixel/ milnacipran. > > > back in the netherlands: this is a medicine that is not registered > > > here. i simply cannot get it here! > > > the doctor here told me to take effexor instead. > > > well, effexor’s nick name is " side effexor" what does not inspire me. > > > what then? > > > zoloft? > > > Celexa? > > > someone has some nice idea? > > > and: > > > i just started with Ixel/ milnacipran 4 days ago. i am taking it > > > instead of paroxetine. well, i can hardly stand up because of > > > dizzyness…. > > > i just dont know what to do now…. > > > txs 4 any help! > > > claudia

Response:

hi, after a post natale depression with some agravations (like bad relationships and such) i started taking antidepressants and found out that i felt better with them then without them. even so, i didnt take any for 7 years and started with paroxetine 4 years ago. since then i am able to have a very good relation with my lovely son, able to cope with life, lead a happy life and have a job that is on my level for the first time in my life ( i am 44!, 2 universities and several low education – low pay jobs) because of some worries about the side effects of the paroxetine i was taking, like heart palpitations, head eaches and weight gain, i consulted a psychiatrist in brazil (where i came from ) and asked him to give me some lighter stuff. so, he prescribed Ixel/ milnacipran. back in the netherlands: this is a medicine that is not registered here. i simply cannot get it here! the doctor here told me to take effexor instead. well, effexor’s nick name is " side effexor" what does not inspire me. what then? zoloft? Celexa? someone has some nice idea? and: i just started with Ixel/ milnacipran 4 days ago. i am taking it instead of paroxetine. well, i can hardly stand up because of dizzyness…. i just dont know what to do now…. txs 4 any help! claudia

Response:

Question:

– Hide quoted text — Show quoted text – you have the right to ask him this very question-there may be enumerable reasons why he wants you to go off zoloft-some may even be valid, but that does not mean you have to, or he is right. It is fine for a doc to change their mind,  but their principal obligation is to you as your medical doctor who’s goal is to make your life better, not more confusing or anxiety producing. Please don’t spend time worrying about his motives his comments or his attitude. Enjoy your holiday as best as you can and deal with this next week. If he does not give you a reasonable explanation, it may be time to find another doctor-you may have outgrown this one. LM, Brilliant post.  You know, now that you mention it, one of my main complaints with him  is that I don’t think this particular doc specializes in Anxiety disorders.  Thus, if we are talking about anxiety or GAD, he doesn’t mind saying what "could" happen.  As in: "Yes, zoloft works for you, but it ‘could’ fail you.", etc.  I feel like saying:  Well, Gee whiz doc, I had never thought of what ‘could’ happen….Why don’t you tell me something else that COULD happen? Could Zoloft cause any permanent physical problems?  "There is no evidence that it causes heart valve failure, but similar drugs do, so heart valve failure ‘could’ happen." I have left many appointments feeling more anxious than when I went in. I think for the new year I’ll hunt for a new Pdoc  (by the way, why do people use the term Pdoc in here?)

Hi, Ron — I think it’s the convention of the group to use the term pdoc to refer to the doctor one sees to treat one’s complaints/problems or whatnot.  For a lot of people, if not most, I think the word pdoc is seen as a shortened term for psychiatrist.  However, there are instances in which people are being treated for their anxiety/panic disorder by someone who is not a psychiatrist – be it psychologist, general practice doctor, or medicine man. Best Wishes — Blue (one who is now seeing a psychiatrist – FINALLY!… ) Remove mypants to email me

Response:

Yes that’s me…sigh.  I don’t know.  5 years ago he said I’d probably be on it the rest of my life.  Now this year, there is this push for me to scale back.  I don’t get it.

you have the right to ask him this very question-there may be enumerable reasons why he wants you to go off zoloft-some may even be valid, but that does not mean you have to, or he is right. It is fine for a doc to change their mind,  but their principal obligation is to you as your medical doctor who’s goal is to make your life better, not more confusing or anxiety producing. Please don’t spend time worrying about his motives his comments or his attitude. Enjoy your holiday as best as you can and deal with this next week. If he does not give you a reasonable explanation, it may be time to find another doctor-you may have outgrown this one. LM

Response:

Ron, Find a new psychiatrist. Run away from this guy.  Run don’t walk !!!! Start looking now while you still have a prescription. Try to speak to potential psychiatrists and explain the situation to them. See how they respond and go with the pdoc that you feel understands you. You are the customer. Find a new source for your health care. Tony

Response:

Well, I just got back from meeting with my Psychiatrist.  I told him I am feeling much better now that I am back up to my original dose of 100mg. of Zoloft.  And the whole nine yards… After I finished my speal about "whew, I’m glad all that (anxiety) is over…."  He then took that opportunity to tell me he recommends I still scale down if not off completely from zoloft and that I see a therapist to work through some issues I have with my childhood.  He said this process will take a long time possibly years, but it would be for the best.

It’s time to go doctor shopping, Ron. Finally something works again and he wants to take you off it…that is not only bad medicine, it’s also downright cruel. Many people need meds and at this pojt you seem to be one of them (as am I). Moreover *working through issues you have with your childhood* is totally useless as a therapy to get rid of anxiety symptoms as any doc worth his salt should know. The therapy of choice is *Cognitive Behavioral Therapy* which is very much a here-and-now therapy. Have you ever tried it? If not, it is highly recommended. I asked him what gave him the idea that I could be off of meds and still function?  His response was that my depression/anxiety was at a moderate to moderate/low level and as such, doesn’t necessarily require medication to fight.

I see…*he* know what you go through better than *you* do? I don’t think so. I am feeling totally confused now.  I’ve tried to scale off of zoloft twice now.  Perhaps I went too rapidly both times, I don’t know.  I dropped off Zoloft completely the first time in about 8 weeks.  The second time I dropped my dosage by .25mg increments and started having anxiety attacks when I hit .50mg (1/2 my optimal dose)   How am I supposed to scale off this time?  Drop by 12.5mg increments and pray?

I wouldn’t stop taking it. It helps you. I *would* do CBT, see what that gets me and if I can maybe do without meds then. If not, that’s fine too. I don’t know folks…what do you think?  Cut my dose in half?  I’d love to.  Elliminate it completely?  There is nothing I’d like better – I’d even do back flips.

Why? If it works, it works. And a med that works is a thing to cherish.  But I just don’t know how I’m going to do it unless I could be hospitalized or something.  I lost 6 months of my life to anxiety the first time I agressively quit zoloft.  When I scaled back, I suffered for 3 weeks till I got stabilized again.  

Please find another pdoc, someone who knows what (s)he is talking about,. Don’t let this clown confuse you. Philip – Hide quoted text — Show quoted text –

Response:

:Also, this whole situation is causing me alot of anxiety as well. amn.  After almost 2 weeks without Xanax I am feeling like I need one :now. {{{{{Ron}}}}} Your pdoc is suppose to help decrease your anxiety, not add to it. Your anxiety might be trying to tell you that you aren`t ready to stop taking zoloft. Listen to your gut. Jackie ~*~The bad things of life were very transitory.It was the good things , the ribbed sand, the wind blowing over the white capped waves , the sunshine and the stars, that were so tough and durable~*~

Response:

.S. I am going out of town tomorrow to spend the day and night at the :in-laws….that has me anxious as well – I suppose many of you can :relate. Very understandable! Happy Thanksgiving I hope you are able to enjoy yourself. Jackie ~*~The bad things of life were very transitory.It was the good things , the ribbed sand, the wind blowing over the white capped waves , the sunshine and the stars, that were so tough and durable~*~

Response:

I just got back from meeting with my Psychiatrist. he recommends I still scale down if not off completely from zoloft and that I see a therapist to work through some issues I have with my childhood.

That’s bullshit. Going into all the perils of your childhood won’t replace the zoloft and your being anxiety free, – what is done is done, (in my opinion).  I think it’s time you shopped around for someone who knows how to treat anxiety disorders. I wish you well – K  

Response:

you have the right to ask him this very question-there may be enumerable reasons why he wants you to go off zoloft-some may even be valid, but that does not mean you have to, or he is right. It is fine for a doc to change their mind,  but their principal obligation is to you as your medical doctor who’s goal is to make your life better, not more confusing or anxiety producing. Please don’t spend time worrying about his motives his comments or his attitude. Enjoy your holiday as best as you can and deal with this next week. If he does not give you a reasonable explanation, it may be time to find another doctor-you may have outgrown this one.

LM, Brilliant post.  You know, now that you mention it, one of my main complaints with him  is that I don’t think this particular doc specializes in Anxiety disorders.  Thus, if we are talking about anxiety or GAD, he doesn’t mind saying what "could" happen.  As in: "Yes, zoloft works for you, but it ‘could’ fail you.", etc.  I feel like saying:  Well, Gee whiz doc, I had never thought of what ‘could’ happen….Why don’t you tell me something else that COULD happen? Could Zoloft cause any permanent physical problems?  "There is no evidence that it causes heart valve failure, but similar drugs do, so heart valve failure ‘could’ happen." I have left many appointments feeling more anxious than when I went in. I think for the new year I’ll hunt for a new Pdoc  (by the way, why do people use the term Pdoc in here?)

Response:

– Hide quoted text — Show quoted text – Ron, Find a new psychiatrist. Run away from this guy.  Run don’t walk !!!! Start looking now while you still have a prescription. Try to speak to potential psychiatrists and explain the situation to them. See how they respond and go with the pdoc that you feel understands you. You are the customer. Find a new source for your health care. Tony

Tony, I think you are right.  I’ve still got some time – time to go pdoc shopping. Ron

Response:

- Hide quoted text — Show quoted text – Well, I just got back from meeting with my Psychiatrist.  I told him I am feeling much better now that I am back up to my original dose of 100mg. of Zoloft.  And the whole nine yards… After I finished my speal about "whew, I’m glad all that (anxiety) is over…."  He then took that opportunity to tell me he recommends I still scale down if not off completely from zoloft and that I see a therapist to work through some issues I have with my childhood.  He said this process will take a long time possibly years, but it would be for the best. I asked him what gave him the idea that I could be off of meds and still function?  His response was that my depression/anxiety was at a moderate to moderate/low level and as such, doesn’t necessarily require medication to fight. I am feeling totally confused now.  I’ve tried to scale off of zoloft twice now.  Perhaps I went too rapidly both times, I don’t know.  I dropped off Zoloft completely the first time in about 8 weeks.  The second time I dropped my dosage by .25mg increments and started having anxiety attacks when I hit .50mg (1/2 my optimal dose)   How am I supposed to scale off this time?  Drop by 12.5mg increments and pray? I don’t know folks…what do you think?  Cut my dose in half?  I’d love to.  Elliminate it completely?  There is nothing I’d like better – I’d even do back flips.  But I just don’t know how I’m going to do it unless I could be hospitalized or something.  I lost 6 months of my life to anxiety the first time I agressively quit zoloft.  When I scaled back, I suffered for 3 weeks till I got stabilized again.   Ron

Dear Ron. My suggestion is to get a second opinion… You are doing better by being on that dose of zoloft. It is imo that you should remain on that while you talk with a therapist and not worry about weaning. I don’t understand why your pysch would even mention this to you at this point. You need to get your meds adjusted, then work with a therapist. I don’t want to sound negative but I would get a second viewpoint regarding your anxiety, medications etc. I feel when a doctor or pyschiatrist starts to disgust tapering off BEFORE any set therapy or mentions that you should be off it altogether is not in your best intersests at this point in your recovery. Some people, regardless of therapy, have to maintain medications through out there life time. That shouldn’t be the issue. SO I suggest the second opinion. My doc has been so good regarding the Effexor and Ativan that I take. I wish everyone had a doctor as compassionate and patient as mine. I tried to wean off the effxor and got down to 150 per day when I started to feel so sad and anxious. So I am taking the 300 per day and am doing just fine. I take the Ativan as needed. I had childhood issues to deal with and even though I am comfortable with the results, I am still taking the medications. Maybe in a year or so I can try and wean again but my doctor says it is when I AM READY to do it… I wish you all the best and please let me know if and when you see another doctor regarding your anxiety and medications. Julie

Response:

– Hide quoted text — Show quoted text – :I don’t know folks…what do you think?  Cut my dose in half?  I’d :love to.  Elliminate it completely?  There is nothing I’d like better :- I’d even do back flips.  But I just don’t know how I’m going to do :it unless I could be hospitalized or something.  I lost 6 months of my :life to anxiety the first time I agressively quit zoloft.  When I :scaled back, I suffered for 3 weeks till I got stabilized again.   Dear Ron, Aren`t you the poster that increased their zoloft dose about 3 1/2 weeks ago because you were having a setback? If so, then I really don`t understand why your doctor would want you to stop taking a med after you just got stabilized on it. I also question his recommending "analyze your childhood" type of therapy. A lot of people, myself included have done the talk therapy, rehashing one`s childhood and the past with very little to no impact on our anxiety disorder. That`s not saying that no one benefits from disorders is congnitive behavioral therapy. You can also do therapy while on medication. If I were you I would get a second opinion. What do you want to do? You seem hesitant about getting off zoloft which is understandable. Take care Jackie ~*~The bad things of life were very transitory.It was the good things , the ribbed sand, the wind blowing over the white capped waves , the sunshine and the stars, that were so tough and durable~*~

Jackie, Yes that’s me…sigh.  I don’t know.  5 years ago he said I’d probably be on it the rest of my life.  Now this year, there is this push for me to scale back.  I don’t get it. Also, this whole situation is causing me alot of anxiety as well. Damn.  After almost 2 weeks without Xanax I am feeling like I need one now. Ron

Response:

Hey Ron, He sounds like he needs those TALK sessions in HIS piggy bank, you just aren’t worth the effort for him if you are so easily managed on meds. sorry to sound so cold and heartless, but thats my NSHO ( NOT so humble opinion) Once in this anx/pan thing we seem to go round on a merry go round, maybe its NOT childhood issues but real life/real time issues. My GP and I do not always see eye to eye on details, but his philosophy here in this hospitality/resort area is that most of us in hospitality professions need medication support because our jobs are so seasonally whacky, we go from 100 MPH to zip  and back and must always be cheerful, helpful, and  NOT STRESSED~~, the epitome of   Yassa Massta. He has joked with me in the past that he thinks he ought to sneak a patent ~~~~~~~ not serious. He’s your doc, but you don’t have to be Yassa Massta.  Good point that you are comfortable at your current dose and want to stay there for a while…… in 3 or 6 or 9 months  or more you may have different insights. Feel Well Ron.  Make it a body memory like walking, running, breathing, eating, laughing, sleeping.   Most of us get stable on a med and then want to get off, we don’t take the time to internalize the good feeling and  own it. Thanks for bringing this up, disagreements with docs should give us opportunities to express our own thoughts. have a happy gobbleday, stay in your PJ/s as long as possible and absolutely indulge in the after meal nap. Sue

– Hide quoted text — Show quoted text – Well, I just got back from meeting with my Psychiatrist.  I told him I am feeling much better now that I am back up to my original dose of 100mg. of Zoloft.  And the whole nine yards… After I finished my speal about "whew, I’m glad all that (anxiety) is over…."  He then took that opportunity to tell me he recommends I still scale down if not off completely from zoloft and that I see a therapist to work through some issues I have with my childhood.  He said this process will take a long time possibly years, but it would be for the best. I asked him what gave him the idea that I could be off of meds and still function?  His response was that my depression/anxiety was at a moderate to moderate/low level and as such, doesn’t necessarily require medication to fight. I am feeling totally confused now.  I’ve tried to scale off of zoloft twice now.  Perhaps I went too rapidly both times, I don’t know.  I dropped off Zoloft completely the first time in about 8 weeks.  The second time I dropped my dosage by .25mg increments and started having anxiety attacks when I hit .50mg (1/2 my optimal dose) How am I supposed to scale off this time?  Drop by 12.5mg increments and pray? I don’t know folks…what do you think?  Cut my dose in half?  I’d love to.  Elliminate it completely?  There is nothing I’d like better – I’d even do back flips.  But I just don’t know how I’m going to do it unless I could be hospitalized or something.  I lost 6 months of my life to anxiety the first time I agressively quit zoloft.  When I scaled back, I suffered for 3 weeks till I got stabilized again. Ron

Response:

– Hide quoted text — Show quoted text – :I don’t know folks…what do you think?  Cut my dose in half?  I’d :love to.  Elliminate it completely?  There is nothing I’d like better :- I’d even do back flips.  But I just don’t know how I’m going to do :it unless I could be hospitalized or something.  I lost 6 months of my :life to anxiety the first time I agressively quit zoloft.  When I :scaled back, I suffered for 3 weeks till I got stabilized again.   Dear Ron, Aren`t you the poster that increased their zoloft dose about 3 1/2 weeks ago because you were having a setback? If so, then I really don`t understand why your doctor would want you to stop taking a med after you just got stabilized on it. I also question his recommending "analyze your childhood" type of therapy. A lot of people, myself included have done the talk therapy, rehashing one`s childhood and the past with very little to no impact on our anxiety disorder. That`s not saying that no one benefits from disorders is congnitive behavioral therapy. You can also do therapy while on medication. If I were you I would get a second opinion. What do you want to do? You seem hesitant about getting off zoloft which is understandable. Take care Jackie ~*~The bad things of life were very transitory.It was the good things , the ribbed sand, the wind blowing over the white capped waves , the sunshine and the stars, that were so tough and durable~*~

P.S. I am going out of town tomorrow to spend the day and night at the in-laws….that has me anxious as well – I suppose many of you can relate.

Response:

If you are comfortable on the med and doing well, then I fail to understand your pdoc’s point of view.  I think you are right to stay on it. Take care, Liz – Hide quoted text — Show quoted text – Well, I just got back from meeting with my Psychiatrist.  I told him I am feeling much better now that I am back up to my original dose of 100mg. of Zoloft.  And the whole nine yards… After I finished my speal about "whew, I’m glad all that (anxiety) is over…."  He then took that opportunity to tell me he recommends I still scale down if not off completely from zoloft and that I see a therapist to work through some issues I have with my childhood.  He said this process will take a long time possibly years, but it would be for the best. I asked him what gave him the idea that I could be off of meds and still function?  His response was that my depression/anxiety was at a moderate to moderate/low level and as such, doesn’t necessarily require medication to fight. I am feeling totally confused now.  I’ve tried to scale off of zoloft twice now.  Perhaps I went too rapidly both times, I don’t know.  I dropped off Zoloft completely the first time in about 8 weeks.  The second time I dropped my dosage by .25mg increments and started having anxiety attacks when I hit .50mg (1/2 my optimal dose)   How am I supposed to scale off this time?  Drop by 12.5mg increments and pray? I don’t know folks…what do you think?  Cut my dose in half?  I’d love to.  Elliminate it completely?  There is nothing I’d like better – I’d even do back flips.  But I just don’t know how I’m going to do it unless I could be hospitalized or something.  I lost 6 months of my life to anxiety the first time I agressively quit zoloft.  When I scaled back, I suffered for 3 weeks till I got stabilized again.   Ron

Response:

:I don’t know folks…what do you think?  Cut my dose in half?  I’d :love to.  Elliminate it completely?  There is nothing I’d like better :- I’d even do back flips.  But I just don’t know how I’m going to do :it unless I could be hospitalized or something.  I lost 6 months of my :life to anxiety the first time I agressively quit zoloft.  When I :scaled back, I suffered for 3 weeks till I got stabilized again.   Dear Ron, Aren`t you the poster that increased their zoloft dose about 3 1/2 weeks ago because you were having a setback? If so, then I really don`t understand why your doctor would want you to stop taking a med after you just got stabilized on it. I also question his recommending "analyze your childhood" type of therapy. A lot of people, myself included have done the talk therapy, rehashing one`s childhood and the past with very little to no impact on our anxiety disorder. That`s not saying that no one benefits from disorders is congnitive behavioral therapy. You can also do therapy while on medication. If I were you I would get a second opinion. What do you want to do? You seem hesitant about getting off zoloft which is understandable. Take care Jackie ~*~The bad things of life were very transitory.It was the good things , the ribbed sand, the wind blowing over the white capped waves , the sunshine and the stars, that were so tough and durable~*~

Response:

Well, I just got back from meeting with my Psychiatrist.  I told him I am feeling much better now that I am back up to my original dose of 100mg. of Zoloft.  And the whole nine yards… After I finished my speal about "whew, I’m glad all that (anxiety) is over…."  He then took that opportunity to tell me he recommends I still scale down if not off completely from zoloft and that I see a therapist to work through some issues I have with my childhood.  He said this process will take a long time possibly years, but it would be for the best. I asked him what gave him the idea that I could be off of meds and still function?  His response was that my depression/anxiety was at a moderate to moderate/low level and as such, doesn’t necessarily require medication to fight. I am feeling totally confused now.  I’ve tried to scale off of zoloft twice now.  Perhaps I went too rapidly both times, I don’t know.  I dropped off Zoloft completely the first time in about 8 weeks.  The second time I dropped my dosage by .25mg increments and started having anxiety attacks when I hit .50mg (1/2 my optimal dose)   How am I supposed to scale off this time?  Drop by 12.5mg increments and pray? I don’t know folks…what do you think?  Cut my dose in half?  I’d love to.  Elliminate it completely?  There is nothing I’d like better – I’d even do back flips.  But I just don’t know how I’m going to do it unless I could be hospitalized or something.  I lost 6 months of my life to anxiety the first time I agressively quit zoloft.  When I scaled back, I suffered for 3 weeks till I got stabilized again.   Ron

Response:

Question:

Frank can’t help it folks, poor thing.

– Hide quoted text — Show quoted text – I can answer these for you (A) What is a chiropractic subluxation? The potential injury caused by unnecessary spinal manipulation. (B) Can you identify one on a radiograph?  If not, what methods do you use to detect them?  How reliable are these methods? Only after a significant trauma.  Spiral CT scan is a very sensitive for delineating the extent of injury. (C) Can a subluxation cause visceral disease (a la Meric chart)? No (D) Can colic be treated chiropractically? No (E) Can a correcting a subluxation help in childhood ear infections? Not really

Response:

Kirk, sham manipulation is fatally flawed.

How can you be certain the sham manipulation is not having an effect by accident. If sham manipulation can be so successful then

why go to a chiropractor and pay good money? Why go to college to study this if anybody can

do it? The issue is knowing were and when to adjust. If the chiropractor understands what he is

doing then he must be able to make a sham treatment. If he doesn’t understand what he is doing then

why go to a chiropractor? Chris Noble

A key is whether or not the subject knows if it is a sham adjustment if one wishes to incorporate a placebo study. Before you buy.

Response:

 A sham could have some different effect that would blow the whole thing. Not very hard to understand.

– Hide quoted text — Show quoted text – Kirk, sham manipulation is fatally flawed.   How can you be certain the sham manipulation is not having an effect by accident. If sham manipulation can be so successful then why go to a chiropractor and pay good money? Why go to college to study this if anybody can do it? If the chiropractor understands what he is doing then he must be able to make a sham treatment. If he doesn’t understand what he is doing then why go to a chiropractor? Chris Noble

Response:

Kirk, sham manipulation is fatally flawed.   How can you be certain the sham manipulation is not having an effect by accident.

If sham manipulation can be so successful then why go to a chiropractor and pay good money? Why go to college to study this if anybody can do it? If the chiropractor understands what he is doing then he must be able to make a sham treatment. If he doesn’t understand what he is doing then why go to a chiropractor? Chris Noble

Response:

    Kirk, sham manipulation is fatally flawed.   How can you be certain the    sham manipulation is not having an effect by accident. If sham manipulation can be so successful then why go to a chiropractor and pay good money? Why go to college to study this if anybody can do it?

Chiro’s have developed techniques that work.   Their patients attest to this. Your sham treatment is neither defined or tested If the chiropractor understands what he is doing then he must be able to make a sham treatment.

 But no-one understands everything about any treatment.   He understands what he is doing works and he understands the basic philosophy behind it.   But he cannot guarantee that his approach is the only one that will work and that your sham treatment cannot possibly work. You want to use a sham treatment?   Prove it is ineffective first. If he doesn’t understand what he is doing then why go to a chiropractor?

Because they have developed successful treatments.   People go through it and say ‘It worked for me’ Until valid studies are done that is all we have to go on. You want a study?   Randomly select patients to consult MD’s or Chiro’s. Blindly evaluate the results.   Which group has a better response? If it’s the MD’s, then I’ll be quite happy to go to an MD first, and if that doesn’t work, go to the Chiro. If it’s the Chiro, then vice versa If it’s the same, then I’ll go to the one with the prettiest receptionist first<g Best wishes — John Bain UK TV Sound Director, magnotherapy user & distributor http://members.aol.com/JBainSI/Magnotherapy.html Surround Sound for Television

Response:

John I have to agree with your post and only wished that I was eloquent enough to have written it. — Dr. Roland R. Hicks Doctor of Chiropractic All good things come from above-down-inside-out Natural Alternative to Celebrex/Vioxx: http://drhicks.joint-pain.com/ Internet Marketing to Win: http://www.aboutimw.com/drhicks.html Nutrition Products and Information: http://freelife.com/Sites/drhicks/redir.cfm?page=/info/welcome/welcom… fm toll free (877) 791-8686

– Hide quoted text — Show quoted text –     Kirk, sham manipulation is fatally flawed.   How can you be certain the    sham manipulation is not having an effect by accident. Not really.  Because the intent of the sham arm of the intervention is to essentially keep the parents blinded, and mimic the conditions of the experimental intervention MINUS the part being investigated.  One could in ensure that a real manipulation is not performed, as long as the parents can’t tell. Not at all.   Just because the patients cannot tell the real treatment from the sham does not mean that the sham is ineffective. It’s like running a test on asprin and using paracetamol as a control. The patients might not be able to tell whether they had the treatment or the control, but the control would never be a placebo.     Comparitive studies are the only way to go until you can develop benchmarks    for the treatment. This, too, is not the case.  With a mere comparison study the conclusions that can be drawn are more prone to being erroneous. To determine if an adjustment (rather than just time spent with the patients, expectation bias, etc) is having an effect, a properly designed sham comparison is the only way to go.  Otherwise we are left with essentially useless studies like the one we are discussing now. Your studies are also useless.   Your controls are invalid.   You have no idea what effect the sham treatment might be having. Randomised comparison studies will show which treatment is more effective, as practised, on a random subject.   I don’t care about the mechanism at this stage, I just want to know which treatment is more effective.   This study will tell me.   It needs to be repeated with a range of practitioners to eliminate charismatic effects, but the results are meaningful.   It gives the odds of a successful outcome for any patient attending either of the two treatments. Controlled studies give us much more useful information than comparisons studies. Not when you do not know whether the sham has any effect.   And you don’t. Your anti-sham philosophy is simply yet another attempt to thwart scientific investigation of alternative modalities (like your arguments against sham acupuncture).  Should we now throw out all negative placebo controlled trials because we can never know if the inert placebo is having some magical, homeopathic, or unknown effect? This is essentially what you are saying if you extend your argument. Not in the slightest.   Unless you can say you totally understand how the therapy works, you cannot say whether the sham treatment has any effect. It must contain enough elements of the treatment to fool the subjects. Inert placebos can be varied to see if there is any difference.   Completely different issue. If you wish to use a sham treatment as a placebo, you must first prove it is ineffective.   How are you going to do that?   Try it against another sham treatment and choose the least effective? No, sham treatments have their place, but cannot be used to prove or disprove a therapy.   All it can prove is that the real treatment is not significantly better than the sham.   Now prove that the sham treatment is ineffective and I’ll listen. Best wishes — John Bain UK TV Sound Director, magnotherapy user & distributor http://members.aol.com/JBainSI/Magnotherapy.html Surround Sound for Television

Response:

    Kirk, sham manipulation is fatally flawed.   How can you be certain the    sham manipulation is not having an effect by accident. Not really.  Because the intent of the sham arm of the intervention is to essentially keep the parents blinded, and mimic the conditions of the experimental intervention MINUS the part being investigated.  One could in ensure that a real manipulation is not performed, as long as the parents can’t tell.  

Not at all.   Just because the patients cannot tell the real treatment from the sham does not mean that the sham is ineffective. It’s like running a test on asprin and using paracetamol as a control.   The patients might not be able to tell whether they had the treatment or the control, but the control would never be a placebo.     Comparitive studies are the only way to go until you can develop benchmarks    for the treatment. This, too, is not the case.  With a mere comparison study the conclusions that can be drawn are more prone to being erroneous. To determine if an adjustment (rather than just time spent with the patients, expectation bias, etc) is having an effect, a properly designed sham comparison is the only way to go.  Otherwise we are left with essentially useless studies like the one we are discussing now.

Your studies are also useless.   Your controls are invalid.   You have no idea what effect the sham treatment might be having. Randomised comparison studies will show which treatment is more effective, as practised, on a random subject.   I don’t care about the mechanism at this stage, I just want to know which treatment is more effective.   This study will tell me.   It needs to be repeated with a range of practitioners to eliminate charismatic effects, but the results are meaningful.   It gives the odds of a successful outcome for any patient attending either of the two treatments. Controlled studies give us much more useful information than comparisons studies.

Not when you do not know whether the sham has any effect.   And you don’t. Your anti-sham philosophy is simply yet another attempt to thwart scientific investigation of alternative modalities (like your arguments against sham acupuncture).  Should we now throw out all negative placebo controlled trials because we can never know if the inert placebo is having some magical, homeopathic, or unknown effect? This is essentially what you are saying if you extend your argument.

Not in the slightest.   Unless you can say you totally understand how the therapy works, you cannot say whether the sham treatment has any effect.   It must contain enough elements of the treatment to fool the subjects.   Inert placebos can be varied to see if there is any difference.   Completely different issue. If you wish to use a sham treatment as a placebo, you must first prove it is ineffective.   How are you going to do that?   Try it against another sham treatment and choose the least effective? No, sham treatments have their place, but cannot be used to prove or disprove a therapy.   All it can prove is that the real treatment is not significantly better than the sham.   Now prove that the sham treatment is ineffective and I’ll listen. Best wishes — John Bain UK TV Sound Director, magnotherapy user & distributor http://members.aol.com/JBainSI/Magnotherapy.html Surround Sound for Television

Response:

Suppose it is simply the child’s karma to be (eventually) free of Colic.  How can we be sure the adjustment, sham adjustment, or other method is not stealing the credit owed to Karma.

Why Andrew, have you done more reading about Karma and are prepared to discuss it now? Here’s the question you kept avoiding all those months ago. Given 100 subjects for a trial,  can we assume that each carries the same Karmic burden Yes or No. If yes, please give your reasons.  When you answer this we can go onto the next question. Best wishes — John Bain UK TV Sound Director, magnotherapy user & distributor http://members.aol.com/JBainSI/Magnotherapy.html Surround Sound for Television

Response:

I understand the need to control variables and the attempted use of sham adjustments to control those variables AMAP. The question of variables does not just enter the control side but also the treatment side of a study.  For example, are all the patients treated with manipulation going to get the same adjustment or the adjustment that is determined to be necessary to correct the dysfunction(subluxation/fixation/restriction).  The reason I bring up this point is because if there is a rotational fixation of the joint then a lateral flexion impulse may or may not correct the fixation and therefore may skew the results to the side of ineffectiveness of the procedure. When it comes to testing a physical medicine the variables are endless.  Not to say that testing should not be done but there must be a global understanding that there are multiple variables that can not be controlled. — Dr. Roland R. Hicks Doctor of Chiropractic All good things come from above-down-inside-out Natural Alternative to Celebrex/Vioxx: http://drhicks.joint-pain.com/ Internet Marketing to Win: http://www.aboutimw.com/drhicks.html Nutrition Products and Information: http://freelife.com/Sites/drhicks/redir.cfm?page=/info/welcome/welcom… fm toll free (877) 791-8686

– Hide quoted text — Show quoted text – Might not be a bad idea to look at all such trials, and shine today’s knowledge on them. I think one might find many old truths to no longer be so. And some to be so. There is much info out there which strongly suggests that we are effected on many subtle levels. By not taking that into account, we can only have faulty or inaccurate information. Surly someone would try to eliminate as many variables as possible. To not do so would, at best , be not worthy of trust. The problem was that the study design compared chiropractic manipulation to administration of a drug.  This is not a true controlled trial, but rather a comparison trial (although JMPT still referred to it as placebo controlled and single blinded). The investigators should have had a manipulation group and a sham group. Kirk, sham manipulation is fatally flawed.   How can you be certain the sham manipulation is not having an effect by accident. Not really.  Because the intent of the sham arm of the intervention is to essentially keep the parents blinded, and mimic the conditions of the experimental intervention MINUS the part being investigated.  One could in ensure that a real manipulation is not performed, as long as the parents can’t tell. Comparitive studies are the only way to go until you can develop benchmarks for the treatment. This, too, is not the case.  With a mere comparison study the conclusions that can be drawn are more prone to being erroneous. To determine if an adjustment (rather than just time spent with the patients, expectation bias, etc) is having an effect, a properly designed sham comparison is the only way to go.  Otherwise we are left with essentially useless studies like the one we are discussing now. Controlled studies give us much more useful information than comparisons studies.  Your anti-sham philosophy is simply yet another attempt to thwart scientific investigation of alternative modalities (like your arguments against sham acupuncture).  Should we now throw out all negative placebo controlled trials because we can never know if the inert placebo is having some magical, homeopathic, or unknown effect? This is essentially what you are saying if you extend your argument. — Kirk Kolas Ontario Veterinary College Class of 2002

Response:

I am not sold on the art of "sham" adjustments.  If there is any joint movement it will have some affect on the joint complex. — Dr. Roland R. Hicks Doctor of Chiropractic All good things come from above-down-inside-out Natural Alternative to Celebrex/Vioxx: http://drhicks.joint-pain.com/ Internet Marketing to Win: http://www.aboutimw.com/drhicks.html Nutrition Products and Information: http://freelife.com/Sites/drhicks/redir.cfm?page=/info/welcome/welcom… fm toll free (877) 791-8686

– Hide quoted text — Show quoted text – "The one study did show that there was a reported improvement but since it was the mothers who reported the improvement the research was not definitive. Who should you ask if a baby’s colic is better?  I think the study is flawed since the measurement is strictly subjective and I hope that they can come up with a more structured study.  Colic is not easily quantified or classified." —- The problem with the design of this study was not really a problem with the measurement of "hours of crying".  This is a reasonable outcome measure, considering "colic" is operationally defined as increased hours of crying. The problem was that the study design compared chiropractic manipulation to administration of a drug.  This is not a true controlled trial, but rather a comparison trial (although JMPT still referred to it as placebo controlled and single blinded). The investigators should have had a manipulation group and a sham group. This way, the parents could be kept in the dark with respect to whether or not their child truly received an adjustment.  By comparing the outcomes of these two groups, the investigators could control for all those other factors that may be at play (e.g. expectation bias, handling of the child, increased time with the parents, etc…) I found it curious that JMPT also referred to the study as single blinded.  In my view it was not even single blinded because the "blinding" referred to the person evaluating the colic diary.  The outcome measure was simply total hours crying, so the diary evaluator, I presume, is simply adding up some numbers.  Blinding this individual is advantageous, but nothing to write home about.  Blinding the evaluators (the parents) is paramount. Nevertheless I have seen this rather poorly designed study touted in some forums.  I’d like to see it done properly with sham manipulation. I have never seen infant adjustments in person, but the couple of instances I have seen it on video, the "adjustments" were so subtle that I fear the investigators would have a hard time devising a convincing "sham" manipulation without actually replicating the adjustment arm of the study. And to end on a completely biased note: most pediatric adjustments look like sham adjustments to me in the first place. — Kirk Kolas Ontario Veterinary College Class of 2002

Response:

The problem was that the study design compared chiropractic manipulation to administration of a drug.  This is not a true controlled trial, but rather a comparison trial (although JMPT still referred to it as placebo controlled and single blinded). The investigators should have had a manipulation group and a sham group. Kirk, sham manipulation is fatally flawed.   How can you be certain the sham manipulation is not having an effect by accident.

Not really.  Because the intent of the sham arm of the intervention is to essentially keep the parents blinded, and mimic the conditions of the experimental intervention MINUS the part being investigated.  One could in ensure that a real manipulation is not performed, as long as the parents can’t tell.   Comparitive studies are the only way to go until you can develop benchmarks for the treatment.

This, too, is not the case.  With a mere comparison study the conclusions that can be drawn are more prone to being erroneous. To determine if an adjustment (rather than just time spent with the patients, expectation bias, etc) is having an effect, a properly designed sham comparison is the only way to go.  Otherwise we are left with essentially useless studies like the one we are discussing now. Controlled studies give us much more useful information than comparisons studies.  Your anti-sham philosophy is simply yet another attempt to thwart scientific investigation of alternative modalities (like your arguments against sham acupuncture).  Should we now throw out all negative placebo controlled trials because we can never know if the inert placebo is having some magical, homeopathic, or unknown effect? This is essentially what you are saying if you extend your argument. — Kirk Kolas Ontario Veterinary College Class of 2002

Response:

 Might not be a bad idea to look at all such trials, and shine today’s knowledge on them. I think one might find many old truths to no longer be so. And some to be so. There is much info out there which strongly suggests that we are effected on many subtle levels. By not taking that into account, we can only have faulty or inaccurate information. Surly someone would try to eliminate as many variables as possible. To not do so would, at best , be not worthy of trust.

– Hide quoted text — Show quoted text – The problem was that the study design compared chiropractic manipulation to administration of a drug.  This is not a true controlled trial, but rather a comparison trial (although JMPT still referred to it as placebo controlled and single blinded). The investigators should have had a manipulation group and a sham group. Kirk, sham manipulation is fatally flawed.   How can you be certain the sham manipulation is not having an effect by accident. Not really.  Because the intent of the sham arm of the intervention is to essentially keep the parents blinded, and mimic the conditions of the experimental intervention MINUS the part being investigated.  One could in ensure that a real manipulation is not performed, as long as the parents can’t tell. Comparitive studies are the only way to go until you can develop benchmarks for the treatment. This, too, is not the case.  With a mere comparison study the conclusions that can be drawn are more prone to being erroneous. To determine if an adjustment (rather than just time spent with the patients, expectation bias, etc) is having an effect, a properly designed sham comparison is the only way to go.  Otherwise we are left with essentially useless studies like the one we are discussing now. Controlled studies give us much more useful information than comparisons studies.  Your anti-sham philosophy is simply yet another attempt to thwart scientific investigation of alternative modalities (like your arguments against sham acupuncture).  Should we now throw out all negative placebo controlled trials because we can never know if the inert placebo is having some magical, homeopathic, or unknown effect? This is essentially what you are saying if you extend your argument. — Kirk Kolas Ontario Veterinary College Class of 2002

Response:

The problem was that the study design compared chiropractic manipulation to administration of a drug.  This is not a true controlled trial, but rather a comparison trial (although JMPT still referred to it as placebo controlled and single blinded).   The investigators should have had a manipulation group and a sham group.

Kirk, sham manipulation is fatally flawed.   How can you be certain the sham manipulation is not having an effect by accident. It’s like using a random drug off the shelves as a placebo, you have no idea what its effects will be on the participants in this study. Comparitive studies are the only way to go until you can develop benchmarks for the treatment. Best wishes — John Bain UK TV Sound Director, magnotherapy user & distributor http://members.aol.com/JBainSI/Magnotherapy.html Surround Sound for Television

Response:

John, Suppose it is simply the child’s karma to be (eventually) free of Colic.  How can we be sure the adjustment, sham adjustment, or other method is not stealing the credit owed to Karma. – Hide quoted text — Show quoted text – The problem was that the study design compared chiropractic manipulation to administration of a drug.  This is not a true controlled trial, but rather a comparison trial (although JMPT still referred to it as placebo controlled and single blinded). The investigators should have had a manipulation group and a sham group. Kirk, sham manipulation is fatally flawed.   How can you be certain the sham manipulation is not having an effect by accident. It’s like using a random drug off the shelves as a placebo, you have no idea what its effects will be on the participants in this study. Comparitive studies are the only way to go until you can develop benchmarks for the treatment. Best wishes — John Bain UK TV Sound Director, magnotherapy user & distributor http://members.aol.com/JBainSI/Magnotherapy.html Surround Sound for Television

Before you buy.

Response:

"The one study did show that there was a reported improvement but since it was the mothers who reported the improvement the research was not definitive. Who should you ask if a baby’s colic is better?  I think the study is flawed since the measurement is strictly subjective and I hope that they can come up with a more structured study.  Colic is not easily quantified or classified."   —- The problem with the design of this study was not really a problem with the measurement of "hours of crying".  This is a reasonable outcome measure, considering "colic" is operationally defined as increased hours of crying. The problem was that the study design compared chiropractic manipulation to administration of a drug.  This is not a true controlled trial, but rather a comparison trial (although JMPT still referred to it as placebo controlled and single blinded).   The investigators should have had a manipulation group and a sham group. This way, the parents could be kept in the dark with respect to whether or not their child truly received an adjustment.  By comparing the outcomes of these two groups, the investigators could control for all those other factors that may be at play (e.g. expectation bias, handling of the child, increased time with the parents, etc…) I found it curious that JMPT also referred to the study as single blinded.  In my view it was not even single blinded because the "blinding" referred to the person evaluating the colic diary.  The outcome measure was simply total hours crying, so the diary evaluator, I presume, is simply adding up some numbers.  Blinding this individual is advantageous, but nothing to write home about.  Blinding the evaluators (the parents) is paramount. Nevertheless I have seen this rather poorly designed study touted in some forums.  I’d like to see it done properly with sham manipulation. I have never seen infant adjustments in person, but the couple of instances I have seen it on video, the "adjustments" were so subtle that I fear the investigators would have a hard time devising a convincing "sham" manipulation without actually replicating the adjustment arm of the study. And to end on a completely biased note: most pediatric adjustments look like sham adjustments to me in the first place.   — Kirk Kolas Ontario Veterinary College Class of 2002

Response:

"Chiropractors are nervous system specialists with a focus on orthopedics. In other words, chiropractors are concerned with mechanical stressors on the nervous system. The nervous system controls all of the blood vessels in the body (via the sympathetic division of the autonomic nervous system). Every tissue in the body needs a healthy blood supply (for nourishment and waste removal). This blood supply is predicated upon having blood vessels functioning properly. Sympathetic innervation causes vasoconstriction (narrows arteries and arterioles), and thus diminishes the blood supply to an area. Profound reduction in blood supply results in hypoxia (decreased oxygen supply). This results in an ischemic condition, resulting in cellular death, and possible necrosis of the tissue. And thus, the functional integrity of the tissue is compromised." "A man may be a fool and not know it – but not if he is married." H.L. Mencken http://www.lifehousemusic.com/lh_music.html catchytune. says me.

Response:

– Dr. Roland R. Hicks Doctor of Chiropractic All good things come from above-down-inside-out Natural Alternative to Celebrex/Vioxx: http://drhicks.joint-pain.com/ Internet Marketing to Win: http://www.aboutimw.com/drhicks.html Nutrition Products and Information: http://freelife.com/Sites/drhicks/redir.cfm?page=/info/welcome/welcom… fm toll free (877) 791-8686

Here are some starter questions: (A) What is a chiropractic subluxation?

Atlas gave a good explanation, however I like to use common language to describet a subluxtion.  It is first and foremost the main object of a theory which attempts to explain what a chiropractor treats.  It is not proven for if it was it would not be a theory.  A subluxation in chiropractic terms is an abnormal positon or movement of the spinal bones/joints which cause a change in the function of the nervous system and to the extent that the nervous system is affected so the subjects health is affected.  Simply put a subluxation is anything which can cause negative effects on the nervous system and related to the structure of the body.  As Atlas stated that there are many causes of subluxations from injury, stress, metabolic, ect. (B) Can you identify one on a radiograph?  If not, what methods do you use to detect them?  How reliable are these methods?

There are instances in which the structural facet of a subluxation may be viewed on xray.  Since a subluxation is biomechanical, structural and neurological in origin one can not see the neurological or biomechanical aspects of a subluxation on a xray. Just as one cannot see the funtion of the sciatic nerve on a pelvic xray.  I propose a scenario to better understand the above explanation.  In my practice, I have the opportunity to see patients with disc degeneration on a daily basis.  These people come in with discs that have degenerated and thinned.  When the disc thins the bones(vertebrae) come closer together.  This caused the facet joints in the back of the spine to also come closer together(imburcate).  When these joints come closer together their biomechanics change and they are prone to Jamming upon extension movements or movements which cause an increase in the normal lumbar curve(lordosis).  Can you see these changes in the normal static Xrays?  yes Can you see the biomechanical changes on the xray? no biomechanical findings cannot be seen on a static test. Can you correlate your findings to the history and examination and predict the outcome of care? yes (C) Can a subluxation cause visceral disease (a la Meric chart)?

What is the Meric chart? A person can have a viscerosomatic reflex like having an upset stomach cause overall body weakness and malaise. A person can have a somatovisceral reflex like having hit one’s thumb with a hammer can cause stomach upset. A person can have a psychosomatic reflex in which they think they are sick and therefore they feel general muscle weakness and malaise. A person can have a somatopsychologica reflex in which the are hurt physically and it sets up the flight/fight reaction. This is the long way of answering the question asked.  Yes, a subluxation can be a cause of a visceral disease/condition/symptom.  The reverse is also part of the "subluxation theory" a visceral condition can reflex to the spine and cause pain and subluxation symptoms of the spine.  Ie. gall bladder causing pain in the right intrascapular region.  Cramping and lumbar muscle spasms and pain associated with painful menses in women are good examples of viscerosomatic reflexes.  The nerves travel both ways. (D) Can colic be treated chiropractically?

There is some clinical evidence that spinal manipulation can reduce the severity of colic however I believe the jury is still out on that one and more studies should be performed.  The one study did show that there was a reported improvement but since it was the mothers who reported the improvement the research was not definitive. Who should you ask if a baby’s colic is better?  I think the study is flawed since the measurement is strictly subjective and I hope that they can come up with a more structured study.  Colic is not easily quantified or classified.  Plus those little rug rats can’t comunicate other than crying or not crying.  My boy was diagnosed with a viral syndrome(possibly meningitis) when he was two months old.  We were up all night and went to the ER at 4AM due to his condition.  The only thing that would calm him was gentle motion of his hips and sacrum. Why? GOT ME.  The lumbar puncture was inconclusive.  I was explained by our pediatrician that just because you dip your hand into a barrel of pickles and don’t grab a pickle doesn’t mean that there are not pickles in there. We had to assume that the child had meningitis and treat it as such. (E) Can a correcting a subluxation help in childhood ear infections?

In my clinical experience, I would have to say emphatically YES.  Does it cure infections? NO I have treated approximately 20-30 children with chronic ear infections over the past 10 years and of those treated, in my observation 80-90% showed improvement in their condition.  Was it just the adjustments?  I doubt it.  I make sure that my patients keep on the medicinal regimine recommended by their medical doctor and simply try to improve the function of the cervical spine. I also try to make dietary changes for the child.  Do I understand the exact mechanism? NO  What my treatments are designed to do is increase drainage of the sinuses and aid in the drainage of the eustacian tube.  If there is restriction of motion in the upper neck causing reduce lymphatic drainage then this may be a factor in the condition.  My son has had chronic ear infections since he was one year old.  He has allergies and that plays a big role in his chronic infections.  I do gentle neck adjustments and skull craniopathy to aid in his congestion to clear his sinuses and have him on antibiotics only when an infection is present. The explanations provided are in no way complete and are for the purposes of presenting my experience.  If you have questions about the areas discussed or are unclear of what I was attempting to explain please ask me to clarify those areas. – Hide quoted text — Show quoted text – I have heard different chiropractors answer these questions differently.  We all know how a "Straight" chiropractor would answer them.  What do you think? — Kirk Kolas Ontario Veterinary College Class of 2002

Response:

If you have a question about chiropractic ask away.  I am not the ultimate expert but I may be able to help you none the less. If you had been to a chiropractor and had a question about the visit, rumors, theory, testing or even the question that you think others will think you are stupid to ask.  I’m on this newsgroup for enjoyment and if I can help another while I’m having fun then I’ve killed two birds with one stone. — Dr. Roland R. Hicks Doctor of Chiropractic All good things come from above-down-inside-out Natural Alternative to Celebrex/Vioxx: http://drhicks.joint-pain.com/ Internet Marketing to Win: http://www.aboutimw.com/drhicks.html Nutrition Products and Information http://freelife.com/Sites/drhicks/redir.cfm?page=/info/welcome/welcom… fm toll free (877) 791-8686

Response:

If you have a question about chiropractic ask away.  I am not the ultimate expert but I may be able to help you none the less.

Here are some starter questions: (A) What is a chiropractic subluxation? (B) Can you identify one on a radiograph?  If not, what methods do you use to detect them?  How reliable are these methods? (C) Can a subluxation cause visceral disease (a la Meric chart)? (D) Can colic be treated chiropractically? (E) Can a correcting a subluxation help in childhood ear infections? I have heard different chiropractors answer these questions differently.  We all know how a "Straight" chiropractor would answer them.  What do you think? — Kirk Kolas Ontario Veterinary College Class of 2002

Response:

I can answer these for you (A) What is a chiropractic subluxation?

The potential injury caused by unnecessary spinal manipulation. (B) Can you identify one on a radiograph?  If not, what methods do you use to detect them?  How reliable are these methods?

Only after a significant trauma.  Spiral CT scan is a very sensitive for delineating the extent of injury. (C) Can a subluxation cause visceral disease (a la Meric chart)?

No (D) Can colic be treated chiropractically?

No (E) Can a correcting a subluxation help in childhood ear infections?

Not really

Response:

(A) What is a chiropractic subluxation?

If you asked a medical doctor and a chiropractor to define a subluxation, you would get two different answers. The medical profession defines a subluxation as: "A partial or incomplete dislocation."  (From Taber’s Cyclopedic Medical Dictionary).      The Chiropractic profession has a different definition (and thus – meaning) for a subluxation. Specifically, a subluxation is an articular lesion which has the following components: 1. Abnormal movement or position of a bone. (Kinesiopathology). In the spine, this could be at the intersegmental level (meaning one vertebra and the vertebra above and below it). Or it could be at the global level (meaning the posture). 2. Abnormal tissue. (Histopathology):  This includes nerves, muscle, ligaments, tendons, adipose tissue, fascia, lymphatics, blood vessels, etc.      Kinesiopathology is composed of rotations and translations. Histopathology is caused by deformations of the tissues [Davis' Law of soft tissues, Wolff's Law of hard tissues]. What causes a subluxation? Subluxations are caused by one of three things:      1. Trauma (Physical stress)      2. Thoughts (Emotional stress)      3. Toxins (Chemical stress) Is a Subluxation the cause of all disease?      There is no one cause for all disease.  If there was, we would have probably found it by now. There are numerous causes for disease. One thing which needs to be stressed at this point is that the human body was designed to be healthy. The body has an innate ability to repair itself from injury, and to fight off pathogens. We were not designed to have to rely on pills, potions, and powders to resolve the majority of our problems.      Chiropractors are nervous system specialists with a focus on orthopedics. In other words, chiropractors are concerned with mechanical stressors on the nervous system. The nervous system controls all of the blood vessels in the body (via the sympathetic division of the autonomic nervous system). Every tissue in the body needs a healthy blood supply (for nourishment and waste removal). This blood supply is predicated upon having blood vessels functioning properly. Sympathetic innervation causes vasoconstriction (narrows arteries and arterioles), and thus diminishes the blood supply to an area. Profound reduction in blood supply results in hypoxia (decreased oxygen supply). This results in an ischemic condition, resulting in cellular death, and possible necrosis of the tissue. And thus, the functional integrity of the tissue is compromised.      Chiropractors do not treat disease. They find and remove subluxations. However, if the subluxation is the cause of the disease, then by removing the subluxation, you are effectively resolving the problem. (B) Can you identify one on a radiograph?  If not, what methods do you use to detect them?  How reliable are these methods?

        The Chiropractic definition of a subluxation involves mechanical, biochemical, and neurophysiological components. Of these, the mechanical component is visible on an x-ray. The neurological, and physiological components are not visible on an x-ray. Chiropractors study x-ray films with line drawing analysis. And with these, they can take precise measurements to determine if the bone(s) are subluxated.      Your chiropractor will only order an x-ray if he/she feels it is necessary. Precautions are used to ensure that you are exposed to the absolutely minimum possible radioation dose. These include lead shielding, high speed films, collimation, and screens. (C) Can a subluxation cause visceral disease (a la Meric chart)?

        Chiropractic has but one purpose. And that is to find and remove subluxations. If the subluxation is the cause of the dis-ease in the body, then it logically follows that by removing the subluxation (the cause), then you’re going to remove the dis-ease (the effect).      However, the subluxation is not the root of every health care problem. There are many reasons why people get sick. Interestingly enough, Chiropractic could help boost the immune system of the patient, so that their own innate immunity is stronger, and the body is better able to rid itself of the disease process. See: http://www.geocities.com/cbpdoc/neuroimmune.html (D) Can colic be treated chiropractically?

        Only if the colic is caused by vertebral subluxation. (E) Can a correcting a subluxation help in childhood ear infections?

        Only if the ear infections are caused by vertebral subluxation. I have heard different chiropractors answer these questions differently.  We all know how a "Straight" chiropractor would answer them.  What do you think?

        Now you know.

Response:

Question:

After about 7 months on Paxil, I started becoming very depressed.  My pdoc reduced the dosage and I was better, but then the pa’s started to get worse again.  When she increased the Paxil, the depression returned.  So now I’m off Paxil.  Actually, I wish the depression hadn’t happened, I was doing pretty good on Paxil for a while. Peg

Response:

 Hi Lynne, The SSRIs can induce or exacerbate movement disorders (possibly related to their effects on dopamine). I had a temporary increase in my restless legs syndrome (RLS) after a Zoloft increase which resolved after a Zoloft dose reduction. Zoloft has more effect on dopamine reuptake than any of the other SSRIs, and thus may cause these problems more frequently than other SSRIs. Bruxism (teeth grinding) can be brought on by an SSRI. A temporary reduction in your Paxil dose may resolve this problem, as may the addition of certain meds (Bromocriptine for one, I think). It’s also possible you’re exeriencing Paxil "poop out" with lessening of anti-aNXIETY EFFECTS AND NEED A DOSAGE ADJUSTMENT OR AUGMENTATION with another med. Good luck, Chip P.s. if I were in your situation I think I would try a reduction in Paxil dose and see if the teethgrinding improved. I have been taking Paxil for a year and a half and have suddenly developed what I think may be new side effects to the medicine. I was wondering if anyone else has had a side effect pop up after being on the medicine for quite awhile?. I am suddenly more nervous, anxious and generally stressed for no known reason. I have developed jaw clenching and have to wear a mouth guard at night. My jaw and neck also get tight during the day. I have had other side effects like insomnia all the way along, but not this new "tension" stuff. Thanks for any help or insight. Lynne

Response:

So your saying everyone is not entitled their own opinion?  Kiss my ass. Xanman — Depressed?  Anxious?  http://members.tripod.com/Xanman22/index.html Xanland – http://www.geocities.com/SoHo/Gallery/9098/ Xanland – A little insanity in an sane wolf.

– Hide quoted text — Show quoted text – Not good to share with the group.  Some people have done great on paxil. I for one don’t want to read what bad things can happen.  Remember, every med reacts differently with everyone. What kind of support is this group for then? You should not share bad experiences with meds? How about bad emotional phases, are they "allowed"? Nonsense. This is a support group, and in order to get support, we have to share the good with the bad. If somebody is in distress because they are unsure what to think of a med they are taking, why should they not ask others about it? It was not a "all meds are evil" mail after all. Skreee http://members.xoom.com/Skreee/James/JamesMason.html

Response:

I have been taking Paxil for a year and a half and have suddenly developed what I think may be new side effects to the medicine.  I was wondering if anyone else has had a side effect pop up after being on the medicine for quite awhile?.  I am suddenly more nervous, anxious and generally stressed for no known reason.  I have developed jaw clenching and have to wear a mouth guard at night.  My jaw and neck also get tight during the day.  I have had other side effects like insomnia all the way along, but not this new "tension" stuff.  Thanks for any help or insight.  Lynne

Response:

Not good to share with the group.  Some people have done great on paxil.  I for one don’t want to read what bad things can happen.  Remember, every med reacts differently with everyone. Xanman — Depressed?  Anxious?  http://members.tripod.com/Xanman22/index.html Xanland – http://www.geocities.com/SoHo/Gallery/9098/ Xanland – A little insanity in an sane wolf.

– Hide quoted text — Show quoted text – I have been taking Paxil for a year and a half and have suddenly developed what I think may be new side effects to the medicine.  I was wondering if anyone else has had a side effect pop up after being on the medicine for quite awhile?.  I am suddenly more nervous, anxious and generally stressed for no known reason.  I have developed jaw clenching and have to wear a mouth guard at night.  My jaw and neck also get tight during the day.  I have had other side effects like insomnia all the way along, but not this new "tension" stuff.  Thanks for any help or insight.  Lynne

Response:

My jaw and neck also get tight during the day.  I have had other side effects like insomnia all the way along, but not this new "tension" stuff.

Hello, I am experiencing this too.  I have to mentally remind myself to loosen my jaw.  I did not think it was because of the paxil though, but who knows.  I get the insomnia occasionally, but to cope with that I switch to taking the pill in the morning for a few days and that seems to fix it.  I don’t know what to think about the jaw clenching, but do not feel it is serious enough to stop the paxil. Take Care, Amy Jo

Response:

HI Lynne, I have the same symptoms of jaw clenching, I know how unpleasant it can be. I had a mouth guard many years ago (at the time we thought it was TMJ).  The guard doesn’t fit any more so now I am getting a partial upper plate (if the damn Dentist would just call me back).  I do relaxation exercises to help me relaxe those clenched muscles.  Oh BTW, I don’t take Paxil. Cathy — P.H.O.B.I.A. People Helping Others Become Independent Again Off-line Self Help Support Group, NJ http://community.nj.com/cc/phobia Anxiety Treatment Options http://www.members.tripod.com/~PhobiaGroup/index.html

– Hide quoted text — Show quoted text – I have been taking Paxil for a year and a half and have suddenly developed what I think may be new side effects to the medicine.  I was wondering if anyone else has had a side effect pop up after being on the medicine for quite awhile?.  I am suddenly more nervous, anxious and generally stressed for no known reason.  I have developed jaw clenching and have to wear a mouth guard at night.  My jaw and neck also get tight during the day.  I have had other side effects like insomnia all the way along, but not this new "tension" stuff.  Thanks for any help or insight.  Lynne

Response:

I have been taking Paxil for a year and a half and have suddenly developed what I think may be new side effects to the medicine.  I was wondering if anyone else has had a side effect pop up after being on the medicine for quite awhile?.  I am suddenly more nervous, anxious and generally stressed for no known reason.  I have developed jaw clenching and have to wear a mouth guard at night.  My jaw and neck also get tight during the day.  I have had other side effects like insomnia all the way along, but not this new "tension" stuff.  Thanks for any help or insight.  Lynne

Dear Lynn, You really should talk to your doctor about how poorly you are feeling. IMO…..it sounds like the Paxil dose you are on is not as effective as it was and you are experiencing a increase in your anxiety. There was recently a thread on SSRI anti-depressants and jaw clenching, it could be a side-effect of Paxil. Jaw clenching is also a symptom of anxiety, and you seem to be living with alot of tension and anxiety right now. You need to talk to your doctor, treatment might include increasing your paxil dose, or augmenting it with another med. Also, have you ever looked into CBT? P.S.  It wouldn`t hurt to have a good checkup with your doctor to rule out any physical causes of these symptoms. Take care. Jackie

Response:

I have been taking Paxil for a year and a half and have suddenly developed what I think may be new side effects to the medicine.  I was wondering if anyone else has had a side effect pop up after being on the medicine for quite awhile?

I feel like some of the effects have really come and gone.  I’ve had almost all of them, it seems, but few have lasted the whole time so far. But how I think about it right now is that they are all tolerable except for weight gain.  And that’s interesting, because I know that without the drug I would totally be in fear of all of them.

Response:

Paxil definitely causes some people to involuntarily clench their jaws and/or grind their teeth (bruxism). I had my dentist custom-make a nighttime mouth guard for me, and that has helped a lot… I was getting a very sore TMJ (temporomandibular joint or something like that — where your jaw hinges to your head, just below your ear) from grinding my teeth all night. I still grind my teeth sometimes during the day but try to prevent it by reminding myself all the time. If it doesn’t look too silly, or when you’re alone, try sticking just the tip of your tongue between your teeth so you won’t bite down or clench! (You can do this with your mouth closed.) So far I’ve cracked two molars, loosened a canine tooth, and scraped the enamel off the tops of my front teeth — all from this newly intensified teeth-grinding since I’ve been on Paxil (one year plus two months). But for me — IT’s WORTH IT! Paxil has worked too well for my panic and depression for me to consider discontinuing it; I’ll stick with my mouth guard and other tricks to try and save my teeth.  :-) – Anne —

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Question:

I have never experienced any sedation or gotten any "buzz" from Xanax, in fact it actually energizes me without making me "speedy", if that makes sense.

It does make sense, and that happens for me at low doses as well. How much have you taken at a time? I am totally screwed up with sleep and energy due to the fact that I work full time night shift and then watch my highly hyperactive toddler all day until 4 or 5 when my eldest daughter comes home to help. So I am always tired and yet cannot fall asleep..frustrating!

You have my sympathies! I often have trouble falling asleep due to pain, and I have problems with waking up in the middle of the night. I’m convinced this has had a deleterious effect on my mental functioning. :-/ -elizabeth

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I have never experienced any sedation or gotten any "buzz" from Xanax, in fact it actually energizes me without making me "speedy", if that makes sense. It does make sense, and that happens for me at low doses as well. How much have you taken at a time?

  In the middle of an extreme panic attack I have once or twice taken 3 mgs at a time..and have taken 2 mgs at once for slightly less severe but still awful ones..Now though I never take more than 1mg at a time, I dont need to with the other meds, in fact dont take any sometimes cause I just plain old forget. May -elizabeth

– "Believe me! The secret of reaping the greatest fruitfulness and the greatest enjoyment from life is to live dangerously!"      -                Nietzsche

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Hi Diana,     If you have never seen a p-doc yet, who prescribed the meds? 25mg is a good starting dose for zoloft, this should keep the side affects bearable. Zoloft taken daily and xanax whenever needed has worked very well for me, but then again YMMV.  The p-doc you are going to see  should be very caring and understanding towards your feelings. One that could try to understand what it is like to feel the way we do. I know mine does. I wish you the best of luck and hope the zoloft works for you. Please keep us posted. steve

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Hello everyone haven’t posted lately but i am back, I finally made a appt with a psych doc today, my appointment if for next tuesday this is the first time for me, alittle nervous, can anyone give me any suggestions on what to look for with her to make sure she is the right one for me?  been having PA for 9 years now and finally being medicated for it .05mg of xanax and 25mg of zoloft is that a good combo? Thanks, Diana

Response:

The med combo is pretty standard, however that Zoloft dose is probably too low for any therapeutic benefit…although with all of the SSRI’s you must increase the dose gradually…and you can anticipate some increase in symptoms while you are going on any meds.  SSRI’s are more popular these days than TCA’s  because they effect fewer systems (less side effects) and are more site specific.  Xanax is a standard med to be used as needed., usually in combo with another med… however, I’ve been doing a lot of reading about a rebound effect … something I experience always, so I stopped.  In terms of your shrink… a good dr. should educate you about the disorder in addition to writing scripts for meds. Find out what percentage of her practice is anxiety patients.  Also, check out the Anxiety Disorder Assoc. web site for more ideas on getting a good shrink: www.adaa.org  GOOD LUCK!!  Keep us posted on the outcome.

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Steve, thanks for responding my family doc got me started on the meds and referred me to the psych doc.

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Hello everyone haven’t posted lately but i am back, I finally made a appt with a psych doc today, my appointment if for next tuesday this is the first time for me, alittle nervous, can anyone give me any suggestions on what to look for with her to make sure she is the right one for me?  been having PA for 9 years now and finally being medicated for it .05mg of xanax and 25mg of zoloft is that a good combo?

Zoloft (SSRI-antidepresant) and Xanax (benzo) make a good combo although our reactions to meds are very personal. One of the things to find out is whether your pdoc is a *benzophobe* (one who doesn’t prescribe benzos because of the alleged *addcition* problem). If she is, she’s not the right one for you. Also you should feel at ease with her. You should be listened to and treated like a responsible adult. You should be able to work on treatment together rather than the doc just telling you what to do. She should explain what she prescribes and proposes and why and then you should *agree* on what’s the right course to take. Philip – Hide quoted text — Show quoted text – Thanks, Diana

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Hi Diana, The only words of advice I can give are not medicine -related. Don’t go into your appointment believing that your doctor can wave a magic wand, say all the right things and heal you. Yes, you can be healed but you will have to work hard. Also, do a lot of reading and decide what sort of therapy will work for you. (If I have to talk about my childhood one more time, I will scream!) Also, if you don’t feel comfortable with your doctor, say so Finally, if you trust your doctor, follow his/her advice. I know how big a step it is to go to a pdoc….good for you! You’re one step closer to feeling better.  Good luck. Let us know how it goes. Charley – Hide quoted text — Show quoted text – Hello everyone haven’t posted lately but i am back, I finally made a appt with a psych doc today, my appointment if for next tuesday this is the first time for me, alittle nervous, can anyone give me any suggestions on what to look for with her to make sure she is the right one for me?  been having PA for 9 years now and finally being medicated for it .05mg of xanax and 25mg of zoloft is that a good combo? Thanks, Diana

Response:

Hey Diana!!  I’m on Zoloft, 100 mgs., and Xanax .25 mgs. as needed.  Be careful with the Zoloft…I didn’t have many side effects but it definitely increased my panic attacks in the beginning.  Hang in there…Zoloft has worked great for me.  I still have a few "muted" PAs but I can handle them much better now.  And the fact that I can drive to and from work and even make it to stores (close to home) by myself is amazing!!  I’m going up to 125 mgs. of Zoloft starting tomorrow on the advice of my pdoc…good luck and keep us all posted. Melissa

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Hi, I take only zoloft 50 mgs. And it works well for me. Except around pms time when anxiety is high anyway. I feel some symtoms but they are very mild. It took 4 weeks to see the difference so give it awhile to work, the longer the better I feel.

Response:

One of the things to find out is whether your pdoc is a *benzophobe* (one who doesn’t prescribe benzos because of the alleged *addcition* problem). If she is, she’s not the right one for you.

I second this…even if I didn’t take benzos, I’d avoid benzophobic doctors just on principle! As everybody has said, Zoloft and Xanax is a good combination for panic disorder. 25mg is a starting dose of Zoloft, not a therapeutic dose; around 50mg, many people start to get some benefit, 100 is often enough, 200 is the high end (though you *can* go higher, this is the "official" recommended maximum). Doses of benzos are pretty individualized – are you taking it "as needed," or on some schedule? When I was using it for panic attacks, I needed 2mg to stop them (I didn’t take it all the time, just when I felt an attack coming on), but that’s just me. I actually don’t know how much other people use for this purpose – anyone? -elizabeth

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Xanax is a standard med to be used as needed., usually in combo with another med… however, I’ve been doing a lot of reading about a rebound effect … something I experience always, so I stopped.

I’ve got a question about this: how many times a day were you taking it? I think that Xanax does not last equally long for everyone, so some people can get by taking twice a day but others need it four times a day. -elizabeth

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Xanax is a standard med to be used as needed., usually in combo with another med… however, I’ve been doing a lot of reading about a rebound effect … something I experience always, so I stopped. I’ve got a question about this: how many times a day were you taking it? I think that Xanax does not last equally long for everyone, so some people can get by taking twice a day but others need it four times a day. -elizabeth

 Personally I had trouble taking it PRN because my pas were often OOB (as in while sleeping or nothing at all) although after enough of them I developed pretty much a state of constant anticipatory anxiety ..I could literally think myself into a panic attack trying to figure out how to avoid them..enter agoraphobia..Anyhow when I finally got Xanax I found if I had a PA it would generally take me 1.5-2 mgs to stop it..and I had little success with twice a day dosage,so I decided to stop the PRN route, as that is almost sure to leave anyone like myself with lots of hours of anxiety, as Xanax lasts 4 to 5 hrs at most for me. I now take it regularly .05 mg to 1 mg every four hours while awake, and if I rememeber..I do skip doses lots of times without even noticing it since my other two meds are helping a good deal too I think. But I can’t imagine twice a day being a very good xanax dosing..I would think 3 times at least given its short action. I have had almost no…nada..zero PAs for 6 weeks or more *knock on wood*, and my anxiety level is low enough to live with..I am sorry I was talked out of Xanax for so long because its tailor made for me and allows me to live, like a ..well not normal..but like a person anyhow ;- May — "Believe me! The secret of reaping the greatest fruitfulness and the greatest enjoyment from life is to live dangerously!"      -                Nietzsche

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Personally I had trouble taking it PRN because my pas were often OOB (as in while sleeping or nothing at all) although after enough of them I developed pretty much a state of constant anticipatory anxiety

I pretty much *exclusively* had OOTB panic attacks; I can only think of one instance in which there’s been an apparent trigger (it was a couple months ago – anxiety about school, actually). However, I experience an aura that predicts panic pretty consistently. I’ve never had one in my sleep, but then again, I don’t sleep much. :-} Anyhow when I finally got Xanax I found if I had a PA it would generally take me 1.5-2 mgs to stop it..and I had little success with twice a day dosage,so I decided to stop the PRN route, as that is almost sure to leave anyone like myself with lots of hours of anxiety, as Xanax lasts 4 to 5 hrs at most for me.

Yowsers. It lasts a lot longer than that for me: if I take a large enough dose to be sedating, I can actually get a full night’s sleep (7-8 hours). Most people do need to take it at least 3 times a day, though. I now take it regularly .05 mg to 1 mg every four hours while awake, and if I rememeber..I do skip doses lots of times without even noticing it since my other two meds are helping a good deal too I think.

Every 4 hours? Wow. Do you wake up in the morning feeling cruddy? When I tried taking Buprenex by itself (without a regular antidepressant), I found that I would get nasty rebound depression if I missed a dose. I think that sort of thing (short-acting) is better if you have an antidepressant (or two to smooth things out. (Now I’m just using the Buprenex as a p.r.n.) -elizabeth

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- Hide quoted text — Show quoted text – Personally I had trouble taking it PRN because my pas were often OOB (as in while sleeping or nothing at all) although after enough of them I developed pretty much a state of constant anticipatory anxiety I pretty much *exclusively* had OOTB panic attacks; I can only think of one instance in which there’s been an apparent trigger (it was a couple months ago – anxiety about school, actually). However, I experience an aura that predicts panic pretty consistently. I’ve never had one in my sleep, but then again, I don’t sleep much. :-} Anyhow when I finally got Xanax I found if I had a PA it would generally take me 1.5-2 mgs to stop it..and I had little success with twice a day dosage,so I decided to stop the PRN route, as that is almost sure to leave anyone like myself with lots of hours of anxiety, as Xanax lasts 4 to 5 hrs at most for me. Yowsers. It lasts a lot longer than that for me: if I take a large enough dose to be sedating, I can actually get a full night’s sleep (7-8 hours).

 I have never experienced any sedation or gotten any "buzz" from Xanax, in fact it actually energizes me without making me "speedy", if that makes sense. I had awful drowsiness on Klonopin that never went any and I was not even on a full therapeutic dosage any of the three times I took it. I still do not sleep well and have Ambien that I take on occasion and find somewhat helpful, but If I take it more than two days in a row it seems to lose its effectiveness for me. I am totally screwed up with sleep and energy due to the fact that I work full time night shift and then watch my highly hyperactive toddler all day until 4 or 5 when my eldest daughter comes home to help. So I am always tired and yet cannot fall asleep..frustrating!  Most people do need to take it at least 3 times a day, though. I now take it regularly .05 mg to 1 mg every four hours while awake, and if I rememeber..I do skip doses lots of times without even noticing it since my other two meds are helping a good deal too I think. Every 4 hours? Wow. Do you wake up in the morning feeling cruddy?

I wake up feeling better than I ever have in my life; I no longer sleep through the alarm or take an hour to drag my butt out of it. As I said though (I think) I am also on Pamelor 50mgs and 20mgs of Prozac and I no longer necessarily take xanax every four hours..On days off at home I have forgotten to take any at all even, and then there are days where I know I am going to be better off to take it every 4 hours  before I *need* it after six…I have never had any aura at all for my OOB attacks and over the years I have accumulated a ton of triggers that I am now working on overcoming..the big one so far was not only to ride comfortably in a car but to drive myself..Now that the Pamelor/Prozac is kicking in, I am taking the xanax pretty much prn..I dont generally take more than 2 mgs total on any day now, and as I say I have never felt more competent or alive in my life =) When I tried taking Buprenex by itself (without a regular antidepressant), I found that I would get nasty rebound depression if I missed a dose. I think that sort of thing (short-acting) is better if you have an antidepressant (or two to smooth things out. (Now I’m just using the Buprenex as a p.r.n.) -elizabeth

May — "Believe me! The secret of reaping the greatest fruitfulness and the greatest enjoyment from life is to live dangerously!"      -                Nietzsche

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Question:

Hello, I started taking Zoloft last friday(25mg/day) and I’ve already started feeling more relaxed, but I’m getting some unpleasant side effects. I’m having problems concentrating & sleeping and my head feels heavy and as if an uncomfortable amount of presure was being applied to it. I’ve lowered my dosage to 5mg a day and the problems concentrating has mostly gone and the other problems aren’t as bad but are still there. Can I expect these side effects to go away with time? If so, how long? If they don’t go away, am I likely to have better luck with a different SSRI or to have the same problems? Also, I’m considering taking melatonin to help with sleeping. Does anyone have experience using melatonin with Zoloft? Steve

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I have tried many SSRI’s for my anxiety, and have not found one I am completely happy with yet.  I have consistently been on clonazepam, though, and it works wonderfully.  My doctor says the SSRI’s have different side effects for everyone…your individual brain’s biochemistry will determine how well each one works for you and how many side effects you encounter.  I am currently on Prozac, but it, like all the SSRI’s I have tried, have sexual side effects for me.  But certainly some have been much better than others. Sexual effects aside, Zoloft was by far the worst for me (I couldn’t stop tensing up, grinding my teeth, even on 1/2 of the lowest dosage) while Paxil had the best anxiolytic effects.  So my opinion would be to give it a shot. If the side effects remain, keep trying the other ones until you find one that works for you.

Response:

Hi Steve, I started taking Zoloft last friday(25mg/day) and I’ve already started feeling more relaxed, but I’m getting some unpleasant side effects. I’m having problems concentrating & sleeping and my head feels heavy and as if an uncomfortable amount of presure was being applied to it.

It is very common to have a increase in anxiety while weaning on anti-depressants. I’ve lowered my dosage to 5mg a day and the problems concentrating has mostly gone and the other problems aren’t as bad but are still there. Can I expect these side effects to go away with time?

They should go away with time. It is hard to say how long you will have to put up with these side-effects. Ask your doctor for a scrpt for a benzo, such as Xanax, or Klonopin, it will help with these side-effects.  If so, how long? This varies from  person to person, but hopefully not more than a few weeks. If they don’t go away, am I likely to have better luck with a different SSRI or to have the same problems?

All anti-depressants can cause a increase in anxiety while weaning on them. It really is a normal,  and quite common to experience some side-effects while weaning on Ad`s. You could switch from Zoloft to Paxil, and find you have the same side-effects, or it is much worse on Paxil. No one can tell you how you will react on any medication, it is a matter of you getting on the med and seeing for yourself. Please don`t get discouraged, it does get better. Let me suggest instead of taking 25mgs of Zoloft, go to 12.5mgs, and do all your increases in 12.5mg increments, and stay at each increase for one week. You may find this helps lessen those side-effects you were feeling. We have a poster here that has had great success weaning on Zoloft in this manner. It can`t hurt to try. Unfortunately, sometimes to get better, we have to tolerate side-effects of certain meds, that will eventually help us. Also, I’m considering taking melatonin to help with sleeping. Does anyone have experience using melatonin with Zoloft?

I am not sure about the safety with taking Melatonin and Zoloft, so I can`t comment. If you are having problems with sleep, don`t take the Zoloft in the PM, take it in the AM. You could ask your doctor for a prescription for something to aid your sleep, Ambien from what I hear is good. Another option, and of course ask your doctor, is to take Benadryl, also known as "Diphenhydramine", it is a anti-histamine, but is quite a effective sleep aid. And is okay for long term use. Take care and hang in there, it will get better Jackie

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I just recently started taking Zoloft also and had some side effects, too.  I’ve been on it for about two weeks now and it seems to have gotten better.  I noticed Jackie mentioned to you that Ambien is good for sleep.  I take that also, and it knocks me out.  I started out on 10 mgs. and down to 5 mgs. because I was feeling groggy the next day from it.  I can sometimes now take 2.5 mgs. and still get a good night’s sleep. Karen – Hide quoted text — Show quoted text – Hello, I started taking Zoloft last friday(25mg/day) and I’ve already started feeling more relaxed, but I’m getting some unpleasant side effects. I’m having problems concentrating & sleeping and my head feels heavy and as if an uncomfortable amount of presure was being applied to it. I’ve lowered my dosage to 5mg a day and the problems concentrating has mostly gone and the other problems aren’t as bad but are still there. Can I expect these side effects to go away with time? If so, how long? If they don’t go away, am I likely to have better luck with a different SSRI or to have the same problems? Also, I’m considering taking melatonin to help with sleeping. Does anyone have experience using melatonin with Zoloft? Steve

– Posted via Talkway – http://www.talkway.com Exchange ideas on practically anything ™.

Response:

Hello, I started taking Zoloft last friday(25mg/day) and I’ve already started feeling more relaxed, but I’m getting some unpleasant side effects. I’m having problems concentrating & sleeping and my head feels heavy and as if an uncomfortable amount of presure was being applied to it. I’ve lowered my dosage to 5mg a day and the problems concentrating has mostly gone and the other problems aren’t as bad but are still there.

Hey, how did you do that? Does Zoloft come in tabs of 10 mgs which you cut in two? I wasn’t aware of that. Can I expect these side effects to go away with time? If so, how long?

The lower you start and the slower you raise the dose, the lesser the SE’s. A benzo on the side is also helpful. Yes, these SE’s should go away but it’s difficult to say when. You might experience some every time you up the dose. You should give Zoloft a fair trial of eight weeks on therapeutic dosage. Side effects may well disappear before that time but as you wean on very slowly (which is *good*) it may take a while. If they don’t go away, am I likely to have better luck with a different SSRI or to have the same problems?

If after eight weeks on a therapeutic dose the SE’s haven’t gone away – but there’s no reason now to think they won’t – it might be a good idea to try another SSRI. It’s often done and it’s done quickly as you don’t have to wean off of one first before being able to get on the other one. But this is not the time to think of that. First give Zoloft a fair trial. Also, I’m considering taking melatonin to help with sleeping. Does anyone have experience using melatonin with Zoloft?

Melatonin doesn’t seem the first choice med for insomnia. Do you take your Zoloft in the evening? In that case you might want to try to take it in the morning which might help with your insomnia. If  insomnia is a product or symptom of PD it will get away when PD is treated properly. If you do need a med, try Ambien or Trazodone, I’d say IMO. Steve

Philip

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Hi Steve, I started taking Zoloft last friday(25mg/day) and I’ve already started feeling more relaxed, but I’m getting some unpleasant side effects. I’m having problems concentrating & sleeping and my head feels heavy and as if an uncomfortable amount of presure was being applied to it. It is very common to have a increase in anxiety while weaning on anti-depressants.

Jackie, Thanks for responding, but I think you misread my above post – I’m not feeling anxiety at all on Zoloft – it works great emotionally it just makes me feel physicaly ill.(as described above) Steve

Response:

I started taking Zoloft last friday(25mg/day) and I’ve already started feeling more relaxed, but I’m getting some unpleasant side effects. I’m having problems concentrating & sleeping and my head feels heavy and as if an uncomfortable amount of presure was being applied to it. I’ve lowered my dosage to 5mg a day and the problems concentrating has mostly gone and the other problems aren’t as bad but are still there. Hey, how did you do that? Does Zoloft come in tabs of 10 mgs which you cut in two? I wasn’t aware of that.

The starter pack I got came with some 25mg pills which I quatered. (It wasn’t easy!) Can I expect these side effects to go away with time? If so, how long? The lower you start and the slower you raise the dose, the lesser the SE’s. A benzo on the side is also helpful. Yes, these SE’s should go away but it’s difficult to say when. You might experience some every time you up the dose. You should give Zoloft a fair trial of eight weeks on therapeutic dosage. Side effects may well disappear before that time but as you wean on very slowly (which is *good*) it may take a while.

I don’t understand how a benzo will help with headaches(?) I thought benzo’s only got rid of anxiety – the Zoloft has already done that. Please explain. Steve

Response:

- Hide quoted text — Show quoted text – I started taking Zoloft last friday(25mg/day) and I’ve already started feeling more relaxed, but I’m getting some unpleasant side effects. I’m having problems concentrating & sleeping and my head feels heavy and as if an uncomfortable amount of presure was being applied to it. I’ve lowered my dosage to 5mg a day and the problems concentrating has mostly gone and the other problems aren’t as bad but are still there. Hey, how did you do that? Does Zoloft come in tabs of 10 mgs which you cut in two? I wasn’t aware of that. The starter pack I got came with some 25mg pills which I quatered. (It wasn’t easy!) Can I expect these side effects to go away with time? If so, how long? The lower you start and the slower you raise the dose, the lesser the SE’s. A benzo on the side is also helpful. Yes, these SE’s should go away but it’s difficult to say when. You might experience some every time you up the dose. You should give Zoloft a fair trial of eight weeks on therapeutic dosage. Side effects may well disappear before that time but as you wean on very slowly (which is *good*) it may take a while. I don’t understand how a benzo will help with headaches(?) I thought benzo’s only got rid of anxiety – the Zoloft has already done that. Please explain. Steve

Ideally a benzo should also help with sleeping and the feeling of pressure in your head. You may not call them that but these are also anxiety symptoms. Philip

Response:

Thanks for responding, but I think you misread my above post – I’m not feeling anxiety at all on Zoloft – it works great emotionally it just makes me feel physicaly ill.(as described above) Steve

Hi Steve, If it is not anxiety it is most definitly a side-effect of the Zoloft. It should pass with time. A benzo might help alleviate some of the symtpoms. Good Luck!! Jackie

Response:

I started taking Zoloft last friday(25mg/day) and I’ve already started feeling more relaxed, but I’m getting some unpleasant side effects. I’m having problems concentrating & sleeping and my head feels heavy and as if an uncomfortable amount of presure was being applied to it.

<snipped Also, I’m considering taking melatonin to help with sleeping. Does anyone have experience using melatonin with Zoloft?

I took Melatonin with Zoloft with my doctors OK, but certainly discuss this with your doctor before deciding to do it. There are certainly other options out there that may be more beneficial for you. Ray

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I don’t understand how a benzo will help with headaches(?) I thought benzo’s only got rid of anxiety – the Zoloft has already done that. Ideally a benzo should also help with sleeping and the feeling of pressure in your head. You may not call them that but these are also anxiety symptoms.

Oh, I see. That’s interesting. I’ve never had those symptoms before taking zoloft. Steve

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I don’t understand how a benzo will help with headaches(?) I thought benzo’s only got rid of anxiety – the Zoloft has already done that. Ideally a benzo should also help with sleeping and the feeling of pressure in your head. You may not call them that but these are also anxiety symptoms. Oh, I see. That’s interesting. I’ve never had those symptoms before taking zoloft. Steve

I was going to ask about this…Since I went to 100 mg, I have had a pressure in my forehead at times…Not a headache, but the kind of feeling you get when you realize that you’ve been tightening your forehead for hours…I know this could be anxiety, but my anxiety has been much better and I haven’t had this before…It’s almost like the Zoloft has the front of my brain in overdrive now…What are the long term affects of these drugs anyway…Do they permanently alter brain chemistry?  I don’t feel different really, but I don’t want to find out when I’m done that I have permanent needs for these things… — Charles Phipps

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– Hide quoted text — Show quoted text -Hello All,    After starting Zoloft (100mg) 10 days ago I have been experiencing some uncomfortable side effects (nervousness, lightheadedness, irritability, etc.).  At this time, the Zoloft seems to be inducing panic attacks, not preventing them.  My doctor had warned me of this and advised me to "weather the storm" and give the meds a few weeks to take effect.  Has anyone experienced similar side effects with Zoloft (or other SSRIs)?  And, if so, how long did it take for these to subside?  I realize that everyone reacts differently to meds, but I’m  looking for some relief in the fact that I am not alone, and other people have shared similar experiences. Best Wishes for a Happy and Healthy New Year— Danno

Zoloft does indeed induce panic in the starting stages.  Many doctors realize this, and start the Zoloft at a very low dose, increasing it gradually over a period of months.  The starting dose can be as low as 12.5 mg every other day, working up to the therapeutic dose from there.  Another way of fighting the panic in the early stages of Zoloft is with a short-term prescription for Xanax or another benzodiazepine during the initial high-anxiety period.  If you are having trouble with the Zoloft, please suggest these ideas to your doctor. Hirsch address in header has been changed to avoid junk mail

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Hello All,         After starting Zoloft (100mg) 10 days ago I have been experiencing some uncomfortable side effects (nervousness, lightheadedness, irritability, etc.).  At this time, the Zoloft seems to be inducing panic attacks, not preventing them.  My doctor had warned me of this and advised me to "weather the storm" and give the meds a few weeks to take effect.  Has anyone experienced similar side effects with Zoloft (or other SSRIs)?  And, if so, how long did it take for these to subside?  I realize that everyone reacts differently to meds, but I’m  looking for some relief in the fact that I am not alone, and other people have shared similar experiences. Best Wishes for a Happy and Healthy New Year— Danno

Response:

- Hide quoted text — Show quoted text -Hello All,        After starting Zoloft (100mg) 10 days ago I have been experiencing some uncomfortable side effects (nervousness, lightheadedness, irritability, etc.).  At this time, the Zoloft seems to be inducing panic attacks, not preventing them.  My doctor had warned me of this and advised me to "weather the storm" and give the meds a few weeks to take effect.  Has anyone experienced similar side effects with Zoloft (or other SSRIs)?   And, if so, how long did it take for these to subside?  I realize that everyone reacts differently to meds, but I’m  looking for some relief in the fact that I am not alone, and other people have shared similar experiences. Best Wishes for a Happy and Healthy New Year— Danno

Hi Danno I just started taking Zoloft also.  My doctor started me out with 50mg and suggested that I take 1/2 for a while until I get used to it.  I experienced some side effects; nausea, diareah, anxiousness; but after a week I was able to increase my dosage to the full 50mg.  It has taken another week at the full dosage to feel O.K.  The side effects seem to be going away.  Now it’s time to see if it will really help me with my PA’s Good Luck, ttfn Kathy

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I have also recently started taking Zoloft and the same has happened to me.  My doctor also gave me the same advice.  At this point I am on 100mg and also taking xanex once a day.  I will continue this and see how it works.  I know how you feel but hang in there.

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