Question:

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 A complete if not outdated book on Candida infections which even reviews the book "the yeast connection" is "Candida and Candidosis: A review and bibliography" (1989-I think) by FC Odds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

Response:

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

Response:

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

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

Response:

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

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

Response:

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

Response:

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

Response:

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

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

Response:

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

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

Response:

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

Response:

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

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

Response:

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

Response:

Question:

 I was given an older Black and Decker Router. Looks just like the  newer DeWalt units. 1/4" collet only all metal with the rack and  pinion depth adjustment. The base is broken as the router was  dropped. Was wondering if anyone had a base, perhaps from an old  burned out unit?  If you have one e-mail me with the price?  Thanks in advance.  Marty

Response:

Home Depot, Builders Square, etc. have generic routah bases that will fit your B&D. – Hide quoted text — Show quoted text –  I was given an older Black and Decker Router. Looks just like the  newer DeWalt units. 1/4" collet only all metal with the rack and  pinion depth adjustment. The base is broken as the router was  dropped. Was wondering if anyone had a base, perhaps from an old  burned out unit?  If you have one e-mail me with the price?  Thanks in advance.  Marty

Response:

For those who do not already know, DeWalt was bought out by Black & Decker.   The DeWalt and the Black & Decker routers are identically the same, except for the color schemes. Thus if you think the DeWalt Router is a good one, then so must the B&D be a good one. This also means that you can get parts for your routers from B&D. This makes it a lot easier to repair an old one or find that otherwise hard to get part. George – Hide quoted text — Show quoted text -Home Depot, Builders Square, etc. have generic routah bases that will fit your B&D.  I was given an older Black and Decker Router. Looks just like the  newer DeWalt units. 1/4" collet only all metal with the rack and  pinion depth adjustment. The base is broken as the router was  dropped. Was wondering if anyone had a base, perhaps from an old  burned out unit?  If you have one e-mail me with the price?  Thanks in advance.  Marty

Response:

: For those who do not already know, DeWalt was bought out by Black & : Decker.   The DeWalt and the Black & Decker routers are identically : the same, except for the color schemes. No, they aren’t.  DeWalt and ELU routers are the same, other than color (ELU is a high-end Swiss tool manufacturer bought by B&D). All routers marketed under the B&S label are low-end, junky ones.         In some other tool lines, particularly cordless drills, the B&D professional tools are identical to DeWalt, other than color and nameplate. : Thus if you think the DeWalt Router is a good one, then so must the : B&D be a good one.         Nope! : This also means that you can get parts for your routers from B&D. : This makes it a lot easier to repair an old one or find that otherwise : hard to get part.         This much is true — contact a B&D repair center if all else fails. : George : Home Depot, Builders Square, etc. have generic routah bases that will : fit your B&D. :

: :  I was given an older Black and Decker Router. Looks just like the :  newer DeWalt units. 1/4" collet only all metal with the rack and :  pinion depth adjustment. The base is broken as the router was :  dropped. Was wondering if anyone had a base, perhaps from an old :  burned out unit? : :  If you have one e-mail me with the price? : :  Thanks in advance. :  Marty — <<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<                            Andrew Barss     Graduate Advisor, Department of Linguistics, University of Arizona              Communications 314A,  621-2201 or 621-6897 <<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<

Response:

- Hide quoted text — Show quoted text – : For those who do not already know, DeWalt was bought out by Black & : Decker.   The DeWalt and the Black & Decker routers are identically : the same, except for the color schemes. No, they aren’t.  DeWalt and ELU routers are the same, other than color (ELU is a high-end Swiss tool manufacturer bought by B&D). All routers marketed under the B&S label are low-end, junky ones.    In some other tool lines, particularly cordless drills, the B&D professional tools are identical to DeWalt, other than color and nameplate. : Thus if you think the DeWalt Router is a good one, then so must the : B&D be a good one.    Nope! : This also means that you can get parts for your routers from B&D. : This makes it a lot easier to repair an old one or find that otherwise : hard to get part.    This much is true — contact a B&D repair center if all else fails. : George : Home Depot, Builders Square, etc. have generic routah bases that will : fit your B&D. : : :  I was given an older Black and Decker Router. Looks just like the :  newer DeWalt units. 1/4" collet only all metal with the rack and :  pinion depth adjustment. The base is broken as the router was :  dropped. Was wondering if anyone had a base, perhaps from an old :  burned out unit? : :  If you have one e-mail me with the price? : :  Thanks in advance. :  Marty — <<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<                           Andrew Barss    Graduate Advisor, Department of Linguistics, University of Arizona         Communications 314A,  621-2201 or 621-6897 <<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<

The buyout of whomever by whomever seems to be relatively unimportant, the end product, or those products that become consumer available are. At the present time B&D offers only one router that is made by the previous supplier of the B&D product.   This product is offered only because of the contract arrangement between the two companies. In the not to distant future all products offered by B&D will be the same as the current product line sold under the DeWalt product line. It seems that in the desire of B&D to improve their product line that the purchase of a well know supplier has been the best way to achieve such goal. Thus, if the DeWalt line is continued and the product continues to be manufactured by the same contractor, then the two products will be very, very similar, if not identical. That is the reason that those of you who are current DeWalt owners may in the future be best advised to attempt to get your repair parts from B&D. Please note that I do not own either B&D or DeWalt tools, and I have no reason to support nor malign either maker. Sincerely George Thomas

Response:

Hi, I use both a 25+ year-old B&D and a new DeWalt. Despite a nearly identical ioutward appearance, the DeWalt has twice the guts of the B&D. It must be the windings. Casey – Hide quoted text — Show quoted text – For those who do not already know, DeWalt was bought out by Black & Decker.   The DeWalt and the Black & Decker routers are identically the same, except for the color schemes. Thus if you think the DeWalt Router is a good one, then so must the B&D be a good one. This also means that you can get parts for your routers from B&D. This makes it a lot easier to repair an old one or find that otherwise hard to get part. George Home Depot, Builders Square, etc. have generic routah bases that will fit your B&D.  I was given an older Black and Decker Router. Looks just like the  newer DeWalt units. 1/4" collet only all metal with the rack and  pinion depth adjustment. The base is broken as the router was  dropped. Was wondering if anyone had a base, perhaps from an old  burned out unit?  If you have one e-mail me with the price?  Thanks in advance.  Marty

Response:

: For those who do not already know, DeWalt was bought out by Black & : Decker.   The DeWalt and the Black & Decker routers are identically : the same, except for the color schemes. No, they aren’t.  DeWalt and ELU routers are the same, other than color (ELU is a high-end Swiss tool manufacturer bought by B&D). All routers marketed under the B&S label are low-end, junky ones.

You are wrong on this.  Black and Decker has always had an industrial line of high quality tools.  They are not sold in hardware stores or other consumer outlets.  WW Grainger has them.   They appear similar to DeWalts except in color and badges.

Response:

: : No, they aren’t.  DeWalt and ELU routers are the same, other than color : (ELU is a high-end Swiss tool manufacturer bought by B&D). : : All routers marketed under the B&S label are low-end, junky ones. : You are wrong on this.  Black and Decker has always had an industrial line : of high quality tools.  They are not sold in hardware stores or other : consumer outlets.  WW Grainger has them.   They appear similar to DeWalts : except in color and badges.         Thanks for the correction.  I was unaware of this — I’ve gotten DeWalt stuff, and Elu stuff, from both industrial supply houses and directly from DeWalt/B&D stores, and had never seen a respectable router sold with the B&D label.  I got my cordless, DeWalt industrial drill from the same B&D store whch sold the el-crapola routers, and assumed that routers were one tool that wasn’t sold under the industrial B&D label.         –Andrew Barss

Response:

Question:

yes, but if the poster is right that the buildup is basically caused by static electricity, then I’ll just wash the Aerochamber every day with some dishwashing liquid.  Why take chances.  It’s not that big an effort to keep it clean.  I was just curious.

Considering the quality of many of its posts, I would strongly suggest you look for a more reliable reference. Ted

Response:

Ted

Question:

Is it possible to minimze the chances for a need to switch meds? What I am wonde

snip yes 2. So if a med doesn’t work for you, how do you know if you should increase after a period of 6-8 weeks if the med shows little benefit after you come close to or arrive at the average target dose, you move on LM

Response:

– Hide quoted text — Show quoted text – Greetings all, Two dum question: 1) Is it possible to minimze the chances for a need to switch meds? What I am wondering here is, can a good pdoc, after talking to you sufficiently long to know your problems, make a good educated suggestion which SSRI is best for you? In other words, are the choices between paxil, zoloft, effexor, etc. completely based on trial and error, or are there guidelines that a good pdoc can use to decide which one is most likely to be the best for you? I’ve noticed that some doctors recommend paxil, some zoloft and others effexor; all for the same person with same sysmptoms. Is it because some know which is best chance of working for you, or is it just a matter of choice? 2) So if a med doesn’t work for you, how do you know if you should increase the dosage or if you should switch to a new med?? Thanks.

Is it not true that the SRIs and SSRIs have been proven no more effective than TCAs? I believe this is the case. If so, wouldn’t it make more sense to start with a TCA since their side-effect and long term effect profiles are much better understood than those of the SRIs and SSRIs?    http://www.newsfeed.com       The #1 Newsgroup Service in the World! —–= Over 100,000 Newsgroups – Unlimited Fast Downloads – 19 Servers =—–

Response:

Greetings all, Two dum question: 1) Is it possible to minimze the chances for a need to switch meds? What I am wondering here is, can a good pdoc, after talking to you sufficiently long to know your problems, make a good educated suggestion which SSRI is best for you? In other words, are the choices between paxil, zoloft, effexor, etc. completely based on trial and error, or are there guidelines that a good pdoc can use to decide which one is most likely to be the best for you?

Well, I disagree with most of the posters.  Individual reactions are just about impossible to predict.  A good pdoc will start you on the one most recommended for your symptoms, taking into consideration physical problems that some drugs can aggravate (blood pressure for Effexor, liver damage for Serzone).  He will then monitor the alleviation of symptoms vs. tolerability of side effects. In other words, the answer is a VERY qualified yes. I’ve noticed that some doctors recommend paxil, some zoloft and others effexor; all for the same person with same sysmptoms. Is it because some know which is best chance of working for you, or is it just a matter of choice? 2) So if a med doesn’t work for you, how do you know if you should increase the dosage or if you should switch to a new med??

Again your doctor should be able to help with this.  Largely the decision depends on side effects, i.e. if your side effects are difficult to tolerate, raising the dosage is not likely to provide a long-term solution! — Mason Barge "People who like this sort of thing will find this the sort of thing they like."         — Abraham Lincoln

Response:

Are you saying that Effexor is more effective for depression than zoloft or paxil,

effexor mimics tricyclic medications in its actions but uses a different mechanism to acheive it that initially was purported to have fewer side effects-it just has different ones-it is useful when more selective meds like ssri’s fail to work -using it instead of a tca has some advantages in certain medical and psychological profiles-neither are better-both have specific characteristics that may hold better therapeutic value to different people. all are effective for depression, all theoretically are equally effective for anxiety-but theory and practice may be at odds Which one in your judgement has the least side effects?

currently they all have similar side effect profiles that can be remediated by using very low doses to start and being patient enough to increase them painfully slowly. Each person has their own level of  toleration of the side effects of any of them. Some meds have greater potency at the synapse and each has its own slightly different molecular stimulating characteristics  so for one person zoloft may be sedating and for another it may be stimulating-we use general characteristics to anticipate the results of each med. If benzos are used along with the ad med-one is more comfortable. LM

Response:

Hi Chip, Are you saying that Effexor is more effective for depression than zoloft or paxil, but they are all equallty effective for anxiety? Which one in your judgement has the least side effects? Cheers Rsina – Hide quoted text — Show quoted text – I believe so. I would select one with the least side effects since they (SSRIs) are all equally effective (as a group, although one might prove to be more effective for one person in particular). Or, if a person has used one SSRI in the past with good results, I would probably select that one. If he/she was depressed in addition to anxiety, I would use Effexor since that tends to be more effective for depression and equally effective for anxiety as the SSRIs.

Response:

Hi Chip, Are you saying that Effexor is more effective for depression than zoloft or paxil, but they are all equallty effective for anxiety?

Yes. Which one in your judgement has the least side effects?

That’s a tough one. Celexa is promoted as having fewer side effects, and some people on ASAP have said that has been their experience. Zoloft seems to be well tolerated. Paxil seems to make people fatigued and sleepy during the day. Prozac is too stimulating and this results in increased anxiety and insomnia. Plus Prozac has such a long half life if you needed to discontinue it because of an adverse reaction it would be around in your system for a few weeks. Plus Prozac tends to interfer with the metabolism of other meds more than the other SSRIs. Luvox seems to be very sedating. I’d be inclined to put patients on Celexa or Zoloft instead of the other SSRIs. Although I’m certain many people are on any of these SSRIs and are experiencing good results. Cheers Rsina

Chip – Hide quoted text — Show quoted text – I believe so. I would select one with the least side effects since they (SSRIs) are all equally effective (as a group, although one might prove to be more effective for one person in particular). Or, if a person has used one SSRI in the past with good results, I would probably select that one. If he/she was depressed in addition to anxiety, I would use Effexor since that tends to be more effective for depression and equally effective for anxiety as the SSRIs.

Response:

Greetings all, Two dum question: 1) Is it possible to minimze the chances for a need to switch meds? What I am wondering here is, can a good pdoc, after talking to you sufficiently long to know your problems, make a good educated suggestion which SSRI is best for you? In other words, are the choices between paxil, zoloft, effexor, etc. completely based on trial and error, or are there guidelines that a good pdoc can use to decide which one is most likely to be the best for you? I’ve noticed that some doctors recommend paxil, some zoloft and others effexor; all for the same person with same sysmptoms. Is it because some know which is best chance of working for you, or is it just a matter of choice? 2) So if a med doesn’t work for you, how do you know if you should increase the dosage or if you should switch to a new med?? Thanks.

Response:

Greetings all, Two dum question: 1) Is it possible to minimze the chances for a need to switch meds?

Yes. What I am wondering here is, can a good pdoc, after talking to you sufficiently long to know your problems, make a good educated suggestion which SSRI is best for you?

I believe so. I would select one with the least side effects since they (SSRIs) are all equally effective (as a group, although one might prove to be more effective for one person in particular). Or, if a person has used one SSRI in the past with good results, I would probably select that one. If he/she was depressed in addition to anxiety, I would use Effexor since that tends to be more effective for depression and equally effective for anxiety as the SSRIs. In other words, are the choices between paxil, zoloft, effexor, etc. completely based on trial and error, or are there guidelines that a good pdoc can use to decide which one is most likely to be the best for you? I’ve noticed that some doctors recommend paxil, some zoloft and others effexor; all for the same person with same sysmptoms. Is it because some know which is best chance of working for you, or is it just a matter of choice?

All for the same person? Or all for different persons with the same symptoms? Docs tend to prescribe meds they have prescribed before and are comfortable with. 2) So if a med doesn’t work for you, how do you know if you should increase the dosage or if you should switch to a new med??

If I got *any* response to the med, I would tend to increase the dose. If after several increases there is no response, I’d try a different med. Chip – Hide quoted text — Show quoted text – Thanks.

Response:

Question:

Hi All, I’m seeing my PCP about my concerns with Zoloft. I’v been on it for maybe three months now and the only positive thing I can say is that it was a far cry better for me than Wellbutrin. I couldn’t tell if the Zoloft eased the anxiety at the switch or if just stopping the W did it. Now for the problems–obviously not initial side effects. Weight gain and unable to lose it not matter what I do–I’m not in to fads, just a good diet and as much excersize as I can tolerate. I’ve tried low fat, then low carb–all smart and balanced as I don’t want it to be in vain as soon as I start eating normally again. But I get no results. This is chipping away at my self esteem (and this has never happened to me before and I’m in my 40’s). Gritting/clenching my teeth. At first I thought it was recent dental work (crowns) but it is getting to be so severe that it is causing headaches and I can’t chew anything more firm than cooked rice. Meat? Forget it! I have been back to the dentist twice and though I haven’t completely let him off the hook, I think since I notice the teeth clenching all day long, I have to take some responsibility and look into the Zoloft possibility. I have small involuntary twitching in my arms and legs. It’s unnerving–I hate it. I fear parkinsons or something similar though, again, it started after I was on the Zoloft for a few months. Heightened anxiety all of a sudden. I was down to .75mgs daily and now am up to twice that–conciously I think for the teeth clenching–it seems to help a little–but also my entire disposition, mood, all over feel. I have horrible nightmares every nightl. I can not even bring myself to tell you the content. They seem to last for ever and if you consider the worst possible thing that could happen to a parent, that is what I am dealing with almost every night. I seem to sob all night long, though I know dreams are very short. Consequently, I wake up with a horrible yet relieved feeling–but very exhausted. I used to get canker sores as a child. NOT COLD SORES–they are so often confused with one another. My mom took me to many doctors and there was nothing they could do back then–I’m hoping medicine has made some progress in this area. This has to be some of the worst pain I have ever had to endure and they seem to be nonstop–two or three coming on the heels of another two or three just healing. I am guaranteed a canker sore (mine always result from trauma) if I eat chips, crisp french bread, if I bite the inside of my cheek when eating. They last a good 1 1/2 to 2 weeks and I realize that the Zoloft may not be to blame but I like to be informed when I see the doc. I have seen a few studies posted here recently about the teeth clenching. Truly, I don’t know if I benefit at all from the Z. I am taking it for anxiety not depression. If anyone has any suggestions or has heard of any one else with a similar story. Any links to pertinent info also greatly appreciated. Finally, does anyone know how well Buspar seems to be working for GAD-ites. Since it’s not a member of the SSRI family—I read somewhere that pre-existing conditions can be exaserbated–something to do with the dopamine????? Obviously, I need some intelligent help here LOL.

Response:

I have small involuntary twitching in my arms and legs. It’s unnerving–I hate it. I fear parkinsons or something similar though,

Hi.. I see you are in your mid 40s,, just have to ask, are you female?? I have found out that many of my symptoms including my anxiety ( which manifests itself in many ways) are all peri/menopause related… have you checked that out?? it does not matter if you still are regular, your hormones can start fluctuating and cause all kinds of symptoms… just consider it , unless you are male of course! Martha

Response:

Hi All,

Hi Little bear I’m seeing my PCP about my concerns with Zoloft. I’v been on it for maybe three months now and the only positive thing I can say is that it was a far cry better for me than Wellbutrin. I couldn’t tell if the Zoloft eased the anxiety at the switch or if just stopping the W did it. Now for the problems–obviously not initial side effects. Weight gain and unable to lose it not matter what I do–I’m not in to fads, just a good diet and as much excersize as I can tolerate. I’ve tried low fat, then low carb–all smart and balanced as I don’t want it to be in vain as soon as I start eating normally again. But I get no results. This is chipping away at my self esteem (and this has never happened to me before and I’m in my 40’s).

Unfortunately alot of the anti-depressants can cause weight gain. Gritting/clenching my teeth. At first I thought it was recent dental work (crowns) but it is getting to be so severe that it is causing headaches and I can’t chew anything more firm than cooked rice. Meat? Forget it! I have been back to the dentist twice and though I haven’t completely let him off the hook, I think since I notice the teeth clenching all day long, I have to take some responsibility and look into the Zoloft possibility.

You can clench your teeth when your anxious, angry, or in pain. It might be a symptom of your anxiety or perhaps the dental work. A few hours after my sister`s accident I started clenching my teeth. It was causing pain in my temples and at times it was so bad I was close to tears. It seemed the more I focused on the clenching the worse it got. Believe it or not, chewing gum seemed to help me. What does your doctor say when you tell him you can`t eat anything harder than rice? I have small involuntary twitching in my arms and legs. It’s unnerving–I hate it. I fear parkinsons or something similar though, again, it started after I was on the Zoloft for a few months.

Twitching is a very common symptom of anxiety. I have had twitches in my arms and legs, the most annoying place to get a twitch is my eyelids. When I went on Paxil they stopped. Maybe your Zoloft dose is just not enough to relieve your anxiety. I think the only way to find out if it is anxiety or the Zoloft causing these symptoms is to get off of it and see what happens. Heightened anxiety all of a sudden. I was down to .75mgs daily and now am up to twice that–conciously I think for the teeth clenching–it seems to help a little–but also my entire disposition, mood, all over feel.

Has increasing the dose helped with the symptoms and the heightened anxiety? I have horrible nightmares every nightl. I can not even bring myself to tell you the content. They seem to last for ever and if you consider the worst possible thing that could happen to a parent, that is what I am dealing with almost every night. I seem to sob all night long, though I know dreams are very short. Consequently, I wake up with a horrible yet relieved feeling–but very exhausted.

When my anxiety is high for a extended period, I get terrible nightmares. I know what you are going through, I use to be afraid to go to sleep for fear of what I would dream. ((((((Little bear))))) I used to get canker sores as a child. NOT COLD SORES–they are so often confused with one another. My mom took me to many doctors and there was nothing they could do back then–I’m hoping medicine has made some progress in this area. This has to be some of the worst pain I have ever had to endure and they seem to be nonstop–two or three coming on the heels of another two or three just healing. I am guaranteed a canker sore (mine always result from trauma) if I eat chips, crisp french bread, if I bite the inside of my cheek when eating. They last a good 1 1/2 to 2 weeks and

Hmmm, did the jaw clenching start after you started getting canker sores? I would bet that your jaw clenching is related to the cankers, indirectly. You said yourself it is some of the worst pain you have endured You might be clenching due to the pain in your mouth. You should tell your doctor about these sores, he may be able to give you a ointment to help with the inflammation. Avoid citrus fruit, tomato`s and nuts. I also heard that many of the toothpaste we use can cause cankers in sensitive individuals. I realize that the Zoloft may not be to blame but I like to be informed when I see the doc. I have seen a few studies posted here recently about the teeth clenching. Truly, I don’t know if I benefit at all from the Z. I am taking it for anxiety not depression. If anyone has any suggestions or has heard of any one else with a similar story. Any links to pertinent info also greatly appreciated. Finally, does anyone know how well Buspar seems to be working for GAD-ites. Since it’s not a member of the SSRI family—I read somewhere that pre-existing conditions can be exaserbated–something to do with the dopamine????? Obviously, I need some intelligent help here LOL.

Buspar is effective for generalized anxiety disorder, which is what I think you said you have. You don`t suffer from panic attacks, right? I don`t think it would hurt to try the Buspar.

really think for your best interest you should see a psych doctor for diagnosis and treatment. Most MD`s  just don`t have the knowledge to treat anxiety disorders properly. Take care and good luck tomorrow. *Hugs* Jackie

Response:

Question:

Newsgroup: I’m hoping you might have some suggestions for me. I have a friend who has had chronic depression most of her life and has been on almost every antidepressant out there. She’s not bipolar. She recently had four ECT treatments and her pdoc took her off all of her meds for that. She definitely sounded more alert being off her meds, but now he put her back on them and she sounds worse than ever. She takes Effexor XR 450 mg. Remeron 45 mg. Zyprexa 10 mg. and Xanax as needed.  This woman is soooo lethargic, fatigued, unmotivated etc. that she just sits and cries. Every medication she takes causes fatigue.  I know because I went through a similar situation with the Effexor XR.  The fatigue from the meds were making me depressed. Anyway, I am accompanying her to see her pdoc on Monday to see if we can get some answers.  Any input on this situation would be greatly appreciated. Glenda

Response:

Glenda, My first question is—why is your friend on Zyprexa if she is depressed and not bipolar, which I assume means that she has never displayed mania?  Zyprexa is major anti-psychotic or "downer." Robert

Response:

Robert: Neuroleptics are sometimes added to AD regimens as augmentation…it helps with uncontrollable suicidal ideation, for instance. One who is there now. Jim "I never had problems with drugs, I had problems with the police." Keith Richards

Response:

<Posted and Mailed to Glenda Newsgroup: I’m hoping you might have some suggestions for me. I have a friend who has had chronic depression most of her life and has been on almost every antidepressant out there. She’s not bipolar. She recently had four ECT treatments and her pdoc took her off all of her meds for that. She definitely sounded more alert being off her meds, but now he put her back on them and she sounds worse than ever. She takes Effexor XR 450 mg. Remeron 45 mg. Zyprexa 10 mg. and Xanax as needed.

If the diagnosis is severe clinical depression, I fail to see why she is taking an antipsychotic. IMO she is way over medicated! I suggest that she get a second opinion ASAP! The Effexor dose is very high as well. Remeron makes many people very sleepy as does Zyprexa and Xanax. This woman is soooo lethargic, fatigued, unmotivated etc. that she just sits and cries.

Considering what she is taking, that is not terribly surprising! Every medication she takes causes fatigue.  I know because I went through a similar situation with the Effexor XR.  The fatigue from the meds were making me depressed. Anyway, I am accompanying her to see her pdoc on Monday to see if we can get some answers.  Any input on this situation would be greatly appreciated.

I suggest that you tell Dr. Mengle adios! What she is taking would turn Robin Williams into a zombie! Glenda

Most sincerely, James D. Milton Standard Medical Disclaimer Any opinions stated should NOT be considered as medical advice! You should confirm any suggestions made with your physician who is solely responsible for prescribing ALL medications and monitoring the patient’s progress. Make NO changes in your prescribed dosages without the approval of your doctor!

Response:

- Hide quoted text — Show quoted text – Newsgroup: I’m hoping you might have some suggestions for me. I have a friend who has had chronic depression most of her life and has been on almost every antidepressant out there. She’s not bipolar. She recently had four ECT treatments and her pdoc took her off all of her meds for that. She definitely sounded more alert being off her meds, but now he put her back on them and she sounds worse than ever. She takes Effexor XR 450 mg. Remeron 45 mg. Zyprexa 10 mg. and Xanax as needed.  This woman is soooo lethargic, fatigued, unmotivated etc. that she just sits and cries. Every medication she takes causes fatigue.  I know because I went through a similar situation with the Effexor XR.  The fatigue from the meds were making me depressed. Anyway, I am accompanying her to see her pdoc on Monday to see if we can get some answers.  Any input on this situation would be greatly appreciated. Glenda

She must rattle so much she makes a good musical instrument.A bit like being a semi comatose member of the percussion family being played by a demented psychiatrist.

Response:

Hi Glenda, – Hide quoted text — Show quoted text – I’m hoping you might have some suggestions for me. I have a friend who has had chronic depression most of her life and has been on almost every antidepressant out there. She’s not bipolar. She recently had four ECT treatments and her pdoc took her off all of her meds for that. She definitely sounded more alert being off her meds, but now he put her back on them and she sounds worse than ever. She takes Effexor XR 450 mg. Remeron 45 mg. Zyprexa 10 mg. and Xanax as needed.  This woman is soooo lethargic, fatigued, unmotivated etc. that she just sits and cries. Every medication she takes causes fatigue.  I know because I went through a similar situation with the Effexor XR.  The fatigue from the meds were making me depressed. Anyway, I am accompanying her to see her pdoc on Monday to see if we can get some answers.  Any input on this situation would be greatly appreciated.

Perhaps she is overmedicated. It is important that her pdoc be informed of her response to the RX meds. Peace, —

Response:

Question:

i am so fucking angry, restless, anxious and pissed off. i think this mood has to do with the fact that i havent been able to refill my meds because i had to switch insurance bullshit. anyway, i’m fucking pissed and i feel like ripping my fucking head off. i hate people. i hate myself for fearing people. okay , i’m done ranting. i think i’m gonna go…like…whatever *LiZ* staring…@aol.com http://welcome.to/mysleep

Response:

What meds did you change?  You are taking no meds? – Hide quoted text — Show quoted text -

i am so fucking angry, restless, anxious and pissed off. i think this mood has to do with the fact that i havent been able to refill my meds because i had to switch insurance bullshit. anyway, i’m fucking pissed and i feel like ripping my fucking head off. i hate people. i hate myself for fearing people. okay , i’m done ranting. i think i’m gonna go…like…whatever *LiZ* staring…@aol.com http://welcome.to/mysleep

*************************************************** Grachman, The

Response:

On 26 Aug 1999 02:47:17 GMT, glass…@aol.communist (LiZ) wrote:

i am so fucking angry, restless, anxious and pissed off.

try saying this "GRRRR!"

i think this mood has to do with the fact that i havent been able to refill my meds because i had to switch insurance bullshit.

Bummer, are you going to be able to get them refilled soon, or at least start new meds?

anyway, i’m fucking pissed and i feel like ripping my fucking head off. i hate people. i hate myself for fearing people.

(( you shouldnt feel like that, its not your fault. the best you can do is work at getting better ya know?

okay , i’m done ranting. i think i’m gonna go…like…whatever *LiZ* staring…@aol.com http://welcome.to/mysleep

Nick Wilde nwilde at punkass dot com ————————- Get paid to surf the web AND chat on IRC http://members.xoom.com/nickwilde_/html/getpaid.html

Response:

From: glass…@aol.communist  (LiZ) i think this mood has to do with the fact that i havent been able to refill my meds because i had to switch insurance bullshit.

Liz, you’re probably right about the med thing…call your p-doc and explain that you’ve been off your meds and ask if s/he might be able to supply you with some sample packets to hold you over, tell them *exactly* how you are feeling…I bet they will come up with something! meanwhile double up on the Xanax! Pam

Response:

Sounds like my worst nightmare. I can relate to that a little bit. I missed one Effexor dose and the next day I was like a frikken junky walking into the pharmacy, shaking and extremely pale looking, with my script. If I had to take another day of that I would have been close to voluntary lock-up. Hope ya get them soon babe. For the time being just sit somewhere quiet, close your eyes and think of the number 1 over and over again Or as Pam says numb your head with Bzo’s. Personally the latter seems like a much more attractive option — Russ "Better living through Chemistry" MzPami <mzp…@aol.com

wrote in message

news:19990826175744.28280.00000029@ng-fl1.aol.com… – Hide quoted text — Show quoted text -

From: glass…@aol.communist  (LiZ) i think this mood has to do with the fact that i havent been able to

refill

my meds because i had to switch insurance bullshit. Liz, you’re probably right about the med thing…call your p-doc and

explain

that you’ve been off your meds and ask if s/he might be able to supply you

with

some sample packets to hold you over, tell them *exactly* how you are feeling…I bet they will come up with something! meanwhile double up on the Xanax! Pam

Response:

Hi Liz

i am so fucking angry, restless, anxious and pissed off.

Congratulations. Me too.

i think this mood has to do with the fact that i havent been able to

refill my

meds because i had to switch insurance bullshit. anyway, i’m fucking pissed and i feel like ripping my fucking head off.

Don’t do it. Maybe you have a nice head.

i hate people.

I don’t hate (all) people: they hate me.

i hate myself for fearing people.

Same here… — Ciao! |  /| | / |ark  ../   /os FIDO 2:284/5.7 E-mail mccm….@hccnet.nl URL http://home.hccnet.nl/mccm.vos ICQ 326628 (PGP key available)

Response:

Question:

I’ve been taking B-multi vitamin for years, and it does help. i recently started drinking st. johns wort tea, which also helps. but i find that none of that helps enough anymore.

Response:

Hello gang, This is my first post here. I started taking St. Johns Wort about two weeks ago for Anxiety/Panic and Depression. Over the past few days my symptoms have almost completely vanished!! I did the Paxil/Zoloft/Xanax/Buspar crap, and all they did was make me worse! Thank God for St. Johns Wort! I also started taking a multivitamin twice a day, and b-complex 3 times a day. I read that most people who suffer from Anxiety/Panic and Depression are usually very deficient in B vitamins. Have a great day!! Bryan Z.

Response:

Hi Bryan, It’s great that you’re feeling better. I just wanted to echo your support for St John’s Wort.  I’m in a similar situation.  I’ve been taking it only about a week and a half, and feel so much better too.  I’m also taking b vitamins and multivitamins… so maybe there is a connection here. Take Care, – Hide quoted text — Show quoted text – Hello gang, This is my first post here. I started taking St. Johns Wort about two weeks ago for Anxiety/Panic and Depression. Over the past few days my symptoms have almost completely vanished!! I did the Paxil/Zoloft/Xanax/Buspar crap, and all they did was make me worse! Thank God for St. Johns Wort! I also started taking a multivitamin twice a day, and b-complex 3 times a day. I read that most people who suffer from Anxiety/Panic and Depression are usually very deficient in B vitamins. Have a great day!! Bryan Z.

Response:

– Hide quoted text — Show quoted text – Hello gang, This is my first post here. I started taking St. Johns Wort about two weeks ago for Anxiety/Panic and Depression. Over the past few days my symptoms have almost completely vanished!! I did the Paxil/Zoloft/Xanax/Buspar crap, and all they did was make me worse! Thank God for St. Johns Wort! I also started taking a multivitamin twice a day, and b-complex 3 times a day. I read that most people who suffer from Anxiety/Panic and Depression are usually very deficient in B vitamins. Have a great day!! Bryan Z.

Wow… I know what I’m switching to when my prozac runs out. — ICQ me at 29104200

Response:

Question:

Hi Jay, Joe, although paxil has been approved by the FDA for use on panic, it’s nevertheless an SSRI antidepressant, which isn’t a medication of choice for anxiety/panic, although many doctors prescribe it.

I’m sorry, but I have to disagree. many thousands, perhaps millions, of people have had there anxiety reduced or stopped cold by SSRIs. Every person is different, what helps one may not help another, or even make matters worse. So we need to be careful about making generalisations. First of all, I’d like for you to know that panic is a "monster" that you created with your own mind; it’s wasn’t caused by anything else, other than the way your cognitive processes work.  

Well my "monster" was caused by breathing in solvent over an extended period. How do I know? Two 2 people that occupied my office and the guy that used it after me also developed anxiety/panic. Conversely, it’s your thinking process that’s going to eventually destroy this "monster".  Just remember throughout the email, that panic is ALL in your head.  

That depends on whether by head you mean mind or brain. Some people’s anxiety is mainly psychologically (mind) based and they usually recover, but a percentage don’t and I suspect thats because there anxiety is brain based. snipped Here’s the deal.  It’s a subconsciously cognitive disorder. Now many psychs argue that panic is a result of a (sometimes inherited) chemical imbalance in the brain (i.e. a reduction in a neurotransmitter, such as serotonin).

No, its an imbalance in receptors (numbers and sensitivity) for some neurotransmitters. An imbalance caused by an inability to adapt correctly to stressors. The ‘normal’ reaction to stress is that the number and/or sensitivity of some receptors is reduced. In those that develop anxiety this adaption does not occur. There is also, IMV, another factor that is rarely mentioned, the brains continual forging of new connects between brain cells. This is, in part, how we learn and I believe its also the reason why anxiety can be so hard to deal with. Over time the connections related to anxiety/fear become so reinforced that they become impossible to disconnect. BTW-its not a lack of serotonin. Most of the (anxiety)problems appear to have more to do with norepinephrin (noradrenaline) receptors, but to the extent that serotonin is involved, its not the lack of it that is a problem, but probably too much. ADs don’t readdress a lack, they induce an even higher level to force the reduction of serotonin receptors. One side effect is that this also ‘normalises’ the norepinephrin receptor levels. How is not well understood. snipped The best antidepressants for panic/anxiety/agoraphobia are undoubtedly MAOI’s. MAOI’s ARE ANTIDEPRESSANTS OF CHOICE FOR ANXIETY. Either parnate or nardil WILL stop the anxiety (along with a benzo). These antidepressants are older than SSRI’s, and doctors who don’t know much about anxiety don’t prescribe them, because there are various food and medication restrictions (no cheese, moderate alcohol, moderate chocolate, etc..). It’s so easy to follow.  But they’re WAY more effective than prozac, paxil, and effexor. A lot of times, SSRI’s can actually make a situation worse. With Nardil or Parnate, the anxiety dissipates. Any psychiatrist who SPECIALIZES in anxiety ONLY will agree with me.

While I agree that MAOIs seem to have the strongest anti-anxiety affect of all the ADs, the dietary restriction should not be dismissed. Much of the food we now eat is prepared by others and its often difficult, if not impossible, to get info on ingredients. snipped Benzos: Now, in addition to an antidepressant, you’ll need a benzo.  

Why? Given that benzos are very effective, then why complicate matters with a AD? The reason is that ADs can, to a greater or lesser degree, correct brain states. Benzos do not. While useful, to suggest that benzos should automatically be taken is, IMO, not necessarily wise, nor in many cases are they needed long term. snipped I’ve seen a lot of postings questioning the drug "Buspar" on here. Buspar is designeed for GAD (Generalized Anxiety Disorder), and is not a medication of choice for panic/agoraphobia. In fact, Buspar has been shown through studies to be ineffective even for GAD. I wouldn’t recommend Buspar for anyone.

While I found Buspar to be totally useless, I disagree with your generalisation. If you check back through the asap archives I think you’ll find that about 80% of posters haven’t benefited from Buspar. But, the remaining 20% do claim that is has. Even if this is only from the placebo effect, its still a good result. (According to psychologists all ADs operate on the placebo effect!) Also, I’ve seen postings on St. John’s Wort, and Kava-Kava. St. Johns Wort supposedly acts like an MAOI, and kava-kava is supposed to act like a benzo.  Kava-Kava may de-stress some people from their daily activities, etc., but as far as acute anxiety, I woudln’t recommend it. Honestly, I haven’t heard of anyone with a clinical anxiety disorder benefit from either. I wouldn’t trust them; I’d go the proper route if I really wanted to get over these.

I agree totally. Anxiety comes in many forms, with many levels of intensity. While these product may have a role in reducing the milder varieties, IMO&E, for severe anxiety their effectiveness is doubtful. THERAPY: Lastly, medication is only a temporary band-aid. It’s useful, and beneficial. But the ultimate cure is COGNITIVE BEHAVIORAL THERAPY.  <snipped

I’m glad that CBT has apparently worked wonders for you, but to suggest that its *THE* cure, is IMO, way over the top. Proponents claim a 70% success rate (about the same as meds), however, most of the studies that support this were undertaken  on people within 12 months of their ‘cure.’ IME, over a longer time frame the results are nowhere near as good. CBT *IS* a useful aid. In some cases it is the only therapy needed. But, for most I believe that medication *PLUS* CBT is the best treatment currently available. Ian "All I want to be is normally insane."  Marlon Brando

Response:

Joe, although paxil has been approved by the FDA for use on panic, it’s nevertheless an SSRI antidepressant, which isn’t a medication of choice for anxiety/panic, although many doctors prescribe it.  Wellbutrin is definitely not a medication of choice for anxiety.  Here is some information I hope you find helpful.  By the way, my name is Jay, and I’m a former sufferer of panic w/ agoraphobia.  I now am a volunteer at an anxiety clinic near my Sububan Detroit home. GENERAL INFORMATION: First of all, I’d like for you to know that panic is a "monster" that you created with your own mind; it’s wasn’t caused by anything else, other than the way your cognitive processes work.  Conversely, it’s your thinking process that’s going to eventually destroy this "monster".  Just remember throughout the email, that panic is ALL in your head.   I would personally estimate that 90% of psychitrists/psychologists don’t know much about anxiety. Anybody who’s been through this and beaten it knows much more than most psychs. You have to shop for an ANXIETY SPECIALIST like you shop for clothes; never go to a doctor who does "depression, anxiety, family issues, attention defecit disorder, marriage problems, childrens’ issues, etc..). Anyway, most doctors who "think" they know how to treat anxiety use two things: an antidepressant, and a benzo. There are three classes of antidepressants: SSRI’s (paxil, zoloft, prozac, etc..), MAOI’s (nardil and parnate), and Tricylics. The three main benzos are xanax, ativan, and klonopin (now that valium is out of style). Here’s the deal.  It’s a subconsciously cognitive disorder. Now many psychs argue that panic is a result of a (sometimes inherited) chemical imbalance in the brain (i.e. a reduction in a neurotransmitter, such as seretonin). This may be true, however it’s one’s thinking pattern that is the cause of this, as well as the trait that’s inherited (the ability to think negatively). Through therapy (which I’ll mention later), you’ll be able to recognize this irrational, distorted, subconscious thinking pattern, and correct it, to think more positive and rational. When you think properly, your brain chemical stablize at an optimal level. Liken panic to this:  There’s a leader of an orchestra (your subconscious mind) hiding behind the curtains, so you don’t recognize him.  But he’s controlling the whole entire band, which is playing lousy, rotten music.  The key to making the band a better one is to locate this leader/conducter of the orchestra, train him to forget about his bad habits that lead to his poor conducting, and reprgram him to conduct a band that plays in peaceful harmony.   MEDICATIONS: Anitdepressants: First of all, most doctors precscribe SSRI’s, because they think it’s this "new" class of antidepressants that have little side effects, and no food restrictions. So most docs do prozac, paxil, zoloft, effexor, whatever. All of these antidepressants are ineffective in treating anxiety; SSRI’s ARE NOT ANTIDEPRESSANTS OF CHOICE FOR ANXIETY. The best antidepressants for panic/anxiety/agoraphobia are undoubtedly MAOI’s. MAOI’s ARE ANTIDEPRESSANTS OF CHOICE FOR ANXIETY. Either parnate or nardil WILL stop the anxiety (along with a benzo). These antidepressants are older than SSRI’s, and doctors who don’t know much about anxiety don’t prescribe them, because there are various food and medication restrictions (no cheese, moderate alcohol, moderate chocolate, etc..). It’s so easy to follow.  But they’re WAY more effective than prozac, paxil, and effexor. A lot of times, SSRI’s can actually make a situation worse. With Nardil or Parnate, the anxiety dissipates. Any psychiatrist who SPECIALIZES in anxiety ONLY will agree with me. They’re hard to find, though; the whole key is finding a doc who knows what he/she’s talking about. Benzos: Now, in addition to an antidepressant, you’ll need a benzo. Benzos are NOT addictive to patients with a clinical anxiety disorder. Xanax is kinda out-of-style. Ativan is good, will block panic, and takes only 5-15 minuites to "kick-in"; it’s lasting effect, however, is only about 6 hours. Klonopin is becoming more popular for treating anxiety. It’s what I take. It takes a half-hour to 45 minutes to "kick in", but lasts all day. It technically has a half life of 24-48 hours! But you take it twice a day. When you wake up in the morning, your panic is still blocked by the pill you took the night before! In summary, Benzos block panic; BENZOS ARE MEDICATIONS OF CHOICE FOR ANXIETY.   There seems to be more research support for the use of  Klonopin (clonazepam) in the treatment of anxiety than for the other anti-anxiety medications.  If a professional tells a person with a definable, DSM-IV anxiety disorder that the anti-anxiety agents may prove addictive to them, the professional (a) is not aware of research in the area of anxiety, and (b) should probably not be treating you.  The anti-anxiety agents work, they are safe, and people with anxiety disorders usually stay on a low dosage while going through CBT.  These medications are nothing to worry about.    When stopping anti-anxiety use, it is necessary to taper off the medication slowly, by reducing the dose over a period of 3 to 4 weeks.   Anyway, for instance, a prescription of Nardil (an MAOI) and Klonopin (a Benzo) would be very ideal for panic, w/ or w/out agoraphobia.  If an antidepressant isn’t needed, the a prescription of klonpin or ativan would be ideal.     Other bad medications: I must admit, I’ve seen a lot of postings questioning the drug "Buspar" on here. Buspar is designeed for GAD (Generalized Anxiety Disorder), and is not a medication of choice for panic/agoraphobia. In fact, Buspar has been shown through studies to be ineffective even for GAD. I wouldn’t recommend Buspar for anyone. Also, I’ve seen postings on St. John’s Wort, and Kava-Kava. St. Johns Wort supposedly acts like an MAOI, and kava-kava is supposed to act like a benzo.  Kava-Kava may de-stress some people from their daily activities, etc., but as far as acute anxiety, I woudln’t recommend it. Honestly, I haven’t heard of anyone with a clinical anxiety disorder benefit from either. I wouldn’t trust them; I’d go the proper route if I really wanted to get over these. THERAPY: Lastly, medication is only a temporary band-aid. It’s useful, and beneficial. But the ultimate cure is COGNITIVE BEHAVIORAL THERAPY. This will include self-hypnosis, which changes the way your subconscious brain thinks, and helps you relax. It also involves other exercises that literally change the way your neuropathways in your brain think, and drills it in to your head, to the point where you can’t go back to your old style of thinking. You’ll learn to recognize the "leader of the orchestra", and reprgram him to think rationally. Remember — anxiety specialist!  You should have health insurance. You have to call them, talk to people, shop around, and find a doctor who SPECIALIZES in anxiety. If your health insurance doesn’t have an anxiety specialist, you’ll have to get some money and go private — it’s worth it, though, and there are very good payment plans available.  I’ll help you find one near you if you let me know where you live. TEMPORARY COPING STRATEGIES: In the meantime, everyone with anxiety – try to think about something else; when you feel it "coming on", turn on the radio; watch t.v.; hop on the computer; call a friend; just think about something else!!! If your mind isn’t on anxiety, you won’t experience anxiety. But in order to prevent it from reocurring, a reprogramming of the subconscious mind is a necessity. Take care, and email me anytime if you have any further questions, or needsdocumentation from an anxiety specialist — or need help in finding an anxiety specialist (I’ll find one for you, near where you live).

Response:

i have been advised to try either wellbutrin or zoloft to quell my panic disorder, anyone with any experience with help, advice? Joe

Response:

i have been advised to try either wellbutrin or zoloft to quell my panic disorder, anyone with any experience with help, advice? Joe

I think I did answer this. Zoloft is a much better med for PD then Wellbutrin is, which if anything might even enhance your panic. Today it seems that the best SSRI’s in terms of side efects are not Zoloft and Paxil but Prozac and Luvox. A benzo like Xanax may be added, especially in the first 4-8 weeks in which the SSRI has to settle in yout system and may cause a worsening of symptoms. Philip

Response:

Question:

Is it possible that drinking alcohol while on prozac can make you MORE depressed? Thanks,

Response:

Besides, it makes people act in ways that are, afterwards, most depressing to recall. Darn! Ami

Oh my! What an opportunity, what a story…….Damn it! Loyalty prevails. Strange that I can remember though — :::::::::::::::::::::::::::::::: AntiEverything Attitude~Incarnate :::::::::::::::::::::::::::::::: The Waffle and Crepe House ( This Space For Rent )

Response:

Is it possible that drinking alcohol while on prozac can make you MORE depressed? Thanks,

since alcohol is a depressant,  i think it is a safe assumption. dennis Oh! somewhere in this favored land the sun is shining bright; The band is playing somewhere, and somewhere hearts are light And somewhere men are laughing, and somewhere children shout But there is no joy in Mudville — mighty Casey has Struck Out

Response:

: Is it possible that drinking alcohol while on prozac can make you MORE : depressed? I’m on Zoloft, Prozac’s next of kin. I found out that according to the manufacturer of Prozac, it is possible to have a FEW drinks. That’s the trick. I test-drank slowly to see how much of an interaction there is with Zoloft. It took surprisingly little to get drunk, and without meds, I’m a heavy drinker. In short, if you insist on drinking on Prozac, be careful. You do so at your own risk. — CAUTION: Email Spam Killer in use. Leave this line in your reply! 152680         "Sometimes the best psychiatrist is a flaky cardiologist" 2125733 bytes of spam mail deleted.           http://www.wwa.com/~nospam/

Response:

- Hide quoted text — Show quoted text – : Is it possible that drinking alcohol while on prozac can make you MORE : depressed? I’m on Zoloft, Prozac’s next of kin. I found out that according to the manufacturer of Prozac, it is possible to have a FEW drinks. That’s the trick. I test-drank slowly to see how much of an interaction there is with Zoloft. It took surprisingly little to get drunk, and without meds, I’m a heavy drinker. In short, if you insist on drinking on Prozac, be careful. You do so at your own risk. — CAUTION: Email Spam Killer in use. Leave this line in your reply! 152680         "Sometimes the best psychiatrist is a flaky cardiologist" 2125733 bytes of spam mail deleted.           http://www.wwa.com/~nospam/

I too am on Zoloft, but have not had any drinks since I started back in January.  I was warned that it would effect a person just the way you described it.  I’m not sure I could handle it and really don’t need the *extra* depressive influence right now. Just out of curiosity, how few drinks did it take?  Was there any after effects, like a bad hang over? Chuck (now drinking vicariously through others)

Response:

Oh my! What an opportunity, what a story…….Damn it! Loyalty prevails. Strange that I can remember though — :::::::::::::::::::::::::::::::: AntiEverything Attitude~Incarnate :::::::::::::::::::::::::::::::: The Waffle and Crepe House ( This Space For Rent ) sounds like an opportunity for black mail.  make her pay you off in kisses.

Nothing to blackmail with Dennis I’m afraid. It was me who had to much to drink and it was Amalie who prevented me from making a fool of myself. she’s too good for me and I don’t deserve her. AE

Response:

– Hide quoted text — Show quoted text – Besides, it makes people act in ways that are, afterwards, most depressing to recall. Darn! Ami Oh my! What an opportunity, what a story…….Damn it! Loyalty prevails. Strange that I can remember though — :::::::::::::::::::::::::::::::: AntiEverything Attitude~Incarnate :::::::::::::::::::::::::::::::: The Waffle and Crepe House ( This Space For Rent )

sounds like an opportunity for black mail.  make her pay you off in kisses. dennis Oh! somewhere in this favored land the sun is shining bright; The band is playing somewhere, and somewhere hearts are light And somewhere men are laughing, and somewhere children shout But there is no joy in Mudville — mighty Casey has Struck Out

Response:

– Hide quoted text — Show quoted text – Oh my! What an opportunity, what a story…….Damn it! Loyalty prevails. Strange that I can remember though — :::::::::::::::::::::::::::::::: AntiEverything Attitude~Incarnate :::::::::::::::::::::::::::::::: The Waffle and Crepe House ( This Space For Rent ) sounds like an opportunity for black mail.  make her pay you off in kisses. Nothing to blackmail with Dennis I’m afraid. It was me who had to much to drink and it was Amalie who prevented me from making a fool of myself. she’s too good for me and I don’t deserve her. AE

oh.  then bribe her with kisses dennis Oh! somewhere in this favored land the sun is shining bright; The band is playing somewhere, and somewhere hearts are light And somewhere men are laughing, and somewhere children shout But there is no joy in Mudville — mighty Casey has Struck Out

Response:

- Hide quoted text — Show quoted text – : I too am on Zoloft, but have not had any drinks since I started back in : January.  I was warned that it would effect a person just the way you : described it.  I’m not sure I could handle it and really don’t need the : *extra* depressive influence right now. : Just out of curiosity, how few drinks did it take?  Was there any after : effects, like a bad hang over? It took only about 6 or 8 drinks over several hours to get drunk, and the drunk feels sort of "glittery" too. In both tests, I woke up pretty early considering, and the hangover is more or less in proportion to the drinking itself. A possible hazard is "serotonin syndrome" at least at higher doses of the Zoloft. My theory (for my liver) is that the liver goes after the booze first and the Zoloft hangs around longer until booze-sobriety. Of course, your liver is different, and you might have a different reaction. It would probably work to go on a Zoloft holiday during a weekend drinking session. Better yet, avoid drinking in the first place. A wierd side-effect with Zoloft not involving booze involves the voice. I’m multi-accented, and one accent, my drinking accent, requires I change the sound of my voice to add "distortion", which has interfered with singing. Now, I don’t do that one accent as well, but my voice doesn’t break up when singing. This side-effect is unique to my exact voice, and probably doesn’t affect anyone who is single-accented. — CAUTION: Email Spam Killer in use. Leave this line in your reply! 152680         "Sometimes the best psychiatrist is a flaky cardiologist" 2142564 bytes of spam mail deleted.           http://www.wwa.com/~nospam/

you should see that alchohol can provide valuable insights into reality, Mike

Response:

: I too am on Zoloft, but have not had any drinks since I started back in : January.  I was warned that it would effect a person just the way you : described it.  I’m not sure I could handle it and really don’t need the : *extra* depressive influence right now. : Just out of curiosity, how few drinks did it take?  Was there any after : effects, like a bad hang over? It took only about 6 or 8 drinks over several hours to get drunk, and the drunk feels sort of "glittery" too. In both tests, I woke up pretty early considering, and the hangover is more or less in proportion to the drinking itself. A possible hazard is "serotonin syndrome" at least at higher doses of the Zoloft. My theory (for my liver) is that the liver goes after the booze first and the Zoloft hangs around longer until booze-sobriety. Of course, your liver is different, and you might have a different reaction. It would probably work to go on a Zoloft holiday during a weekend drinking session. Better yet, avoid drinking in the first place. A wierd side-effect with Zoloft not involving booze involves the voice. I’m multi-accented, and one accent, my drinking accent, requires I change the sound of my voice to add "distortion", which has interfered with singing. Now, I don’t do that one accent as well, but my voice doesn’t break up when singing. This side-effect is unique to my exact voice, and probably doesn’t affect anyone who is single-accented. — CAUTION: Email Spam Killer in use. Leave this line in your reply! 152680         "Sometimes the best psychiatrist is a flaky cardiologist" 2142564 bytes of spam mail deleted.           http://www.wwa.com/~nospam/

Response:

Just out of curiosity, how few drinks did it take?  Was there any after effects, like a bad hang over?

I too have been on Zoloft for 18 months. I still drink wine and beer, finding that after 3 glasses of wine for dinner, I seem quite intoxicated. Does drinking enhance my depressed mood? I believe that the day after, my mood seems more depressed than usual, plus my sleep is interupted during the night after drinking, making me feel more tired and irratable. And forget about sex <g..my SO needs a two-by-four to whack me into a sexual realm <OUCH!!

Response:

I was wondering about this subject.  See ever since I went on ad’s (just Effexor and now Prozac) I seem to have lost any desire for drinking. (of course, supplementing that with pain killers is probably a good reason) Anyway, when I was in Vegas, I just wanted to get good and drunk and I couldn’t.  I had two Banana Colada’s (oh my god, they are heavenly)…got buzzed then had to take a nap.  It’s weird. Absolutely no desire what so ever to drink.  It justs make me feel lousy.  I wonder if that is due to ad’s cuz before them I drank all the time (well not all the time) but I was in college and partied quite a bit. ?  Anyone else find this happening? Now……if I can only get the same effect with the pain killers! Nik They say, "she’s crazy as anyone can be" That’s what they say, they say of me…….Sheryl Crow "On the Outside"

Response:

Okay…couldn’t find the original question but I know its one that I myself asked many times (what happens when you drink..on prozac..etc.) I have been on Prozac for almost two years..and have been an alcoholic for about 6 mos (yes I’m about to go into treatment..no worries). I never found that drinking interacted with the drug itself in any way…but I know that as a depressive…drinking for me was not such a good idea (I am invited to every college party..not because people like me..but because my screaming and/or crying jags seem to liven up any game of as*hole) So do I recommend drinking on Prozac? Who cares! I DON"T recommend drinking if you are sick..and being on prozac would imply that…. CAUTION: Email Spam Killer in use. Leave this line in your reply! 152680         "Sometimes the best psychiatrist is a flaky cardiologist" 2142564 bytes of spam mail deleted.           http://www.wwa.com/~nospam/

Response:

I think the fact I was off to bed anyway probably meant that I slept through the worst of it ! The good feeling the next day was probably just the tail-end of the effect. I’m undecided whether to try again. I’m over my depression now thankfully but am being weaned off the pills slowly. My chance to do this again will be gone soon ! Steve the Smurf – Hide quoted text — Show quoted text – hi steve i’ve been on prozac for months now. i hardly ever drink anymore but i’ve certainly noticed the a wilder, deeper drunkenness than ever before. i had blackouts on champagne cocktails and get very drowsy quickly. pete Hi folks, well last week I made a mistake and had a large vodka before bedtime , forgetting that I had taken my Prozac earlier ! Well, I felt wonderful, I was buzzing all day the next day and had a wonderful sleep that night. After looking at the info leaflet that came with the drugs I noticed it says " avoid alcohol." Has anyone else had prozac with alcohol? Will it do me any harm if I do it again ( not constantly just occasionally !) Steve the Smurf — ICQ 12996897. Before you buy.

– ICQ 12996897. Before you buy.

Response:

Just curious.. does this happen with other anti-depressents? I am on Celexa, Wellbutrin, and a little bit of Trazadone.. does it have an effect on any one of those medications? -Bernie – Hide quoted text — Show quoted text – hi steve i’ve been on prozac for months now. i hardly ever drink anymore but i’ve certainly noticed the a wilder, deeper drunkenness than ever before. i had blackouts on champagne cocktails and get very drowsy quickly. pete Hi folks, well last week I made a mistake and had a large vodka before bedtime , forgetting that I had taken my Prozac earlier ! Well, I felt wonderful, I was buzzing all day the next day and had a wonderful sleep that night. After looking at the info leaflet that came with the drugs I noticed it says " avoid alcohol." Has anyone else had prozac with alcohol? Will it do me any harm if I do it again ( not constantly just occasionally !) Steve the Smurf — ICQ 12996897. Before you buy.

Response:

Just curious.. does this happen with other anti-depressents? I am on Celexa, Wellbutrin, and a little bit of Trazadone.. does it have an effect on any one of those medications?

i just did a short trial of wellbutrin, and while i was researching it i came across repeated warnings that alcohol can increase the risk of seizure while on this drug. i wouldn’t drink while taking it if i were you. Erik Erik Martin Schneider rhetorician of sorts http://www.concentric.net/~catdoc

Response:

 Hi folks, well last week I made a mistake and had a large vodka before bedtime , forgetting that I had taken my Prozac earlier ! Well, I felt wonderful, I was buzzing all day the next day and had a wonderful sleep that night. After looking at the info leaflet that came with the drugs I noticed it says " avoid alcohol." Has anyone else had prozac with alcohol? Will it do me any harm if I do it again ( not constantly just occasionally !) Steve the Smurf — ICQ 12996897. Before you buy.

Response:

Has anyone else had prozac with alcohol? Will it do me any harm if I do it again ( not constantly just occasionally !) Steve the Smurf

Hi Steve, Recently I decided to see what happened if I combined my Prozac (40 mg at that time) with about one standard drink of a vodka, wine and lemon mix (bottled, so I know it was mixed properly) and a tiny bit of Bayleys Irish Cream (which was disgusting!), spead out over several hours at a party. I felt fine for a while, but according to my father he could see in my eyes that I was smashed!  About 4 hours after I stopped drinking I started vomiting and was up repeatedly during the night.  I still felt tired and sick the next day. I’ll admit, the facts that I’m female, have a small body size, and am fairly inexperienced with alcohol didn’t help, but I should not have been that bad after two standard drinks (maximum!) I purposely mixed alcohol and prozac in a safe, controlled environment to see how it would effect me.  All I can say is NEVER AGAIN!  For me, it just wasn’t worth it. If it didn’t effect you too badly, drinking occasionally and in a controlled way shouldn’t hurt.  But only occasionally and only one or two drinks, because in my opinion, since alcohol is a depressant anyway, more than that could be dangerous. Just my two cents worth.  I hope this helps. Kylie. * Sent from RemarQ http://www.remarq.com The Internet’s Discussion Network * The fastest and easiest way to search and participate in Usenet – Free!

Response:

hi steve i’ve been on prozac for months now. i hardly ever drink anymore but i’ve certainly noticed the a wilder, deeper drunkenness than ever before. i had blackouts on champagne cocktails and get very drowsy quickly. pete – Hide quoted text — Show quoted text – Hi folks, well last week I made a mistake and had a large vodka before bedtime , forgetting that I had taken my Prozac earlier ! Well, I felt wonderful, I was buzzing all day the next day and had a wonderful sleep that night. After looking at the info leaflet that came with the drugs I noticed it says " avoid alcohol." Has anyone else had prozac with alcohol? Will it do me any harm if I do it again ( not constantly just occasionally !) Steve the Smurf — ICQ 12996897. Before you buy.

Response: