Posted by jay on July 31, 2003, at 23:41:30
Well, I went to a 'professional' psychiatric evaluation today, that lasted about 2.5 hours, and there where two excellent psychiatrists. (Both youngish women, who I seemed more comfortable than with older men. They where both clincians and researchers.) We eventually got to talk of benzos, and the doctor who was the clinic director (and a world reknowned researcher) and I got talking about benzos. She refered heavily to reaserch, and 'observable, objective facts.' She said the only *real* concern with benzos is in people who have absued other substances. Even then, she said, they are often underutilized in a 'total treatment regiment' (that often includes a number of medications along with therapy of some sort) by doctors who often have little experience in research and modern medicine.(And that *includes* many, many psychiatrists!) Any good doctor can eventually pick up signs of abuse, she said, with the proper pre-cautions.
I then told her I had an 'excellent' response to even below-average doses and use of Xanax, and she mentioned some of the previous research that suggest Xanax seems to have an 'anti-depressant' like quality, and even if it's modes of action are similar to other benzos, it's immediate and powerful affect may in itself help work with the system of obliterating the psychic anxiety of a depressed person. (She also mentioned that there is a fair amount of research pointing to anxiety and depression possibly being 'two heads of the same coin'. But she did flatly state outright that for the most part, anxiety has to be treated, often separately, from depression, and not many things work as well as benzos. She said one of the most powerful tools, besides an MAOI, to treating both is med-to-high dose of an SSRI with a high-dose benzo.) She *also* mentioned that Effexor, despite what the drug companies say, is quite often very difficult in anything above 150 mg's for a very anxious person. (C'est moi!) That explains my really, really difficult time with this drug. She said out of all of the medications, the ones that work also powerfully on the norepinephrine system can sometimes cause problems with a highly anxious person, even despite the 'regulation' explanation.
It was both empowering, and made me feel really positive and good, to speak to and get help from some cutting edge clinicians. I will be starting possibly a few different types of therapy within a few weeks, and they are going to send the information above with their medication recomendations, to my doctor. My 'cocktail' of Prozac(20mg's), Klonopin(.5 mg's 3x daily), and Zyprexa (5mg's daily) has caused some fairly positive changes in me over the past six months..."touch wood"...please. :-) (I was on the above, with Effexor for about 5 years, instead of Prozac, before.) So, we will likely ramp-up and go onto Xanax at a good, theraputic dose, as well as play around with bumping up the Prozac and Zyprexa doses. If problems arise, there is obviously room to change around a few things. They did ask about my reaction to tricyclics, and I stated that they caused 'a tad of improvement sometimes, but the negative side-effects often cancelled out the benefits.) They also asked me about MAOI's, and I told them if things got *much worse* instead of better, I would consider it. It is just my lack of discipline to a diet that I am fearful of. (I do once-in-awhile 'binge' on large amounts of anything with cheese of all types, as well as many of the 'no-go's' on the needed diet. But if Prozac wasn't working, I wouldn't be closed to using an MAOI.)
If anyone from Ontario, Canada wishes for info on the clinic I went to, please let me know and I can pass the info onto you. I also looked at the board they had up about research trials, and they had everything from one on 'diet and mental health' to "TMS", as well as uses both of off-label medications and not-yet-released meds. The other nice thing about this all is being in Canada, none of this costs me a single penny!
So, I wish someone to get some kind of help, hope, and or info from this.
Thanks!
Jay
poster:jay
thread:247239
URL: http://www.dr-bob.org/babble/20030728/msgs/247239.html