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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 14 to 38 of 38. Go back in thread:
Posted by joy on November 21, 2002, at 20:56:22
In reply to Re: What is this supposed Benzo euphoria like?? » Jefff, posted by Ritch on November 21, 2002, at 7:49:51
Posted by Mr.Scott on November 22, 2002, at 0:08:12
In reply to Re: What is this supposed Benzo euphoria like?? » Jefff, posted by Ritch on November 21, 2002, at 7:49:51
Benzo's are a strange breed lets face it. They are hard to categorize in terms of their abuse liability. I agree with the poster above who said people who abuse them are trying to treat something else. I would also add many hard core druggies use it to smooth over the edges of alcohol withdrawal and cocaine jitters or to amplify heroin. Benzo's are nowhere near those drugs in terms of abuse potential in and of themselves.
I think the euphoria benzo's provide is subtle and is more about quick relief and removal of negative feelings than actually eliciting good feelings on their own. If you are chronically stressed out anxious and unhappy and you take 10mg of valium, believe me you'll feel very different and much better in 20 minutes. For some people I believe that can be a problem, for others it's not.
If you're looking for therapeutic relief it's best to start with a low dose and climb as needed to avoid the immediate feelings. Also Klonopin and many others that take longer to get into the brain don't provide the immediate sense of relief that is reinforcing like valium does.
Scott
Posted by Ritch on November 22, 2002, at 9:49:39
In reply to Benzo Euphoria, posted by Mr.Scott on November 22, 2002, at 0:08:12
> Benzo's are a strange breed lets face it. They are hard to categorize in terms of their abuse liability. I agree with the poster above who said people who abuse them are trying to treat something else. I would also add many hard core druggies use it to smooth over the edges of alcohol withdrawal and cocaine jitters or to amplify heroin. Benzo's are nowhere near those drugs in terms of abuse potential in and of themselves.
>
> I think the euphoria benzo's provide is subtle and is more about quick relief and removal of negative feelings than actually eliciting good feelings on their own. If you are chronically stressed out anxious and unhappy and you take 10mg of valium, believe me you'll feel very different and much better in 20 minutes. For some people I believe that can be a problem, for others it's not.
>
> If you're looking for therapeutic relief it's best to start with a low dose and climb as needed to avoid the immediate feelings. Also Klonopin and many others that take longer to get into the brain don't provide the immediate sense of relief that is reinforcing like valium does.
>
> Scott
Hi, Scott. The *time* factor is the main thing for sure. The time it takes for the med to take effect and the duration of action. Of all the stimulant trials I have been through, only Adderall was something that I could take just once a day (at the same time every day), and just forget about it. All of the others would leave my system in just a few hours. I would yawn or something, and find myself looking at my watch. The AD's that have major withdrawal problems are the short half-life ones (Effexor, Paxil). Xanax is troublesome due to its brief half-life.
Posted by HIBA on November 22, 2002, at 23:55:08
In reply to Re: What do Benzo's do exactly? » Alan, posted by Mr.Scott on November 19, 2002, at 19:09:49
Dear Mr. Scott,
<<I advocate only the best way to alleviate suffering, and from my point of view if you can do it with Lexapro or Prozac thats probably (although not necessarily) going to cause less problems than Ativan or Xanax>>
Less problems than ativan or xanax ? I have experienced both type of withdrawals. Xanax withdrawal gave me some bouts of anxiety and dysphoria which I could easily manage with intensifying social activity. Things were not the same with zoloft. Obsessive rumination and consequent depression led me to the psychiatric clinic and only the answer was prozac. (which I am still on). I was a stranger to obsession prior to zoloft.
I agree with you, if a person can do with benzos alone he is the luckiest psychiatric patient. Isn't that what you meant ?
HIBA
Posted by viridis on November 23, 2002, at 1:42:40
In reply to Benzo Euphoria, posted by Mr.Scott on November 22, 2002, at 0:08:12
Hi Ritch and Mr. Scott (and everybody),
I think you're right -- the great majority of people who "abuse" benzos are actually trying to medicate themselves for a real (usually undiagnosed) disorder, not get high. But there is a small subset of people who do seem to get a genuine high from certain benzos. I've known a few who used Valium and Xanax recreationally, often in combination with alcohol (obviously a dangerous mix).
My pdoc told me that for the vast majority of his patients to whom he prescibes benzos, they're very safe and effective both short and long term. However, he added that occasionally, he's had patients who repeatedly "lose", "spill" etc. their prescriptions and request frequent replacements, then (sometimes) admit to bingeing on these drugs (usually Xanax; Klonopin doesn't seem to be a problem). He's quite willing to adjust doses as appropriate, but said that when he sees any evidence of misuse, he insists on a switch to a different class of meds. Again, he emphasized that this is a very small subset of the patients for whom he prescribes benzos, but he is very alert to signs that a patient is enjoying the meds and escalating doses beyond those needed for anxiety relief.
The first few times I took Xanax, I experienced what might almost be called a "high", but really it was more a sense of tremendous relief from unrelenting anxiety. I wasn't "stoned"; I just felt positive and able to deal with stress. Now, with daily use of Klonopin, I'm able feel this way much of the time, and I can't imagine going back to the way I was.
Posted by Mr.Scott on November 23, 2002, at 1:45:57
In reply to Re: What do Benzo's do exactly? » Mr.Scott, posted by HIBA on November 22, 2002, at 23:55:08
Hello Mitch,
Can we exchange current cocktails?
Currently I'm taking:
2.5 mg of Lexapro (am)
200mg Caffeine (am)
.25 mg of clonazepam (pm) or 3.75mg Tranxene (pm)
3000mg EPA (OmegaBrite)(pm)I would like to try 1)another soothing anticonvulsant, 2)back to more benzos or else 3)I may have to add some lithium back in, which is fine at the low end. Neurontin which I enjoy very much is highly side effect laden believe it or not for some reason. hmmm... perhaps 100mg only might work though. Stimulants are magic at first for me, but always degenerate into a sickening dysphoria. Doesn't seem to matter if it's Cylert, Cocaine, Ritalin, or Amphetamine. Only Caffeine can I tolerate...
What magic recipe helps keep you sane and productive these days?
Scott
Posted by Squiggles on November 23, 2002, at 6:51:34
In reply to Re: Benzo Euphoria, posted by viridis on November 23, 2002, at 1:42:40
I'm glad your doctor emphasized the "subset"
portion of the benzo usage you describe.My doctor practically had the shove the pill
down my throat when raising the Rivotril.Some people belong to the subset of "drugphobia",
others to the type you describe.As for euphoria, i find it interesting that
a CNS depressant or "downer" as the slang term
goes, can produce such an effect. But i suppose
since benzos are so much like alcohol, perphaps
the first time does do that.If there is abuse, the pill bottle will tell,
and neither the pharmacist nor the doctor will
miss that. An attempt on the part of the patient
to abuse these, may indicate the first signs
of addiction. So, it would be something for the
doctor to watch for.Squiggles
Posted by Ritch on November 23, 2002, at 9:57:03
In reply to Mitch!!!, posted by Mr.Scott on November 23, 2002, at 1:45:57
> Hello Mitch,
>
> Can we exchange current cocktails?
>
> Currently I'm taking:
>
> 2.5 mg of Lexapro (am)
> 200mg Caffeine (am)
> .25 mg of clonazepam (pm) or 3.75mg Tranxene (pm)
> 3000mg EPA (OmegaBrite)(pm)
>
> I would like to try 1)another soothing anticonvulsant, 2)back to more benzos or else 3)I may have to add some lithium back in, which is fine at the low end. Neurontin which I enjoy very much is highly side effect laden believe it or not for some reason. hmmm... perhaps 100mg only might work though. Stimulants are magic at first for me, but always degenerate into a sickening dysphoria. Doesn't seem to matter if it's Cylert, Cocaine, Ritalin, or Amphetamine. Only Caffeine can I tolerate...
>
> What magic recipe helps keep you sane and productive these days?
>
> Scott
>
>Hi Scott, Currently:
1) Effexor XR 4 mg (yes that's right) A.M. and 4mg afternoons (approximate of course). That's just enough to "dust" the 5-HT transporters and relieve some anxiety (also helps with muscle aches/pains). I had a sleepwalking episode after taking it all at bedtime as an experiment-ain't doing that again! I will push the Effexor XR up to a max of 18.75mg per day (again approx.)when (and IF) I get depressive symptoms (during about 3-6 days of my 3-week cycle). I will back off to just the tiny 4mg AM dose when I get a little on the high side (2-4 days of my 3-week cycle). I have to keep it VERY low or I will get hypomanic big time.
2) Sublingual B-complex and fish oil (1G cap) and 150mg of Trileptal with lunch (along with a single multivitamin). I also am going to add on 500mg of L-tyrosine for a few days if I hit a low spot. It seems to really help, but only for a *few* days, then it poops.
3) A second fish oil capsule with food in the late afternoon with the 4mg of Effexor XR (if I think I need it).
4) Depakote 125mg + Klonopin .5mg at bedtime. This time I got the sprinkle Depakote. I thought they screwed up and gave me Prozac! No vanilla smell and they are green and white-odd. I also got a script for 250mg Depakote to take instead of the 125mg SPR if I am a little high.
5) Off stimulants. Feel much better. My mood was fairly stable on them, but like you I tend to get "icky" on them after awhile and would prefer a little distractability. Incidentally, the Trileptal addition is an experiment to see if I can get *improved* cognitive function with it without needing an ADD med. I must say it is working fairly well. I went to a 3-hr meeting the other day and actually sat in ONE chair and listened throughout the presentation. Something else too-I've noticed that tastes and smells seem "normal", they don't seem flat or nasty like they evidently have been for some time. I swear I have got some kind of temporal lobe problem. I don't want to go up on the Trileptal any more just yet. I almost barfed on it the last time I went to 300mg, but I was also on an SSRI (Zoloft), that triggers a lot of nausea anyhow.
Hey, I have got one question for you: Does your mood cycling follow a D-M-E or a M-D-E pattern? Mine follows a clearcut DME pattern. I tend to "bounce" out of depression with hypomania and then the hypomania just fades, then I crash out of 'normality' into depression rather suddenly.
Mitch
Posted by Mr.Scott on November 23, 2002, at 11:42:57
In reply to Re: Mitch!!! » Mr.Scott, posted by Ritch on November 23, 2002, at 9:57:03
Hey Mitch,
Thanks for that in depth response! I will surely try some of your methods.
Actually come to think of it...I did come out of a nasty and lengthy depressive episode 3-4 weeks into a clear cut 2-3 day hypomania (induced by antidepressant change) and now I am kind of mixed I guess. It might be the recently substituted Lexapro for Effexor XR however that is 'jacking me around' where I might be otherwise euthymic.
I'm irritable, and I awoke this AM feeling like a truck had run me over. I know not what happened to my alarm clock...I swear I set it though. I'm not sure if this is euthymic and anxious or mildly hypo and irritable. It all starts to get confusing...
Scott
Posted by Ritch on November 23, 2002, at 13:09:02
In reply to Re: Mitch!!! » Ritch, posted by Mr.Scott on November 23, 2002, at 11:42:57
> Hey Mitch,
>
> Thanks for that in depth response! I will surely try some of your methods.
>
> Actually come to think of it...I did come out of a nasty and lengthy depressive episode 3-4 weeks into a clear cut 2-3 day hypomania (induced by antidepressant change) and now I am kind of mixed I guess. It might be the recently substituted Lexapro for Effexor XR however that is 'jacking me around' where I might be otherwise euthymic.
>
> I'm irritable, and I awoke this AM feeling like a truck had run me over. I know not what happened to my alarm clock...I swear I set it though. I'm not sure if this is euthymic and anxious or mildly hypo and irritable. It all starts to get confusing...
>
> Scott
>Scott, so you probably have a DME pattern too. My 3-week (actually about 20 day) cycles are burned in really well as far as peak to peak timing goes. What changes is the *duration* and *intensity* of the hypomanias and depressions and those changes are seasonal. The depressions lengthen in Nov/Dec to the point where they hit 14-days out of 20 and I technically have a major depressive episode, and I will get a hypomanic spell suddenly but just for a day or two at most and it is fairly mild. The "normal" or euthymic days dwindle down to nil as well. The next depressive spell is due next week right at Thanksgiving and then the next one (which usually is a whopper) will be before Christmas, but I should have a mild hypomanic spell the day before and Christmas Day, so that's a relief. I guess I will put this new med regime to a test. OH, the easiest way I can predict these things it to make a mark on the most remarkably hypomanic day (during a period of relative hypomania), and then look exactly 20 days forward and then make a question mark. The depressions are harder to predict but I know I will be depressed the most the few days before the highpoint. I noticed you aren't taking any mood stabilizer except Klonopin and Fish Oil. Have you considered a little Depakote? The ONE thing it seems to work the best on for me is grouchiness for sure.
Mitch
Posted by Peter S. on November 23, 2002, at 22:53:28
In reply to Re: cycling » Mr.Scott, posted by Ritch on November 23, 2002, at 13:09:02
Ritch,
You have an amazing regimen! How did you decide on all of it? I've tried fish oil and Omega 3 but never saw any real results. Can you tell when you drop a med or substance?
I have intense cycling which seems to be about 3 days in duration. It has especially increased since I've been taking meds. It's driving me crazy. For the last 2 days I've been in an incredibly deep hole. 3 days ago I felt great.
I really don't know what to do anymore. I've tried every med under the sun. I'm now taking Lamictal and Neurontin and have just added Lithium.
Posted by Ritch on November 24, 2002, at 10:38:36
In reply to Re: cycling, posted by Peter S. on November 23, 2002, at 22:53:28
> Ritch,
>
> You have an amazing regimen! How did you decide on all of it? I've tried fish oil and Omega 3 but never saw any real results. Can you tell when you drop a med or substance?
>
> I have intense cycling which seems to be about 3 days in duration. It has especially increased since I've been taking meds. It's driving me crazy. For the last 2 days I've been in an incredibly deep hole. 3 days ago I felt great.
>
> I really don't know what to do anymore. I've tried every med under the sun. I'm now taking Lamictal and Neurontin and have just added Lithium.
>
>Hi Peter, it was arrived at by LOTS of trial and error over years. Also, it is always evolving, so it is by no means final. The basic conclusions that I have found through going through lots of med trials and mood charting (that's a very good idea BTW), is that (for me) Depakote works the best for hostility and hypomania, and Clonazepam simply prevents panic attacks period (I haven't had ONE full-blown panic attack while I stay on a low dose maintenance). Now that leaves bipolar depression and ADHD symptoms that are relatively unaddressed. Serotonin reuptake inhibitors (currently low-dose Effexor), help with generalized anxiety and can reasonably pull me out of BP depression, BUT they trigger intense hypomania like nothing else I have ever taken. Stimulants don't trigger hypomania, but they make anxiety worse. I've tried several and tried to manage anxiety in different ways while trying them to no avail. So they are off the table. Wellbutrin didn't help the ADHD symptoms very well and also caused lots of anxiety, so it is out. So.... now we are trying fish oil, L-tyrosine (intermittently), and oxcarbazepine as an atypical antidepressant to see if I can get by. So far so good, but I won't know until I get through a full cycle on it (middle or end of next week).
Posted by Mr.Scott on November 24, 2002, at 14:12:21
In reply to Re: cycling » Peter S., posted by Ritch on November 24, 2002, at 10:38:36
Mitch,
Can you remind me why hypomania is bad?
Scott
Posted by Ritch on November 24, 2002, at 23:46:15
In reply to Re: cycling » Ritch, posted by Mr.Scott on November 24, 2002, at 14:12:21
> Mitch,
>
> Can you remind me why hypomania is bad?
>
> ScottScott, it is only really "bad" when it becomes dysphoric, mixed, combined with hostility. I'd say that only about half the highs I have are "good" highs, and sometimes I can suddenly flip from being in a bubbly everything is wonderful state to an agitated hostile phase where I get very mean with people who don't deserve it and don't understand it. My Dad (who was bipolar) used to argue with me NONSTOP at times and we would get into fights. He couldn't control his impulsive speech, etc. and I punched him once and he chased me around the farm with a shotgun-don't need that chaos......
Posted by alphamale on November 25, 2002, at 11:52:32
In reply to Re: cycling » Mr.Scott, posted by Ritch on November 24, 2002, at 23:46:15
That does sound a bit like you Mr. Scott.
Although I've heard you like the undeserved victims of your abuse to be female, the latest a very good friend of mine suffering from depression.
Thought quite highly of you I heard, till you snapped and started calling her things like
Douche-bag, and Idiot bitch. Why? from what I gather, she had the unmitigated gall to be understanding.Stand tall my friend,
Be proud
It takes the manliest of men to pick such deserving victims.
And be glad you have a pansy-ass excuse.
A 'cycle'Or perhaps there is another Mr. Scott here who is having a "cycle"
I'm leaving,
said all I need to say.
Posted by Gabbix2 on November 25, 2002, at 12:29:21
In reply to Re: cycling-Mr.Scott, posted by alphamale on November 25, 2002, at 11:52:32
alpha male.
You obviously don't know much about the nature of depression or bpd, it does manifest itself in unpredictable ways, that are not always kind, to say the least. There is not really a rational way to suffer any form of mental illness.
Its not a place to post personal grievances although I'm sure in a case like this it must be tempting.I think you've overlooked the fact that someone posting here is trying to resolve some of their problems in a place which is to be supportive.
Thats is a huge admission.Cycling I know from personal experience is not an "excuse" and often as frightening for the person going through it, as it can be for those around them.
Perhaps your 'friend' is more aware of this than you are.
And I might add, its not "manly" in my opinion to make a statement like yours, knowing that there is no real way the person you are 'attacking' can explain themselves.
There are two sides (or more) to every story.
Posted by alphamale on November 25, 2002, at 13:30:59
In reply to Re: cycling-Mr.Scott » alphamale, posted by Gabbix2 on November 25, 2002, at 12:29:21
Whatever! Maybe I'm cycling too.
Thats why I can't control my need to call a mysoginistic ass a mysoginistic ass..Excuse me
I'm depressed
Posted by Mr.Scott on November 25, 2002, at 21:37:35
In reply to Re: cycling-Mr.Scott Reality Check. » Gabbix2, posted by alphamale on November 25, 2002, at 13:30:59
I know I lose credibility when I reply to fools who have instigated me, but how can I resist when I think that these two posters are actually one person who doesn't like me...
If you want to see naked pictures of Gabbix2 and alphamale (which I think is the same person BTW using two different logins) let me know and I'll direct you to the server where they will be posted. But I can't be responsible for the side-effects viewing them may induce which will make Effexor and Depakote look like breath mints comparatively.
By the way the main side effects are nausea and impotence...
Good Day and smiling all the way! :)
[edited]
Posted by Squiggles on November 25, 2002, at 21:42:19
In reply to Ugly Naked Pictures to be posted online, posted by Mr.Scott on November 25, 2002, at 21:37:35
I knew you were trolls - just too
"unyielding", "gamey" and "stinky"
like my dog (pit bull extraordinaire);
I take it you 're not coming back, but
this performance really puts Benzoland
in a brighter light.Thanks
Squiggles
Posted by Dinah on November 25, 2002, at 21:49:21
In reply to Ugly Naked Pictures to be posted online, posted by Mr.Scott on November 25, 2002, at 21:37:35
Please don't post anything that could lead others to feel accused or put down.
Posted by Dinah on November 25, 2002, at 21:50:05
In reply to Re: Ugly Naked Pictures to be posted online » Mr.Scott, posted by Squiggles on November 25, 2002, at 21:42:19
Please don't post anything that could lead others to feel accused or put down.
Posted by Dr. Bob on November 25, 2002, at 22:09:23
In reply to Re: cycling-Mr.Scott Reality Check. » Gabbix2, posted by alphamale on November 25, 2002, at 13:30:59
> Whatever! Maybe I'm cycling too.
> Thats why I can't control my need to call a mysoginistic ass a mysoginistic ass..
>
> Excuse me
> I'm depressedSorry, but people need to be civil here even if they're depressed. You'd already been asked to be civil, so I'm going to block you from posting for a week.
Bob
PS: Follow-ups regarding posting policies, and complaints about posts, should be redirected to Psycho-Babble Administration; otherwise, they may be deleted.
Posted by Gabbix2 on November 25, 2002, at 23:11:55
In reply to Re: blocked for week » alphamale, posted by Dr. Bob on November 25, 2002, at 22:09:23
for that vulgar display.
Alpha Male is my roomate and humiliated me also with that and revealed something I was keeping quiet about. I'm so sorry.
As for the other comments. They speak for themselves.
Posted by Gabbix2 on November 25, 2002, at 23:18:13
In reply to Not necessary Not true., posted by Gabbix2 on November 25, 2002, at 23:11:55
See me posting, see Alpha Male has been blocked
Perhaps you should investigate more thoroughly before you make your remarks.
I do hope there is some understanding as to my need to defend myself after that..Any other false accusations, or fake picture comments will be considered harrasment
Enough of that
Back to medication
Posted by Dr. Bob on November 26, 2002, at 3:05:52
In reply to Unnecessary Untrue Mr. Scott, posted by Gabbix2 on November 25, 2002, at 23:18:13
> See me posting, see Alpha Male has been blocked
When you're blocked, you're not supposed to post, so I'm going to block this posting name, too.
Bob
This is the end of the thread.
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