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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 13 of 13. This is the beginning of the thread.
Posted by smittay17 on January 11, 2004, at 19:20:02
Hi everyone. I have been on 300mg of Imipramine and 2mg of Klonopin for the last 8 years for Panic Disorder and OCD. I have haven't had one single Panic Attack and barely was obsessive at all.
I recently have had to change my medicine to Celexa, due to the weight gain of Imipramine. It gave me sleep apnea. And its been really hard facing all this stuff again...
After a long, hard 6 months of transition and a professional career and wife to juggle, I am now on 80mg of Celexa/day and the same amount of Klonopin. It seems to have helped a little cause I was able to shed 6- 50mg pills of Imipramine, whereas I couldn't do that without Celexa before.
BUT- I feel really jittery, shaky, headaches, unable to relax and still have had minor panic attacks. It has been real scary for me going through all this again.
Based on your experience and knowledge- Do you think this is this too much Celexa? (I heard you were only supposed to go up to 60mg/day). Maybe I should lower the Celexa... I just don't know.
Or on the other hand, maybe I should increase it to 100mg? What have your experiences been? I feel great once I put that new pill of 20mg of Celexa in for about 5 days, but then it wears off (is that a bad sign?) Also at the same time, i have taken away 1 pill of Imipramine. That could be causing the "good felling" to go away. The last pill of Imipramine has only been out for a little over a week. Maybe this is withdrawal?
Thats why I am really interested in finding out what others on here take for their Panic Disorder that has effectively treated them.
Or if you are a Dr. on here who treats patients for Panic Disorder or OCD what remedies work without causing the weight gain like the Imipramine? I'd be interested in hearing your experiences.
Thank you so much and hopefully with the continuation and sharing of knowledge we will all find a remedy for our ailments some day!
Thanks again and I'd really like to hear from you, especially as I am not doing well and could need some encouragement. :)
Posted by KathrynLex on January 11, 2004, at 21:18:08
In reply to What medication do YOU take for Panic Disorder?, posted by smittay17 on January 11, 2004, at 19:20:02
Hi Smittay,
I don't have any experience with the meds you're on, but I wanted to offer some encouragement. Panic attacks are a nightmare, my heart goes out to you.
I've just started week 4 of 10 mg Lexapro. Some of the side effects have been difficult to deal with, but my anxiety is subsiding which is wonderful.
Keep up your hope. There IS a drug out there that will help you.
K.
Posted by smittay17 on January 11, 2004, at 21:33:57
In reply to Re: What medication do YOU take for Panic Disorder?, posted by KathrynLex on January 11, 2004, at 21:18:08
> Hi Smittay,
>
> I don't have any experience with the meds you're on, but I wanted to offer some encouragement. Panic attacks are a nightmare, my heart goes out to you.
>
> I've just started week 4 of 10 mg Lexapro. Some of the side effects have been difficult to deal with, but my anxiety is subsiding which is wonderful.
>
> Keep up your hope. There IS a drug out there that will help you.
>
> K.Thanks,
Lexapro is a derivative of Celexa, right? How do the doses go? Celexa is in 20mg and 40mg pills... I'm on 80mg, but I have severe Panic and OCD and was on a ton of Imipramine... I need a lot I think just to get rid of the OCD... I'll look into Lexapro.Anybody else have any other success stories? Anybody ever gone from a TCA-> SSRI and had success?
just wondering still....
Erik :)
Posted by mattdds on January 11, 2004, at 22:03:31
In reply to What medication do YOU take for Panic Disorder?, posted by smittay17 on January 11, 2004, at 19:20:02
Posted by smittay17 on January 12, 2004, at 7:24:11
In reply to Klonopin - Gold Standard for Panic Disorder 2 mg/d (nm) » smittay17, posted by mattdds on January 11, 2004, at 22:03:31
I didnt get a message with that title there Matty :)
Posted by Ame Sans Vie on January 12, 2004, at 9:11:18
In reply to Re: Klonopin - Gold Standard for Panic Disorder 2 mg/d, posted by smittay17 on January 12, 2004, at 7:24:11
Affirmative. Klonopin is the prototypical antipanic agent, in my opinion. Two milligrams daily is an insufficient dose for panic disorder much of the time, however. I take 8mg/day myself, and have gone as high as 20mg. Granted, I use it to treat agoraphobia and social phobia in addition to my panic disorder, but I believe the usual dosage of Klonopin for panic ranges from 2-6mg/day. Of course, there are always those lucky sons-a-guns who need much less. My stepfather, for example, just switched from Xanax 1/8mg three times daily to an equivalent dose of Klonopin -- 1/16mg once daily, and the man weighs 330 pounds! But then there are people like me who require very high doses. While 8mg isn't extremely high, I would require more than double that if it weren't for Adderall and Prozac. So obviously, I recommend you discuss a dosage titration with your prescribing physician. About as good as Klonopin is Xanax, and with the new 24-hour version on the market (Xanax XR), it too is an ideal medication for panic disorder. It can also be a good idea to keep immediate-release Xanax or Ativan on hand in case of breakthrough attacks, as they can be taken sublingually (dissolved under the tongue and delivered directly into the bloodstream) and begin working in about five minutes, quickly averting the panic symptoms.
As for Celexa, no -- 80mg is not, generally speaking, "too much", but it may be too much for you. I've taken Lexapro in the past which is purported to be, milligram for milligram, quadruple the strength of Celexa. I took 80mg, which should be equivalent to 320mg Celexa.
How are your OCD symptoms? Once I know that I can be of more help.
Michael
Posted by Elle2021 on January 12, 2004, at 10:46:45
In reply to What medication do YOU take for Panic Disorder?, posted by smittay17 on January 11, 2004, at 19:20:02
I took Celexa for my OCD and it did absolutely nothing for it. All the SSRI's seem to make me really panicky.
Right now I'm taking 20mg. of Chlorpromazine. It seems to be helping. I also take 1mg of Klonopin and 0.5 mg. of Ativan.
Hang in there, you will find the right combo soon.
Elle
Posted by CareBear04 on January 12, 2004, at 11:15:53
In reply to Re: What medication do YOU take for Panic Disorder? ?smittay17, posted by Elle2021 on January 12, 2004, at 10:46:45
Ativan or Xanax. I don't like taking benzos regularly, so I rely on the fast-acting stuff to kick in quickly when I get panicky. Even though Xanax is supposed to work faster, I think Ativan under the tongue actually starts working quicker. I also take an SSRI, but I think it's pretty worthless on the panic front.
Posted by smittay17 on January 12, 2004, at 11:32:26
In reply to Re: What medication do YOU take for Panic Disorder? » smittay17, posted by Elle2021 on January 12, 2004, at 10:46:45
> I took Celexa for my OCD and it did absolutely nothing for it. All the SSRI's seem to make me really panicky.
>
> Right now I'm taking 20mg. of Chlorpromazine. It seems to be helping. I also take 1mg of Klonopin and 0.5 mg. of Ativan.
>
> Hang in there, you will find the right combo soon.
> ElleIs that common that SSRI's dont work, make people more panicky with Panic Disorder???
I have to believe SSRI's work for some people?
Or is it just that SSRIs take awhlie (1-2 months) for the initial anxiety to go away?
i heard TCA's work really well because they sedate you, but i cant be on a TCA because of weight gain.
is there another type of sedative that doesnt cause weight gain? non benzodiazepine-wise?
I really hope this Celexa works for me, im jittery at work today, but i feel a little better each day.
I also have to remember the Celexa is building and the Imipramine is leaving... im in transition... in a month i should be able to tell what to increase or decrease or if it just doesnt work and i need something added.
Please keep your posts coming, its helping me in a very difficult time, especially if you have had good experience with Celexa or another SSRI for Panic Disorder .
Thanks,
Erik
Posted by Viridis on January 12, 2004, at 23:10:48
In reply to Re: What medication do YOU take for Panic Disorder?, posted by smittay17 on January 12, 2004, at 11:32:26
Klonopin is best by far for me, and continues to work at 1 mg/day. Xanax is very helpful for really severe anxiety/panic, but I limit its use to special situations because I did develop some tolerance (although no problems), even with occasional use -- not the case with Klonopin.
The SSRIs I've tried make me extremely anxious and induce either bizarre mood swings or "wired apathy". I can't tolerate them at all. But that's just me -- others do very well with them. My pdoc says Prozac is the SSRI most likely to induce anxiety and considers Zoloft "gentlest". However, I actually had a worse reaction to Zoloft than Prozac. Wellbutrin (not an SSRI) was probably the worst for me.
Klonopin really does seem to be the "gold standard" for panic disorder, based on my experiences, what I've seen here and elsewhere, and what my pdoc tells me.
Posted by Elle2021 on January 13, 2004, at 5:45:11
In reply to Re: What medication do YOU take for Panic Disorder?, posted by smittay17 on January 12, 2004, at 11:32:26
> Is that common that SSRI's dont work, make people more panicky with Panic Disorder???
I don't know for people in general. I know for me, they just made me a jittery mess. I took Zoloft for a long time, but had no luck.
> I have to believe SSRI's work for some people?
They probably do, just not for me. I also wonder if they work better for people who are depressed without the panic problems.
> Or is it just that SSRIs take awhlie (1-2 months) for the initial anxiety to go away?Possibly, but in my case the jitters never went away. Everyone is different though. I'm allergic to a lot of anti-biotics, maybe that has something to do with my low tolerance level regarding SSRI's.
> is there another type of sedative that doesnt cause weight gain? non benzodiazepine-wise?
You might talk to your doctor about an anti-psychotic drug. They tend to be sedating. Some of them DO cause weight gain, but there are others that don't have that effect, such as Risperidol (but be careful, even thought it doesn't cause weight-gain, it is very sedating, at least for me it was).
> I really hope this Celexa works for me, im jittery at work today, but i feel a little better each day.I hope it works for you too, it's worth a try. :)
Elle
Posted by Bfly on January 13, 2004, at 23:16:04
In reply to Re: What medication do YOU take for Panic Disorder? » smittay17, posted by Elle2021 on January 12, 2004, at 10:46:45
Hello.
I take Lectopam, a benzodiazepine, for anxiety.
Also Effexor for the O.C.D.
Posted by smittay17 on January 14, 2004, at 8:13:16
In reply to Re: What medication do YOU take for Panic Disorder?, posted by Bfly on January 13, 2004, at 23:16:04
Thanks everyone this is helping me so much...
Anyone else with Panic Disorder and on a SSRI (or have been on one)... step up to the plate!
I wanna hear about it.
***FYI- an update on me, on 80mg of Celexa, the last Imipramine has left and i have crazy dry mouth, gas, burping, stomach aches, a little jitteriness, headaches, but these all seemed to go away after 2-3 weeks of being on the celexa (every time i up the dosage 20mg, it starts over again for the 2-3 weeks) ... just pray my levels become adjusted. The celexa HAS to be working because i wouldnt be able to have gotten all these Imipramines out by themselves...
You know you no longer suffer from Panic Disorder when you're not thinking about it (ask a loved one, they will tell you your balanced if you havent talked to them about it in the last 5 mintues :)
This is the end of the thread.
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