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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 5 of 5. This is the beginning of the thread.
Posted by tendency on March 30, 2005, at 18:37:01
Well, been diagnosed with bpII, depression and add. one thing ive been noticing lately is that i have a near constant level of low to mid grade anxiety and irritability. do you all have some ideas on good meeds to treat these symptoms?
what's the best med for anxiety? benzos?
thanks
Posted by Minnie-Haha on March 30, 2005, at 18:47:53
In reply to anxious all the time, posted by tendency on March 30, 2005, at 18:37:01
> Well, been diagnosed with bpII, depression and add. one thing ive been noticing lately is that i have a near constant level of low to mid grade anxiety and irritability. do you all have some ideas on good meeds to treat these symptoms?
>
> what's the best med for anxiety? benzos?
>
> thanksThis is a chicken-or-egg question for sure! I had anxiety and insomnia for 15 months. I was a wreck. Looked for medical reasons; really came up with nothing definitive. Benzos and sleeping pills did not help. I got no relief till I went on an antidepressant (on top of a mood stabilizer... I'm BP II as well).
Others here can probably report that they didn't get their depression under control until they treated their anxiety. Ugh!
Posted by tendency on March 30, 2005, at 19:20:07
In reply to Re: anxious all the time, posted by Minnie-Haha on March 30, 2005, at 18:47:53
> This is a chicken-or-egg question for sure! I had anxiety and insomnia for 15 months. I was a wreck. Looked for medical reasons; really came up with nothing definitive. Benzos and sleeping pills did not help. I got no relief till I went on an antidepressant (on top of a mood stabilizer... I'm BP II as well).
>
> Others here can probably report that they didn't get their depression under control until they treated their anxiety. Ugh!
>what AD are you on?
Posted by Minnie-Haha on March 31, 2005, at 10:33:35
In reply to Re: anxious all the time » Minnie-Haha, posted by tendency on March 30, 2005, at 19:20:07
> what AD are you on?
I take:
Trileptal - 150mg a.m. & 150mg p.m.
Wellbutrin XL - 150mg a.m.
Cymbalta - 40mg p.m.Reports here about Cymbalta have been mixed. Some love it, some hated it or couldn't handle side effects. (My side effects have been pretty mild.) Also, although the therapeutic dose is 60mg, some here take 90-120mg, and some break apart the 20mg capsules and just take a few of the little pellets inside! Like many of the drugs used here, I think you have to be willing to start out slow and wait several weeks to feel better.
I took 30mg for one week and then went up to 60. I felt really good after about 3 weeks on 60mg, but my blood pressure went up a little, so we dropped my dose down to 40mg. After a few weeks on that, I added the Wellbutrin XL to augment. So far, so good.
Posted by temoigneur on March 31, 2005, at 21:35:12
In reply to anxious all the time, posted by tendency on March 30, 2005, at 18:37:01
I can only guess at what's like try to find your way through the haze of these diagnoseses. But, just like not all drugs were created equal, not all diagnosis are correct either.
Not Being a psychiatrist, it seems impossible to responsibly guess at a med. that would effectively treat you're anxiety without potentially affecting your BPII.
I'll get back to meds, my first recommendation would be to get a clear diagnosis from your specialist. It seems odd if in fact you were diagnosed with BPII and depression. But if you're feeling depressed because of the anxiety that's another thing.
If you're problem is primarily anxiety the first line is SSRI's - lots of debate on how long they take to work - I would contact the Anxiety Disorder Association of America for guidliness. Some benzodiazpines tend to worsen depression, while improving anxiety - but you might know about all the mem. impairment and sed. associated with them, Tricylic antidepressants although older, and not without side effects, can be VERY useful for anxiety. Unfortunately for many, they do cause cognitive dulling, and lack of drive, but others don't complain much about this. Of course if nothing works, and the anxiety is really troublesome there's MAOI - Many swear by Nardil, Parnate seems to work well for some - although there may be more risk of tolerance with the latter.
Alternatively, if you live in the states, I would ask about pregabalin, it's not indicated for anxiety, but at the national anxiety conference a pfizer rep. presented promising results on how it can relieve anxiety, with relatively minor side effects.
Again I think key is getting a reliable diagnosis - get a second - third heck fourth opinion if necessaryAll the best
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