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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 10 of 10. This is the beginning of the thread.
Posted by Gary Engel on September 29, 2007, at 13:45:56
I'm 38 y.o. WM. I recently lost my best friend (my brother) unexpectedly. He was my best friend in the world. I really didn't have other close friends besides him. I am married with two kids 5 and 7. I've had anxiety/panic since I was 18 years old, but it was always tolerable and I made it through college and have worked as an RN x 14 years now. Right around the time my brother passed away, I started having terrible anxiety, not so much panic attacks. To make a long story short, I've had a thorough medical workup which was negative. I've been in counseling every week since march. I've been out of work since march due to this. I've seen 5 different Psychiatrists, every medication I've taken whether it be an SSRI or depakote, wellbutrin, or nortriptaline has made me sick, like I have the flu. The meds also exacerbate my anxiety 4 fold. I've tried every SSRI and a few of them more than once. Even on 2.5mg of Lexapro, I get sick. I'm off the Lex now as my 4th try on it only lasted 6 days before I had to abort. I've been on serzone for years and was fine on it, but now I'm weaning off. I was on the highest dose you can take and it stopped working. I'm down to 150mg/day and getting ready to drop another 25-50mg in a few days. Other than that I take Klonopin 1mg twice/day, I take a beta blocker for the anxiety, and I take Xanax 0.5mg as needed. I'm a complete mess. I get terrible depression and anxiety. The depression seems to get better on the meds immediately, but since I can't tolerate them ???????? My anxiety is manageable with the Xanax, but on the meds it is out of control. My psychiatrist is a 30 year veteran from Johns Hopkins. I like him, but he thinks I'm conditioned to taking a pill a getting sick. In other words, I make myself sick when I stick a pilll in my mouth. I disagree with him, as I can't make my stomach rumble and be heard across the room, I can't make my anxiety flip off the charts...It's not even panic I get...just the worst anxiety I've ever experienced on the meds. No sweating or palpitations, just an uncomfortable feeling in my chest. Like I said, it's better off the meds. Trying to figure out what to do next. I'm on disability from my work now and I have a private plan, which together I'm bringing in more money than if I was well and working, but I only have 18 more months of that and then I will have to live off of SS. So I need to get well quick and get myself back to work...........Any help or suggestions would be great....BTW, I've tried accupuncture, hypnotherapy, and have read every self help book out there. I know this is all in my head, the question is, Is this chemical or is this in my control? Havn't figured it out yet. Also, my father suffered from this when he was about my age, and Zoloft fixed him, so he claims. Of course Zoloft made me sick too. I have an uncle who suffers and doesn't go too far from home. And my dad tells me me great grandmother suffered as well
Posted by Netch on September 29, 2007, at 15:13:03
In reply to Can someone give me some direction...So Lost !!!, posted by Gary Engel on September 29, 2007, at 13:45:56
I've read about one person who was helped with a combo of lyrica and remeron.
Another option is mood stabilizers like lamictal or trileptal, which also have antidepressive and anxiolytic effect. These can be combined with buspar, lithium or SSRI.
Stablon is an option if you can get a license.
I've heard of people ordering it from online pharmacies.Gary, just don't give up.
/Netch
Posted by Netch on September 29, 2007, at 20:43:37
In reply to Re: Can someone give me some direction...So Lost !!!, posted by Netch on September 29, 2007, at 15:13:03
If you have problems with anxiety you should also avoid any stimulants like caffeine/theine
Netch
Posted by Phillipa on September 29, 2007, at 21:58:26
In reply to Can someone give me some direction...So Lost !!!, posted by Gary Engel on September 29, 2007, at 13:45:56
Sorry was so late in responding good you posted it. Phillipa
Posted by elanor roosevelt on September 29, 2007, at 22:20:30
In reply to Re: Can someone give me some direction...So Lost !!!, posted by Netch on September 29, 2007, at 20:43:37
take buspar to get you past this
but no more than 3 months
Posted by Jedi on September 29, 2007, at 22:57:40
In reply to Can someone give me some direction...So Lost !!!, posted by Gary Engel on September 29, 2007, at 13:45:56
Hi Gary,
If you get off the Serzone for two weeks, you could try Nardil, a MAOI. Like clonazepam it affects the GABA receptors and thus is one of the best antidepressants for anxiety and social anxiety. In my opinion, it should also be a 2nd tier choice for atypical depression.Make sure that your doctor has checked your liver function after so many years on Serzone. The stomach problems could be one of the early symptoms of liver failure, which is a rare side effect of Serzone.
The MAOIs are not without side effects, but for severe treatment reistant depression and social anxiety, they can work when nothing else has.
I am so sorry about your brother and best friend. A stressor like that when you are already depressed and anxious can be almost unbearable.
Be Well,
Jedi
Posted by med_empowered on September 30, 2007, at 8:14:21
In reply to Re: Can someone give me some direction...So Lost !!! » Gary Engel, posted by Jedi on September 29, 2007, at 22:57:40
can you increase the benzo and forget about the other stuff? If you're tolerating your dose of xanax, maybe you just should skip over the antidepressants, mood stabilizers, and just go straight for the benzos. People usually tolerate those far better than many other psychiatric drugs anyway.
Posted by Racer on September 30, 2007, at 11:44:58
In reply to Can someone give me some direction...So Lost !!!, posted by Gary Engel on September 29, 2007, at 13:45:56
I started a nice, long, truly brilliant post to you last night -- and lost it. Sorry, this one will only be -- at best -- one quarter as brilliant...
I'm not understanding the timeline here, I think. You say that you've been getting treatment since March? Have you tried all the SSRIs since then? If so, you haven't given any of them an adequate trial.
Any serotinergic drug will have some GI side effects during the adjustment phase, because of how serotonin affects the digestive process. After a few weeks -- or sometimes months -- the serotonin receptors in the gut recalibrate, and the side effects go away. It's not comfortable in the meantime, but it does get better.
I know how easy it is to get spooked by medications, because I've done it myself. I've done exactly what your doctor thinks you have: made myself sick as soon as I take that pill. Even before you wrote that, I wondered if you weren't doing the same thing I was. Don't get me wrong -- there was truth to what I was experiencing. But I had to get past that phase in order to feel better. And I did.
At the time I went through this, a friend of mine called me every morning to tease me into making it through another day of taking my pills. Without him, I have no doubt I'd still be unmedicated and taking a drug for three days at a time. Instead, I've been mostly functional for a couple of years now, even if I'm not in an optimal state. (Like you, I have some situational factors to grieve.)
I hope you'll try one of those SSRIs again, and stick it out for a couple of weeks, to see if it works or not. If the GI effects don't go away, they can be mitigated. The thought that helped me most was this: "Wouldn't it be a shame if you missed out on a drug that might help you, just because your anxiety got in the way of taking it?" Maybe a variation on that thought might help you.
Good luck.
Posted by bleauberry on September 30, 2007, at 18:28:25
In reply to Can someone give me some direction...So Lost !!!, posted by Gary Engel on September 29, 2007, at 13:45:56
There is a biological cause to what you are feeling. It is not a deficiency in xanax or any drug.
You might want to jump to the alternative board and start over.
Common things related to your condition and easily remedied are:
Faulty metabolism of tryptophan to serotonin (take 5htp)
Faulty taurine. (take taurine)
Low magnesium.
Low Gaba.
Excessive adrenal cortisol (siberian ginseng, ashwaghanda or rhodiola rosea or all)
There are other biological causes to what you are feeling. Above are some of the most common ones that came to mind on the spur of the moment. Drugs will not fix them but will only mask the symptoms somewhat, maybe, sort of, in a way, with side effects.
Posted by Phillipa on September 30, 2007, at 18:48:30
In reply to Re: Can someone give me some direction...So Lost !!!, posted by bleauberry on September 30, 2007, at 18:28:25
Good suggestion and I do know a woman who ran the beach last day of chemo for breast cancer she was getting accupunture and massage is wonderful too my old pdoc used to have each patient receive a one hour massage from licensed therapists before sessions with him as he wanted them relaxed. He did his own theraphy too so appointment total time with both two hours. Unfortunately don't live nears him anymore and the insurance companies got on him about the massage. Phillipa
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