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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 9 of 9. This is the beginning of the thread.
Posted by jms600 on December 29, 2008, at 15:49:23
Hi
Does anyone know of the efficacy of Gabapentin in the treatment of anxiety disorders (GAD, panic disorder and social phobia)?
I have read that Gabapentin mimics GABA in the brain. Surely, if it does this then it must be as effective as at least some of the benzos (e.g. Valium)?
Could anyone advise on the above? I suffer from chronic anxiety (GAD, panic disorder, social phobia). Benzos are out as tolerance started to occur. I've also been through all the SSRIs, a couple of TCAs, Zyprexa, Seroquel, Haloperidol, Stelazine, Effexor, Remeron, Buspar and lithium - all of which haven't done that much. Also had five months of CBT which also hasn't helped much.
Posted by Phillipa on December 30, 2008, at 0:08:15
In reply to Gabapentin v Benzodiazepines, posted by jms600 on December 29, 2008, at 15:49:23
I've got tolerance to benzos and guess most of SSRI, SNRI's but didn't know it happened with antipschotics. Tried lyrica? Will Google gabapentin Phillipa
Posted by Phillipa on December 30, 2008, at 0:15:03
In reply to Re: Gabapentin v Benzodiazepines » jms600, posted by Phillipa on December 30, 2008, at 0:08:15
Looks like it's lyrica newer version. Phillipa
Posted by yxibow on December 30, 2008, at 0:29:28
In reply to Gabapentin v Benzodiazepines, posted by jms600 on December 29, 2008, at 15:49:23
> Hi
>
> Does anyone know of the efficacy of Gabapentin in the treatment of anxiety disorders (GAD, panic disorder and social phobia)?
>
> I have read that Gabapentin mimics GABA in the brain. Surely, if it does this then it must be as effective as at least some of the benzos (e.g. Valium)?
>
> Could anyone advise on the above? I suffer from chronic anxiety (GAD, panic disorder, social phobia). Benzos are out as tolerance started to occur. I've also been through all the SSRIs, a couple of TCAs, Zyprexa, Seroquel, Haloperidol, Stelazine, Effexor, Remeron, Buspar and lithium - all of which haven't done that much. Also had five months of CBT which also hasn't helped much.> Hi
>
> Does anyone know of the efficacy of Gabapentin in the treatment of anxiety disorders (GAD, panic disorder and social phobia)?
>
> I have read that Gabapentin mimics GABA in the brain. Surely, if it does this then it must be as effective as at least some of the benzos (e.g. Valium)?
>
> Could anyone advise on the above? I suffer from chronic anxiety (GAD, panic disorder, social phobia). Benzos are out as tolerance started to occur. I've also been through all the SSRIs, a couple of TCAs, Zyprexa, Seroquel, Haloperidol, Stelazine, Effexor, Remeron, Buspar and lithium - all of which haven't done that much. Also had five months of CBT which also hasn't helped much.
That's quite a list of medications, especially the neuroleptics -- I'm not doubting you, but how much time did you give Seroquel, because it can take months for real improvement.Buspar works for about 1/3 of people and tends to make (some) people dizzy too.
Yes, tolerance unfortunately is a problem and backing off when that happens is necessary. Sometimes you just have to let your GABA transmitters readjust themselves.
If you've recently stopped a benzodiazepine, I'm not sure how effective Neurontin would be in crosstolerance but its worth a try certainly as its not terribly harmful -- Lyrica is stronger and some people say it is more effective, which made it enough to be C-V.
You have to be really open to CBT to have success with it, especially with GAD. Have you tried regular psychotherapy?Also how many AED augmenters have you tried -- Lithium is fairly strong and can be jittery in its own right. E.g. Trileptal and especially Lamictal.
I assume the TCAs included Clomipramine ?
-- Jay
Posted by jms600 on December 30, 2008, at 11:18:21
In reply to Re: Gabapentin v Benzodiazepines » jms600, posted by yxibow on December 30, 2008, at 0:29:28
> > Hi
> >
> > Does anyone know of the efficacy of Gabapentin in the treatment of anxiety disorders (GAD, panic disorder and social phobia)?
> >
> > I have read that Gabapentin mimics GABA in the brain. Surely, if it does this then it must be as effective as at least some of the benzos (e.g. Valium)?
> >
> > Could anyone advise on the above? I suffer from chronic anxiety (GAD, panic disorder, social phobia). Benzos are out as tolerance started to occur. I've also been through all the SSRIs, a couple of TCAs, Zyprexa, Seroquel, Haloperidol, Stelazine, Effexor, Remeron, Buspar and lithium - all of which haven't done that much. Also had five months of CBT which also hasn't helped much.
>
> > Hi
> >
> > Does anyone know of the efficacy of Gabapentin in the treatment of anxiety disorders (GAD, panic disorder and social phobia)?
> >
> > I have read that Gabapentin mimics GABA in the brain. Surely, if it does this then it must be as effective as at least some of the benzos (e.g. Valium)?
> >
> > Could anyone advise on the above? I suffer from chronic anxiety (GAD, panic disorder, social phobia). Benzos are out as tolerance started to occur. I've also been through all the SSRIs, a couple of TCAs, Zyprexa, Seroquel, Haloperidol, Stelazine, Effexor, Remeron, Buspar and lithium - all of which haven't done that much. Also had five months of CBT which also hasn't helped much.
>
>
> That's quite a list of medications, especially the neuroleptics -- I'm not doubting you, but how much time did you give Seroquel, because it can take months for real improvement.
>
> Buspar works for about 1/3 of people and tends to make (some) people dizzy too.
>
> Yes, tolerance unfortunately is a problem and backing off when that happens is necessary. Sometimes you just have to let your GABA transmitters readjust themselves.
>
>
> If you've recently stopped a benzodiazepine, I'm not sure how effective Neurontin would be in crosstolerance but its worth a try certainly as its not terribly harmful -- Lyrica is stronger and some people say it is more effective, which made it enough to be C-V.
>
>
> You have to be really open to CBT to have success with it, especially with GAD. Have you tried regular psychotherapy?
>
> Also how many AED augmenters have you tried -- Lithium is fairly strong and can be jittery in its own right. E.g. Trileptal and especially Lamictal.
>
> I assume the TCAs included Clomipramine ?
>
>
> -- Jay
Hi JaySeroquel - took it for about 8 weeks at a dosage of up to 250mg. I didn't gain any benefit from it. Zyprexa did help, but only a bit - and even then at 10-15mg+ (dosages which my p/doc refuses to prescribe for anxiety).
I'm currently taking Lithium (600 mg) with 150mg Amitriptyline and 40mg Buspirone.
How do you mean - "Lithium is fairly strong and can be jittery in its own right. E.g. Trileptal and especially Lamictal." Do you mean that Lithium can cause anxiety??
Also, dose using Lyrica on a daily basis lead to tolerance??
Thanks for your advice.
Posted by yxibow on December 30, 2008, at 15:03:56
In reply to Re: Gabapentin v Benzodiazepines, posted by jms600 on December 30, 2008, at 11:18:21
> > > Hi
> > >
> > > Does anyone know of the efficacy of Gabapentin in the treatment of anxiety disorders (GAD, panic disorder and social phobia)?
> > >
> > > I have read that Gabapentin mimics GABA in the brain. Surely, if it does this then it must be as effective as at least some of the benzos (e.g. Valium)?
> > >
> > > Could anyone advise on the above? I suffer from chronic anxiety (GAD, panic disorder, social phobia). Benzos are out as tolerance started to occur. I've also been through all the SSRIs, a couple of TCAs, Zyprexa, Seroquel, Haloperidol, Stelazine, Effexor, Remeron, Buspar and lithium - all of which haven't done that much. Also had five months of CBT which also hasn't helped much.
> >
> > > Hi
> > >
> > > Does anyone know of the efficacy of Gabapentin in the treatment of anxiety disorders (GAD, panic disorder and social phobia)?
> > >
> > > I have read that Gabapentin mimics GABA in the brain. Surely, if it does this then it must be as effective as at least some of the benzos (e.g. Valium)?
> > >
> > > Could anyone advise on the above? I suffer from chronic anxiety (GAD, panic disorder, social phobia). Benzos are out as tolerance started to occur. I've also been through all the SSRIs, a couple of TCAs, Zyprexa, Seroquel, Haloperidol, Stelazine, Effexor, Remeron, Buspar and lithium - all of which haven't done that much. Also had five months of CBT which also hasn't helped much.
> >
> >
> > That's quite a list of medications, especially the neuroleptics -- I'm not doubting you, but how much time did you give Seroquel, because it can take months for real improvement.
> >
> > Buspar works for about 1/3 of people and tends to make (some) people dizzy too.
> >
> > Yes, tolerance unfortunately is a problem and backing off when that happens is necessary. Sometimes you just have to let your GABA transmitters readjust themselves.
> >
> >
> > If you've recently stopped a benzodiazepine, I'm not sure how effective Neurontin would be in crosstolerance but its worth a try certainly as its not terribly harmful -- Lyrica is stronger and some people say it is more effective, which made it enough to be C-V.
> >
> >
> > You have to be really open to CBT to have success with it, especially with GAD. Have you tried regular psychotherapy?
> >
> > Also how many AED augmenters have you tried -- Lithium is fairly strong and can be jittery in its own right. E.g. Trileptal and especially Lamictal.
> >
> > I assume the TCAs included Clomipramine ?
> >
> >
> > -- Jay
>
>
> Hi Jay
>
> Seroquel - took it for about 8 weeks at a dosage of up to 250mg. I didn't gain any benefit from it. Zyprexa did help, but only a bit - and even then at 10-15mg+ (dosages which my p/doc refuses to prescribe for anxiety).
Two months -- well I suppose that's plenty enough of a trial, some people may need more, like 400mg or so of Seroquel.
Yes, I'd agree that 10-15mg of Zyprexa is on the higher end of things, and caution (maybe my bias) is always worth watching for.Mainly for APs the MED (minimum effective dose) should be used, but maybe you didn't have enough of an effective dose, I can't speak for you though.
> I'm currently taking Lithium (600 mg) with 150mg Amitriptyline and 40mg Buspirone.
That sounds like a full load of all the medications, I mean some people take Lithium up to 1000mg+ but its usually for bipolar. Should monitor your salt functions with a test every so often with Lithium.> How do you mean - "Lithium is fairly strong and can be jittery in its own right. E.g. Trileptal and especially Lamictal." Do you mean that Lithium can cause anxiety??
It was a compound sentence, not applying to the other AEDs -- I didn't say Lithium could necessarily cause anxiety in some people, but the jitters it produces could seem like anxiety.
Lamictal is a good antidepressant outright in itself but it takes a long while to ramp up to a good dose to prevent SJS (the really "bad rash", internal damage)
> Also, dose using Lyrica on a daily basis lead to tolerance??
Not in the immediate run -- in the long run, either of the GABA replacements can become less effective but I wouldn't call it quite tolerance like benzodiazepines, but there is a possibility of diminishing returns for -some- people.
That's why for Lyrica even though most studies showed very little potential for addictiveness at all, it was eventually agreed to be marketed at the lowest habituation mark, Category V.> Thanks for your advice.
No problem
-- best wishes
-- Jay
Posted by Phillipa on December 30, 2008, at 20:40:23
In reply to Re: Gabapentin v Benzodiazepines » jms600, posted by yxibow on December 30, 2008, at 15:03:56
Jay I have some would it help with the tolerance to benzos and just relax and at what dose? Love Jan
Posted by yxibow on December 31, 2008, at 5:30:31
In reply to Re: Gabapentin v Benzodiazepines » yxibow, posted by Phillipa on December 30, 2008, at 20:40:23
> Jay I have some would it help with the tolerance to benzos and just relax and at what dose? Love Jan
The dose for a particular person is a cosmic question -- not to be offensive at all, I simply can't guess, but if you've never tried it or its been a long while since you've tried it, restarting Neurontin could help.
It typically is dosed around 4x a day up to 600mg per dose (occasionally 900 with diminishing returns), as its plasma peaks aren't particularly long and it tends to be excreted through the kidneys pretty fast.Lyrica is stronger -- as a personal aside I wasn't able to take it or whatever combination I was on wasn't able to be mixed in that fashion because I got, what around 10% of people get, which is some offset or blur in their vision. Then again, Neurontin can do the same thing. I have no idea if this goes away since I did take it for most of a month I think (Lyrica).
But, its generic, its worth a try -- I would do this with your doctor's commentary though, I don't think it is good to self-prescribe, even if Neurontin is fairly innocuous besides some slurring of voice and tiredness possible at the beginning (which I did have).
-- tidingsJay
Posted by Phillipa on December 31, 2008, at 19:43:44
In reply to Re: Gabapentin v Benzodiazepines » Phillipa, posted by yxibow on December 31, 2008, at 5:30:31
Jay forgot about the eye blurring think that's why never tried it. Was told that 25mg could be seadating and more activating. Love Jan
This is the end of the thread.
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