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Dr. Bob is Robert Hsiung, MD,
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Posted by linkadge on September 10, 2011, at 20:46:11
In reply to The religion of benzodiazpines; an article » herpills, posted by floatingbridge on September 10, 2011, at 18:25:26
Just changed from clonazepam to ativan. I much prefer this medication to any atypical antipsychotic. I can think just fine on lorazepam. I would be completely wonked out on an AP.
Linkadge
Posted by floatingbridge on September 10, 2011, at 21:01:36
In reply to Re: The religion of benzodiazpines; an article, posted by linkadge on September 10, 2011, at 20:46:11
Link, I wished I like Ativan. I feel edgy inside. Strange, eh?
In general, I think just fine on benzos. The risperdone needs to be taken (by me) before bed.
Posted by sleepygirl2 on September 10, 2011, at 21:01:45
In reply to Re: Antipsychotics Increasingly Prescribed for Anxiety, posted by Dinah on September 10, 2011, at 17:20:05
Dinah,
You manage to take the risperdal only prn?
How often do you take it?
Thanks,
Sleepy
Posted by Phillipa on September 10, 2011, at 21:02:01
In reply to Re: The religion of benzodiazpines; an article, posted by linkadge on September 10, 2011, at 20:46:11
Link the one time was put on one was totally out of it couldn't talk the words wouldn't leave my mouth. Benzos relax feel the muscles twitch as they unwind. And then lights out and sleep. Don't take during day anymore. Have cut down to such a tiny piece of xanax probably .125 and 7.5 of valium. Will go lower as don't notice a difference. I'm with CE on the new benzo. In the 70's it was valium "Mother's little helper". But worked marvelously for panic. Phillipa
Posted by Dinah on September 10, 2011, at 21:09:04
In reply to Re: Antipsychotics Increasingly Prescribed for Anxiety » Dinah, posted by sleepygirl2 on September 10, 2011, at 21:01:45
I say maybe ten a month, but my prescription of thirty seems to last forever, so maybe I don't use that many. Or maybe I do sometimes but not others. I've got no sense of time. None. At all.
Posted by Dinah on September 10, 2011, at 21:11:09
In reply to Re: Antipsychotics Increasingly Prescribed for Anxiety » sleepygirl2, posted by Dinah on September 10, 2011, at 21:09:04
This has been ok'd by my pdoc or it would make me anxious to use. But the best combination for me with regard to work productivity is a Risperdal and a Provigil taken at the same time.
I still feel a bit guilty about that.
Posted by floatingbridge on September 10, 2011, at 21:13:28
In reply to Re: Antipsychotics Increasingly Prescribed for Anxiety » Dinah, posted by sleepygirl2 on September 10, 2011, at 21:01:45
> Dinah,
> You manage to take the risperdal only prn?
> How often do you take it?
> Thanks,
> SleepyUmmm. O. K. What does PRN stand for?
I think it means as needed, yes?
Posted by floatingbridge on September 10, 2011, at 21:19:31
In reply to Re: Antipsychotics Increasingly Prescribed for Anxiety » sleepygirl2, posted by Dinah on September 10, 2011, at 21:09:04
> I say maybe ten a month, but my prescription of thirty seems to last forever, so maybe I don't use that many. Or maybe I do sometimes but not others. I've got no sense of time. None. At all.
______________That's kinda nice that way, Dinah. Is it?
I've been instructed a few times to take nightly and steadily. .5mg per night. Tried to fly the 'as-needed' by pdoc, but didn't
like that for me.I'm curious about the sense of guilt expressed over in your other post about ripsperdone and provigil.
Posted by Dinah on September 10, 2011, at 21:19:50
In reply to Re: Antipsychotics Increasingly Prescribed for Anxiety » sleepygirl2, posted by floatingbridge on September 10, 2011, at 21:13:28
Posted by Dinah on September 10, 2011, at 21:58:31
In reply to Re: Antipsychotics Increasingly Prescribed for Anxiety » Dinah, posted by floatingbridge on September 10, 2011, at 21:19:31
I would prefer more of a sense of myself as a single continuous individual existing through a steady flow of time. I don't really have that.
I feel like that combination is combining uppers and downers. Though technically speaking, Risperdal doesn't feel much like a downer.
The Risperdal helps with the anxiety and obsessions and the Provigil helps with wakefulness and focus. It really does seem to work, though I use it sparingly. I'm afraid using it regularly would dilute the effect.
Posted by floatingbridge on September 10, 2011, at 22:47:38
In reply to Re: Antipsychotics Increasingly Prescribed for Anxiety » floatingbridge, posted by Dinah on September 10, 2011, at 21:58:31
> I would prefer more of a sense of myself as a single continuous individual existing through a steady flow of time. I don't really have that.
>
> I feel like that combination is combining uppers and downers. Though technically speaking, Risperdal doesn't feel much like a downer.
>
> The Risperdal helps with the anxiety and obsessions and the Provigil helps with wakefulness and focus. It really does
seem to work, though I use it sparingly. I'm afraid using it regularly would dilute the effect.Dinah, now that you've explained it, I feel little dense for not understanding more w/o your explanation. I used to say my older daily treatment was a 'speedball', something that made the ex-pdoc uncomfortable. (Me too!) Legal or not, it was how I felt, and still do. Xanax, risperdone (though ostensibly for other reasons), plus Emsam is reproducing a similar effect. It's my tightrope walk between depression/lethargy and anxiety.
I feel badly that I asked you to spell out your discomfort. Online is not irl. Online, you have to me a real steady sense.
Btw, progivil is an odd med. I found it intolerable. I'm glad you have these tools in your kit.
fb
Posted by linkadge on September 11, 2011, at 15:38:42
In reply to Re: Antipsychotics Increasingly Prescribed for Anxiety, posted by Dinah on September 10, 2011, at 21:11:09
It depends on the person and the type of anxiety I guess. I was on such a merry go round for anxiety before my doctor finally tried benzodiazapines.
We came to the conclusion that I really don't have GAD, its more of a periodic anxiety attack thing - also with a lot of insomnia etc.
Linkadge
Posted by Zonked on September 11, 2011, at 19:19:59
In reply to Re: Antipsychotics Increasingly Prescribed for Anxiety, posted by linkadge on September 11, 2011, at 15:38:42
How disturbing but not suprising. Years from now, this will probably be seen as a barbaric mistake, and I'd bet anyone 100 bucks the APA will say so, too. I understand that some people are happy with the results of AAP therapy, but the risks outweigh any potential benefit for me. I am aware long term benzo use carries some risks as well but I am okay with that. APs have entered my body twice, and made me feel like a drooling emotionless zombie both times. I'd also be afraid of EPS and diabetes. Xanax kills anxiety without making me feel unlike myself. If you go to askapatient.com and look at what patients have to say about these meds, or look up tardive dyskinesia on youtube, you might want to think twice before taking these pills for a nonpsychotic condition. I am less afraid of the Temodar chemotherapy drug my mom takes for brain cancer than I am of these drugs. At least she won't start having uncontrollable movements, develop diabetes, or feel restless. What really bugs me is that we have extremely safe and effective drugs available to treat anxiety disorders. I would support their use in nonpsychotic conditions only as last line treatment. And only if the patient were always made fully aware of potential side effects which I doubt is the case much of the time. I never thought I'd see antipsychotics advertised on TV for anything. One day we might consider these as revolting as old ads for Thorazine in medical journals to treat things like anxiety or ADHD go children. Yes, there were ads like that. My .002 -z
Posted by JONO_IN_ADELAIDE on September 11, 2011, at 19:52:50
In reply to Re: Antipsychotics Increasingly Prescribed for Anxiety yuck, posted by Zonked on September 11, 2011, at 19:19:59
In low doses (1mg per day) risperidone only hits the 5HT2 receptor, so it isnt realy an antipsychotic in thses doses. I think like most things, its the dose that matters.
And, for me, low dose risperidone + Xanax + antidepressants gave a much better result than Xanax + antidepressants.
Having said that, hydroxyzine (Atarax) would probably do more or less the same job.
Posted by Phillipa on September 11, 2011, at 21:32:00
In reply to Re: Antipsychotics Increasingly Prescribed for Anxiety yuck, posted by Zonked on September 11, 2011, at 19:19:59
A few years from now the error of over prescribing will become apparanent if hasn't already with weight gain, diabetes. Already they have increased and bet no studies done on that yet. A benzo has been around for half a century. Work fine Phillipa
Posted by hyperfocus on September 12, 2011, at 16:41:11
In reply to Antipsychotics Increasingly Prescribed for Anxiety, posted by herpills on September 9, 2011, at 21:47:22
The dosages of AAPs used to treat anxiety are much lower than typical neuroleptic dosages. Risperidone for example might rarely get over 1mg. So the risk of EPS and for weight gain and developing diabetes is less, but still greatly heightened.
When I took benzos for my anxiety I never felt that anything more than the surface anxiety symptoms were reduced. Like my body would relax and my startle response would decrease, and there would be a lot less sweating and trembling. But it's like the thoughts themselves would still be whirling around in my head. Only on ADs and AAPs have I ever felt that the thoughts themselves were decreasing. Also I never felt like I was getting 'better' on benzos; if I missed one or two doses the anxiety would be bad as ever. Withdrawing from years-long use was not fun. But still, after almost ten years of untreated anxiety Xanax felt like a miracle first-time I took it. It just didn't pan out as a long-term solution
For some anxiety conditions like panic attacks benzos should be first-line treatments, as well as for people with untreated debilitating anxiety. But for certain people with stuff like social phobia with the abnormal paranoid thoughts and neurotic (old fashioned term I know) thinking, APs might produce a better long-term response.
Posted by linkadge on September 13, 2011, at 20:06:54
In reply to Re: Antipsychotics Increasingly Prescribed for Anxiety yuck, posted by JONO_IN_ADELAIDE on September 11, 2011, at 19:52:50
Risperdal will hit the d2 receptors at any dose.
Yes, it has a higher affinity for the 5-ht2 receptors, but it still will block the d2 receptors (to varying extents) at all doses.
Linkadge
Posted by linkadge on September 13, 2011, at 20:11:55
In reply to Re: Antipsychotics Increasingly Prescribed for Anxiety, posted by hyperfocus on September 12, 2011, at 16:41:11
>Also I never felt like I was getting 'better' on benzos; if I missed one or two doses the anxiety would be bad as ever.
To each his own. I never felt like I was getting better on SSRIs or AP's. It just feels like my emotions are numbed and I'm not anxious because I don't care about anything. With the benzos, I still feel like me, and I don't feel like my regular drives are significantly lessened. For instacne, on SSRI's I don't care to play the piano any more. On a bit of lorazepam, I still enjoy playing the piano, and I can focus on it without the crippling anxiety.
>Withdrawing from years-long use was not fun.Neither is it for SSRI's. It took me a year for my brain to recover from getting off celexa. I experienced acute psychosis during withdrawl. Benzo withdrawl just makes me anxious, but it doesn't turn my world upside down.
>Xanax felt like a miracle first-time I took it. >It just didn't pan out as a long-term solution
SSRIs / APS's were not a long term solution for me either. I just became an apathetic zombie.
Linakdge
Posted by Phillipa on September 13, 2011, at 21:29:40
In reply to Re: Antipsychotics Increasingly Prescribed for Anxiety » hyperfocus, posted by linkadge on September 13, 2011, at 20:11:55
Agree benzos felt normal always. Phillipa
Posted by Zyprexa on September 17, 2011, at 22:33:40
In reply to Re: Antipsychotics Increasingly Prescribed for Anxiety, posted by Phillipa on September 13, 2011, at 21:29:40
I find APs great for anxiety! Better to take something that does not have addiction potential. Plus I'm psychotic, so they have that benifit too. Plus APs don't lose effectiveness over time.
Posted by linkadge on September 18, 2011, at 6:00:23
In reply to Re: Antipsychotics Increasingly Prescribed for Anxiety, posted by Zyprexa on September 17, 2011, at 22:33:40
>I find APs great for anxiety! Better to take >something that does not have addiction >potential. Plus I'm psychotic, so they have that >benifit too. Plus APs don't lose effectiveness >over time.
Uh....everything has addiction potential!! The number of times I have heard of people coming on here having a heck of a time getting off zyprexa.
Anyhow, AP's can lose their effectiveness over time and in animal models they lead to brain shrinkage.Linkadge
Posted by SLS on September 18, 2011, at 6:49:48
In reply to Re: Antipsychotics Increasingly Prescribed for Anxiety » Zyprexa, posted by linkadge on September 18, 2011, at 6:00:23
> Anyhow, AP's can lose their effectiveness over time and in animal models they lead to brain shrinkage.
>
> Linkadge
Is there any speculation as to what the mechanisms are for APs causing brain shrinkage? Any mitochondrial stuff going on? How might Abilify compare to other APs regarding brain shrinkage; understanding that it is a partial agonist of D2 and 5-HT1a receptors?Thanks.
I guess you know by now that I discontinued Nardil once again for lack of a lasting robust improvement. The drug that I will be using to replace it with is Viibryd (vilazodone). I am going into this thing virtually blind in that I am not going to speculate what are its chances of working based upon what is known about the drug's mechanisms. I know that it is a SRI and 5-HT1a partial agonist, but I don't know what else it might do. My only concern is that both Abilify and Viibryd act as partial agonists of 5-HT1a receptors. Perhaps the two drugs bind selectively at different receptor populations (somato-dendrytic autoreceptors versus postsynaptic excititory receptors).
Currently:
nortriptyline 150mg
Lamictal 200mg
Abilify 10mg
lithium 300mg* To add Viibryd 40mg in 7 days.
- Scott
Posted by Phillipa on September 18, 2011, at 19:35:04
In reply to Re: Antipsychotics Increasingly Prescribed for Anxiety » linkadge, posted by SLS on September 18, 2011, at 6:49:48
Scott how is the withdrawal going and have a feeling this might be the right combo. Fingers and toes crossed!!!! Phillipa
Posted by SLS on September 18, 2011, at 19:57:27
In reply to Re: Antipsychotics Increasingly Prescribed for Anxiety » SLS, posted by Phillipa on September 18, 2011, at 19:35:04
> Scott how is the withdrawal going and have a feeling this might be the right combo. Fingers and toes crossed!!!! Phillipa
Some mild brain-zap sensations and GI upset, but not too bad. My mood has begun to deteriorate, but is not yet what I would consider to be a total relapse. I have almost no appetite, and have lost a few pounds. I imagine my appetite will recover as time passes, but it is nice not to fight constant food cravings.
- Scott
Posted by Phillipa on September 18, 2011, at 23:21:57
In reply to Re: Antipsychotics Increasingly Prescribed for Anxiety » Phillipa, posted by SLS on September 18, 2011, at 19:57:27
Scott you must eat well. Good ratio of proteins, to carbohydrates, fruits, and vegetables. As you know!!!! Phillipa
This is the end of the thread.
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