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Dr. Bob is Robert Hsiung, MD,
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Posted by phidippus on September 30, 2012, at 14:45:43
In reply to Re: I'm done with benzos. What else can I use? » SLS, posted by ChicagoKat on September 30, 2012, at 10:57:34
I get a drug rash from Gabapentin, however I do fine on Lyrica. Maybe I should try it again.
Eric
Posted by phidippus on September 30, 2012, at 14:48:43
In reply to Re: I'm done with benzos. What else can I use? » jono_in_adelaide, posted by SLS on September 30, 2012, at 8:14:52
I use Hydroxyzine as a sleep aid, but nothing more. I don't find its anxiolytic effect strong enough.
I've been on Buspar. It did nothing for me.
Eric
Posted by phidippus on September 30, 2012, at 14:51:57
In reply to Re: I'm done with benzos. What else can I use?, posted by jono_in_adelaide on September 30, 2012, at 5:45:03
I use hydroxyzine to help me sleep. Its isn't strong enough to use PRN for anxiety.
Buspar did nothing for me.
I was on Melleril as a kid.
Eric
Posted by phidippus on September 30, 2012, at 14:52:51
In reply to Re: I'm done with benzos. What else can I use?, posted by vbs on September 30, 2012, at 0:57:39
Thanks
Eric
Posted by phidippus on September 30, 2012, at 14:59:15
In reply to Re: I'm done with benzos. What else can I use?, posted by jono_in_adelaide on September 30, 2012, at 0:18:23
Gabapentin and Pregablin take effect right away. I've been on Lyrica before. It worked alright for anxiety. Just wish I could take it PRN.
Eric
Posted by phidippus on September 30, 2012, at 15:09:10
In reply to Re: I'm done with benzos. What else can I use? » phidippus, posted by SLS on September 29, 2012, at 23:08:05
about Promethazine:
"Also used to potentiate any opiates. Commonly combined with pethidine (AKA, meperidine, or Demerol) in a brand called Mepergan, a meperidine/promethazine combination. Also frequently used in conjunction with codeine, in a syrup form. The combination leads to more powerful euphoric effects than with codeine alone"-wikipedia.
I take 50 mg of Oxycodone almost every day. How would Promethazine affect me?
I have taken Gabapentin before-I got a drug rash. Lyrica I had no problems with.
Seroquel just makes me sleepy.
I'm curious to see if Geodon works. I've never found an atypical antipsychotic to be anxiolitic.
Eric
Posted by phidippus on September 30, 2012, at 15:12:01
In reply to Re: I'm done with benzos. What else can I use?, posted by Beckett on September 29, 2012, at 22:36:26
May I ask how you managed to kick the klonopin so quickly?
It took me a couple weeks to get down to 1 mg, then I just stopped it. No tricks.
Eric
Posted by SLS on September 30, 2012, at 15:12:11
In reply to Re: I'm done with benzos. What else can I use? » SLS, posted by ChicagoKat on September 30, 2012, at 10:57:34
Hi Kat.
> 1. For the most part you are all avoiding my suggestion of gabapentin.
Actually, I think several posts (including one of mine) are in agreement with your suggestion.
> 2. As far as "atypicals" go, I don't believe they are really so atypical. I don't believe they really cause that much less EPS.
You might be right. However, what I have encountered in the medical literature suggests that the differences in the occurrence of EPS - especially TD - are rather large; with SGAs being far less liable to produce these effects than the FGAs.
> I know I had akathisia while on Zyprexa, and I've heard horror stories from many other people too.
It seems to me that EPS is an infrequent occurrence on Psycho-Babble; this, despite the observation that EPS is more common among people with bipolar disorder than those with schizophrenia. I don't think most unaffected people will go out of their way to spontaneously post on Internet forums that they are not experiencing EPS.
> I really believe, except for the people who really need them, that they are a dangerous class of drugs and not to be messed around with.
I used to think that any AP was devilishly dangerous.
When should an AP not be used, in your opinion?
> 3. Buspar does indeed take weeks, if not months to work. I tried it and it did squat for me. I believe it is simply a hyped-up SSRI.
Like most other psychotropics, individual reactions to Buspar can be highly variable. Some people have reported here that Buspar has been the best anxiolytic that they had ever taken. I never tried it. For quite some time, it was thought that prior exposure to a BZD rendered Buspar less effective. I don't think this notion has been substantiated scientifically. I'm not sure, though.
- Scott
Posted by phidippus on September 30, 2012, at 15:14:19
In reply to Re: I'm done with benzos. What else can I use? » phidippus, posted by phillipa on September 29, 2012, at 21:28:31
Klonopin was making me depressed. It seems every benzo I try I just get paradoxical reactions. I'm sick of it. I need something else.
Eric
Posted by phidippus on September 30, 2012, at 15:16:42
In reply to Re: I'm done with benzos. What else can I use?, posted by jono_in_adelaide on September 30, 2012, at 0:31:13
Interesting, I might try this.
Eric
Posted by ChicagoKat on September 30, 2012, at 16:09:52
In reply to Re: I'm done with benzos. What else can I use? » jono_in_adelaide, posted by phidippus on September 30, 2012, at 14:59:15
> Gabapentin and Pregablin take effect right away. I've been on Lyrica before. It worked alright for anxiety. Just wish I could take it PRN.
>
> EricJust FYI Eric, I took Lyrica, and it worked, but not as well as Neurontin (for me, anyway), and it seemed to make my depression worse. but again, that's just for me, you may have a different experience. And I surely didn't take it prn, I had no idea I couldn't, even though the pdoc did write for an interval....I never pay attention to those. bad me....ha ha. but anyways, I never had any trouble taking it prn, just so you know. Good luck.
Kat
p.s. I do take things at interval that I KNOW should be taken at whatever interval they are written for. But I know which drugs I can just ignore that interval with....I AM a pharmacist, after all :)
Posted by ChicagoKat on September 30, 2012, at 16:14:28
In reply to Re: I'm done with benzos. What else can I use?, posted by phidippus on September 30, 2012, at 15:09:10
> about Promethazine:
>
> "Also used to potentiate any opiates. Commonly combined with pethidine (AKA, meperidine, or Demerol) in a brand called Mepergan, a meperidine/promethazine combination. Also frequently used in conjunction with codeine, in a syrup form. The combination leads to more powerful euphoric effects than with codeine alone"-wikipedia.
>
> I take 50 mg of Oxycodone almost every day. How would Promethazine affect me?
>
> I have taken Gabapentin before-I got a drug rash. Lyrica I had no problems with.
>
> Seroquel just makes me sleepy.
>
> I'm curious to see if Geodon works. I've never found an atypical antipsychotic to be anxiolitic.
>
> Eric
>
>
>
Eric, just another FYI, I'd warn you to stay away from Phergan...it can have some pretty nasty side effects, especially when mixed with the drugs you are taking. And again, I'd warn you against the Geodon, b/c I think antipsychotics, be they "atiypical" or not can have some really nasty side effects and be downright dangerous in certain conditions. The drugs you are on makes me urge this warning to you even more strongly.
Kat
Posted by ChicagoKat on September 30, 2012, at 16:43:55
In reply to Re: I'm done with benzos. What else can I use?, posted by SLS on September 30, 2012, at 15:12:11
> Hi Kat.
>
> > 1. For the most part you are all avoiding my suggestion of gabapentin.
>
> Actually, I think several posts (including one of mine) are in agreement with your suggestion.
>
> > 2. As far as "atypicals" go, I don't believe they are really so atypical. I don't believe they really cause that much less EPS.
>
> You might be right. However, what I have encountered in the medical literature suggests that the differences in the occurrence of EPS - especially TD - are rather large; with SGAs being far less liable to produce these effects than the FGAs.
>
> > I know I had akathisia while on Zyprexa, and I've heard horror stories from many other people too.
>
> It seems to me that EPS is an infrequent occurrence on Psycho-Babble; this, despite the observation that EPS is more common among people with bipolar disorder than those with schizophrenia. I don't think most unaffected people will go out of their way to spontaneously post on Internet forums that they are not experiencing EPS.
>
> > I really believe, except for the people who really need them, that they are a dangerous class of drugs and not to be messed around with.
>
> I used to think that any AP was devilishly dangerous.
>
> When should an AP not be used, in your opinion?Oh, I believe antipsychotics should be used for certain, but only in people in whom I believe the benefit outweighs the risk. I'm talking of people with schizophrenia or bipolar individuals who experience psyshotic episodes. I think the antipsychotics are very useful in those incidences. But using them for other purposes..to augment depression treatment, to help with sleep I see as using a cannon when a simple gun will suffice. Let's face it..all antipsychotics carry the risk of EPS, including the atypicals, and as you well know, some of those effects, especially TD, is irreversible. So why expose people to such a very real and very bad risk when it's not necessary? Of course, I may be biased b/c of my experience with akathisia which went on for an entire hellish summer. At the time I just thought it was worsening of my condition, that my anxiety was getting worse. Then I noticed how much pacing I was/had been doing and got to thinking about it. The minute I stopped Zyprexa is when that HELL went away. And, let's face too, that a LOT of people may experience akathisia from antipsychotics, atypical or not, and will do the same thing I did: think it's just a worsening of their anxiety and will never imagine it's actually akathisia caused by the AP they are taking. I was lucky I knew more about the subject, but it took even me months to pick up on it, and my pdoc at the time (a different one than I have now..my current one would have picked it up in an instant)..anyways even my super-highly trained, supposedly incredibly knowledgeable pdoc never even suspected it.
Anyways that is a long post ( as usual, from me!) to let you know why I don't think APs should be used so casually, even if they are atypical, b/c I experienced a nightmare from one, I expect many innocent people are experiencing the same nightmare right now b/c of them, and I have heard lots of other horror stories, and I think more will come out. I just don't believe the atypicals are as free from EPS as the manufacturers have led us to believe. But, of course, I believe 100% in their use in those who truly need them, be they atypicals or not.
Oh - and I certainly believe in the use of chlorpromazine in the treatment of SS.OK, end of rant. Guess that's why there's a forum; it provides info, but it also gives us space to disagree in a (hopefully) respectful way. b/c I truly do respect your knowledge and opinions on this board. Just not when it comes to this topic. Hope you are feeling better!
Kat
>
> > 3. Buspar does indeed take weeks, if not months to work. I tried it and it did squat for me. I believe it is simply a hyped-up SSRI.
>
> Like most other psychotropics, individual reactions to Buspar can be highly variable. Some people have reported here that Buspar has been the best anxiolytic that they had ever taken. I never tried it. For quite some time, it was thought that prior exposure to a BZD rendered Buspar less effective. I don't think this notion has been substantiated scientifically. I'm not sure, though.I concede your points on Buspar. I guess I tend to get negative on things that didn't work for me, but that is very wrong of me b/c the brain is so not understood, it is like the universe in the way we don't understand it, and everyone reacts differently to different psyhotropics. So I concede your point that Buspar may indeed be very effective for some, even though it is certainly true it takes weeks to work.
>
>
> - Scott
Posted by jono_in_adelaide on September 30, 2012, at 17:38:49
In reply to Re: I'm done with benzos. What else can I use? » jono_in_adelaide, posted by SLS on September 30, 2012, at 8:14:52
No, I think Buspar would have to be taken twice daily on an ongoing basis, not PRN
Atarax/Vistaril could be taken PRN, but would probably be more effective if taken regularly, with perhaps an extra PRN dose when needed.
One I didnt think of at fiorst that would again need to be taken each day would be mirtazapine - as well as being a robust antidepressant, it has a potent antianxiety effect, I think that he should try Atarax, Buspar and Mirtazapine alone and in combination before going down the path of geodon or any other atypical.
I'm glad I have a good response to benzos, and no tolorance/dependence issues, it makes things so much easier!
> > You may well be right scott, but given that he has failed on numerous benzos, his options seem to be hydroxyzine, buspar, or failing that, one of the atypicals..... and I thought of geodon because it has less sedative and metabolic effects than the others, and (as per that study) has some evidence base for PRN use in anxiety.
> >
> > I think his first option should be Atarax or Buspar, and his second option should be Atarax + Buspar, with an atypical comming a distant third'
> >
> > For what its worth, Melleril would have been good in this situation, but unfortunatly it is no more
>
>
> I think your reasons for choosing Geodon are good ones.
>
> Do you think Buspar can be used as a PRN? I thought that it takes a few weeks to begin working.
>
>
> - Scott
Posted by brynb on September 30, 2012, at 17:50:51
In reply to I'm done with benzos. What else can I use?, posted by phidippus on September 29, 2012, at 17:48:43
> Benzos just make me depressed. I just came off 2mg of Klonopin and felt much brighter. What else can I use PRN for anxiety?
>
> EricHey Eric,
This is an issue I've been dealing with. Nothing works on anxiety like benzos.
What about Suboxone or Subutex (at a low dose)? I'm thinking aloud here; I used these to come off benzos before and found them helpful.
-b
Posted by jono_in_adelaide on September 30, 2012, at 18:04:48
In reply to Re: I'm done with benzos. SLS, posted by jono_in_adelaide on September 30, 2012, at 17:38:49
Just to clarify my thoughts and distil them into one post, I'd suggest trying:
1. Buspar taken regularly twice a day or Atarax taken either regularly three times a day or PRN
2. Mirtazapine 30mg at bedtime regularly
3. Mirtazapine or Atarax plus Buspar
4. (last choice) Geodon or another low dose atypical
Posted by phidippus on September 30, 2012, at 18:30:16
In reply to Re: I'm done with benzos. What else can I use? » phidippus, posted by brynb on September 30, 2012, at 17:50:51
I used to take Buprenorphine. It never imparted an anxiolitic effect.
Eric
Posted by phillipa on September 30, 2012, at 19:10:04
In reply to Re: I'm done with benzos. What else can I use? » brynb, posted by phidippus on September 30, 2012, at 18:30:16
If lyrica worked go with this med? Phillipa
Posted by phidippus on September 30, 2012, at 19:16:43
In reply to Re: I'm done with benzos. What else can I use? » phidippus, posted by phillipa on September 30, 2012, at 19:10:04
I don't think Lyrica was strong enough.
Eric
Posted by jono_in_adelaide on September 30, 2012, at 21:23:48
In reply to Re: I'm done with benzos. What else can I use? » phillipa, posted by phidippus on September 30, 2012, at 19:16:43
Lyrica is generaly more postet than gabapentin, if Lyrica didnt cut it its extremely unlikely that gabapentin will
Eric - thinking it through, I'd suggest that you try
Atarax/Vistaril
Buspar
Remeron
of these, you can take Atarax prn, the other two you'd need to take regularly
and if none of these cut it, then try a low dose atypical (I found risperidone 0.5-1mg at night very helpful and almost no side effects)
Posted by gadchik on October 1, 2012, at 9:47:25
In reply to Re: I'm done with benzos. What else can I use? » Beckett, posted by phidippus on September 30, 2012, at 15:12:01
I dont know how you went from 1mg to nothing. But you're a lucky guy to be able to do that. Your brain must snap back(plasticity?) easily.
Posted by phidippus on October 1, 2012, at 13:07:30
In reply to Re: I'm done with benzos. What else can I use?, posted by jono_in_adelaide on September 30, 2012, at 21:23:48
Atarax I use to sleep.
I've taken Mirtazapine before it and did a good job of treating my OCD. Do you think 15 mg would be sufficient?
Thanks for your suggestions.
Eric
Posted by jono_in_adelaide on October 1, 2012, at 18:14:42
In reply to Re: I'm done with benzos. What else can I use? » jono_in_adelaide, posted by phidippus on October 1, 2012, at 13:07:30
I'd probably go 30, but thats just me.... you need to find the dose that sits well with you.
Mirtazapine has strong anxiolytic effects (because of its action at the 5HT2 receptors among others)
If it also helps your depression and OCD, I'd say this might be the one to go for.
Best of luck
Posted by ChicagoKat on October 4, 2012, at 10:28:55
In reply to Re: I'm done with benzos. What else can I use?, posted by jono_in_adelaide on October 1, 2012, at 18:14:42
> I'd probably go 30, but thats just me.... you need to find the dose that sits well with you.
>
> Mirtazapine has strong anxiolytic effects (because of its action at the 5HT2 receptors among others)
>
> If it also helps your depression and OCD, I'd say this might be the one to go for.
>
> Best of luckOne interesting fact about Remeron: It tends to cause more sedation at lower doses. So if you are using it as a sleep, anti/anxiety aid, stick with a lower does, 15mg or even lower. But if you are using it for depression, it's OK to go higher and of course it can then be more effective, and it can be good to be more free of the sedation side effect.
Kat
Posted by CaffeinePoet on October 6, 2012, at 13:01:14
In reply to I'm done with benzos. What else can I use?, posted by phidippus on September 29, 2012, at 17:48:43
Based on my experience, buspirone can be used either prn or daily. It doesn't work for everyone, and some are skeptical that it works after benzos.
I have GAD as well and buspirone has worked for me after klonopin.
This is the end of the thread.
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