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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 8 of 8. This is the beginning of the thread.
Posted by LouisianaSportsman on March 17, 2014, at 3:24:54
I believe that Xanax XR would be a superior ancillary for my current gabapentin therapy. Xanax XR is the only benzodiazepine medication with an extended-release mechanism. There are no other alternatives in this class that are designated for all-day amelioration of my anxiety symptoms.
One of the main concerns proposed is the abuse potential of this medication. It is an extended-release medication, and I realize that I need it. If I were to over-medicate, then I would be hurting myself in the future which is just stupid.
This medicine, all I'm wanting is 1mg. to take QAM would momentously improve my quality of life, I feel like. I would not abuse this medication under any circumstance ever. I do not have a substance problem, and I take all medication as prescribed.
I have summarized information from my readings of the research. The drug is amazing for patients like me. I've read that you can take it in the morning for all day anxiety relief. Im hoping that this medication could get rid of the weird, anxious nervous feeling (I've had it before Adderall) that I sometimes get during the day when I think too existentially.Im also hoping the extended-release alprazolam will help me out in social situations and not think about a car crash every time that Im driving.
Suggested Dosage: #30 1mg. XANAX XR CIV (alprazolam)extended-release tablets
This is a low dose, but conservatism is necessary with benzodiazepines. Is 1mg. enough to last through the daytime (8-5)? Or should I get #60 1mg. or #90 0.5mg.?
Via PI:
"Xanax XR Dosage and Administration:
Xanax XR Tablets may be administered once daily, preferably in the morning. The suggested total daily dose ranges between 3 to 6 mg/day. There will be some patients who require doses greater than 6 mg/day. In such cases, dosage should be increased cautiously to avoid adverse effects."What do you think about Xanax XR?
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I AM GOING TO POST MY RESPONSE TO: http://www.dr-bob.org/babble/20140307/msgs/1062360.htmlBELOW DUE TO GREATER VISIBILITY, ERIC YOU CAN RESPOND HERE:
---------------------Extremely b*d*ss post, Eric! It's about time somebody has given me some real talk.
>
> I'm a big fan of amphetamines. They help with executive function, mood and even some anxiety disorders (OCD). If anytyhing, I'd recommend 70 mg of Vyvanse, which just lasts longer.
>
Im not sure about your Vyvanse suggestion because 70mg = 30mg. IR which is half of what Im prescribed now. Once you go IR, youll never go back. Yes, I can see the advantages of a brand-name pure dexamp over the salts, but I feel like Adderall/Dexedrine IR is the best therapy. Its also a slightly modified response to the effect of the time-released amphetamine too because it is all at once; that neurologic feel is superior to eliminate symptoms.>
> Odd number there. With the amphetamines on board it gets difficult to recommend bupropion, but there's no denying it can help with mood. I'd do a quick check and go off it for a bit to see if it really makes a difference.
>
Im considering going off of it. It also effects with my metabolism of Brintellix significantly.>
> I made it to 20 mg before I started puking all over the place. This is an awesome drug for anxiety - 5ht1d antagonism, 5ht3a antagonism, 5ht1b agonism, 5ht1a agonism, 5ht7 antagonism. I had an amelioration of my OCD about 4 weeks into the drug. However, it didn't seem to impact my mood in 6 weeks. Maybe if I'd stayed on it longer...
>
Im thinking about staying at 10mg. since Im responding well and the studies dont show much of a difference. Also, Im taking bupropion and a half dose is suggested anyway with that. This drug is a potent anxiolytic. Day 15 and I know I am getting anxiety relief that is not placebo. I am also feeling less depressed, but Im not sure vortioxetine is the culprit, lol.>
> I like Geodon more-it has a lot of the same mechanisms of action as Brintellix and is an SNRI to boot. BUT, Latuda gets the job done and helps with anxiety at higher doses (120-160 mg).
>
Im sorry, Eric, but I like Brintellix way better than the dirty, off-label drug, Geodon. Geodon does indeed possess NE activity, which is interesting vortioxetine is strictly serotoninergic and reuptakes SERT (5-HT) 1.6 nM, compared to ziprasidones effort of 53 nM. Geodon lacks Brintellixs novel 5-HT3 modulation (same receptor that lamotrigine effects). Also, while I would say that Brintellix is notorious for nausea, the potential side effects of Geodon are more severe.
In studies, higher doses Latuda were not significantly more effective than the lower doses. How do you know it helps with anxiety at such significant levels before I titrate up tho? Of all psychiatric medications I have taken, I have responded well to Latuda. Its my perfect everyday AAP.
I feel like Im living in the future because Brintellix and Latuda both effect 5-H7 receptors which is all the hype lately, and Brintellix also shares 5-HT3 actions like my prescribed Lamictal. Teammates!
I really think the combination of Lamictal + Brintellix + Latuda will become popular for people suffering from bipolar depression.
Rightly so.
>
> Fun, fun. What do you need this for?
>
Alert, ADHD, Awake, Active>
> That's a lot of anticonvulsant and I'd be worried about what depressive effects the some total is having. Topamax is probably only contributing side effects at that dose (and maybe preventing migraines).
>
I need the topiramate to help me lose weight.
>
> If your looking for more mood stabilization because you're taking more antidepressant, I would first look at increasing your antipsychotic. That will reduce mania and OCD symptoms.
>
I agree, but lurasidone just doesnt seem to be aggressive enough. But, Im gonna read some of the schizophrenia trials later and see.>
> Otherwise, I'd go for 400 mg on the Lamictal-the higher you go with lamictal the better the mood stabilization. Something to do with the potentials of sodium channels...I had a cool pdf around her somewhere...
>
I wish you could find it? Can you find it now? So, I really need to DOUBLE the suggested dosage?
>
> Neurontin will provide some mood stabilization and some relief from anxiety-as a glutamate antagonist it will also reduce your OCD. Can you tolerate it at 2400 mg?
>
Absolutely, its just that I was being realistic about my PDOCC. Id love 3,600mg. honestly.
>
> try 400, unless your moving that way slowly.
>
I might titrate up to that point.
>
> The difference between 1200 and 1600 mg is nil. You really need to double it to feel results.
>
I agree, but I was just being realistic since my PDOC probably wont double it immediately.> I'd just drop the Tokendi XR
> This is true, but we're talking about Dopomax here.
>
It really depends on the patient. Am I dumb to you? Youve suggest Zonegran in another thread which is probably worse than topiramate in terms of executive function. .
>
>> Trileptal just doesn't have the 'zing' of Lamictal.
Lamotrigine, imo, should be on a higher-tier than Trileptal, youre correct.
>
> Eric
>REFERENCE, ACTUAL CURRENT REGIMEN AS FOLLOWS:
Adderall IR (amphetamine salts) 60mg.;
Aplenzin (bupropion hydrobromide) 522mg.;
Brintellix (vortioxetine) 10mg.;
Lamictal (lamotrigine) 200mg.;
Latuda (lurasidone) 80mg.;
Nuvigil (armodafinil) 250mg.;
Neurontin (gabapentin) 1,200mg.;
Trokendi XR (topiramate extended-release) 100mg.in a few months time...
Adderall IR (amphetamine salts) 60mg.;
Brintellix (vortioxetine) 20mg.;
Lamictal (lamotrigine) 300mg.;
Latuda (lurasidone) 120mg.;
Nuvigil (armodafinil) 250mg.;
Neurontin (gabapentin) 2,400mg.;
Trokendi XR (topiramate extended-release) 200mg.
Xanax XR (alprazolam extended-release) 1mg.# Replace bupropion with alprazolam ER 1mg.
# Increase vortioxetine to 20mg.
# Increase lamotrigine to 300mg.
# Increase lurasidone to 120mg.
# Increase gabapentin to 2,400mg.(I do not believe the PDOC will allow 400mg. of lamotrigine.)
--------------------------------------------------Anyways, it boils down to your thoughts about anything Xanax XR and my meds.
Thoughts? Opinions? Advice?
I <3 community and its input!
Posted by Phillipa on March 17, 2014, at 9:44:49
In reply to Xanax XR Proposal/ERIC (Phidippus) Med Regimen RE., posted by LouisianaSportsman on March 17, 2014, at 3:24:54
Not sure what you are asking. So much information. Phillipa
Posted by rjlockhart37 on March 17, 2014, at 11:10:52
In reply to Xanax XR Proposal/ERIC (Phidippus) Med Regimen RE., posted by LouisianaSportsman on March 17, 2014, at 3:24:54
goodness that cocktail is intense, wished i was on it......the cocktail im on right now is not pleasant.....but yea 60mg of adderall with nuvigil 250, im so sick of my doctor putting me on moodstablizers at maxed doses...
need to find another doctor....
Posted by rjlockhart37 on March 17, 2014, at 11:16:45
In reply to Xanax XR Proposal/ERIC (Phidippus) Med Regimen RE., posted by LouisianaSportsman on March 17, 2014, at 3:24:54
i've been on xanax xr.....3mg tablet, it doenst all hit at once, it's more like .5mg released through the day.....you can increase it to 6mg but it is vary sedating at that....but if you take adderall and nuvigil ... that won't be a problem....
it's just diffrent from regular xanax, it's hard to explain, the feeling is diffrent....its more passive, less direct than regular xana....
it would really be good med for you, xanax ir is for panic attacks and need to calm people down, xr is all day....like phenobarbital....
r
Posted by phidippus on March 17, 2014, at 14:19:29
In reply to Xanax XR Proposal/ERIC (Phidippus) Med Regimen RE., posted by LouisianaSportsman on March 17, 2014, at 3:24:54
> One of the main concerns proposed is the abuse potential of this medication.
Do you get high off it? If you don't, I doubt you'll become addicted to it.
>Im hoping that this medication could get rid of the weird, anxious nervous feeling (I've had it before Adderall) that I sometimes get during the day when I think too existentially. anxiety relief.
What sort of existential worries do you have? Are they recurrent in nature?
> What do you think about Xanax XR?
I don't like benzos overall, but they get the job done.
> Im not sure about your Vyvanse suggestion because 70mg = 30mg. IR which is half of what Im
prescribed now.I thought 70 mg Vyvanse = 60 mg Adderall IR
>neurologic feel is superior to eliminate symptoms.
Maybe I'll have to revisit Adderall
>
> >
> > I like Geodon more-it has a lot of the same mechanisms of action as Brintellix and is an SNRI to boot. BUT, Latuda gets the job done and helps with anxiety at higher doses (120-160 mg).> In studies, higher doses Latuda were not significantly more effective than the lower doses. How do you know it helps with anxiety at such significant levels before I titrate up tho?
Two psychiatrist friends I know read studies and relayed the results to me - one was in a journal.
> Alert, ADHD, Awake, Active
I don't think their are any studies that show Nuvigil helps ADHD.
> I wish you could find it? Can you find it now? So, I really need to DOUBLE the suggested dosage?
Csn't find it, but did found some conflicting evidence: "In the clinical trials, doses up to 400 mg/day as monotherapy were evaluated; however, no additional benefit was seen at 400 mg/day compared with 200 mg/day" - rxlist.com
> I agree, but I was just being realistic since my PDOC probably wont double it immediately.doesn't hurt to try.
>Am I dumb to you?
Hardly
>Youve suggest Zonegran in another thread which is probably worse than topiramate in terms of executive function.
They're about the same.
> Anyways, it boils down to your thoughts about anything Xanax XR and my meds.
>
> Thoughts? Opinions? Advice?Xanax does nothing for OCD
Eric
Posted by Beckett on March 17, 2014, at 21:49:20
In reply to Xanax XR Proposal/ERIC (Phidippus) Med Regimen RE., posted by LouisianaSportsman on March 17, 2014, at 3:24:54
It's possible to dose XanaxXR twice a day. They come in 0.5 mg as well. I took it that way.
Honestly, I think Xanax is insidious. The rebound from it is fierce. But iI found it fairly transparent, which is a plus if you're thinking of adding benzodiazepine.
Posted by LouisianaSportsman on March 17, 2014, at 22:55:55
In reply to Re: Xanax XR Proposal/ERIC (Phidippus) Med Regimen RE. » LouisianaSportsman, posted by Beckett on March 17, 2014, at 21:49:20
> It's possible to dose XanaxXR twice a day. They come in 0.5 mg as well. I took it that way.
>
> Honestly, I think Xanax is insidious. The rebound from it is fierce. But iI found it fairly transparent, which is a plus if you're thinking of adding benzodiazepine.Great information,Beckett! Thanks for sharing. This is exactly what I was looking for.
I think #60 0.5mg. BID would be better, I'll see if that's a realistic starter dose.
Cool.
Posted by LouisianaSportsman on March 17, 2014, at 22:59:32
In reply to Re: Xanax XR Proposal/ERIC (Phidippus) Med Regimen RE. » LouisianaSportsman, posted by rjlockhart37 on March 17, 2014, at 11:16:45
> i've been on xanax xr.....3mg tablet, it doenst all hit at once, it's more like .5mg released through the day.....you can increase it to 6mg but it is vary sedating at that....but if you take adderall and nuvigil ... that won't be a problem....
>
> it's just diffrent from regular xanax, it's hard to explain, the feeling is diffrent....its more passive, less direct than regular xana....
>
> it would really be good med for you, xanax ir is for panic attacks and need to calm people down, xr is all day....like phenobarbital....
>
> rI like the personal description of the medication. Is it similar to how Adderall ER and Adderll IR are different in feel?
This is the end of the thread.
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