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Dr. Bob is Robert Hsiung, MD,
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Posted by corafree on February 21, 2006, at 4:43:11
In reply to Re: best med for GAD? » corafree, posted by Ljoltof on February 20, 2006, at 22:36:50
L -
I had police records of spouse tossing me about like a ragdoll, but PCP just ordered MRIs for a definite dx after I told him of the horrible pain.
When the injuries occurred, I didn't feel the 'real bad' pain right away, .. ya' know just sore a few days.
As aged, those injuries became more prominent, and left untreated, nerve rubbing against bone, pretty soon more damage done, and then it hit me hard approx 10yrs later. I recall when just wore warm wraps around my neck and took Excedrin. Forgive me if sharing this may scare you; may not happen w/ you. Also docs may be withholding re: your age, possibility pain temporary, or thinking 'let's wait until it gets worse .. he's young, strong, too early to start narcotics'.
I had no idea it would help anxiety until I first took one (duh), and don't think my psych dx was GAD then.
Darovocet became ineffective. Morphine yuch! I think Vicodin should be provided for break-though. Regimen w/ break-through is continue reg med as prescribed and another on top of it until it subsides.
So good to hear that the paradox can come and go; believe that's what you meant. I was hoping so, ... like break-through pain! Too bad my doc didn't help me or at least tell me this.
Your post was good and I printed it. I will look at again tomorrow sometime for reference and 'get back to ya' if I've missed something.
Some heart meds can lessen anxiety greatly also.
Tks for taking time and thought to help me.
bestwishes, cf
Posted by corafree on February 21, 2006, at 10:29:48
In reply to Re: best med for GAD? » corafree, posted by Ljoltof on February 20, 2006, at 22:36:50
L
My understanding that paradox can come and go; correct?
Would you pls explain/dispute the following re: your following statements?
>In my case, physical I will not ever believe that GAD can exist in a person without depression. It took me a while to face the depression as it's own entity, but looking back and adding it all up leads me to insist that I would not have gotten to the levels of depression I have seen without the GAD causing so much difficulty. Now add in some physical injuries (either before or after GAD/dep. onset) and the chronic pain becomes a major obstacle to everyday life as you very well know.<
Have you ever had 'a wonderful thing' occur in your life, alongside successful GAD treatment, and felt lifting of your depression? I have experienced the aforementioned. Does that mean I do not have GAD? I'd think that would disprove that depression always co-exists alongside GAD.
>I have received 0 rx pain pills to this point (mid 20's now) but I have had far too many psychiatric drugs thrown my way to start counting as I write this. Is it just me or is something wrong with that picture?<Are you saying docs don't validate physical pain because you are on psych meds, or (You can yell @ me if wrong!:) are you invalidating your pain for the same reason?
I'm slow on the uptake - overwhelmed right now'! Just called re: counseling, heard back; short staffed, so no! Ohhh, I'm feeling so tiny!! Need to talk very badly.
bestwishes, cf
Posted by ed_uk on February 21, 2006, at 14:19:59
In reply to Re: best med for GAD? » ed_uk, posted by corafree on February 21, 2006, at 4:11:01
Hi CF
Yes, both Elavil and Pamelor can be effective for chronic pain. Amitriptyline (Elavil) is normally taken as a single dose in the evening.
Ed x
Posted by corafree on February 21, 2006, at 14:39:53
In reply to Re: best med for GAD? » corafree, posted by ed_uk on February 21, 2006, at 14:19:59
Hi Ed! Are they both SSRIs? I do have IBS and am lactose intolerant.
tks and bw, cf
Posted by ed_uk on February 21, 2006, at 14:43:34
In reply to Re: best med for GAD? » ed_uk, posted by corafree on February 21, 2006, at 14:39:53
Hi CF
No, they are not SSRIs, they are tricyclic antidepressants. Amitriptyline (Elavil) and nortriptyline (Pamelor) can relieve the pain and diarrhea of IBS, but they do tend to cause constipation at high doses.
Ed
Posted by corafree on February 21, 2006, at 14:48:00
In reply to Re: best med for GAD? » corafree, posted by Phillipa on February 17, 2006, at 22:41:38
Me too 'my very good friend'!
I am seeing my new case manager today. I'll await excusing myself from P assigned to, until after visit with her and filling my Valium prescription.
!!! QUESTION FOR ALL !!!
Has anyone been on a dosage of Valium 10mg 3x a day and ever had to have it increased or replaced by something stronger? I would greatly appreciate anyone who is able to share, if they have done the above.
bestwishesPhillipa&All, cf
Posted by Ljoltof on February 22, 2006, at 12:20:59
In reply to Re: best med for GAD? » Phillipa, posted by corafree on February 21, 2006, at 14:48:00
Corafree! I had typed out a long and thought out response yesterday to the questions you had asked and somehow when I went to post everything was gone....grrrr! It was probably due to me using Safari (apple user here) ..I will try to re-do the post, except this time writing down on paper then typing. I can type very fast but over the years my ability to compose a message on the fly without getting too lengthy has diminished. See what I mean? Hah.
I'm glad you're getting some fresh help, I knew it'd happen. I have been on 10mg x 3/day Valium. My current script is written this way. However I take 10mg x 2/day right now because I'm doing the Klonopin taper. I will in less than a week be cutting another .5mg Klonopin down and taking probably 30-40mg V daily. My suggestion is to try for an increase in your Valium script. I really think Valium is a strong benzo, it's just that it's not as "compressed" as the other benzo's in it's composition. Plenty of people take between 2-4mg Klonopin daily. Using the common equivalency chart, 4mg K = 80mg Valium. I, for one am not afraid of big numbers in this case!
-Lj
> Me too 'my very good friend'!
>
> I am seeing my new case manager today. I'll await excusing myself from P assigned to, until after visit with her and filling my Valium prescription.
>
> !!! QUESTION FOR ALL !!!
>
> Has anyone been on a dosage of Valium 10mg 3x a day and ever had to have it increased or replaced by something stronger? I would greatly appreciate anyone who is able to share, if they have done the above.
>
> bestwishesPhillipa&All, cf
Posted by linkadge on February 22, 2006, at 13:31:43
In reply to Re: best med for GAD? » corafree, posted by Ljoltof on February 20, 2006, at 22:36:50
"I will not ever believe that GAD can exist in a person without depression. "
Based on my own life experiences, I think GAD can happen completely independantly of depression.
Right now, I still have some bad GAD, but my depressive symtpoms left me a long while back.
Linkadge
Posted by corafree on February 24, 2006, at 11:27:06
In reply to Re: best med for GAD? » corafree, posted by Ljoltof on February 22, 2006, at 12:20:59
L ..
I've had that happen too! I feel like, "I waste too much time on my own! Now my 'supposed to be devoted to me computer' is wasting more of it! (Makes ya' wanna take something out on something! Need a 'blow up hit me' stress gadget!)
Good to know that 40mg a day of Val is not out in left field; can be an acceptable dosage in strong anxiety. That's what I'm understanding.
Why did you and P decide to pull out the Klonopin? Oh, and can you explain the following in a bit more 'layman language' pls L?
I really think Valium is a strong benzo, it's just that it's not as "compressed" as the other benzo's in it's composition. Plenty of people take between 2-4mg Klonopin daily. Using the common equivalency chart, 4mg K = 80mg Valium. I, for one am not afraid of big numbers in this case!
tkssomuchbestwishes,cf Ha!
Posted by corafree on February 24, 2006, at 11:30:53
In reply to Re: best med for GAD? » corafree, posted by Ljoltof on February 22, 2006, at 12:20:59
Apologize for not copying and pasting your para' in proper < > or > <. cf
Posted by corafree on February 24, 2006, at 11:42:29
In reply to Re: best med for GAD? » corafree, posted by ed_uk on February 21, 2006, at 14:19:59
Ed - Haven't seen a P yet. I was asked what pdrugs I would or would not prefer to try or take again? I put Elavil and Pamelor on 'maybe try' list (tks to you). Are these drugs in the original class .. SSRIs? No .. what class? A P told me once that they don't prescribe much re: dietary restrictions. (Dejavu?) I also put 'Abilify' and 'Lyrica' on the 'maybe try' list. Pls respond if can. Got to get a new P now. Will begin work on that tomorrow. tkscf
Posted by Phillipa on February 24, 2006, at 19:04:39
In reply to Re: best med for GAD? » ed_uk, posted by corafree on February 24, 2006, at 11:42:29
Elavil and Pamelor are TCA's tricyclics. Pamelor definitely put me out one night and I felt like I was melted in the bed. Last and first time I ever took it and it was only l0mg. Fondly, Phillipa
Posted by corafree on February 27, 2006, at 9:08:03
In reply to Re: best med for GAD? » corafree, posted by Phillipa on February 24, 2006, at 19:04:39
I had a similar reaction to Elavil, but thought maybe 'brain chemistry' changed since then, approx. 15yrs back maybe. Never on Pamelor as far as can recall. Just thought 'worth a shot'. I wasn't sure what all to say when asked which meds I would take! I'd never had that question put to me before!? I'd, of course, d.c. anything that disagreed me w/ too rapidly.
tksforsharing, bestwishes cf
Posted by corafree on February 27, 2006, at 9:25:17
In reply to Re: best med for GAD? » Phillipa, posted by corafree on February 27, 2006, at 9:08:03
I've had bad break-through pain .. my back injuries. Been on med on-top-of-regular med.
After meeting w/ new case manager here in particular county system, I'm anxiously awaiting some HELP! Feel like I'm 'knocking on heaven's door' (don't want to go though tho') and having thoughts re: my own mortality.
They seem to be 'putting me' in the 'personality disorder' slot out here, whereas when left past REBA, they had me in the 'GAD' slot. (I'm in a large manilla envelope .. ha!)
Don't know why posting this for sure; think maybe just need know friends here 'have my back', so to speak.
These pain meds complicate my clarity, and hence my capability of being pro-active.
bw, cf
Posted by ed_uk on February 27, 2006, at 13:23:34
In reply to Re: best med for GAD? » ed_uk, posted by corafree on February 24, 2006, at 11:42:29
Hi CF
Elavil and Pamelor are not SSRIs, they belong to a group of meds called the tricyclics.
>A P told me once that they don't prescribe much re: dietary restrictions.
There are no dietary restritions with Elavil or Pamelor, you're thinking of a different class of drugs called the MAOIs.
What dose of Percocet are you taking at the moment?
Ed
Posted by corafree on February 27, 2006, at 14:53:41
In reply to Re: best med for GAD? » corafree, posted by ed_uk on February 27, 2006, at 13:23:34
Perc 10/650 3x a day, and when have break-through pain .. Vicodin 10mg on top. The BT pain usually lasts only a couple days, but this is a longer stint.
Am fine on the Perc 10/650 3x a day, but when take the Vicodin, my behavior is off .. get a "slam door kind of feeling, or an 'angry sort of feeling', not dangerous or anything, just can be short' w/ objects, people, i.e., "Didn't you get it the first time I said it?" Don't care for the Vicodin, but don't want to take morphine.
My anxiety 'stills' beneath the narcotics. Well, you know that, I think.
Awaiting too many, 'Can't the government get anything straight?', phone calls. This MOVE has turned my 'usage of every assistance program out there' upside down. I lost a telephone assistance program and learned I can never apply again in my lifetime! Crazy!
Tks for any input if wish, cf
Posted by ed_uk on February 27, 2006, at 17:23:16
In reply to Re: best med for GAD? » ed_uk, posted by corafree on February 27, 2006, at 14:53:41
Hi CF
Taking Vicodin on top of Percocet probably isn't a good idea, you'd be better off taking a higher dose of Percocet eg. 10/650 four times a day instead of three times a day.
Remember not to exceed the maximum dose of acetaminophen, since both Percocet and Vicodin contain acetaminophen.
Ed
Posted by corafree on February 27, 2006, at 18:48:12
In reply to Re: best med for GAD? » corafree, posted by ed_uk on February 27, 2006, at 17:23:16
Ed -
Yes you're right. But .. my PCP won't allow me to take 4x Perc.
I just awakened from nap and it is gone .. now if I'm really careful the rest of the eve', it should stay away.
I have gone to quite a few pain docs that say they'll not prescribe. That's an alley I'm not finished going down tho'. My prob is again $.
Awaited to hear from DES all day and no response from a supervisor that said she would check to see if I was entitled to a 'spin down'; med $ by way of food stamps for those in 'catch-22' area of our wonderful 'system'.
(I just went to kitchen .. couldn't remember the two words - spin down - .. recall easier if take mind off a minute. There I spilled ice cubes and chased them all over the room .. they're shaped aerodynamically, and when you try to grab one they fly away .. off to a great start!) bw, cf
Posted by chess on February 27, 2006, at 18:54:32
In reply to Re: best med for GAD? » ed_uk, posted by corafree on February 27, 2006, at 18:48:12
anyone ever try xanax-xr compared to regular xanax?
Posted by corafree on February 27, 2006, at 19:19:14
In reply to Re: best med for GAD? » corafree, posted by Ljoltof on February 20, 2006, at 22:36:50
L -
I just came across your long, well spoken, helpful, and 'probably saved' post!
Somehow I missed it. Sorry!!!!
I've printed it and will give it a good one over and get back to you.
Sorry if you felt I'd not appreciated something you had done for me.
I DO. I'll get back to you. Okay.
Tks, cf
Posted by ed_uk on February 28, 2006, at 14:32:24
In reply to Re: best med for GAD? » ed_uk, posted by corafree on February 27, 2006, at 18:48:12
Hi CF
>Yes you're right. But .. my PCP won't allow me to take 4x Perc.
But he gives you Vicodin to take in combination with the Perc? That doesn't really make sense.
Ed
Posted by Chairman_MAO on March 1, 2006, at 11:43:30
In reply to best med for GAD?, posted by chess on February 16, 2006, at 14:02:36
Neurontin is what doctors Rx for anxiety when they do not want to give you a real anxiolytic.
10mg diazepam at bedtime is enough for many cases of GAD (nordiazepam accumulates).
Overall, I like clonazepam the best for long-term use because of its pharmacokinetics. Alprazolam is the least sedating for me. This is an individual preference sort of thing.
Of course, methaqualone or pentobarbital work better, but I'm assuming you still want to be legal to drive.
A tiny dose of galantamine bid-tid will eliminate all benzodiazepine sedation/cognitive impairment/muscle relaxation if that bothers you.
Posted by chess on March 1, 2006, at 14:02:24
In reply to Re: best med for GAD? » chess, posted by Chairman_MAO on March 1, 2006, at 11:43:30
but does neurontin work as well as an anxyliotic as the benzos?
and what is galantamine?
Posted by sdb on March 1, 2006, at 16:52:40
In reply to Re: best med for GAD? » chess, posted by Chairman_MAO on March 1, 2006, at 11:43:30
>>10mg diazepam at bedtime is enough for many >>cases of GAD (nordiazepam accumulates).
nordazepam tolerance is common.
>>Alprazolam is the least sedating for me
interesting. There are differences in similarity.
buspirone is an alternative. Some individuals have success.
~sdb
Posted by corafree on March 3, 2006, at 10:48:12
In reply to Re: best med for GAD? » corafree, posted by ed_uk on February 28, 2006, at 14:32:24
Sorry late getting back.
Are you thinking morph sulfate or oxycontin are a better idea?
I've been to a handful of pain docs who do not prescribe.
My PCP is the only one who is helping me. He isn't specifically knowledgable re pain mgt. My pocketbook is closed! I'm 'falling thru' the cracks' out here in this new location. I keep thinking I should move?!!
I don't know what else to do Ed. Let me know what you have known to be helpful or effective.
All I know is a cap needs to be put on top of your reg pain med. What cap would you put on Perc? Or, should my reg pain med be diff'?
I did not like the 'messing w/ my mind' that morphine seemed to do, so never stayed on it very long.
bw, cf
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