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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 18 of 18. This is the beginning of the thread.
Posted by jefferey snow on September 10, 2008, at 11:47:34
So I have been trying to deel with this anxiety problem that has been getting increasingly worse for the past year. I have tried many medications...Prozac, lexapro, cymbalta, paxil, xanax,effexor, doxepin, and now i am currently taking buspar and inderal. Nothing really seemed to work except the inderal(which helps but not enough) and the xanax. I am about to be taken off of the buspar because it has not seemed to help any atall. Nothing really seemed to work except the inderal and the xanax and my doctor refuses to give me xanax because I am only 20 yrs old and it can be very addicting. I feel as though i have exhausted my options. Does anyone have any suggestions or advice?
Posted by Phillipa on September 10, 2008, at 12:07:32
In reply to anxiety medication, posted by jefferey snow on September 10, 2008, at 11:47:34
At age 24 had my first panic attack and way back then 1972? valium was the drug of choice so given 5mg three times a day and also miltown no longer used and still drank beer nightly. Now I've never increased my doesage but still take valium and some xanax no longer drink and gave up miltown when about a year had gone by and felt well. Well long story short got about 30 years out of benzos working well and at you age you would be biding time as I'm sure something will come out in the future so you can go off them. Mine don't really work but I'm tolerant to them so basically deal as best I can with the anxiety on the same dose of valium. So I'd say to you stay on them and soon something better will be out. Me I don't think I'll see the day but I bet you do. Good luck in what you and your doc choose to do. I do know anxiety. Phillipa
Posted by jefferey snow on September 10, 2008, at 19:24:02
In reply to Re: anxiety medication » jefferey snow, posted by Phillipa on September 10, 2008, at 12:07:32
> At age 24 had my first panic attack and way back then 1972? valium was the drug of choice so given 5mg three times a day and also miltown no longer used and still drank beer nightly. Now I've never increased my doesage but still take valium and some xanax no longer drink and gave up miltown when about a year had gone by and felt well. Well long story short got about 30 years out of benzos working well and at you age you would be biding time as I'm sure something will come out in the future so you can go off them. Mine don't really work but I'm tolerant to them so basically deal as best I can with the anxiety on the same dose of valium. So I'd say to you stay on them and soon something better will be out. Me I don't think I'll see the day but I bet you do. Good luck in what you and your doc choose to do. I do know anxiety. Phillipa
I definately think that your advice would be the way to go, stay on the xanax until i find something else. But my doctor has taken me off of them. Even though I am telling her that they for sure work and although she obviously knows that I am struggling pretty hard with my anxiety, she thinks that a dependency on the drug would be even worse. I think it is pretty rediculous and I feel as though she is depriving me of something that helps, but benzos are out of the question.
Posted by bleauberry on September 10, 2008, at 20:05:29
In reply to anxiety medication, posted by jefferey snow on September 10, 2008, at 11:47:34
You should probably seek a second opinion. Your doctor has made some valiant attempts, but unfortunately they have all been in the antidepressant category. Your inderal is more for stage fright situational anxiety, not for longterm prophalactic use.
While those can also be good for anxiety for many people, they are useless for others. They are really not anti-anxiety meds. Anti-anxiety meds include xanax, klonopin, diazepam, valium, and family. Benzodiazepines. That's what they are for. Your doctor is robbing you of your potential by being too conservative. Sure benzos cause dependence over time and often require higher doses over time. But isn't that the same with any of these meds? You can't tell me you didn't have aweful withdrawals on your other meds. Your body was dependent on them, regardless they didn't do any good. Right?
Other meds used for anxiety include Zyprexa or Seroquel, sometimes Risperdal (antipsychotics). Mood stabilizers such as Depakote, Lamictal, or Lithium sometimes work. Any way you look at it, you need a doctor who is willing to venture out of the limited world of antidepressants and try some other stuff. It makes pretty logical sense at this point, considering your diligence so far, to turn to things that work most of the time, things that are intended specifically for anxiety. Yeah? If your doc won't do that, you need to see a second one who will.
You would not be the first to find surprising relief at the local health food store. Magnesium glycinate if you can find it. If not, magnesium citrate. Get a bottle of Glycine, or L-Glycine. Sometimes GABA works. Herbs would include Valerian or Passionflower. If your anxiety is from overblown cortisol, which it could be since inderal helps, then anti-cortisol herbs would be helpful. Siberian ginseng, holy basil, sometimes St Johns Wort, sometimes Rhodiola Rosea (after an initial worsening of anxiety). Of all the comments I've seen here over the years, the best and most common herb is Valerian in mid to high doses. It acts similar to the benzos.
You can provide a good foundation to your body against anxiety by diet. Probably not a cure, but a turbocharge to anything else you do against anxiety. That is, no or very little caffeine, no or very little sugars. A diet high in proteins and veggies.
For vitamins, include a high dose of Niacinimide (specifically Niacinimide, not Niacin or any other form of Niacin). It also acts on the benzo receptors. I mention the above natural options because they are cheap and easy to try while you wait to sort out the doctor thing.
Posted by theo on September 10, 2008, at 20:14:45
In reply to Re: anxiety medication, posted by jefferey snow on September 10, 2008, at 19:24:02
Ask your doctor about Xanax XR. I decided to give it a spin and take the lowest dose, .5mg in the morning. It actually takes a few days to work and there is really not much abuse potential. It is very smooth and you don't feel any peaks and valleys. My doc actually prescribed it twice daily, that way if I needed to I could take it every 12 hours. He said for bigger doses, it's better to split the dose so your not to tired, which makes sense. For now just sticking with once daily.
> I definately think that your advice would be the way to go, stay on the xanax until i find something else. But my doctor has taken me off of them.
Posted by jefferey snow on September 10, 2008, at 21:35:07
In reply to Re: anxiety medication, posted by bleauberry on September 10, 2008, at 20:05:29
Thank you for the advise. I am definately going to try some of the dietary methods. The medical path has actually only caused more problems than anything. I did not mention this earlier but I have gone to 3 different doctors. I went to one after my psychiatrist couldn't help me, then that doctor told me that she just could not do anything else for me. And then after having been going to a couple of different doctor's offices, when I ask if I can try the xanax again they immediately think i just want drugs. Event though i stick with them and try all these medicines that never work, I still get the same answer. Their biased opinions towards benzos have definately gotten in the way of me having a more normal lifestyle. These doctor's priorities are not in line and it has affected me in the negative. I live in the deep south and that might be why they are all so conservative, but i still think there is no valid excuse.
Posted by sam K on September 11, 2008, at 15:08:24
In reply to anxiety medication, posted by jefferey snow on September 10, 2008, at 11:47:34
Kava Kava maybe. Its a pretty potent herb. Or valerian. Kava Kava seems to act like a natural xanax.
Posted by Phillipa on September 11, 2008, at 18:48:07
In reply to Re: anxiety medication, posted by sam K on September 11, 2008, at 15:08:24
Sorry as a lot of people stop them when they feel better and anxiety is controlled. Phillipa
Posted by med_empowered on September 11, 2008, at 19:07:55
In reply to Re: anxiety medication, posted by Phillipa on September 11, 2008, at 18:48:07
I live in the south, too, and docs around here vary wildly in how they deal with benzos. Some of them are wildly anti-BZD, while other (like my doc) don't have a problem with it as long as you don't ask for dosage increases and there aren't any signs of misuse. How old have your docs been?
In my experience, younger p-docs are the worst. They're anti-benzos ("addicition"), but pro-antipsychotics, and they seem to think that its better to load somebody up on a ton of non-controlled, non-addictive substances than to prescribe a controlled substance that actually gets the job done.
Also, younger docs seem to be really into the idea that they're "treating a disease," whereas older docs (at least mine) are way more interested in controlling particular symptoms so your existence is more comfortable...the result seems to be that older docs will put together something that works for you (even if it involves older and/or potentially addictive meds), while younger (cookie-cutter) docs seem hell bent on making YOU fit into THEIR treatment plan.
Also...how are you paying for your docs? If you can afford it, you might want to go to a cash-only doc.
As for stuff you can do yourself...niacinamide is a great idea. I personally take 4grams daily, and it keeps me on an even keel (more or less...).Whatever you do, try to avoid antipsychotics. They cause more problems than they fix, and they're expensive.
Posted by Phillipa on September 11, 2008, at 19:58:35
In reply to get a new doc..., posted by med_empowered on September 11, 2008, at 19:07:55
Med is right I too live in the South and my doc is four hours away but she's nearing 70 and has no problem with using benzos. Phillipa
Posted by jefferey snow on September 11, 2008, at 20:23:37
In reply to get a new doc..., posted by med_empowered on September 11, 2008, at 19:07:55
Well you seemed to describe my doctor's pretty well. They have all been younger women and they are all about these new antidepressants and they are completely convinced that they work. I have gone through alot of antipsychotics so far and they just want me to keep trying different ones until one works.
I probably should try to go find a new doctor but the more doctor's i see the more they get suspicious of what i am really looking for. I have already seen 3 doctor's and it might take me another 5 until i find a good one and by that time they will be seriously wondering why i have been "Doctor shopping". It just seems like a double ended sword, either I try to deal with my anxiety on my own and sort of suffer through it or i go hunt for someone who can help me and get accused of many things along the way. When i started seeking medical help I never thought that it would be such a struggle. I guess i was just naively thinking that these doctors would sincerely want to help.
Posted by Phillipa on September 11, 2008, at 20:31:59
In reply to Re: get a new doc..., posted by jefferey snow on September 11, 2008, at 20:23:37
What state maybe we can help. Phillipa
Posted by Jefferey Snow on September 11, 2008, at 22:31:23
In reply to Re: get a new doc... » jefferey snow, posted by Phillipa on September 11, 2008, at 20:31:59
Tennessee. Some help would be nice though. I probably haven't had much luck because I don't know anything about the doctors around here and I don't have anyone who can refer me to a good one.
Posted by rskontos on September 12, 2008, at 11:37:23
In reply to Re: get a new doc..., posted by Jefferey Snow on September 11, 2008, at 22:31:23
I Agree with all. I have extreme anxiety and my gp put me on cymbalta and lexapro to help. Did a little bit to help with anxiety but left me numb or suicidal. So I went off and looked for a p-doc. As i was describing to him some of what was going on, I called in a panic state, he said I was also suffering from panic attacks and prescribed xanax at first PRN, then because I did not take it much he prescribe it every 4 hours. I did not take it every 4 hours but I took it more and finally it helped the panic attacks. He had me pre-medicate before I went into stressful situations.
I really hope you find a doc that will allow you the use of benzos. Interestingly my doc is older, 70 or so. I asked him if I would become addicted he said no, just may have to up the dose at some time.
I lived in Tennesse for 13 years but alas never seeked p-doc help. So I am no help.
rsk
Posted by bleauberry on September 12, 2008, at 18:05:53
In reply to Re: get a new doc..., posted by jefferey snow on September 11, 2008, at 20:23:37
> Well you seemed to describe my doctor's pretty well. They have all been younger women and they are all about these new antidepressants and they are completely convinced that they work. I have gone through alot of antipsychotics so far and they just want me to keep trying different ones until one works.
Ridiculous. So many complications from antipsychotics, so few with benzos. Not to mention the massive price difference.
>
> I probably should try to go find a new doctor but the more doctor's i see the more they get suspicious of what i am really looking for. I have already seen 3 doctor's and it might take me another 5 until i find a good one and by that time they will be seriously wondering why i have been "Doctor shopping". It just seems like a double ended sword, either I try to deal with my anxiety on my own and sort of suffer through it or i go hunt for someone who can help me and get accused of many things along the way. When i started seeking medical help I never thought that it would be such a struggle. I guess i was just naively thinking that these doctors would sincerely want to help.Were some of your doctors psychiatrists? If so, shame on them. If not, how about it, give it a look?
You know, it is not at all unusual to give someone as-needed xanax when starting a new med that may or may not work. A doctor who doesn't really doesn't have the patient's best interest in mind. They are probably looking more after their own butts, or they were trained in facilities that frowned on certain meds like benzos. Hey, benzos are the most common prescriptions in the entire world and the cheapest too, and they work almost immediately almost all the time.
If a doctor thinks you are doctor shopping, tell them the truth...you want a doctor who will end the anxiety immediately so you can get on with other med trials that may or may not replace it, but that you have already wasted X amount of years of your life doing what they wanted with zero success. Enough is enough already. Be emphatic about it, don't be shy. Ask them, would you continue to see a doctor who was not treating you correctly?
Also, we often forget, who is paying who? You are the paying customer. You are the boss. Don't let them run the show completely. Tell them what you want and why. You have a perfect record of diligence and failure at other things to justify your requests. It isn't as if you are just seeking a doctor for the first time and want to jump straight into benzos.
Be forceful yet polite with your requests. You could even say, look I didn't come here and give you all this money for you to not treat me properly. I am not depressed I don't need an antidepressant and I been there done that anyway. If a chemical imbalance like serotonin was my problem, one of these many meds I've tried would have done something for me but they didn't. I am not schizophrenic and don't want parkinsons, diabetes, or tardive whatever, so save any more antipsychotic trials as a last ditch effort, not a front line treatment. Besides, they are not FDA approved to treat anxiety. I have anxiety and the benzos are the fastest, cheapest, most commonly used medications on the planet to quickly give the patient some relief to think about the next move and to save their jobs and relationships, and that's what they are FDA approved for. I probably don't need much. That's all I want. If that's ok with you, I would like to go forward with that today right now. I have way to many other med failures to waste any more time.
If they have a comeback to try something else instead, say...well let's do this, let me try xanax or one of its cousins right away, and let's save your suggestion for our next meeting. There is no sense in beating around the bush any longer and I can't survive another day with this anxiety.
Basically in all this, you are being the polite boss, and using keywords like FDA, serotonin, tardive, etc, you let them know they are not dealing with some naive person who doesn't know anything.
Worst case scenario they refuse to help you the way you want, well, be honest...I am very disappointed in this office, I came here willing to pay you more money for a short meeting than most people make in an entire day, and I could have paid someone else, but I chose you, and you are preferring that I leave this office no better than I came in. Pardon me, but I find that unprofessional, selfish and biased. It makes me sad to see a doctor who really does not have the patient's wellness as a top priority. Makes me wonder what your priorities are. It's sad.
And don't forget the natural biological things you can do that I mentioned in my previous post. They really can and do work for a lot of people. Sometimes not enough to rule out medications, but enough for noticeable relief and enough to keep med doses lower. Things like magnesium, valerian, passionflower, have saved me more than once when xanax was not handy, heck even helped when withdrawing from zyprexa which was anxiety from hell.
Posted by Phillipa on September 12, 2008, at 19:16:42
In reply to Re: get a new doc..., posted by Jefferey Snow on September 11, 2008, at 22:31:23
Google psychiatrists in you town or city and state maybe a lot have website and descriptions of their philosopies. Love Phillipa
Posted by rskontos on September 12, 2008, at 19:31:16
In reply to Re: get a new doc..., posted by bleauberry on September 12, 2008, at 18:05:53
I totally agree with you Bleauberry. Jefferey could also say give me a trial presciption with no refills of say 60 or 30 pills like my p-doc did. Now mine had to ask me why I hadn't asked for a refill so he knew I wasn't just popping them right and left. He gave me a PRN at first. Which was alright. I still don't take them all the time all day long, just when I really need them. I can go several days now without them. Well, not right now, but I have gone 4-5 days without them.
I do remember asking two other docs for them and they said OH no I can't prescribe those. You would have thought I asked for morphine or something.
rsk
Posted by jefferey snow on September 13, 2008, at 20:38:22
In reply to Re: get a new doc..., posted by rskontos on September 12, 2008, at 19:31:16
well guys, thanks for the help. I have an appointment with a referred psychiatrist next week. I'll definately keep your advice in mind while going through this whole procedure again. And once its over, I will start a new thread and let everybody know how it went. Thanks again.
-Jefferey Snow
This is the end of the thread.
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