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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 14 of 14. This is the beginning of the thread.
Posted by paulbwell on July 11, 2005, at 22:02:50
Does anyone take an low dose anti psycotic Phencthiazine like Stelazine 2.5mgs with a stimulant, to counter over stimulating? do you still get the stimulant benefits?
Cheers
Posted by rjlockhart98 on July 11, 2005, at 22:40:25
In reply to Anti psycotic with Stimulant?, posted by paulbwell on July 11, 2005, at 22:02:50
i have taken not a AP
i used to take Adderall 40mg
Lorazepam 1mgit would work on the nerve ok. I could do things but not at the psychostimulant level. I had the eneregy but some ease.
I stopped lorazepam. I was on 6mg after i stopped Adderall after 8 years.
I then went on klonopin
Posted by med_empowered on July 12, 2005, at 4:40:40
In reply to Re: Anti psycotic with Stimulant?, posted by rjlockhart98 on July 11, 2005, at 22:40:25
hey! The antipsychotic+stimulant combination is used now and then. I used to take Abilify @ 15mgs with Adderall, 60mgs. The combo wasn't great, but I did OK before I changed it. Stelazine is commonly used for anxiety, but on a time-limited basis. The rule seems to be to use as little Stelazine as possible (always under 6mgs) and use it for as little time as possible (the accepted practice is 4months MAXIMUM). The problem is that drugs like Stelazine have LOTS of side effects, even at low doses. Tremors, akathisia (intense feelings of unease and restlessness) are common; neuroleptic malignancy disorder is a problem with all antipsychotics, and tardive dyskinesia is an issue with ALL antipsychotics, including the new atypicals and the old drugs. Low-dose antipsychotics seem to carry a reduced risk of tardive dyskinesia, but the disorder can occur at any dosage level after chronic administration of the antipsychotic. With old antipsychotics, the risks overall (for ALL conventional antipsychotics) were something like this: 3% TD per year of treatment *baseline risk*--the very young, the old, females, and those on multiple medications and those with mood-disorders have a higher risk; at the end of 5 years, at least 20% of patients have moderate to severe tardive dyskinesia. Some estimates put this number closer to 30%; if you factor in "minor" cases of tardive dyskinesia, the numbers could be even higher. At "end-point," or the end of long term (10years+) therapy, the number of patients with tardive dyskinesia is over 50%. I guess my point is that I think using an antipsychotic in someone who isnt psychotic, especially for the purposes of controlling the effects of another medication, is unjustifiably risky. I later used Klonopin for anxiety and to cushion the Adderall a bit; it worked fine, I also used propranolol in low doses strictly on an as-needed basis, and this also helped tremendously. Some other options: meprobamate (supposedly its making a comeback), propranolol, buspar (helped me tremendously), reducing the adderall dosage, using Provigil in place of the Adderall, combining Adderall and provigil or possibly cylert or a stimulating antidepressant, such as Wellbutrin or high-dose effexor/cymbalta, or combining something like Straterra with reduced dosage adderall. Using an anticonvulsant mood-stabilizer, like Trileptal, with the Adderall can also smooth things out. Good luck!
Posted by blueberry on July 12, 2005, at 6:07:58
In reply to Anti psycotic with Stimulant?, posted by paulbwell on July 11, 2005, at 22:02:50
The only way to tell how they would go together, for you, is to try. Sounds like a good combo to me. But I would stick with the atypical antipsychotics like zyprexa or seroquel. They will probably counteract insomnia, and will probably take the edge off during the day. Whether either med ruins the good effects of the other though is something you'll only find out in a trial. Just my guess, but I think they would be synergistic together. The good thing is that you will know within a week if you like it or not.
Posted by linkadge on July 12, 2005, at 15:25:37
In reply to Re: Anti psycotic with Stimulant?, posted by blueberry on July 12, 2005, at 6:07:58
I took ritalin and zyprexa for a short while, all I can say is that it was the WEIRDest thing I have ever experienced in my life.
Linkadge
Posted by paulbwell on July 12, 2005, at 16:39:38
In reply to Re: Anti psycotic with Stimulant?, posted by linkadge on July 12, 2005, at 15:25:37
> I took ritalin and zyprexa for a short while, all I can say is that it was the WEIRDest thing I have ever experienced in my life.
>
>
> LinkadgeLike Pot and Coffee?
Posted by linkadge on July 12, 2005, at 17:09:31
In reply to Re: Anti psycotic with Stimulant?, posted by paulbwell on July 12, 2005, at 16:39:38
Pot and coffee for me was good. (although I have only smoked pot once).
Zyprexa and ritalin was like, every half an hour I felt like I swiched from living 100 years in the past to 100 years in the future.
Linkadge
Posted by Phillipa on July 12, 2005, at 18:37:10
In reply to Re: Anti psycotic with Stimulant?, posted by med_empowered on July 12, 2005, at 4:40:40
Med_empowered, What's this about Meprobomate making a comeback? I took it years ago with 5mg valium TID. 450mg. It took away my panic attacks. I was eventually able to wean myself off of it easily as my life situation improved. I wonder if it would help me now as the l5mg valium I don't think does a thing. I'm afraid of my shadow. Fondly, Phillipa
Posted by med_empowered on July 12, 2005, at 21:49:20
In reply to Re: Anti psycotic with Stimulant? » med_empowered, posted by Phillipa on July 12, 2005, at 18:37:10
hey! OK, from what I understand, now that some states require triplicates for all controlled substances and some require special forms just for the benzodiazepenes, shrinks are rediscovering meprobamate. The doses are higher than with benzos, and it tends to be more barbiturate-like in terms of toxicit in overdose, but...it does work well. I read an article where they were re-examining meprobamate; turns out, its an anticonvulsant sedative/hypnotic that works differently than the benzos or the barbiturates, although it has some characteristics in common with both. The dosage range is huge; I think the usual max dose is 2400mgs or so. Anyway, I think its kinda dumb that shrinks will rx this stuff instead of just giving people adequate doses of benzos, but...whatever. Weirdly enough, its been used off and on throughout the years as an add-on sedative in schizophrenia; the benzos have also been demonstrated to have some antipsychotic properties and seem to augment the effects of neuroleptics, so doses can usually be lowered if they're used long-term. As for your situation...15mgs of valium really isnt much; when Valium first hit the market, the recommended dose for everybody was 30-40mgs a day (the 40mgs dose was designed to ease anxiety at nite, so an additional sedative would not be necessary). These days, it seems like shrinks are afraid of benzos, and do ridiculous things, like giving out mood-stabilizers and antipsychotics to anxious people, just to avoid prescribing them. Sigh. Miltown could help you, I imagine, but bumping up your valium to 30mgs or so would probably help just as much, with fewer side effects and medication costs. Good luck!
Posted by Phillipa on July 12, 2005, at 22:00:47
In reply to meprobamate is coming back, posted by med_empowered on July 12, 2005, at 21:49:20
Med_empowered, Thanks for your response. I want to get off all these meds. Right now my wt is going up also. I'm afraid it's from the valium slowing down my metabolism. I still excercise, but I used to do it nonstop. How can I drop the extra l0lbs? I gained this in a few months. I'm not going to take any luvox tonight. I never went up past l00mg then a few days later decided to drop that dose too. I don't want to take meds! I thought of ending my posts with the saying "Just Do It" and then realized if the post was about suicide I would get blocked. So it's still Fondly, Phillipa
Posted by paulbwell on July 13, 2005, at 0:46:52
In reply to Re: meprobamate is coming back » med_empowered, posted by Phillipa on July 12, 2005, at 22:00:47
> Med_empowered, Thanks for your response. I want to get off all these meds. Right now my wt is going up also. I'm afraid it's from the valium slowing down my metabolism. I still excercise, but I used to do it nonstop. How can I drop the extra l0lbs? I gained this in a few months. I'm not going to take any luvox tonight. I never went up past l00mg then a few days later decided to drop that dose too. I don't want to take meds! I thought of ending my posts with the saying "Just Do It" and then realized if the post was about suicide I would get blocked. So it's still Fondly, Phillipa
How is Meprobamate different than Benzos?
Thanks
Posted by Declan on July 13, 2005, at 0:52:32
In reply to Re: meprobamate is coming back, posted by paulbwell on July 13, 2005, at 0:46:52
Meprobamate felt pretty much the same as a benzo to me as I recall. Isn't the withdrawal supposed to be worse?
Declan
Posted by med_empowered on July 13, 2005, at 1:19:03
In reply to Re: meprobamate and benzos, posted by Declan on July 13, 2005, at 0:52:32
hey! OK, from what I read, meprobamate is kind of like a middle-ground between the barbiturates and benzos, with some odd characteristics all its own. It is a sedative, anticonvulsant, and hypnotic. In overdose, death is more likely than with a benzodiazepene, but less likely than with a barbiturate. The withdrawal syndrome is similar to that of benzos or barbiturates, with the intensity and severity of the symptoms depending upon the dosage and duration of administration, as well as any other medication co-prescribed. Unlike barbiturates, though, a meprobamate withdrawal-induced seizure is very unlikely to result in death. Now, in terms of effects on the brain...it is less selective in the GABA department than the benzos, but more so than the barbiturates. Just like the barbs, large doses result in intoxication similar to alcohol intoxication; this is what lead to the infamous "Miltown Parties" that popped up in affluent suburbs after Miltown gained popularity. Miltown has been used some in schizophrenia; from what I understand, it has a little-understood mild antipsychotic effect. It also is better at relieving the somatic symptoms of anxiety than benzos--to this day, Equagesic, a meprobamate-containing preparation, is used in the treatment of sprains, strains, and headaches (for some reason, it seems to be much less popular than Midrin or Fioricet/Fiorinal for headache treatment).
Posted by Phillipa on July 13, 2005, at 16:25:54
In reply to Re: meprobamate and benzos, posted by med_empowered on July 13, 2005, at 1:19:03
Med_empowered, Thanks for your response. I want to get off all these meds. Right now my wt is going up also. I'm afraid it's from the valium slowing down my metabolism. I still excercise, but I used to do it nonstop. How can I drop the extra l0lbs? I gained this in a few months. I'm not going to take any luvox tonight. I never went up past l00mg then a few days later decided to drop that dose too. I don't want to take meds! I thought of ending my posts with the saying "Just Do It" and then realized if the post was about suicided I would get blocked. So it's still Fondly, Phillipa
This is the end of the thread.
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