[adeline]

Hi, my pdoc sent me home with a list of benzodiazepines and ADs to research: xanax, ativan, clonozepine, and prozac, paxil and zoloft. I'm mostly interested in the clonozepine, since I've tried Xanax (completely useless) and respond badly to ADs.

Some background info: I'm bipolar, adhd, and recovering bulimic, and stopped all meds ~3 weeks ago.

Besides Lamictal, no meds have ever really helped me. Benzodiazepines (xanax and vistiril) make me feel extremely useless and depressed. Which is the same way I feel when I can't control my anxiety anyhow.

Is there anything that won't make me lethargic? The only thing that works for my anxiety is alcohol, which is probably a bad idea.

now thats different and quite unprofessional of a pdoc sending the cleint home with names but no info. If it was me if he was suggesting the medications I would also have made sure he supplied the info pamplets and fliers to match those medications so that I had the professional information instead of the catch all and gossip of the medications.

My suggestion put a call in to this pdoc and tell him to send you the required information he was supposed to have supplied you with when recommending that medication like the medical professions ethics laws and so on require him or her to do.

If he does not supply the info then I would consider the suggestion to be unethical and or "fishy" at the least and I would be contacting other pdocs in the area to switch my mental health care over to.

[darkeyes]

Hi there,
My DX is Bipolar-II(mild) and ADD(mild), I take Lamictal,Concerta and for anxiety, Klonopin ONLY as needed, and Ativan ONLY if needed.
I do not use the benzos on daily basis, so they seem effective when I do. I'm sure by not taking them daily has helped prevent addiction, soooooooo I take as pdoc suggested.
Just started with occasional panick/anxiety attacks, in 2004, I'm happy they have not been often, I never knew what they feel like till out of nowhere it happened, horrible feeling, the Klonopin has helped when I feel I may have one come on.
Personally, but everyone is different, I'd go with the Klonopin or Ativan.
As far as AD's, I've been on almost all, when a GP thought I was suffering clinical depression, when after it turned out to be Bipolar-II's depression, after DXed by a psychiatrist.
Now I will or would have a mental health professional only be the person to prescribe any of those kinds of meds.
Lots of luck with your decision.
Take care now,
DE

[Maven]

I agree with myself. I've never heard of a pdoc doing that. I mean, I encourage you to research psychiatric drugs and your conditions, as well as mental health in general, but it makes no sense that a pdoc would tell you to do research without providing you information him/herself. Like myself said, I'd be looking for a new source for mental health care.

I can't say what will make you feel lethargic and what won't. Everyone responds differently to each of the drugs.

[darkeyes]

Oh, I agree with you too, I didn't read the post too closely, oops!
But yeah, if a doc told me to go home and research some meds, I'd look for a new pdoc,that would walk through options,different meds.
Maven,and myself, you are so right on this, I totally agree with you both.
Kind of makes me feel this pdoc is like saying "do it yourself", not supplying the client with proper info/help.
I think the client should bring this to his or her's attention, before changing pdocs, just to make the point made.
Take care y'all,
DE

[adeline]

Thanks to all for the advice. I think what my pdoc's intention was in giving me a few names to research was to make me feel like I have control over what I put into my body -- but not to leave me out in the cold. He gave me some info on all of the meds, and then told me I could have time to decide what was right for me (I go back in a few days) instead of deciding on the spot.

The reason I like him so much is that he's not an authoritarian, controlling doctor. The reason I got the right treatment for bipolar was because I was proactively questioning meds and researching throughout it's course. Since you know yourself AND have to deal with the consequences of taking or not taking the meds, I think the ultimate decision maker needs to be you (unless of course psychosis is involved, or any other condition where you are not capable of making that decision).

Right now I really don't want to put anything in my body, since what makes me stable makes me depressed. Does Klonopin or ativan cause mental fog, lethargy, or weight gain?

Thank you for your help!

Jessie

[adeline]

Sorry, one more thing -- are zoloft, paxil or other ADs functionally different for most people than lexapro or wellbutrin? Lexapro made me feel horribly mixed (like mixed episodes) and incredibly suicidal; with wellbutrin I had tactile hallucinations, fatigue and outbursts of anger.

I know meds are different for everyone, but in general are there ADs that are more effective with less side effects?

Thanks!

Jessie

The bottom line is that EVERYONE reacts differently on the same medications one person with paxil can have a shoit load of problems and another person can have no problems.

Which is why prescribing doctors are required to give accurate information to their clients, answer their questions and have follow up appointments to address any side effects THAT person is going through.

You can research all these meds and end up totally confused with this person having this problem with paxil and that person having no porblems and the same with all the other medications.

you want accurate information and want to know what you should expect -

only the prescribing doctor can tell you that based on your reactions to other medications and the accurate information he has from a professional point of view.

If he supplied you with information use that to make your decisions not base your decisions on what everyone else experiences.

Its your body and you and your doctor know your body that is where your focus should be when making medication decisions.

In general AD's work for some and don't for others. And it is unprofessional of a pdoc to send a client home to do research regardless of how proactive they are. My doctor knows Im proactive so he makes sure I come home fully informed and the decision of medication is made between him and I discussing the pros and cons not by random reseach on the web that can result in getting misconceptions and misinformation of that medication.

That professionsal shoud have given you all the pros cons and answered your questions and the two of you should be making the decision based on truthful accurate professional information Thats the bottom line.

the heading on this thread is "Need Anxiety Med Advice, Please.....i didn't see where the poster asked for a critique of her Pdoc. and it was also stated, in a later post, that she really likes the doctor and, being proactive, he is allowing her to help choose her meds. and respecting her choice, i believe is being supportive.

i take xanax, lamictal, wellbutrin and prozac. i am bipolarII. it took forever for my Pdoc and i to find something that works fairly well. my lows are incredibly low, so i was determined to try and stay on the wellbutrin and i finally got through the worst of it.

i wish that i could help you with your question and i hope that the support that you get does help. xoxoxo pat

[adeline]

Thank you very much Pat, I agree that the post isn't on topic!

Kudos!!

Jessie

[darkeyes]

Okay, gotcha, you are right, the poster's title is stated.
As further explained, I see her pdoc IS working with her, and that is good.
I wish you all well with meds and pdocs, I understand how frustrating it can all be.
Take care,
DE

when we make a personal choice and someone invalidates it by criticizing it, it can cause more anxiety. as i said, i didn't see that you were asking for criticism.

i hope that you and your doctor can work it all out and you find a mix that works. it takes time, as you very well know by now. i hate the struggles of it but hang in there......i'm here, xoxoxo pat

[drunksunflower]

</font><blockquote><div id="quote"><font class="small">Quote:</font>
adeline said:

Thank you very much Pat, I agree that the post isn't on topic!

Kudos!!

Jessie

</div></font></blockquote><font class="post">

i am going to stay with the off topic thing for one sec - i think it is AWESOME that your pdoc encourages you to make your own decisions in this way.

i have a phd in psych (criminal justice, not the clinical side, but obviously you do a fair few abnormal psyc, etc papers all the same). My doctor knows this and will occasionally speak to me "as a colleague" (his words). i completely trust him but i think he knows i don't react well to being told what to do, i want some input as well. if i said i wanted to do my own research that would be encouraged (and i do).

horses for courses i guess

[Jerrypharmstudent]

</font><blockquote><div id="quote"><font class="small">Quote:</font>
adeline said:

Hi, my pdoc sent me home with a list of benzodiazepines and ADs to research: xanax, ativan, clonozepine, and prozac, paxil and zoloft. I'm mostly interested in the clonozepine, since I've tried Xanax (completely useless) and respond badly to ADs.

Some background info: I'm bipolar, adhd, and recovering bulimic, and stopped all meds ~3 weeks ago.

Besides Lamictal, no meds have ever really helped me. Benzodiazepines (xanax and vistiril) make me feel extremely useless and depressed. Which is the same way I feel when I can't control my anxiety anyhow.

Is there anything that won't make me lethargic? The only thing that works for my anxiety is alcohol, which is probably a bad idea.

</div></font></blockquote><font class="post">

Hi adeline!

I haven't had time to read all of the other posts in response to your initial post - so I apologize if anything I post had already been said.

Benzodiazapines like Xanax, Klonopin (clonazapam), Ativan all work pretty much the same, however, I've known people to respond one way to one benzo and the exact opposite to another benzo. Xanax has a very short half-life, then comes Ativan and then Klonopin. Doctors like to use Klonopin because it has a very long half-life so you aren't as likely to experience ups & downs or lapses in coverage for your anxiety symptoms as you would with shorter-acting benzos like Xanax (although there is a new extended-release form of Xanax available called Xanax XR). Sometimes you'll hear doctors refer to benzo meds as "alcohol in a pill" however, this statement is false because the way benzos act in the brain and the way alcohol acts in the brain are not the same.

Clozaril (clozapine) is an atypical anti-psychotic. Research has shown that these meds are useful in treating other disorders as well including bipolar disorder.

Vistaril (Hydroxyzine) is actually a novel antihistamine - unrelated to benzodiazapines (Xanax, etc). It's novel because it has anti-nausea, anti-anxiety and sedative/hypnotic properties (among others).

Selective Serotonin Reuptake Inhibitors (SSRIs) are meds like Prozac, Paxil, Zoloft, Luvox, Celexa, and Lexapro. They work by blocking reuptake of serotonin in the brain and are mostly prescribed for major depression and anxiety. Other antidepressants like Effexor and Cymbalta work on serotonin and norepinephrine. Wellbutrin mostly works on norepinephrine and a little on dopamine. Remeron is more of a serotonin "enhancer" and at higher dosages enhances norepinephrine as well.

Lamictal was originally developed as an anti-convulsant, but has been found to help with mood stabilization, depression, and anxiety.

Some people who are bipolar find that SSRIs don't help much and can cause hypomania. However, I have heard of those who are bipolar who do well on a combination of an SSRI + Lamictal or Lithium. Wellbutrin can be helpful for bipolar and ADHD but it can also aggravate anxiety and cause insomnia. SSRIs are very helpful for eating disorders like bulimia.

I hope this helps some. Please don't hesitate to ask more questions!

Jerry

[adeline]

Hi, thank you all very much for all of the advice!! Also, I really appreciate the support I've received for my decision to do my own research on my meds. This is something that's important to me, so I'm glad that people here are open-minded about it.

To Jerry, thank you for the med info, it has really helped me to think about what kind of med I'd like to pursue. Also, I found it interesting that some doctors would equate benzo's to alcohol -- the effects are totally different for me, personally.

I've tried the SSRIs with and without a mood stabilizer, and both times I couldn't stand the way it made me feel/act (also made my obsessive-compulsive tendencies worse when used with the anti-convulsant).

I think that most anxiolytic meds don't work for me. I can only take them when I don't need to function; so they're all very counter-productive, and leave me lethargic and unable to think straight for the next 1-2 days.

Is there anything else that's used for anxiety?

Thanks!

Jessie

[Eleora]

If you haven't tried Zoloft, I'd say give it a shot. It's worked well for my depression, and I had minor anxiety which is non-existent on the Zoloft.

It's not uncommon for pdoc's to just give you names and idea's. I'd suggest a book called "The Anxiety Workbook". It not only gives you advice on medications, but various ways to change eatig habits, sleep habits, work-out habits etc to help as well. I found the book extremely helpful.

[crazymusiclvr]

It sounds like your doctor is giving you way too many options. It is not a doctor's job to list to you which mediations may work and ask you what you think. It is the doctor's job to perscribe the right medication that he/she thinks will best help you and perscribe something else fit eh first one doesn't help.

I know what you mean by being anxious. I used to be that way and used alcohol to try and soothe it (which works for about an hour). However, I think once you find the right medication or the right combination of medications, that anxious feeling will be less apparent. Hopefully, you'll then not crave a drink anymore (like me).

Hang in there!

Lia

Crazymusiclvr@aol.com

[sujunew]

just to add my 2 cents worth sorry (!!), I have finally found the best combination for me is venlafaxine, clonazapam, quetiapine and sodium valporate. The quetiapine and clonazapam were as needed, but with a certain amount charted regularly too. This mix has done more for me than any other combination, not without little probs of course along the way...
Good luck and all the best. I think it is fantastic you are being empowered by having such a say in your meds. I hope the ones you decide on are the ones that work best for you. Good luck