Benzodiazepines (Klonopin) and Memory

Question:

Hello All, I am curious as to your experience with Benzodiazepines in general, and Klonopin in particular, as to its effects on both short and long- term memory.  My memory is important to me as I am an academic who must have his wits, and recall, about me. I am on a relatively high dosage, about 4 mg/day. In addition, I will occasionally take Ambien 10 mg for insomnia. I also take 150 mg of Wellbutrin and 200 mg/2x daily for depression. Thank you for sharing your experiences. markhw2002

I’ve had short term memory problems all my life but it was a LOT worse when I was on 6mg klonopin and 2mg PRN of Ativan.  I’m now on 4mg klonopin and 2mg ativan plus 1mg ativan PRN and I’m sure the klonopin was the main cause for the bad memory. What were we talking about? Tony — The charter is available at: http://readystump.algebra.com/~asapm

Response:

Hello All, I am curious as to your experience with Benzodiazepines in general, and Klonopin in particular, as to its effects on both short and long- term memory.  My memory is important to me as I am an academic who must have his wits, and recall, about me. I am on a relatively high dosage, about 4 mg/day. In addition, I will occasionally take Ambien 10 mg for insomnia. I also take 150 mg of Wellbutrin and 200 mg/2x daily for depression. Thank you for sharing your experiences. markhw2002 — The charter is available at: http://readystump.algebra.com/~asapm

Response:

Hello All, I am curious as to your experience with Benzodiazepines in general, and Klonopin in particular, as to its effects on both short and long- term memory.  My memory is important to me as I am an academic who must have his wits, and recall, about me. I am on a relatively high dosage, about 4 mg/day. In addition, I will occasionally take Ambien 10 mg for insomnia. I also take 150 mg of Wellbutrin and 200 mg/2x daily for depression. Thank you for sharing your experiences. markhw2002

hi mark.  i have not had any memory problems with klonopin.  i only take 1mg a day though.  ambien messes my cognitive abilities up however so i don’t take it very often. — _TJ_ — The charter is available at: http://readystump.algebra.com/~asapm

Response:

– Hide quoted text — Show quoted text – Hello All, I am curious as to your experience with Benzodiazepines in general, and Klonopin in particular, as to its effects on both short and long- term memory. My memory is important to me as I am an academic who must have his wits, and recall, about me. I am on a relatively high dosage, about 4 mg/day. In addition, I will occasionally take Ambien 10 mg for insomnia. I also take 150 mg of Wellbutrin and 200 mg/2x daily for depression. Thank you for sharing your experiences. markhw2002 — The charter is available at:http://readystump.algebra.com/~asapm

I have used Librium in the past and will again start using it again starting today.  The benzos that I use help me concentrate and get my detail done.  I may have a little sleepiness when I start.  I was able to get through Mechanical Engineering school with the use of 25 mg every evening before I went to sleep.  It had an additional affect in that it helped me go to sleep and stay asleep.  My trouble is that I can only take the drug for 2 to 3 years before it no longer works for me.  I then need to slowly titrate off the drug and then I can start taking it again in a year or so. Fred — The charter is available at: http://readystump.algebra.com/~asapm

Response:

markhw2002 schreef: Hello All, I am curious as to your experience with Benzodiazepines in general, and Klonopin in particular, as to its effects on both short and long- term memory.  My memory is important to me as I am an academic who must have his wits, and recall, about me. I am on a relatively high dosage, about 4 mg/day. In addition, I will occasionally take Ambien 10 mg for insomnia. I also take 150 mg of Wellbutrin and 200 mg/2x daily for depression. Thank you for sharing your experiences. markhw2002

4 mg of Klonopin is well within the normal therapeutic range. All benzos can impair short-term memory to some extent after a long time on a maintenance dose like yours (or mone). This is reversible when you stop taking them (which should be done only by way of a slow taper!). I never heard of long-term memory problems. My personal exeperience: After almost 40 years on benzos my short-term memory is much worse than it was, in my opinion more so than is warranted by age (59). Still, it’s mostly trivia I forget. I am an academic too < koff koff and I have no problems memorizing facts etc. I need for my work – which these days mainly consists of writing. Philip — The charter is available at: http://readystump.algebra.com/~asapm

Response:

Fred schreef: – Hide quoted text — Show quoted text – Hello All, I am curious as to your experience with Benzodiazepines in general, and Klonopin in particular, as to its effects on both short and long- term memory. My memory is important to me as I am an academic who must have his wits, and recall, about me. I am on a relatively high dosage, about 4 mg/day. In addition, I will occasionally take Ambien 10 mg for insomnia. I also take 150 mg of Wellbutrin and 200 mg/2x daily for depression. Thank you for sharing your experiences. markhw2002 — The charter is available at:http://readystump.algebra.com/~asapm I have used Librium in the past and will again start using it again starting today.  The benzos that I use help me concentrate and get my detail done.  I may have a little sleepiness when I start.  I was able to get through Mechanical Engineering school with the use of 25 mg every evening before I went to sleep.  It had an additional affect in that it helped me go to sleep and stay asleep.  My trouble is that I can only take the drug for 2 to 3 years before it no longer works for me.  I then need to slowly titrate off the drug and then I can start taking it again in a year or so. Fred

You can worry about that when (and if) the time comes. There are other benzos which may work and raising the dose is another possibility as you’re on a very low dose. Philip — The charter is available at: http://readystump.algebra.com/~asapm

Response:

Hello All, I am curious as to your experience with Benzodiazepines in general, and Klonopin in particular, as to its effects on both short and long- term memory.  My memory is important to me as I am an academic who must have his wits, and recall, about me. I am on a relatively high dosage, about 4 mg/day. In addition, I will occasionally take Ambien 10 mg for insomnia. I also take 150 mg of Wellbutrin and 200 mg/2x daily for depression. Thank you for sharing your experiences. markhw2002 —

I’m on Lexapro and Ativan and do seem to have some memory problems, however I can concentrate well and my problem solving skills have not suffered. — The charter is available at: http://readystump.algebra.com/~asapm

Response:

– Hide quoted text — Show quoted text – I am curious as to your experience with Benzodiazepines in general, and Klonopin in particular, as to its effects on both short and long- term memory.  My memory is important to me as I am an academic who must have his wits, and recall, about me. I am on a relatively high dosage, about 4 mg/day. In addition, I will occasionally take Ambien 10 mg for insomnia. I also take 150 mg of Wellbutrin and 200 mg/2x daily for depression. Thank you for sharing your experiences. markhw2002 — I’m on Lexapro and Ativan and do seem to have some memory problems, however I can concentrate well and my problem solving skills have not suffered. — The charter is available at:http://readystump.algebra.com/~asapm

It is my understanding that anxiety itself can have a profound effect on memory so I guess it’s a fair trade off. — The charter is available at: http://readystump.algebra.com/~asapm

Response:

irritating and contradictory sleep hygiene advice

Question:

– Hide quoted text — Show quoted text – hi folks.  as i have had a long standing problem with insomnia, i often read articles about sleep related issues.  on the subject of sleep hygiene i keep coming across these two contradictory ideas: 1) you should go to bed at the same time every night.  this will     teach your body to get sleepy at that time. 2) you should not go to bed until you feel sleepy.  otherwise you’ll     just lay awake for ages staring at the ceiling. which of these statements strikes you as most correct?  or do you think it probably depends on the individual? many thanks =) — _TJ_ Hi TJ, I’ve battled insomnia for years, read all of the advice and finally came to what works best for me. It’s more important to get up at the same time every day, not go to bed at the same time every night. If I get so sleepy during the day that I can’t stand it, I will allow myself a 20 minute nap, but not a 2 hour one! That will really mess up your sleep schedule. As for me, I go to bed when I get sleepy, but get up at the same time regardless of when I go to bed. It’s good to do relaxing things before bed. Maybe turn on some low music and read for half an hour – nothing to stimulating. And this one I cannot vouch for: it is some advice I heard on the radio, and I have not tried this, but it supposedly came from sleep experts. They said to hop on one foot, (I am not kidding) for 30 seconds. Not vigorously.. but in theory, it takes all of your attention and puts it toward your balance – and diverts it away from things that might be running through your mind and keep you awake. It is supposed to be a way to clear your mind. As I said, I have not tried this, and I’m sure, YMMV.. but I thought I’d throw it out for anyone who might want to try it.

I too will give this a shot Sally when I have one of those really restless nights and report back. Interesting… Carl Love, Sally — The charter is available at: http://readystump.algebra.com/~asapm

– The charter is available at: http://readystump.algebra.com/~asapm

Response:

For me, I have to go to bed when I am sleepy, which is not a problem too much lately.  I have to get up at 4am and work 4 days, 10 hours a day.  I also have to drive an hour to and from work (it’s worth it)  It absolutely catches up with me.  My doc did give me Ambien and it truly helps especially if I have had a long day LIKE TODAY! nite nite all, Vicki

– Hide quoted text — Show quoted text – hi folks.  as i have had a long standing problem with insomnia, i often read articles about sleep related issues.  on the subject of sleep hygiene i keep coming across these two contradictory ideas: 1) you should go to bed at the same time every night.  this will    teach your body to get sleepy at that time. 2) you should not go to bed until you feel sleepy.  otherwise you’ll    just lay awake for ages staring at the ceiling. which of these statements strikes you as most correct?  or do you think it probably depends on the individual? many thanks =) — _TJ_ — The charter is available at: http://readystump.algebra.com/~asapm

– The charter is available at: http://readystump.algebra.com/~asapm

Response:

I’ve battled insomnia for years, read all of the advice and finally came to what works best for me. It’s more important to get up at the same time every day, not go to bed at the same time every night.

thanks sally!  something tells me your method is probably the one that would work for me the best. And this one I cannot vouch for: it is some advice I heard on the radio, and I have not tried this, but it supposedly came from sleep experts. They said to hop on one foot, (I am not kidding) for 30 seconds.

lol i never heard that one before.  i’ll certainly have to give it a go if i have a busy mind one of these nights =) — _TJ_ — The charter is available at: http://readystump.algebra.com/~asapm

Response:

– Hide quoted text — Show quoted text – hi folks.  as i have had a long standing problem with insomnia, i often read articles about sleep related issues.  on the subject of sleep hygiene i keep coming across these two contradictory ideas: 1) you should go to bed at the same time every night.  this will     teach your body to get sleepy at that time. 2) you should not go to bed until you feel sleepy.  otherwise you’ll     just lay awake for ages staring at the ceiling. which of these statements strikes you as most correct?  or do you think it probably depends on the individual? many thanks =) — _TJ_

(grin) Good observation TJ. I’ve noticed this contradiction as well. Personally, I find myself going back and forth between the two. Sometimes one approach works best and other times the other approach works best. Best Wishes, Arthur — The charter is available at: http://readystump.algebra.com/~asapm

Response:

– Hide quoted text — Show quoted text – hi folks.  as i have had a long standing problem with insomnia, i often read articles about sleep related issues.  on the subject of sleep hygiene i keep coming across these two contradictory ideas: 1) you should go to bed at the same time every night.  this will     teach your body to get sleepy at that time. 2) you should not go to bed until you feel sleepy.  otherwise you’ll     just lay awake for ages staring at the ceiling. which of these statements strikes you as most correct?  or do you think it probably depends on the individual? many thanks =) — _TJ_

Hi TJ, I’ve battled insomnia for years, read all of the advice and finally came to what works best for me. It’s more important to get up at the same time every day, not go to bed at the same time every night. If I get so sleepy during the day that I can’t stand it, I will allow myself a 20 minute nap, but not a 2 hour one! That will really mess up your sleep schedule. As for me, I go to bed when I get sleepy, but get up at the same time regardless of when I go to bed. It’s good to do relaxing things before bed. Maybe turn on some low music and read for half an hour – nothing to stimulating. And this one I cannot vouch for: it is some advice I heard on the radio, and I have not tried this, but it supposedly came from sleep experts. They said to hop on one foot, (I am not kidding) for 30 seconds. Not vigorously.. but in theory, it takes all of your attention and puts it toward your balance – and diverts it away from things that might be running through your mind and keep you awake. It is supposed to be a way to clear your mind. As I said, I have not tried this, and I’m sure, YMMV.. but I thought I’d throw it out for anyone who might want to try it. Love, Sally — The charter is available at: http://readystump.algebra.com/~asapm

Response:

hi folks.  as i have had a long standing problem with insomnia, i often read articles about sleep related issues.  on the subject of sleep hygiene i keep coming across these two contradictory ideas: 1) you should go to bed at the same time every night.  this will     teach your body to get sleepy at that time. 2) you should not go to bed until you feel sleepy.  otherwise you’ll     just lay awake for ages staring at the ceiling. which of these statements strikes you as most correct?  or do you think it probably depends on the individual? many thanks =) — _TJ_ — The charter is available at: http://readystump.algebra.com/~asapm

Response:

Progressive Muscle Relaxation Exercises <08/28/07>

Question:

Progressive Muscle Relaxation     Progressive muscle relaxation is one example of a deep relaxation technique that can be used to reduce symptoms of stress, anxiety, insomnia, and certain types of chronic pain. Based upon the simple premise of tensing, or tightening, one muscle group at a time followed by a release of the tension, this form of relaxation is used by physicians (in combination with standard therapies) for a number of conditions, including headaches, cancer pain, high blood pressure, and digestive disturbances. This form of muscle relaxation is progressive in two senses.   Firstly, the muscle groups are tightened and relaxed one at a time in a specific order, generally commencing with the lower extremities and ending with the face, abdomen, and chest, although other sequences have been used by some practitioners. Secondly, a greater degree of muscle tension is attempted in subsequent exercises as compared with beginning efforts as one gains experience with the technique. The technique of progressive muscle relaxation was described by Edmund Jacobson in the 1930s based upon his premise that mental relaxation should naturally result from physical relaxation. Like the Relaxation Response pioneered by Herbert Benson in the 1970s, progressive muscle relaxation can be learned by nearly anyone and requires only 10-20 minutes per day. You may practice this technique seated or lying down in a completely quiet place free from all distractions. The individual muscle groups are tightened for 5-8 seconds and the tension is then released. While releasing the tension, try to focus on the changes you feel when the muscle group is relaxed. Imagery may be helpful in conjunction with the release of tension; you can try to imagine stressful feelings flowing out of your body as you relax each muscle group. You should stay relaxed for 15-30 seconds and move on to the next muscle group. In addition to its stress-reduction and health benefits, progressive muscle relaxation is an excellent tool to help learn about the body and its signals. With practice and time, you can learn to accurately identify tension signals in your body and actively work to reduce stress and tension and their accompanying physical reactions. http://stress.about.com/cs/relaxation/a/aa110600a.htm How to Create a Serene Sacred Space "Sacred Space" is a special place you can retreat to and spend time alone in quiet meditation or retrospection. Here are a few helpful ideas for creating an indoor sanctuary. Difficulty Level: average Time Required: 25 to 45 minutes Here’s How: Choose an area within the interior of your home for your "Sacred Space" (a spare bedroom, a revamped pantry area, a corner space, etc.) Clear this space of stagnant energies by performing a ritual smudging (cleanse with smoke from burning sage wand). This should also be repeated periodically after you begin using your sacred space Consider your personal comforts and each of your senses in choosing the suggested furniture and articles to fill this space. Comfort: floor cushions, a gentle swaying rocker, or perhaps a stuffed chaise to stretch out in. Sounds: wind chimes, water fountains, CDs & player, a hand-carved wooden flute. Taste: peppermints for mental clarity, calming herbal tea blends, cinnamon red hot candies to awaken the taste buds. Smells: scented candles, incense, freshly cut sprig of lavender. Visual: mirrors, posters, paintings, artwork, altar. Touch: objects with a variety of textures such as crystals, feathers, sea shells, woven cloths, teddy bears, etc. A window placement within the space is especially welcome to allow fresh air and sunshine for healing and happiness. Tips: Once your space is ready, honor it by making your presence there often. Set boundaries by deciding who else, if anyone, is allowed in your Sacred Space. Keep a supply of colored pens and notebooks if you want to maintain a journal in your Sacred Space. http://healing.about.com/library/howto/ht_sacredspace.htm How to Relax and Ground Your Body Grounding exercises help tremendously with maintaining a balance of our physical and spiritual bodies. This particular exercise can serve as an excellent tool for identifying physical stresses and upsets. Difficulty Level: average Time Required: 25-60 minutes Here’s How: Lay down comfortably on a bed or massage table. Bring your thoughts from its busy mental chatter downward by focusing on your feet. Notice the soles of your feet, your toes, in-between your toes, the top of your feet. Do they feel hot? or cold? Do they hurt? Are they numb? Do you feel your blood circulating through them? Are they feeling tired? Once you have a made a strong connection with your feet, you may then move your focus upwards to your ankles. Notice, but don’t judge how the different parts feel. For example, when you wiggled your toes, how did that feel? Gradually shift your focus now to your lower legs, onto your knee caps, behind your knees, your thighs and upward. Keep reminding yourself not to rush. Allow yourself to breathe throughout the exercise, especially as you come to any areas of discomfort (stressed muscles, soreness, etc.) or at any spot that feels like there may be an energy block. Once you have moved through your torso and up to your neck drop back to your fingertips. Move to the hands, up your arms and shoulders, returning now to your neck. Finish up with your face and scalp. Tips: Don’t rush this process. Take your time moving upwards to each part of your body. Do not touch yourself. Just allow your mind to switch focus from wherever it is and mentally consider your body’s sensations. Do this exercise while laying down is recommended, but for anyone who tends to fall asleep quickly upon hitting the pillow sitting upright in a chair may be preferable. http://healing.about.com/library/howto/ht_ground.htm Basic Guided Relaxation: Advanced Technique Article by L. John Mason, Ph.D. This guided relaxation exercise is taken from exercises from Dr. Mason’s best selling book, Guide to Stress Reduction. A version of this technique is found on most of the guided relaxation tapes/CD’s found at the Stress Education Center’s Tapes/CD’s page. Please find the one that is best for your specific requirements. Look in the health series, if you have symptoms of stress. For the best results, have someone read this guided relaxation slowly to you, with appropriate pauses. You can also read this exercise into a tape recorder and then play it back to yourself when you want to relax. Remember, this exercise will work best for you with regular daily use and repetition over time. (4-6 weeks to see positive change and 8-12 weeks of regular use for the maximum benefits to begin.) Good health and enjoy your relaxation! Start of relaxation. Begin here. When you are ready to begin, start by getting yourself into a comfortable position in a space where you will not be unnecessarily disturbed, for about twenty minutes. As you sit back or lie back more comfortably, check to see if your arms and legs are in a relaxed uncrossed position. Let your shoulders release tension and let your neck begin to relax by letting your head just sink back comfortably into the pillow or chair. Check the muscles of your head and face, especially the muscles around your eyes, even your eye brows, and the muscles around your mouth, including your jaw and even your tongue. Before we begin, let me remind you that I do not want you to try to relax too quickly. In fact, I do not want you to try to relax at all! Because without any effort you will be able drift as deeply into relaxation as you wish to go, by just letting go of stress, thoughts, and physical tensions. To begin, start by taking three deep slow diaphragmatic breaths…pausing after you inhale, and then exhaling fully and completely. You might even imagine that as you exhale you can begin to release thoughts, tensions, even discomforts with the warm breath that you breathe out and away. (pause) After these first three slow breaths, then continue to breathe slowly, but naturally. Perhaps you can feel yourself taking another step deeper into relaxation and comfort with every exhalation. As you breathe slowly and naturally, please turn your attention to the relaxation that may be beginning in your arms and down into your hands. If you look very carefully, you might feel a slight difference, where one of your arms might be just a bit more relaxed than the other. It might be just a subtle difference, but one arm might feel slightly heavier, as if the muscles in that arm were more loose or more flexible. Or perhaps, one arms feels slightly warmer, as if, blood and energy could flow more freely and easily all the way down that arm… as if it were flowing down, through wide open blood vessels, and slowly, but freely, pulsing down into the hand and fingers. (pause) Or perhaps, both of your arms are equally relaxed, and that would be perfect as well. The only thing that matters is that you continue to breathe slowly and naturally, and perhaps you can begin to feel yourself drifting deeper into a dreamlike state where you can feel greater calmness and comfort, and where you begin to develop even greater awareness and control. As you continue to breathe slowly and gently, perhaps you can begin to become aware of the relaxation that may be starting down into your legs and feet. If you were to look very carefully, you might become aware of a slight difference, where one of your legs might be a bit more relaxed than the other. You might also find that one leg feels slightly heavier, as if the muscles in that leg were more … read more »

Response:

Insomnia Can Lead to Anxiety and Depression *article*

Question:

Insomnia Can Lead to Anxiety and Depression By: Psych Central Senior News Editor     on Thursday, Jul, 5, 2007 Reviewed by: John M. Grohol, Psy.D.     on July 5, 2007 at 10:41 am A night of bad sleep is a common event. For most people, insomnia lasts only a few days and goes away without treatment. However, when the sleep loss becomes the norm, the mind is ripe for development of anxiety or depression. Stress is known to cause a higher level of insomnia that may last for several weeks. This kind of insomnia may not go away on its own, and can lead to both short- and long-term health problems if left untreated. According to a study published in the journal SLEEP, chronic insomnia can increase one

A new question for the group…..

Question:

Hi:

"When dropping the ol’ head to the pillow at night I find my mind racing and my body exhausted and unable to slow down.. I sort of mentally get myself all worked up and generally, over nothing. It’s trivial stuff my mind just gets run away with. Outside of dropping sleeping pills or three 1mg Xanax I have been unable to wrestle myself to a comfortable state on many occasions. I try the breathing and rationalization of what is going on but it is futile at best.

Any suggestions that work for you?" If you have not done so, you might want to try changing the place where you sleep.  That works for me at times, especially when I’m waking with panic. I don’t have trouble getting to sleep because the 15 mgs of remeron and 50 mgs of trazadone seems to have a nice sedating effect on me. You might want to try remeron.  Just a thot. Good luck and hope you start gettings good sleep — its soooo important. –frizz — The charter is available at: http://readystump.algebra.com/~asapm

Response:

— Hi Again Rob-

 I have to agree with many of the things that have been suggested here. Have you tried watching TV for a while before going to sleep or setting the timer on the tv to go off after a certain time? I have tried that and it usually helps me and I’m sleeping before the tv goes off. I also agree that maybe listen to some relaxation cds. You might try getting a progressive muscle relaxation cd, it keeps you concentrating on tensing and relaxing all the muscle groups and usually put you to sleep quickly! I understand what you’re saying, when you go to bed and everything is quiet your mind tends to wander and we are just lucky enough to wander to our catastrophic thinking!!!! Try some of the suggestions here and see if that won’t help you relax some and get better sleep. I agree as well that new/fresh sheets and new quality pillows make a difference as well. I noticed a difference when I FINALLY broke down and paid for nice 600 threadcount sheets!!! It hurt the pocketbook but the rest was worth it! Good Luck Kellie — The charter is available at: http://readystump.algebra.com/~asapm

Response:

Hi, I agree with Frizz’s reply about changing sleeping places.  When I went through the worst of my insomnia I found it easier and comforting to sleep on the couch. smiles, Elise

– Hide quoted text — Show quoted text – Hi: "When dropping the ol’ head to the pillow at night I find my mind racing and my body exhausted and unable to slow down.. I sort of mentally get myself all worked up and generally, over nothing. It’s trivial stuff my mind just gets run away with. Outside of dropping sleeping pills or three 1mg Xanax I have been unable to wrestle myself to a comfortable state on many occasions. I try the breathing and rationalization of what is going on but it is futile at best. Any suggestions that work for you?" If you have not done so, you might want to try changing the place where you sleep.  That works for me at times, especially when I’m waking with panic. I don’t have trouble getting to sleep because the 15 mgs of remeron and 50 mgs of trazadone seems to have a nice sedating effect on me. You might want to try remeron.  Just a thot. Good luck and hope you start gettings good sleep — its soooo important. –frizz — The charter is available at: http://readystump.algebra.com/~asapm

– The charter is available at: http://readystump.algebra.com/~asapm

Response:

::My mind is all I really have to lose and it’s mostly gone anyhow! Mine too Jackie "Be Who You Are.. And Say What You Feel.. Because Those Who Mind Don’t Matter.. And Those That Matter Don’t Mind…"    ~~ Dr. Seuss — The charter is available at: http://readystump.algebra.com/~asapm

Response:

<gently snipped ::      Is it appropriate to look to speaking with a perspective counselor on ::a cursory basis to see if there is a "click" or is it more of " fill out the ::paperwork and hope for the best" and move on if it’s a bad fit?  I have very ::limited experience with doing something like this but it would seem sort of ::like a good idea…. Just like a job interview. After all, the counselor ::does work for the client correct? Hi RDF, You are paying them so this should not be an issue. Give it a try. What do you have to lose? Jackie "Be Who You Are.. And Say What You Feel.. Because Those Who Mind Don’t Matter.. And Those That Matter Don’t Mind…"    ~~ Dr. Seuss — The charter is available at: http://readystump.algebra.com/~asapm

Response:

Hi all,     In respect to all your advice I tried the TV thing and it just drives me nuts. I need dead-quiet and a cold room like all of you (God, I thought it was just me!)  I think I’m going to get rid of the TV in the room and just use the radio if anything. I did try something new…. 03:30 rolled around and alas, staring at the ceiling got a bit boring so I took my dog for a walk. I just grabbed a bottle of water and enjoyed the quiet cool evening. I am surrounded by woods so it’s pretty peaceful and quiet and 30 min. out there seemed to burn off some pent-up energy. I’m headed to a linen store for some good quality sheets. My mattress is firm as a rock and it helps.  I think just having so much on my plate and being in pain is a mitigating factor for 99.999% of this in a short term view.  The anxiety and stress as well as the agoraphobia is being given serious thought and I think I’m going to "shop around" for a counselor. Frankly if there is no connection as you all have pointed out this is a lesson in futility.  In retrospect the counselors I did see in the past seemed more concerned with my HMO status rather than my well being so I think I just fished in the wrong pond.      I took some time and read a ton of the content on the links that were supplied in my last posting on the anxiety and fear of dammed near everything under the sun! (Thanks Jackie !)  Seems like I qualify for a lot of the criteria for a clinical definition of a few issues.       Is it appropriate to look to speaking with a perspective counselor on a cursory basis to see if there is a "click" or is it more of " fill out the paperwork and hope for the best" and move on if it’s a bad fit?  I have very limited experience with doing something like this but it would seem sort of like a good idea…. Just like a job interview. After all, the counselor does work for the client correct?        Thanks again to you all. I really, really appreciate the help and the last two weeks have made me feel a lot less alone and messed up.    I can’t thank you enough. And as soon as Amazon delivers the suggested reading materials mentioned I’ll have some help reading something other than work crap before bed!!!                Respects,                         Rob

– Hide quoted text — Show quoted text – <gently snipped ::   When dropping the ol’ head to the pillow at night I find my mind racing ::and my body exhausted and unable to slow down.. I sort of mentally get ::myself all worked up and generally, over nothing. It’s trivial stuff my mind ::just gets run away with. Outside of dropping sleeping pills or three 1mg ::Xanax I have been unable to wrestle myself to a comfortable state on many ::occasions. I try the breathing and rationalization of what is going on but ::it is futile at best. ::     Any suggestions that work for you? Dear RDF, It would be better when you’re in this state to get out of bed and get into a quiet, non-stimulating activity, like reading a book or watching TV. Trying to force yourself to sleep when you’re this wound up is pretty much futile. I’ve gotten into a bad habit of needing the TV to help me fall asleep but it really helps. Also, nix the caffeine. Caffeine stays in your body for at least 6 hours. Have you ever tried to not sleep? ~*~Paradoxical intention can also be applied in cases of sleep disturbance. The fear of sleeplessness results in a hyper-intention to fall asleep, which, in turn, incapacitates the patient to do so. To overcome this particular fear, I usually advise the patient not to try to sleep but rather to try to do the opposite, that is, to stay awake as long as possible. In other words, the hyper-intention to fall asleep, arising from the anticipatory anxiety of not being able to do so, must be replaced by the paradoxical intention not to fall asleep, which will soon be followed by sleep~*~ page 150, "Man`s Search for Meaning" by Viktor Frankl", Wishing you sweet dreams! Jackie "Be Who You Are.. And Say What You Feel.. Because Those Who Mind Don’t Matter.. And Those That Matter Don’t Mind…"   ~~ Dr. Seuss — The charter is available at: http://readystump.algebra.com/~asapm

– The charter is available at: http://readystump.algebra.com/~asapm

Response:

My mind is all I really have to lose and it’s mostly gone anyhow!        Live well,              Rob

– Hide quoted text — Show quoted text – <gently snipped ::      Is it appropriate to look to speaking with a perspective counselor on ::a cursory basis to see if there is a "click" or is it more of " fill out the ::paperwork and hope for the best" and move on if it’s a bad fit?  I have very ::limited experience with doing something like this but it would seem sort of ::like a good idea…. Just like a job interview. After all, the counselor ::does work for the client correct? Hi RDF, You are paying them so this should not be an issue. Give it a try. What do you have to lose? Jackie "Be Who You Are.. And Say What You Feel.. Because Those Who Mind Don’t Matter.. And Those That Matter Don’t Mind…"   ~~ Dr. Seuss — The charter is available at: http://readystump.algebra.com/~asapm

– The charter is available at: http://readystump.algebra.com/~asapm

Response:

– Hide quoted text — Show quoted text – Hi all,     In respect to all your advice I tried the TV thing and it just drives me nuts. I need dead-quiet and a cold room like all of you (God, I thought it was just me!)  I think I’m going to get rid of the TV in the room and just use the radio if anything. I did try something new…. 03:30 rolled around and alas, staring at the ceiling got a bit boring so I took my dog for a walk. I just grabbed a bottle of water and enjoyed the quiet cool evening. I am surrounded by woods so it’s pretty peaceful and quiet and 30 min. out there seemed to burn off some pent-up energy. I’m headed to a linen store for some good quality sheets. My mattress is firm as a rock and it helps.  I think just having so much on my plate and being in pain is a mitigating factor for 99.999% of this in a short term view.  The anxiety and stress as well as the agoraphobia is being given serious thought and I think I’m going to "shop around" for a counselor. Frankly if there is no connection as you all have pointed out this is a lesson in futility.  In retrospect the counselors I did see in the past seemed more concerned with my HMO status rather than my well being so I think I just fished in the wrong pond.      I took some time and read a ton of the content on the links that were supplied in my last posting on the anxiety and fear of dammed near everything under the sun! (Thanks Jackie !)  Seems like I qualify for a lot of the criteria for a clinical definition of a few issues.       Is it appropriate to look to speaking with a perspective counselor on a cursorybasis to see if there is a "click" or is it more of " fill out the paperwork and hope for the best" and move on if it’s a bad fit?  I have very limited experience with doing something like this but it would seem sort of like a good idea…. Just like a job interview. After all, the counselor does work for the client correct?        Thanks again to you all. I really, really appreciate the help and the last two weeks have made me feel a lot less alone and messed up.    I can’t thank you enough. And as soon as Amazon delivers the suggested reading materials mentioned I’ll have some help reading something other than work crap before bed!!!                Respects,                         Rob <gently snipped ::   When dropping the ol’ head to the pillow at night I find my mind racing ::and my body exhausted and unable to slow down.. I sort of mentally get ::myself all worked up and generally, over nothing. It’s trivial stuff my mind ::just gets run away with. Outside of dropping sleeping pills or three 1mg ::Xanax I have been unable to wrestle myself to a comfortable state on many ::occasions. I try the breathing and rationalization of what is going on but ::it is futile at best. ::     Any suggestions that work for you? Dear RDF, It would be better when you’re in this state to get out of bed and get into a quiet, non-stimulating activity, like reading a book or watching TV. Trying to force yourself to sleep when you’re this wound up is pretty much futile. I’ve gotten into a bad habit of needing the TV to help me fall asleep but it really helps. Also, nix the caffeine. Caffeine stays in your body for at least 6 hours. Have you ever tried to not sleep? ~*~Paradoxical intention can also be applied in cases of sleep disturbance. The fear of sleeplessness results in a hyper-intention to fall asleep, which, in turn, incapacitates the patient to do so. To overcome this particular fear, I usually advise the patient not to try to sleep but rather to try to do the opposite, that is, to stay awake as long as possible. In other words, the hyper-intention to fall asleep, arising from the anticipatory anxiety of not being able to do so, must be replaced by the paradoxical intention not to fall asleep, which will soon be followed by sleep~*~ page 150, "Man`s Search for Meaning" by Viktor Frankl", Wishing you sweet dreams! Jackie "Be Who You Are.. And Say What You Feel.. Because Those Who Mind Don’t Matter.. And Those That Matter Don’t Mind…"   ~~ Dr. Seuss

Rob, It sounds like you are working on finding what works and what doesn’t work for you in regards to sleep. Good for you. I’d nix the TV if it makes you anxious.  Music can either relax you or invigorate you.. would depend on the music and you, really.. a nice, boring book might help too. I about fell asleep tonight reading a book about feet. The guy was naming all of the bones, muscles and tendons, and I got extremely sleepy, so maybe you could get a book on something you really don’t want to know about. I think you did the right thing getting up when you could not sleep. I do that, too. Just make a mental note when you notice stuff that does NOT work.. those things.. don’t do ‘em. Do something not that. LOL. Eventually, you’ll find what works best for you. Now I want good sheets. Mine are about 100 count, I think, LOL. re : the therapist – My hunch is that you will have to fill out the paperwork and the personal inventories, etc.. see the therapist, and if they are wrong for you, repeat the process with another therapist. I have actually only gone to one office for therapy, but I’ve had 3 different therapists – the first two left the practice… so my experience is limited, but I bet you have to fill out the paperwork, and if you don’t like/trust the therapist, get thee to another.. it’s mostly about relationship and your comfort level and a desire on your part to want to get better and be willing to do the work it takes to get better. It is a goal worth working toward. Good luck. Sally — The charter is available at: http://readystump.algebra.com/~asapm

Response:

<gently snipped ::   When dropping the ol’ head to the pillow at night I find my mind racing ::and my body exhausted and unable to slow down.. I sort of mentally get ::myself all worked up and generally, over nothing. It’s trivial stuff my mind ::just gets run away with. Outside of dropping sleeping pills or three 1mg ::Xanax I have been unable to wrestle myself to a comfortable state on many ::occasions. I try the breathing and rationalization of what is going on but ::it is futile at best. ::     Any suggestions that work for you? Dear RDF, It would be better when you’re in this state to get out of bed and get into a quiet, non-stimulating activity, like reading a book or watching TV. Trying to force yourself to sleep when you’re this wound up is pretty much futile. I’ve gotten into a bad habit of needing the TV to help me fall asleep but it really helps. Also, nix the caffeine. Caffeine stays in your body for at least 6 hours. Have you ever tried to not sleep? ~*~Paradoxical intention can also be applied in cases of sleep disturbance. The fear of sleeplessness results in a hyper-intention to fall asleep, which, in turn, incapacitates the patient to do so. To overcome this particular fear, I usually advise the patient not to try to sleep but rather to try to do the opposite, that is, to stay awake as long as possible. In other words, the hyper-intention to fall asleep, arising from the anticipatory anxiety of not being able to do so, must be replaced by the paradoxical intention not to fall asleep, which will soon be followed by sleep~*~ page 150, "Man`s Search for Meaning" by Viktor Frankl", Wishing you sweet dreams! Jackie "Be Who You Are.. And Say What You Feel.. Because Those Who Mind Don’t Matter.. And Those That Matter Don’t Mind…"    ~~ Dr. Seuss — The charter is available at: http://readystump.algebra.com/~asapm

Response:

Hi all….     First, I wanted to thank you for the public and private replies to my recent post in respect to my panic, anxiety and depression issues. I am most grateful and appreciative for the supportive and kind words of understanding and support. It feels good to not be "lost in the woods alone."     Now for the million dollar question that I wanted to pose……     When dropping the ol’ head to the pillow at night I find my mind racing and my body exhausted and unable to slow down.. I sort of mentally get myself all worked up and generally, over nothing. It’s trivial stuff my mind just gets run away with. Outside of dropping sleeping pills or three 1mg Xanax I have been unable to wrestle myself to a comfortable state on many occasions. I try the breathing and rationalization of what is going on but it is futile at best.      Any suggestions that work for you?                  Many respects,                           Rob — The charter is available at: http://readystump.algebra.com/~asapm

Response:

– Hide quoted text — Show quoted text -Hi all….    First, I wanted to thank you for the public and private replies to my recent post in respect to my panic, anxiety and depression issues. I am most grateful and appreciative for the supportive and kind words of understanding and support. It feels good to not be "lost in the woods alone."    Now for the million dollar question that I wanted to pose……    When dropping the ol’ head to the pillow at night I find my mind racing and my body exhausted and unable to slow down.. I sort of mentally get myself all worked up and generally, over nothing. It’s trivial stuff my mind just gets run away with. Outside of dropping sleeping pills or three 1mg Xanax I have been unable to wrestle myself to a comfortable state on many occasions. I try the breathing and rationalization of what is going on but it is futile at best.     Any suggestions that work for you?                 Many respects,                          Rob

Listen to Relaxation music/CD through headphones: like: waterfall running brook thunderstorm etc etc or get a white noise generator or get a machine that makes these calming sounds. Before the CD is finished, you will be asleep already. Lg — The charter is available at: http://readystump.algebra.com/~asapm

Response:

I put on TV Land really low and get in bed and massage my head, neck and face until I can’t do it anymore.  That really works well for me and I roll over and go to sleep.  I have used the other suggestions of music, sound machines too.  The massage thing works like magic on me . I also, and just my opinion…since I got some good quality sheets and new pillows, I have slept sooo much better (300tc egyptian cotton from Penny’s) I keep my room cool and the fan on.  That noise of the fan and the tv light helps me from that racing mind too.  " When dropping the ol’ head to the pillow at night I find my mind racing and my body exhausted and unable to slow down.. I sort of mentally get myself all worked up and generally, over nothing. It’s trivial stuff my mind just gets run away with. Outside of dropping sleeping pills or three 1mg Xanax I have been unable to wrestle myself to a comfortable state on many occasions. I try the breathing and rationalization of what is going on but it is futile at best.      Any suggestions that work for you?                  Many respects,                           Rob"

– The charter is available at: http://readystump.algebra.com/~asapm

Response:

I have suffered from insomnia for years and these are things that help me: 1. Have a quiet period for a couple of hours before bed time. Sit in a comfortable chair in a room with dim light and read something soothing (or boring , or listen to soft music. Books on tape are also good if the reader has a soothing voice and the topic doesn’t upset you. 2. Try mindfulness. When you notice your mind racing, don’t get upset. Just note it and turn your mind towards something soothing. I like to visualize flowers and things I see during my walk. 3. Speaking of which, get exercise but not right before going to bed. I find that taking a brisk walk a couple of hours before bed time so my body warms up really relaxes me as I cool down. During the winter, I use an exercise bicycle and an aerobic step. 4. Probably most important, work on convincing yourself that you will do OK even if you don’t sleep or sleep poorly. And do it. If you don’t sleep, get on with your life the next day. Don’t obsess about sleep; think about something else. This will take away the power of the insomnia. I accept that I am anxious and will not sleep well some nights. I just figure that I will sleep better the next night. Bob — The charter is available at: http://readystump.algebra.com/~asapm

Response:

– Hide quoted text — Show quoted text – Hi all….     First, I wanted to thank you for the public and private replies to my recent post in respect to my panic, anxiety and depression issues. I am most grateful and appreciative for the supportive and kind words of understanding and support. It feels good to not be "lost in the woods alone."     Now for the million dollar question that I wanted to pose……     When dropping the ol’ head to the pillow at night I find my mind racing and my body exhausted and unable to slow down.. I sort of mentally get myself all worked up and generally, over nothing. It’s trivial stuff my mind just gets run away with. Outside of dropping sleeping pills or three 1mg Xanax I have been unable to wrestle myself to a comfortable state on many occasions. I try the breathing and rationalization of what is going on but it is futile at best.      Any suggestions that work for you?                  Many respects,                           Rob

Hi Rob, I had insomnia for years – until I decided to follow the advice that I had read about a million times already – do not go to bed until you are sleepy. If it is 10, fine.. if it is 4 am.. then that is when you are tired.  I can’t honestly remember the last time I struggled with insomnia, as I never go near the bed until I am SO ready to sleep. I do take Xanax at night, but not to sleep – it just seems to be my cycle that my anxiety is highest in the evenings.. but it’s not the Xanax that gets me sleepy. It’s just the fact I’m ready to sleep. I do work, and I do have some days when I have to work after not sleeping for a full night – but so what? I do seem to make it up eventually sometime. d/c any late afternoon and evening caffeine. That will definitely keep you awake longer – and it’s good to have some kind of routine every night, and a cool room that is comfortable and inviting – but the thing that really worked for me was simply not getting into bed until I was so sleepy I could not stand it.. As for racing thoughts.. just have a conversation with yourself and KNOW that you cannot do one thing about much late at night.. like Scarlett O’Hara – tell yourself you will think about that tomorrow. I never, ever tell myself I need to get to bed by such and such time. I go when my body says it is time to go – you will sleep eventually. Worrying about it only hurts, does not help – and the majority of the population is walking around with a sleep debt – lack of sleep is not usually a life or death matter – just a matter of being tired the next day. Do not awfulize not getting enough sleep. It’s not awful, it’s is only uncomfortable, and not unbearably so. Take care, Sally — The charter is available at: http://readystump.algebra.com/~asapm

Response:

Just one more question.

Question:

Now you know how I picked up my nickname  (Peter Faulk’s  tv character; Columbo) But my question is : (and I promise to be quiet for awhile after this): Is anyone aware of any studies that show which anti- depressant’s (IF ANY); do NOT affect your sleep? Either way–by keeping you awake or making you too sleepy? I’ve tried several -with no great results. Different doses and switching times morning or night-not much difference. Please share your anti-depressant medical experience if any. Peace and happiness to all. — The charter is available at: http://readystump.algebra.com/~asapm

Response:

Now you know how I picked up my nickname  (Peter Faulk’s  tv character; Columbo) But my question is : (and I promise to be quiet for awhile after this): Is anyone aware of any studies that show which anti- depressant’s (IF ANY); do NOT affect your sleep? Either way–by keeping you awake or making you too sleepy? I’ve tried several -with no great results. Different doses and switching times morning or night-not much difference. Please share your anti-depressant medical experience if any.

No no no! Don’t ever keep qiuet! As far as I know, they all have it listed as a possible side effect. But it doesn not mean that everyone who uses it experiences it or maybe only while weaning on them. When I started fluvoxamine I was very tired, disturbed sleep patterens and I woke up at night about every 2 hours. But now, about 3 months later, I sleep just fine with just the occasional nightly wake up, every now and then. I think I still sleep light but it doesnt affect me that much anymore. I do get sleepy a bit earlyer in the evening than usual but I don’t think there’s anything wrong with that. I used to stay up very late each night.. Before that, I was on paxil, wich affected me a lot more. Vivid dreams, noctural PAs and flattened emotions. If I took xanax before sleep, I was not going to wake up in time the next morning for sure (wouldn’t even hear the alarm clock going off). But everyone reacts differently, as always it’s trial and error untill you find what works best for you. How much time have you been on each of these different meds? Switching every few weeks won’t give any med a fair chance to see how it will work for you. I hope it is all supervised by your doctor? — The charter is available at: http://readystump.algebra.com/~asapm

Response:

::Now you know how I picked up my nickname  (Peter Faulk’s  tv ::character; Columbo) :: ::But my question is : (and I promise to be quiet for awhile after ::this): Is anyone aware of any studies that show which anti- ::depressant’s (IF ANY); do NOT affect your sleep? Either way–by ::keeping you awake or making you too sleepy? :: ::I’ve tried several -with no great results. Different doses and ::switching times morning or night-not much difference. :: ::Please share your anti-depressant medical experience if any. :: ::Peace and happiness to all. Hi Dan, You don’t have to be quiet…….you can ask as many questions as you like Unfortunately, most antidepressants can affect your sleep in one way or another. You may have to try a few more to find one that won’t cause this problem. Or, antidepressants may not be a class of meds for you. What antidepressant are you taking now? I recall you being on Imipramine. Did you have sleep problems before starting antidepressants? What sleep problem are you experiencing now (sleepiness or insomnia)? I know, I’m nosey Jackie ~*~I’ve seen and met angels wearing the disguise of ordinary people living ordinary lives~*~    ~~Tracy Chapman — The charter is available at: http://readystump.algebra.com/~asapm

Response:

– Hide quoted text — Show quoted text – ::Now you know how I picked up my nickname  (Peter Faulk’s  tv ::character; Columbo) :: ::But my question is : (and I promise to be quiet for awhile after ::this): Is anyone aware of any studies that show which anti- ::depressant’s (IF ANY); do NOT affect your sleep? Either way–by ::keeping you awake or making you too sleepy? :: ::I’ve tried several -with no great results. Different doses and ::switching times morning or night-not much difference. :: ::Please share your anti-depressant medical experience if any. :: ::Peace and happiness to all. Hi Dan, You don’t have to be quiet…….you can ask as many questions as you like Unfortunately, most antidepressants can affect your sleep in one way or another. You may have to try a few more to find one that won’t cause this problem. Or, antidepressants may not be a class of meds for you. What antidepressant are you taking now? I recall you being on Imipramine. Did you have sleep problems before starting antidepressants? What sleep problem are you experiencing now (sleepiness or insomnia)? I know, I’m nosey Jackie ~*~I’ve seen and met angels wearing the disguise of ordinary people living ordinary lives~*~    ~~Tracy Chapman The charter is available at:http://readystump.algebra.com/~asapm

I’m not currently taking any anti-depressant meds. Imipramine -I took for a long time. I thought that was more for anxiety. It was the only one that made me sleepy. Most of the others had the opposite effect. Maybe I’ll check with doc again about imipramine. While, I wasn’t as anxious while taking it, maybe it helped more than I recall now for depression. Thanks. — The charter is available at: http://readystump.algebra.com/~asapm

Response:

I’m not currently taking any anti-depressant meds. Imipramine -I took for a long time. I thought that was more for anxiety. It was the only one that made me sleepy. Most of the others had the opposite effect. Maybe I’ll check with doc again about imipramine. While, I wasn’t as anxious while taking it, maybe it helped more than I recall now for depression. Thanks.

Imipramine is an effective antidepressant. Chip — The charter is available at: http://readystump.algebra.com/~asapm

Response:

::I’m not currently taking any anti-depressant meds. Imipramine -I took ::for a long time. I thought that was more for anxiety. It was the only ::one that made me sleepy. Most of the others had the opposite effect. ::Maybe I’ll check with doc again about imipramine. While, I wasn’t as ::anxious while taking it, maybe it helped more than I recall now for ::depression. Thanks. Dear Dan, Imipramine can be effective for both depression and anxiety. Since you mentioned that you are depressed recently, it would be a good idea to ask your doctor to put you back on Imipramine. Paxil makes me very tired but it is a side-effect I am willing to tolerate since it works so well for me. My sleep has greatly improve since being on Paxil. Take care Jackie ~*~I’ve seen and met angels wearing the disguise of ordinary people living ordinary lives~*~    ~~Tracy Chapman — The charter is available at: http://readystump.algebra.com/~asapm

Response:

SSRI's -friend or foe

Question:

Z.Beeblebrox schreef: Well, so far so good for me on an SSRI (Celexa). It’s been about 3 months since I started. I’ve had panic/anxiety for 10yrs and have previously been on a beta blocker (propranolol) and xanax. Back in january, my system freaked out (why?) and my anxiety/panic went from little to major. So the doc put me on celexa and I’ve improved slowly but surely – no complaints. My anxiety is fairly low now – close to what it was in the past. There have also been some other positives. My mood in general is better. I never realized my mood was dark until now. It’s definitely had a positive effect on my general outlook & personality. So, I’m pleased right now. We’ll see how it goes long term.

This sounds positively promising. A med that works is a thing to cherish. If necessary Celexa and Xanax can be combined, often with good results. I’m glads you;re doing so well! Philip – Hide quoted text — Show quoted text – -z- aka rob Hello everyone. I have been put on SSRI drugs (paxil, effexor, cymbalta) for anxiety and every time the drugs didnt work. Every time I stopped taking one of these (even with a slow process of gradually lowering doses) I experience horrible dizzy spells, tingling in my hands, nausea and other unpleasant side effects. Finally, my doc gave me a low dose of alprazolam to take as needed and everything is fine. Is it just me, or do you guys think that doctors use these anti- depressants as a blanket treatment for everything from insomnia to claustrophobia without really considering the patient? Almost everyone I know is now taking an SSRI. I have heard a few people say they felt horrible after stopping these meds.

– The charter is available at: http://readystump.algebra.com/~asapm

Response:

- Hide quoted text — Show quoted text – Nonetheless, this hasn’t stopped some docs from suggesting I go back on an SSRI (including Paxil PRN, which turns out to be just a slick way of saying short-term use of Paxil, moan!). I don’t think I’ve heard of anyone using Paxil PRN before?  Since it takes time to wean onto it, I would think using it PRN would just make every attack worse? Tony That was my thought as well. When I asked the doctor about this, he wasn’t sure how to answer and had to consult someone about this between our visits. He later agreed with me that "PRN" was misleading in this situation and that it would actually amount to me simply taking Paxil (which I had already reacted to badly). I suspect that this was a case of him passing along misleading info from an overzealous pharm rep. Best Wishes, Arthur

Just writing "pharm rep" explains many medical questions. Tony — The charter is available at: http://readystump.algebra.com/~asapm

Response:

<gently snipped ::Is it just me, or do you guys think that doctors use these anti- ::depressants as a blanket treatment for everything from insomnia to ::claustrophobia without really considering the patient? Almost everyone ::I know is now taking an SSRI. I agree! It bothers me to see my doctor’s med closet filled with all kinds of psych meds. A friend of mine’s doctor urged her to give Paxil a try. She bragged that most of her staff was on it.  Just like antibiotics, antidepressants are being over prescribed in my opinion. ::I have heard a few people say they felt horrible after stopping these ::meds. Got to go really, really slow when weaning off There are some options, like switching to Prozac if trying to wean off Paxil or switching to liquid Paxil which would allow one to decrease their dose in very tiny amounts Practical Tips for Tapering Off Antidepressants Part 1 – Cause and Effects A scenario: You’ve been on an SSRI antidepressant for five weeks or more. The doctor feels that the dosage needs to be decreased or the medication needs to be discontinued. He prescribes changes and tapering in the usual 10mg increments. Within a couple of days of starting this, you begin to exhibit severe flulike symptoms – headache, diarrhea, nausea, vomiting, chills, dizziness and fatigue. There may be insomnia. Agitation, impaired concentration, vivid dreams, depersonalization, irritability and suicidal thoughts are sometimes occurring. These symptoms last anywhere from one to seven weeks and vary in intensity. You wonder what the heck is going on. It’s called SSRI discontinuation syndrome, and it can really be the pits. Here is what causes it: Some SSRI medications have a very short half-life. This means they produce no metabolites that help the medication stay in the body for an extended period. They go in, last a few hours, and come out again. SSRI’s are split into two categories: long acting and short acting. For example, Prozac is a longer-acting SSRI. Paxil, Effexor, Zoloft and Luvox are short-acting. The shorter acting SSRIs, when discontinued or when the dosage is lowered, produce an "anticholinergic rebound," which is an interruption in production of the key neurotransmitter acetylcholine. (Acetylcholine is the neurotransmitter used more when a person is under greater stress.) These symptoms will last anywhere from one to seven weeks, and then disappear. Neurologic symptoms include: Dizziness Vertigo Lightheadedness Difficulty walking Somatic (bodily) complaints include: Nausea/vomiting Fatigue Headaches Insomnia Less common difficulties: Shock-like sensations Parasthesia (skin crawling, burning or prickling) Visual disturbances Diarrhea Muscle pain Chills Non-specific mental symptoms: Shock-like sensations Agitation Impaired concentration Vivid dreams Depersonalization – sense of unreality and loss of self Irritability Suicidal thoughts Double-blind controlled studies now indicate that 35-78% of patients who, after five weeks or more of treatment with the medication, abruptly stop certain antidepressants or titrate down in 10mg increments or more, will develop one or more of the discontinuation symptoms. When allowed to run its course, the syndrome duration is variable (one to several weeks) and ranges from mild-moderate intensity in most patients, to extremely distressing in a small number. Part 2: Practical Tips for Tapering Off So … you are using a short-acting SSRI medication. You have to discontinue itor titrate it down, you tend to be very sensitive to the effects of medication withdrawal, and you want to know what to do to head off discontinuationsyndrome? First, ask your doctor if a special dose is available for the specific purpose of weaning down. Some pharmaceutical companies are now manufacturing and offering them in sample form to doctors. Ask. If such a dose is not available, the main thing to remember is that you want to try and wean down very slowly – usually in half the increments that your doctor would normally suggest for the weaning process in most people. If you have tablets, and the insert doesn’t indicate that splitting or crushing is taboo, you can split them (a pill splitter helps, a couple of bucks at the pharmacy). ALWAYS check the insert or a drug monograph first to make sure you can split them. This makes it pretty easy to halve the original titration recommendation and take each step down for a week. If you have capsules, you have a different type of problem … you obviously can’t open them and take the contents raw…but you can still taper off. Buy some empty gelcaps (very cheap – a couple bucks for a hundred). Take a single 24-hour dosage and set it aside. Open your capsules and redistribute the medication into the empty gelcaps to spread the total 24 hour dosage into smaller increments. Rub each capsule prior to storing with a dry cloth to get any of the medication off of the outside of the capsule. There is a little tool that can help you with this if you have pain in your hands or motor problems. You then set a 24-hour dosage amount aside, and gradually reduce it, using each amount for a week. I had great success using this method when titrating down from Paxil, one of the most notorious drugs for causing DS. My doctor refused to acknowledge the discontinuation problem and couldn’t seem to give me any helpful suggestions for reducing the discomfort. So I did it this way, and the effects were much more tolerable. The main thing is that the brain’s production of acetylcholine is not interrupted. One of the simplest things you can do to prevent this in addition to ultra-slow titration is to add supplements: in particular, choline, lecithin, and B complex. The B vitamins will help sustain your brain’s current levels of the neurotransmitter acetylcholine (the depletion of which is the cause of DS). You should also use choline supplements or lecithin supplements (which are 13 percent choline) to help increase the level of available choline that the brain uses to make acetylcholine while the titration or discontinuation is happening. Dietary changes (temporary if you wish until after the med is weaned) can also be made. Lecithin and choline can be found in a wide variety of foods, but many of the richest sources are foods also high in cholesterol and fat. Egg yolks are one of the best dietary sources of lecithin/choline. Other excellent sources of dietary choline are beef steak, liver, organ meat, spinach, soybeans, cauliflower, wheat germ, peanuts, and brewer’s yeast. Discontinuation symptoms are not restricted to the SSRIs, as many of you here can attest. Many drugs that act on the central nervous system can cause DS symptoms: monoamine oxidase inhibitors, tricyclic antidepressants, antiparkinsonian agents, traditional antipsychotics, and clozapine. Some people have a condition known as rebound, that occurs with the consumption of short acting medications (an agitated state of emotion that occurs at the end of the dosage cycle, and lasts for fifteen or twenty minutes, then disappears). The dietary modifications are helpful for this problem. It’s good to know that the psychiatric professional community recognizes this phenomenon as valid. Although the symptoms are varied, and are both physical and psychological, a characteristic SSRI discontinuation syndrome is now recognized. http://bipolar.about.com/cs/antidep/a/0207_ssridisc2.htm Jackie ~*~"What I cannot love, I overlook."~*~    ~~ Anais Nin — The charter is available at: http://readystump.algebra.com/~asapm

Response:

Nonetheless, this hasn’t stopped some docs from suggesting I go back on an SSRI (including Paxil PRN, which turns out to be just a slick way of saying short-term use of Paxil, moan!). I don’t think I’ve heard of anyone using Paxil PRN before?  Since it takes time to wean onto it, I would think using it PRN would just make every attack worse? Tony

That was my thought as well. When I asked the doctor about this, he wasn’t sure how to answer and had to consult someone about this between our visits. He later agreed with me that "PRN" was misleading in this situation and that it would actually amount to me simply taking Paxil (which I had already reacted to badly). I suspect that this was a case of him passing along misleading info from an overzealous pharm rep. Best Wishes, Arthur — The charter is available at: http://readystump.algebra.com/~asapm

Response:

– Hide quoted text — Show quoted text – Hello everyone. I have been put on SSRI drugs (paxil, effexor, cymbalta) for anxiety and every time the drugs didnt work. Every time I stopped taking one of these (even with a slow process of gradually lowering doses) I experience horrible dizzy spells, tingling in my hands, nausea and other unpleasant side effects. Finally, my doc gave me a low dose of alprazolam to take as needed and everything is fine. I’m glad the alprazolam is helping but be careful not to rely on that too much.  Its a wonderful med but that too has withdrawal side effects that are not nice.  I don’t know how low a doze the pdoc gave you but I’m assuming .25 mgs.? Is it just me, or do you guys think that doctors use these anti- depressants as a blanket treatment for everything from insomnia to claustrophobia without really considering the patient? Almost everyone I know is now taking an SSRI. Its true and my pdoc is angry about it.  He claims that the GP/FPs and IMs should NOT be giving scripts for these meds because most of them are not trained in all the aspects of anxiety and depression. I have heard a few people say they felt horrible after stopping these meds. Any thoughts on the subject?? I think Tony hit the nail on the head when he said to go slow.  The slower the better.  I tried to wean off Remeron (not an SSRI but an NaSSa cause the SSRI’s don’t work for me) and just when I thot I was free of the med. I started with the dizziness and sleeplessness, etc. I cut the tablets into crumbs and that helped; altho I’m still on it and probably will be the rest of my days unless they find something new. Are you getting off all antidepressants?  I’m a bit confused as to why you are stopping.  Please explain?  Have you found the magic cure? <g Good luck! -frizz —

Frizz, Yes, I am getting off of all anti-depressants. Occaisionally I do take an alprazolam (xanax-but very low dosage) when I cant sleep or my anxiety gets out of control. I found that the SSRI’s didnt help me at all. I wish I had found a magic cure!!!!!! But, until then I dont want to be taking a pill every day that does more harm than good. I am FINALLY over all of the withdrawl symptoms, and I will never take another SSRI. — The charter is available at: http://readystump.algebra.com/~asapm

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Well, so far so good for me on an SSRI (Celexa). It’s been about 3 months since I started. I’ve had panic/anxiety for 10yrs and have previously been on a beta blocker (propranolol) and xanax. Back in january, my system freaked out (why?) and my anxiety/panic went from little to major. So the doc put me on celexa and I’ve improved slowly but surely – no complaints. My anxiety is fairly low now – close to what it was in the past. There have also been some other positives. My mood in general is better. I never realized my mood was dark until now. It’s definitely had a positive effect on my general outlook & personality. So, I’m pleased right now. We’ll see how it goes long term. -z- aka rob

Hello everyone. I have been put on SSRI drugs (paxil, effexor, cymbalta) for anxiety and every time the drugs didnt work. Every time I stopped taking one of these (even with a slow process of gradually lowering doses) I experience horrible dizzy spells, tingling in my hands, nausea and other unpleasant side effects. Finally, my doc gave me a low dose of alprazolam to take as needed and everything is fine. Is it just me, or do you guys think that doctors use these anti- depressants as a blanket treatment for everything from insomnia to claustrophobia without really considering the patient? Almost everyone I know is now taking an SSRI. I have heard a few people say they felt horrible after stopping these meds.

– The charter is available at: http://readystump.algebra.com/~asapm

Response:

Hello everyone. I have been put on SSRI drugs (paxil, effexor, cymbalta) for anxiety and every time the drugs didnt work. Every time I stopped taking one of these (even with a slow process of gradually lowering doses) I experience horrible dizzy spells, tingling in my hands, nausea and other unpleasant side effects. Finally, my doc gave me a low dose of alprazolam to take as needed and everything is fine. Is it just me, or do you guys think that doctors use these anti- depressants as a blanket treatment for everything from insomnia to claustrophobia without really considering the patient? Almost everyone I know is now taking an SSRI. I have heard a few people say they felt horrible after stopping these meds. Any thoughts on the subject?? — The charter is available at: http://readystump.algebra.com/~asapm

Response:

Hello everyone. I have been put on SSRI drugs (paxil, effexor, cymbalta) for anxiety and every time the drugs didnt work. Every time I stopped taking one of these (even with a slow process of gradually lowering doses) I experience horrible dizzy spells, tingling in my hands, nausea and other unpleasant side effects. Finally, my doc gave me a low dose of alprazolam to take as needed and everything is fine.

That is common.  Tapering off them slowly is important.  I don’t know how fast you tapered off, but some people taper off very very slow taking a month or more.  I tapered off years ago and if I got some of the symptoms, I simply took a very tiny dose to help me through the day.   (I had the smallest dose pills cut up into pieces.) Is it just me, or do you guys think that doctors use these anti- depressants as a blanket treatment for everything from insomnia to claustrophobia without really considering the patient? Almost everyone I know is now taking an SSRI.

I believe them to be over prescribed. I have heard a few people say they felt horrible after stopping these meds.

Some of that is the Drs fault, and some is the patients fault.  I’ve heard of many people quit cold turkey which is very stupid if they have ever read the paperwork that comes with the meds. Tony — The charter is available at: http://readystump.algebra.com/~asapm

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- Hide quoted text — Show quoted text – Hello everyone. I have been put on SSRI drugs (paxil, effexor, cymbalta) for anxiety and every time the drugs didnt work. Every time I stopped taking one of these (even with a slow process of gradually lowering doses) I experience horrible dizzy spells, tingling in my hands, nausea and other unpleasant side effects. Finally, my doc gave me a low dose of alprazolam to take as needed and everything is fine. Is it just me, or do you guys think that doctors use these anti- depressants as a blanket treatment for everything from insomnia to claustrophobia without really considering the patient? Almost everyone I know is now taking an SSRI. I have heard a few people say they felt horrible after stopping these meds. Any thoughts on the subject??

I’ve had about every SSRI going and none of them ever helped me in any way.  Some old TCAs were a bit better – at least I got a good nights sleep on them!  I’m doing better with a benzo and a beta-blocker to be honest — _TJ_ <TJ_IREL at YAHOO dot IE — The charter is available at: http://readystump.algebra.com/~asapm

Response:

– Hide quoted text — Show quoted text – Hello everyone. I have been put on SSRI drugs (paxil, effexor, cymbalta) for anxiety and every time the drugs didnt work. Every time I stopped taking one of these (even with a slow process of gradually lowering doses) I experience horrible dizzy spells, tingling in my hands, nausea and other unpleasant side effects. Finally, my doc gave me a low dose of alprazolam to take as needed and everything is fine. Is it just me, or do you guys think that doctors use these anti- depressants as a blanket treatment for everything from insomnia to claustrophobia without really considering the patient? Almost everyone I know is now taking an SSRI. I have heard a few people say they felt horrible after stopping these meds. Any thoughts on the subject??

Your experience is much like mine. I tried Paxil for 2-years, reacted badly to the med (including fainting spells), then tapered off Paxil and I did much better simply on alprazolam PRN (as needed). Nonetheless, this hasn’t stopped some docs from suggesting I go back on an SSRI (including Paxil PRN, which turns out to be just a slick way of saying short-term use of Paxil, moan!). The jury still seems out on SSRI meds in general. They seem helpful for some, hurtful for others. Also much debate still going on over the possible connection with suicide, which is being left to doc judgement calls for now. There is still much to learn about the etiology of anxiety disorders and even more to learn about treating individual patients. Best Wishes, Arthur — The charter is available at: http://readystump.algebra.com/~asapm

Response:

Hi, Welcome to ASAPM! That’s good the Alprazolam was helpful for you in getting off of the SSRI. Side effects are usually there when starting and stopping these meds. I also don’t know too many people who aren’t on some sort of antidepressants, including many young teens. smiles, Elise

– Hide quoted text — Show quoted text – Hello everyone. I have been put on SSRI drugs (paxil, effexor, cymbalta) for anxiety and every time the drugs didnt work. Every time I stopped taking one of these (even with a slow process of gradually lowering doses) I experience horrible dizzy spells, tingling in my hands, nausea and other unpleasant side effects. Finally, my doc gave me a low dose of alprazolam to take as needed and everything is fine. Is it just me, or do you guys think that doctors use these anti- depressants as a blanket treatment for everything from insomnia to claustrophobia without really considering the patient? Almost everyone I know is now taking an SSRI. I have heard a few people say they felt horrible after stopping these meds. Any thoughts on the subject?? — The charter is available at: http://readystump.algebra.com/~asapm

– The charter is available at: http://readystump.algebra.com/~asapm

Response:

Nonetheless, this hasn’t stopped some docs from suggesting I go back on an SSRI (including Paxil PRN, which turns out to be just a slick way of saying short-term use of Paxil, moan!).

I don’t think I’ve heard of anyone using Paxil PRN before?  Since it takes time to wean onto it, I would think using it PRN would just make every attack worse? Tony — The charter is available at: http://readystump.algebra.com/~asapm

Response:

Hello everyone. I have been put on SSRI drugs (paxil, effexor, cymbalta) for anxiety and every time the drugs didnt work. Every time I stopped taking one of these (even with a slow process of gradually lowering doses) I experience horrible dizzy spells, tingling in my hands, nausea and other unpleasant side effects. Finally, my doc gave me a low dose of alprazolam to take as needed and everything is fine.

I’m glad the alprazolam is helping but be careful not to rely on that too much.  Its a wonderful med but that too has withdrawal side effects that are not nice.  I don’t know how low a doze the pdoc gave you but I’m assuming .25 mgs.? Is it just me, or do you guys think that doctors use these anti- depressants as a blanket treatment for everything from insomnia to claustrophobia without really considering the patient? Almost everyone I know is now taking an SSRI.

Its true and my pdoc is angry about it.  He claims that the GP/FPs and IMs should NOT be giving scripts for these meds because most of them are not trained in all the aspects of anxiety and depression. I have heard a few people say they felt horrible after stopping these meds. Any thoughts on the subject??

I think Tony hit the nail on the head when he said to go slow.  The slower the better.  I tried to wean off Remeron (not an SSRI but an NaSSa cause the SSRI’s don’t work for me) and just when I thot I was free of the med. I started with the dizziness and sleeplessness, etc. I cut the tablets into crumbs and that helped; altho I’m still on it and probably will be the rest of my days unless they find something new. Are you getting off all antidepressants?  I’m a bit confused as to why you are stopping.  Please explain?  Have you found the magic cure? <g Good luck! -frizz — The charter is available at: http://readystump.algebra.com/~asapm

Response:

Safe drugs to take long term for sleeping

Question:

_TJ_ schreef: Hey TJ, where do you live in Europe? Doxepin is still available in Holland (where I live). I just checked. Hi Philip.  I am told this one is gone in the UK and Ireland

Hop over to the continent for a nice supply   tried *melatonin*? I never tried it.  Do you get it in pharmacies or health-food shops?

In the US it’s available OTC but here you need a prescription. I suppose you’ll need one i the UK as ell, I’m not sure. Philip — The charter is available at: http://readystump.algebra.com/~asapm

Response:

Hi. Did you ever try Lunesta? I have used it short-term, and had no side effefcts. It worked well for me. -z-

– Hide quoted text — Show quoted text – Hi folks.  I am still fighting my never ending battle with insomnia. Does anyone have any opinions on what drugs might be safe to take for sleep long term? Here are some I have encountered… Ambien (I use this some nights – makes me ill) Remeron (tried this – bad side-effects) Seroquel (bad side-effects) Paxil (LOL, I don’t want to sleep all day!) Doxepin (no longer available in Europe) Trazodone (never tried it) Halcion (never tried it) Elavil (do they even still make this?) Can anyone recommend a sleepy med I could take safely in the long term? Many thanks — _TJ_ <TJ_IREL at YAHOO dot IE — The charter is available at: http://readystump.algebra.com/~asapm

– The charter is available at: http://readystump.algebra.com/~asapm

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– Hide quoted text — Show quoted text – <gently snipped ::Can anyone recommend a sleepy med I could take safely in ::the long term? Umm, that liquidy white stuff that come in cartons or glass bottles. Just make sure to heat it up Jackie Cow juice is not medicine! Please don’t make me take to the wooden mallet again in desperation…

It is just as medicinal as turkey which is supposed to make you sleepy. — Ron P Member of the invisible generation — The charter is available at: http://readystump.algebra.com/~asapm

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Hi folks.  I am still fighting my never ending battle with insomnia. Does anyone have any opinions on what drugs might be safe to take for sleep long term? Trazodone (never tried it)

Trazodone is good for inducing sleep and keeping you asleep. Also it will augment (potentiate) the antianxiety and antidepressant effects of the Lexapro you are taking for anxiety and depression. Chip — The charter is available at: http://readystump.algebra.com/~asapm

Response:

Trazodone is good for inducing sleep and keeping you asleep. Chip

Thanks Chip!  I have a feeling there is some Trazodone in my future — _TJ_ <TJ_IREL at YAHOO dot IE — The charter is available at: http://readystump.algebra.com/~asapm

Response:

Hi folks.  I am still fighting my never ending battle with insomnia. Does anyone have any opinions on what drugs might be safe to take for sleep long term? Here are some I have encountered… Ambien (I use this some nights – makes me ill) Remeron (tried this – bad side-effects) Seroquel (bad side-effects) Paxil (LOL, I don’t want to sleep all day!) Doxepin (no longer available in Europe) Trazodone (never tried it) Halcion (never tried it) Elavil (do they even still make this?) Can anyone recommend a sleepy med I could take safely in the long term? Many thanks — _TJ_ <TJ_IREL at YAHOO dot IE — The charter is available at: http://readystump.algebra.com/~asapm

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– Hide quoted text — Show quoted text – Hi folks.

OT….*Bonus* Question of the day 01/31/07

Question:

Well, I will chime in to say how much I love having my hubby’s big warm body next to mine. We usually end up either back to back or (lying on our backs) side to side. Generally our feet or legs are touching. Usually I fall asleep on my back with my left foot touching his leg or foot. It’s very reassuring to me. xxoo Anne — The charter is available at: http://readystump.algebra.com/~asapm

Response:

01/31/07: Today’s question is being brought to you by an anon poster When sleeping with another person, do you maintain physical contact or sleep not touching?

Not touching. I can’t stand to have someone too close to me when I sleep. Stephen is very warm and I’d burn up if I had to sleep touching him. Plus, he tends to latch on and not let go, which makes it hard to shift positions or sleep . Dawn — The charter is available at: http://readystump.algebra.com/~asapm

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01/31/07: Today’s question is being brought to you by an anon poster When sleeping with another person, do you maintain physical contact or sleep not touching?

I don’t know because I’m asleep;-) — Ron P Member of the invisible generation — The charter is available at: http://readystump.algebra.com/~asapm

Response:

When sleeping with another person, do you maintain physical contact or sleep not touching?

        Don’t touch.  We are both pretty restless sleepers.  Currently we don’t sleep together <sigh.  She almost has to sleep in a recliner. Dennis — The charter is available at: http://readystump.algebra.com/~asapm

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- Hide quoted text — Show quoted text – 01/31/07: Today’s question is being brought to you by an anon poster When sleeping with another person, do you maintain physical contact or sleep not touching? My husband is a flailer.  I wake up to an elbow to my head and sometimes a slap to my face.  If he wasn’t so restless in his sleep, I’d probably snuggle all night long. kili Kili, I am a flailer to.  You really do not want to sleep in the same bed as me.  Probably not the same house.  I sleep walk as well.  I once broke a clavicle and that did not wake me up.  It sure as hell hurt the next day. I am having a good time at the moment, just two bad bruises that I can not account for. Simon

What I want to know is what are you dreaming when you’re flailing or sleep walking?  Do you remember? kili — The charter is available at: http://readystump.algebra.com/~asapm

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01/31/07: Today’s question is being brought to you by an anon poster   When sleeping with another person, do you maintain physical contact or sleep not touching? Jackie ~*~When in doubt, make a fool of yourself.  There is a microscopically thin line between being brilliantly creative and acting like the most gigantic idiot on earth.  So what the hell, leap~*~ — The charter is available at: http://readystump.algebra.com/~asapm

Response:

I like my space in bed.  There’s time for physical contact and then it’s roll over and give me my space…<vbg smiles, Elise

– Hide quoted text — Show quoted text – 01/31/07: Today’s question is being brought to you by an anon poster When sleeping with another person, do you maintain physical contact or sleep not touching? Jackie ~*~When in doubt, make a fool of yourself.  There is a microscopically thin line between being brilliantly creative and acting like the most gigantic idiot on earth.  So what the hell, leap~*~ — The charter is available at: http://readystump.algebra.com/~asapm

– The charter is available at: http://readystump.algebra.com/~asapm

Response:

01/31/07: Today’s question is being brought to you by an anon poster When sleeping with another person, do you maintain physical contact or sleep not touching? Jackie ~*~When in doubt, make a fool of yourself.  There is a microscopically thin line between being brilliantly creative and acting like the most gigantic idiot on earth.  So what the hell, leap~*~

I like my space. Dislike people’s faces and arms and things near me. Sally — The charter is available at: http://readystump.algebra.com/~asapm

Response:

01/31/07: Today’s question is being brought to you by an anon poster When sleeping with another person, do you maintain physical contact or sleep not touching?

My husband is a flailer.  I wake up to an elbow to my head and sometimes a slap to my face.  If he wasn’t so restless in his sleep, I’d probably snuggle all night long. kili — The charter is available at: http://readystump.algebra.com/~asapm

Response:

For Margrove only please

Question:

- Hide quoted text — Show quoted text – That sadi, it is possible that it can have a somewhat rapid onset but I would guess, that most likely it is just doing some calming of some overtly excited neurons in your brain-it takes about 2 weeks to really stabilize in serum and usually a long acting drug is used after initial titration -that’s when the effect on affect is seen as being dramatic. Thank you for your answer. Yes, that’s what I have been feeling lately–my mnd is more calm and my body seems to follow. I don’t feel as hyper or hurried. Zoloft does act nore quickly then other ssri meds, that’s one reason I like it-it can like the others poop out as well…. One question I do have for you is this: My Pdoc wants me to take the Zoloft down to 100 mg from the 200 mg as the Lithium kicks in. That means a 50mg reduction every week for the next two weeks. Isn’t this a little too fast?  At this rate, discontinuation symptoms can set in. If there’s no harm being done in the 175-200 mg range, is she assuming that higher doses of Zoloft are causing some mood cycling? this is probably what she believes-if in fact you are cyclothymic it may be true, but the ssri drugs rarely cause mania in bi polar disorders to become problematict, the tca’s do. It seems that bi polared brains respond differently to increases and decreases in 5ht then other people-so those who may actually have hypomania from a ssri usually do not have a bi polar disorder but are reactive to hyperserotonism -so even though you are at a higher dose, I would opine you were always a bit cyclic in mood-so I think reducing the dose may be premature until she observes what lithium does for you-changing two variables may add confusion-the high dose of zoloft may  theoretically cause some unwarranted mood elevation into the realm of hypomania but I really don’t see that based on your writing or what you report as your feelings, usually it would pruduce "side effects" first and they may be things like "jittery, nervous, prssed speach, movement disorders, insomnia and excitability". It may be prudent to back off 25mg a week until you reduce it by 50mg once you are at a therapeutic level of lithium for several weeks but only  if she notes some pressed affect-but I don’t think she will anyway while you are on lithium and seroquel-what she may see is that the benefit of adding lithium does little and then thinks she may want to increase the seroquel and this becomes a medical merry go round-one thing at a time is a better move in my opinion. Some people with a predisposition to mania do well using seroquel as monotherapy or lithium as mono therapy, you are on both now.  She has not witnessed the level of your depression and how it manifests itself yet-she also has not done any psychometric testing and is basing her diagnoses on one visit-all poor indicators for making sweeping moves in your medical regimen-take one thing at a time, you have lived with this for some time now. It is time for a deeper evlauative process to me anyway. Sh’e the doctor, has had an opportunity to see you, so if this is concerning to you, just ask her if she would allow you to stay put for a while longer and make other adjustments after let’s say a month Wouldn’t it be better to stay at the higher dose at this time to see if Lithium will do better as an adjunctive med that as a replacement for 100 mg of Zoloft? If on my next vist I tell her the depression is coming back, she might assume I need more Lithium, when I may just be experiencing discontinuation from the Zoloft.-

my typing sucks and I don’t proof read -so sorry — The charter is available at: http://readystump.algebra.com/~asapm

Response:

If there’s no harm being done in the 175-200 mg range, is she assuming that higher doses of Zoloft are causing some mood cycling? I think reducing the dose may be premature until she observes what lithium does for you-changing two variables may add confusion-the high dose of zoloft may theoretically cause some unwarranted mood elevation into the realm of hypomania but I really don’t see that based on your writing or what you report as your feelings,

Thank you for your response, Margrove, which is always greatly appreciated. Maybe, just maybe, she responded to my verbally expessed desire to get rid of the Zoloft for good. I forgot to state this in my earlier post. If she is fulfilling my wishes, then I will take your sound judgment into account and hold on to the 200 mg Zoloft for now until the Lithium kicks in. Some people with a predisposition to mania do well using seroquel as monotherapy or lithium as mono therapy, you are on both now.

Yes, however, at very sub-therapeutic doses. She has not witnessed the level of your depression and how it manifests itself yet-she also has not done any psychometric testing and is basing her diagnoses on one visit-all poor indicators for making sweeping moves in your medical regimen-take one thing at a time, you have lived with this for some time now. It is time for a deeper evlauative process to me anyway. Sh’e the doctor, has had an opportunity to see you, so if this is concerning to you, just ask her if she would allow you to stay put for a while longer and make other adjustments after let’s say a month

Okay. Now may I ask you a question?  My Pdoc seems open to her patients trying ADs they would like to try. I know that I need a good AD. However, the Zoloft doesn’t seem to pack a punch. At 200 mg, I still have some background depression. The Lithium has really calmed my mind, as it rarely races now,. and in a small way it has improved my mood. I’m back to my hobbies of old that required intense concentration but which were put away for a year because of the racing thoughts. What, in your experience, have been the best ADs for severe depression? My guess is that SSRIs *alone* won’t remit severe depressions. SNRIs? Or will an augmentation strategy do better, and, if so, which ones? — The charter is available at: http://readystump.algebra.com/~asapm

Response:

- Hide quoted text — Show quoted text – If there’s no harm being done in the 175-200 mg range, is she assuming that higher doses of Zoloft are causing some mood cycling? I think reducing the dose may be premature until she observes what lithium does for you-changing two variables may add confusion-the high dose of zoloft may theoretically cause some unwarranted mood elevation into the realm of hypomania but I really don’t see that based on your writing or what you report as your feelings, Thank you for your response, Margrove, which is always greatly appreciated. Maybe, just maybe, she responded to my verbally expessed desire to get rid of the Zoloft for good. I forgot to state this in my earlier post. If she is fulfilling my wishes, then I will take your sound judgment into account and hold on to the 200 mg Zoloft for now until the Lithium kicks in. Some people with a predisposition to mania do well using seroquel as monotherapy or lithium as mono therapy, you are on both now. Yes, however, at very sub-therapeutic doses. She has not witnessed the level of your depression and how it manifests itself yet-she also has not done any psychometric testing and is basing her diagnoses on one visit-all poor indicators for making sweeping moves in your medical regimen-take one thing at a time, you have lived with this for some time now. It is time for a deeper evlauative process to me anyway. Sh’e the doctor, has had an opportunity to see you, so if this is concerning to you, just ask her if she would allow you to stay put for a while longer and make other adjustments after let’s say a month Okay. Now may I ask you a question?  My Pdoc seems open to her patients trying ADs they would like to try. I know that I need a good AD. However, the Zoloft doesn’t seem to pack a punch. At 200 mg, I still have some background depression. The Lithium has really calmed my mind, as it rarely races now,. and in a small way it has improved my mood. I’m back to my hobbies of old that required intense concentration but which were put away for a year because of the racing thoughts. What, in your experience, have been the best ADs for severe depression? My guess is that SSRIs *alone* won’t remit severe depressions. SNRIs? Or will an augmentation strategy do better, and, if so, which ones?

there is no "best" drug for any psychiatric disorder-best is what works for the patient. Each drug has a specific general profile which can be used to determine if it may be appropriate for a patient. I don’t know what you have tried or what its effects were to make any educated comment. Generally if monotherapy fails drugs that synergize the ad med are tried-you are using two of them lithium and seroquel-if you are not bi polar you could try a tca like pamelor or imipramine, if you weren’t on seroquel or lithium you could try an maoi, but there would be some drug to drug interaction with the other drugs you are using and there would be some risk that may not be worth trying them. If depression is the target and the primary disorder then waiting until a therapeutic level of lithium is achieved will determine what can be done next-if the depression is still prominent then replacing zoloft with another drug may be in order depending on what other drugs you have tried-trying to gain maximum effect from one drug is the best choice, if this doesn’t work then other drugs can be added. Your seroquel can be increased, or replaced with zyprexa or another newer neuroleptic, or the lithium can be dumped and valproate or carbamezapine given a shot, or if you are indeed not bi polar drugs like provigil or amphetamine analogues can be used, the  zoloft can be augmented with a tca or another ssri-there are many many options-but they need to be addressed systematically under as controlled an environment as possible. I also highly recommend some cbt therapy-most likely on going for some time to help you find better ways to structure the way you respond to stimuli and challenges. Let’s not put the cart before the horse, wait and see how you respond to the lithium-if the zoloft still isn’t doing the job, but almost is, either increasing the seroquel or adding imipramine or desipramine in very low doses may help if there are no contraindications like cardiac disease or bi polar disorders-if you do have a bi polar issue then the brunt of the ad therapy will be in the form of an ssri or an snri-cymbalta would be my next choice augmented by novel ap drugs like the seroquel in higher doses or another one if they are tolerated-geodon is one that comes to mind which has pretty potent mood stabilizing effect comparable to lithum but has an extra 5ht kick in the pants aspect that is a bit more potent then seroquel and less zoning out then zyprexa-but again–just be patient for now and see how this pans over a few weeks — The charter is available at: http://readystump.algebra.com/~asapm

Response:

Generally if monotherapy fails drugs that synergize the ad med are tried-you are using two of them lithium and seroquel-if you are not bi polar you could try a tca like pamelor or imipramine,

I was mildly depressed today until the evening, and *very* tight and tense physically. This always begins the first Monday of the month, and picks up gradually until the first day of my cycle. Only light therapy and massage machines helped. I suspect high prolactin levels caused by the Seroquel of all things to be the cause of my lack of total remission. If there are high prolactin levels, then maybe folks on this newsgroup may be helped if their moods cycle with their monthly hormonal changes. Dopamine agonists IIRC may correct this imbalance. If depression is the target and the primary disorder then waiting until a therapeutic level of lithium is achieved will determine what can be done next-if the depression is still prominent then replacing zoloft with another drug may be in order depending on what other drugs you have tried-trying to gain maximum effect from one drug is the best choice,

I called my doc today and she offered to put me on Wellbutrin, 150 mg a day, and Zoloft 100 mg daily. Not a bad combo, but the hormone tests coming soon are probably going to be the most important. if this doesn’t work then other drugs can be added. Your seroquel can be increased, or replaced with zyprexa or another newer neuroleptic, or the lithium can be dumped and valproate or carbamezapine given a shot, or if you are indeed not bi polar drugs like provigil or amphetamine analogues can be used, the  zoloft can be augmented with a tca or another ssri-

Well, Wellbutrin will be the secondary SSRI, and just because, like Lithium, it is used as an augmenting agent to an SSRI. I think that the Seroquel is screwing up with my hormones if the zoloft still isn’t doing the job, but almost is, either increasing the seroquel or adding imipramine or desipramine in very low doses may help if there are no contraindications like cardiac disease or bi polar disorders-if you do have a bi polar issue then the brunt of the ad therapy will be in the form of an ssri or an snri-cymbalta would be my next choice augmented by novel ap drugs like the seroquel in higher doses or another one if they are tolerated-geodon is one that comes to mind which has pretty potent mood stabilizing effect comparable to lithum but has an extra 5ht kick in the pants aspect that is a bit more potent then seroquel and less zoning out then zyprexa-but again–just be patient for now and see how this pans over a few weeks

Low-dose desipramine would be a good option. It does work for Chip here. Thanks you, Margrove. I like your info a lot, but I no longer believe this is a "neck up" problem entirely. My mood cycles are now more predictable than the weather. My sister has PMS-A, and my older sister had PMS-D.  Apparently it runs in our family. — The charter is available at: http://readystump.algebra.com/~asapm

Response:

- Hide quoted text — Show quoted text – That sadi, it is possible that it can have a somewhat rapid onset but I would guess, that most likely it is just doing some calming of some overtly excited neurons in your brain-it takes about 2 weeks to really stabilize in serum and usually a long acting drug is used after initial titration -that’s when the effect on affect is seen as being dramatic. Thank you for your answer. Yes, that’s what I have been feeling lately–my mnd is more calm and my body seems to follow. I don’t feel as hyper or hurried. Zoloft does act nore quickly then other ssri meds, that’s one reason I like it-it can like the others poop out as well…. One question I do have for you is this: My Pdoc wants me to take the Zoloft down to 100 mg from the 200 mg as the Lithium kicks in. That means a 50mg reduction every week for the next two weeks. Isn’t this a little too fast?  At this rate, discontinuation symptoms can set in. If there’s no harm being done in the 175-200 mg range, is she assuming that higher doses of Zoloft are causing some mood cycling?

this is probably what she believes-if in fact you are cyclothymic it may be true, but the ssri drugs rarely cause mania in bi polar disorders to become problematict, the tca’s do. It seems that bi polared brains respond differently to increases and decreases in 5ht then other people-so those who may actually have hypomania from a ssri usually do not have a bi polar disorder but are reactive to hyperserotonism -so even though you are at a higher dose, I would opine you were always a bit cyclic in mood-so I think reducing the dose may be premature until she observes what lithium does for you-changing two variables may add confusion-the high dose of zoloft may  theoretically cause some unwarranted mood elevation into the realm of hypomania but I really don’t see that based on your writing or what you report as your feelings, usually it would pruduce "side effects" first and they may be things like "jittery, nervous, prssed speach, movement disorders, insomnia and excitability". It may be prudent to back off 25mg a week until you reduce it by 50mg once you are at a therapeutic level of lithium for several weeks but only  if she notes some pressed affect-but I don’t think she will anyway while you are on lithium and seroquel-what she may see is that the benefit of adding lithium does little and then thinks she may want to increase the seroquel and this becomes a medical merry go round-one thing at a time is a better move in my opinion. Some people with a predisposition to mania do well using seroquel as monotherapy or lithium as mono therapy, you are on both now.  She has not witnessed the level of your depression and how it manifests itself yet-she also has not done any psychometric testing and is basing her diagnoses on one visit-all poor indicators for making sweeping moves in your medical regimen-take one thing at a time, you have lived with this for some time now. It is time for a deeper evlauative process to me anyway. Sh’e the doctor, has had an opportunity to see you, so if this is concerning to you, just ask her if she would allow you to stay put for a while longer and make other adjustments after let’s say a month Wouldn’t it be better to stay at the higher dose at this time to see if Lithium will do better as an adjunctive med that as a replacement for 100 mg of Zoloft? If on my next vist I tell her the depression is coming back, she might assume I need more Lithium, when I may just be experiencing discontinuation from the Zoloft.-

– The charter is available at: http://readystump.algebra.com/~asapm

Response:

That sadi, it is possible that it can have a somewhat rapid onset but I would guess, that most likely it is just doing some calming of some overtly excited neurons in your brain-it takes about 2 weeks to really stabilize in serum and usually a long acting drug is used after initial titration -that’s when the effect on affect is seen as being dramatic.

Thank you for your answer. Yes, that’s what I have been feeling lately–my mnd is more calm and my body seems to follow. I don’t feel as hyper or hurried. Zoloft does act nore quickly then other ssri meds, that’s one reason I like it-it can like the others poop out as well….

One question I do have for you is this: My Pdoc wants me to take the Zoloft down to 100 mg from the 200 mg as the Lithium kicks in. That means a 50mg reduction every week for the next two weeks. Isn’t this a little too fast?  At this rate, discontinuation symptoms can set in. If there’s no harm being done in the 175-200 mg range, is she assuming that higher doses of Zoloft are causing some mood cycling? Wouldn’t it be better to stay at the higher dose at this time to see if Lithium will do better as an adjunctive med that as a replacement for 100 mg of Zoloft? If on my next vist I tell her the depression is coming back, she might assume I need more Lithium, when I may just be experiencing discontinuation from the Zoloft. — The charter is available at: http://readystump.algebra.com/~asapm

Response:

Thank you for your response to my previous post. Apparently you are right..one cannot micromanage depression/anxiety into single receptors/aminies, etc. Yesterday I saw a new Pdoc who was totally different than any of the others I have seen before. She knows her meds well based on people’s personal experiences (not just pharmacological math), and did a throrough assessment. She did tell me that all of my thoughts processes, cycling of  mood swings, brain lock of obsessive thoughts, and depression mixed with agitation/irritability, etc.–and especially the fact that the Zoloft did well and quickly semi-pooped out, was all indicative of Bipolar II. Well, yesterday, being a Christian, I prayed to God about what the heck was going on–why meds helped me feel better and think more clearly but didn’t quite get the job done. I then remained silent, to listen to Him..and lo, and behold, the unexpected Lithium came to my mind. I thought Lithium was for BPI only, so I semi-dismissed the thought. When I went to see her,  she had mentioned Lithium as the only change she wanted to make in my med regimen at this time. I didn’t mention to her anything about Lithium. In fact, I wasn’t thinking of any med, and had little hope that *this* Pdoc had any brains, much less a heart. Her warmth was quite sincere–first Pdoc who possessed that value. Well, today I took that IR LIthium Carbonate, 300 mg twice already. My mind is quite calm, and I feel pleasantly happy, but not totally depression-free. Unexpectedly, I also feel unusually calm physically and unhurried–outside of a few obsessive thoughts here and there, my mind didn’t race all day as it has done before. Is this possibly a placebo effect? Can Lithium possibly work this fast? Or is it the (very) minor sedation that is responsible for the mind-calming effect? Thank you for your response. — The charter is available at: http://readystump.algebra.com/~asapm

Response:

- Hide quoted text — Show quoted text – Thank you for your response to my previous post. Apparently you are right..one cannot micromanage depression/anxiety into single receptors/aminies, etc. Yesterday I saw a new Pdoc who was totally different than any of the others I have seen before. She knows her meds well based on people’s personal experiences (not just pharmacological math), and did a throrough assessment. She did tell me that all of my thoughts processes, cycling of  mood swings, brain lock of obsessive thoughts, and depression mixed with agitation/irritability, etc.–and especially the fact that the Zoloft did well and quickly semi-pooped out, was all indicative of Bipolar II. Well, yesterday, being a Christian, I prayed to God about what the heck was going on–why meds helped me feel better and think more clearly but didn’t quite get the job done. I then remained silent, to listen to Him..and lo, and behold, the unexpected Lithium came to my mind. I thought Lithium was for BPI only, so I semi-dismissed the thought. When I went to see her,  she had mentioned Lithium as the only change she wanted to make in my med regimen at this time. I didn’t mention to her anything about Lithium. In fact, I wasn’t thinking of any med, and had little hope that *this* Pdoc had any brains, much less a heart. Her warmth was quite sincere–first Pdoc who possessed that value. Well, today I took that IR LIthium Carbonate, 300 mg twice already. My mind is quite calm, and I feel pleasantly happy, but not totally depression-free. Unexpectedly, I also feel unusually calm physically and unhurried–outside of a few obsessive thoughts here and there, my mind didn’t race all day as it has done before. Is this possibly a placebo effect? Can Lithium possibly work this fast? Or is it the (very) minor sedation that is responsible for the mind-calming effect? Thank you for your response.

bi polar diagnosis are very haute couter these days and are pretty tricky to diagnose-it takes some time, some tests, and a whole heap of evaluations-that said, lithium can be very good as an adjuvant drug to treat severe depressions that don’t respond all that well to standard ad meds-it is after all the putative gold standard of mood stabilizers and possibly the most widely studied compound in medicine. That sadi, it is possible that it can have a somewhat rapid onset but I would guess, that most likely it is just doing some calming of some overtly excited neurons in your brain-it takes about 2 weeks to really stabilize in serum and usually a long acting drug is used after initial titration -that’s when the effect on affect is seen as being dramatic.  Zoloft does act nore quickly then other ssri meds, that’s one reason I like it-it can like the others poop out as well- When one is sensitive to the effects of these drugs and relatively vigilant and internally focused one can notice a drug working and believe this must be something good-then focus on that goodness-feel better and then "bam" they start to feel lousy again and doubt the effectiveness of the drug-using your response to zoloft or other drugs in no way completes a differential diagnosis for bi polar disorder-but this doesn’t mean you don’t have one or that in the least you may be a responder to mood stabilizing effects of lithium-by the way seroquel can have similar effects and can be augmentive to the lithium-you do find that drug also calms you down and clears your ability to cogitate-Make sure you get a serum lithium test done within 2 weeks and while you are at it since you are still on seroquel, have an sma done as well with a fasting blood sugar-time will tell about how well lithium wil work for you-let’s see how you feel after a serum shows you are on target for a few weeks- I certainly hope it helps you regardless of anyones dx — The charter is available at: http://readystump.algebra.com/~asapm

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