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additional meds for anxiety?

Old 03-14-2008, 03:22 AM
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Question additional meds for anxiety?

I'm on Topamax for my anxiety. It's used off label and it's helping. I'm able to sleep through the night most of the time. I also have 1/4 mg xanax for times when my anxiety is really bad. I very seldom use that; only when I'm having a panic attack.

I recently went back on Wellbutrin. I'm on 200 mg for depression. Extreem stress brought about due to a work situation.

Anyway, my pdoc and counselors all say that I should go on more meds for anxiety. I am hesitant.

In the past, I was totally stoned out on psyche drugs. I have no intention of going there again. Since I'm already on two anxiety drugs, why would I need any more?

The counselors knew me when I was stoned out and fully understand my concerns. I told the pdoc about it. I doubt she completely understands exactly how stoned out I was - I was unable to function at all, and told to go on disability! But, she is aware; I told her and told her she could talk to my counselors too. At the very least, she is aware of my fears of going back there.

I don't know. I don't *feel* that anxious. But, they are obviously seeing something for all of them to say the same thing. I am crying alot. And I do bounce my leg while I'm sitting. I just don't want to get messed up again. And I'm afraid of that.

Any thoughts?

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Old 03-14-2008, 03:40 AM
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**************{teach}}}}}}

I'm so not a doc.

But I'm also not a med dump.

kindly do not give me MORE pills.
the pharmaceutical companies ...
are rich enough, thank you.
last I looked.

I haven't the first answer.
but I'm going back to simplifying my life.
And I"M sticking to that.
I got OFF that for a bit.
and I'm going back to it.
There's gentler things than TOpamax ... for me.
it's just .. got a bit too rough a trot for this old gal to sit..
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Old 03-14-2008, 02:00 PM
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Thanks, Barb;

I wasn't having any problems with the Topamax when I was just on that.
But, I was experiencing depression. So, that's why she put me on the Wellbutrin. I didn't want an SSRI, as I had a bad time with them before, with serotonin syndrome.

But, I know I had a bad time with Wellbutrin in the past before too. I was on 300 mg then. And I got panic attacks. I tolerated it cuz it helped me quit smoking. So, I thought the 200 mg would be ok. But, maybe it's just the Wellbutrin that's the problem.

So, then, what's left with anti depressants? I do have to be very careful, cuz, I've been pre-diabetic, and I'm not going on anything that causes weight gain. I've lost @ 30 pounds, but have more to go.

Topamax is also used off label for depression. But, once you get to higher levels, it starts causing memory problems in many people. I don't have that problem now. And I'm a teacher, so, that wouldn't be a good idea to get into that problem! :rof

So, Barb, I do hear ya. Yea, they do make plenty of dough. And I can't make bread out of it. LOL! But, I don't like this crying jag that's happening with me. I gotta do something. I recognize a problem, and want to be proactive. I just don't know what to do at this point.

So, any other thoughts?

Shalom!
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Old 03-14-2008, 02:15 PM
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Hmmm, I can relate Teach...

You know how/what they did with me, they just kept giving me meds, meds, meds, then... etc..

I do think the Wellbutrin causes some extra anxiety but like you, for me it the pros out weight the extra anxiety. Eventually that extra anxiety went away.

If you are hesitant in trying more meds there are other things you can try first.
I posted this in Chiy's post the other day. Maybe something in here might help.

Maybe you can give yourself another two weeks or week or so.
Make a list of some other things you can try first.
If none of those things work, then give more meds a try?
Just my thoughts...


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Old 03-15-2008, 12:43 AM
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Thanks, Miss Done!!!

I know I can take the B complex vitamins. As for the other stuff, I have to check with a doc, or pharmacist first, as some of those things can interact with meds. But, I'll check out that link!

Shalom!
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Old 03-18-2008, 02:48 AM
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Originally Posted by historyteach View Post
I'm on Topamax for my anxiety. It's used off label and it's helping. I'm able to sleep through the night most of the time. I also have 1/4 mg xanax for times when my anxiety is really bad. I very seldom use that; only when I'm having a panic attack.
Hi HistoryTeach! I never knew that Topomax was used for anxiety. My "knowledge base" of this medication was that it was an adjunct med prescribed along with a mood stabilizer so that weight gain would not be as extreem as it could be (Please just take this as a layman's opinon, which I know you will~~~). However, I have heard that this medication can cause the leg shakes that you speak about later in this post)

Originally Posted by historyteach View Post
I recently went back on Wellbutrin. I'm on 200mg for depression. Extreem stress brought about due to a work situation.

Anyway, my pdoc and counselors all say that I should go on more meds for anxiety. I am hesitant.
Another non-medical opinion: ) I was on Wellbutrin, which shifted this old codger from serious depression to a full-blown mania. Of course, this is a risk with most anti-depressants when given to folks with Bi-Polar disorder, but HT, I am concerned about the lowered threshold for seizures with this medication. There are so many other "cleaner" anti-depressants, I have heard about. Have you discussed them with your Pdoc? Or is Wellbutrin the one anti-depressant that works for you? For me, Effexor is THE only antidepressant I can tolerate and I know it has a horrific list of possible side effects....

I do not blame you for feeling the way you do about going up an any of these meds. Is your anxiety intolerable right now.

Honestly, these combinations of medications sort of freak me out...


Originally Posted by historyteach View Post
In the past, I was totally stoned out on psyche drugs. I have no intention of going there again. Since I'm already on two anxiety drugs, why would I need any more?
I agree with you, and do not have the answer. The docs and counselors seem to be more enthusiastic that you about this, my friend. I know addiction is a concern, which is why this combination was suggestion, perhaps?


Originally Posted by historyteach View Post
The counselors knew me when I was stoned out and fully understand my concerns. I told the pdoc about it. I doubt she completely understands exactly how stoned out I was - I was unable to function at all, and told to go on disability! But, she is aware; I told her and told her she could talk to my counselors too. At the very least, she is aware of my fears of going back there.

I don't know. I don't *feel* that anxious. But, they are obviously seeing something for all of them to say the same thing. I am crying alot. And I do bounce my leg while I'm sitting. I just don't want to get messed up again. And I'm afraid of that.

Any thoughts?

Shalom!
Teach....

I do not like the feeling I am getting from what your experiences have been with this staff. Any MD who tell you to go on disability rather than explore an alternative method of managing an anxiety problem which, by your admission, is not unmanageable, seems to not be concerned with you as a functioning and productive human being. In my unqualified medical opinion, this MD should have her licensed yanked.

However, you do seem to have possible signs of depression which is evidenced by the crying you mentioned. Of course, I am only a member of this forum, but I am trained in recognizing what words mean in this profession. As someone who cares about you, my first thought would be to get a second opinion from another organization; one who has staff that listen to their patients and that do not push medications down your throat that make you a zombie.

Other thoughts I have concern whether or not the crying is related to a very real situation in your life or is it simply inexplicable to you and appears out of the blue?

I hope you get a second opinion, my friend...

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Old 03-18-2008, 04:37 AM
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Topomax and Uncontrollable Shaking

I became inspired due to my insomnia and my feeling scared about what I had read in a member's post about the off-label use of the medication Topomax as an anti-depressant.

This data is all over the web and I only chose a few selected examples that mentioned leg tremors, uncontrollable shaking of limbs or odd sensations in the feet and hands.

NONE OF THIS MATERIAL IS INTENDED TO REPLACE A QUALIFIED MEDICAL DOCTOR'S OPINION

Topomax can cause uncontrollable shaking of a part of the body

(Source: MedlinePlus Drug Information: Topiramate)

I started Topamax at 25mg at night for 2weeks and just moved up to 50mg at night. My husband kicks me out of bed every night saying I kick my legs. I don't even realize I am doing this. Them when I try to go back to sleep, my legs feel like I have to tense them up to relax in a constant cyle.


(Source: Topamax and effexor : Medications.com)



Dropping down
Tonight I made the decision to drop back to 150 mgs a day of Topamax. I was supposed to up to 200mgs, but instead I went down. This is a first for me. I usually try to max out to get the full effect, but for once side effects are worse then any possible benefit.

For the past week I have felt like I am shaking internally. This morning I did yoga and it was hellish. My hands and feet tingled something horrible during so many of the poses. I have eaten so little and gotten full so fast. Yesterday I slept for 11 hours and woke up feeling exhausted and still with headache. My bowels are like bricks and my brain is deep in a fog like never before.

I had to ask myself if eliminating pain is really all that matters and in the end I want for a greater quality of life not just pain relief. So tonight, I compromise with my body. Hopefully it will accept my trade.


(Source: This is my brain on migraines: Dropping down)



I started taking Topamax for my migraines at 25 mg and moved up to 50 mg a week later. Right after I started taking 50 mg, I started to have diarrhea and bad stomach cramps, as well as tingling in my hands and feet. I have barely been able to keep food in my body for a week now and am still waiting for my Dr. to return my phone call.

(Source: Ratings for topamax: side effects and patient comments)

:wtf2
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Old 03-18-2008, 04:29 PM
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Ksos;

First, thank you for your comments and for your research.

Then, I just want to note that I *have* to finish my student's progress reports, due tomorrow morning. Afterwards, I'll be able to come back and address these posts.

But, one quick thing. The pdoc I'm seeing now is *not* the one who made me stoned out of my gourd. That happened @8 years ago. And I told this one about what happened, and that I would *not* allow it to happen again.

Thank you again, my friend...

Shalom!
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Old 03-18-2008, 06:13 PM
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ksos, I just wanted to say I am glad you stuck around our mental health forum even though things got off to a rocky start. I have enjoyed your input.
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Old 03-18-2008, 10:14 PM
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Originally Posted by nandm View Post
ksos, I just wanted to say I am glad you stuck around our mental health forum even though things got off to a rocky start. I have enjoyed your input.
Thank you so much for your understanding and for the very kind words, nandm. I think I also reacted to my own unresolved issues surrounding my mental health challenges over the years.

When I first joined SR in 2003, I never posted in the "Substance Abuse" forums for my primary issues were my mental health and my home life being affected by my Bi-polar Disorder and other issues. So, this was my "home base", so to speak.

I am very flattered to hear that you enjoy my participation and allow me to say ditto for your input! Although I had some bumps in the road, it is a learning experience for me, as the group helped me to more deeply examine what exactly was churning up these feelings!

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Old 03-18-2008, 10:19 PM
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Dear HistoryTeach....

Keep on trucking with your student's progress reports and thanks for clearing up my misunderstanding of which MD should be tarred and feathered<only kidding--sort of!>!
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Old 03-19-2008, 04:30 PM
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Hi, Ksos;

Progress reports done. It's all over but the tears, LOL! ;>)

Yea, the Topamax is used for many things off label. Anxiety and depression are just a few. You can see the list, which is from Revolutionhealth dot com if you'd like on the link at the end of this post.

My anxiety is not "intolerable" right now. But, it's up there. Of course, that's why I had the Topamax and the xanax to begin with. I got the Topamax cuz I didn't want to take too much of the xanax. I've had the xanax for a long time, and take it very, very infrequently. I know it's addictive, and don't want a dependency to form. One drug addict in the family is enough for me, tyvm! ;>)

But, I've had Wellbutrin before. I was on 300mg then to quit smoking. And it did cause panic attacks, but, it helped me quit, so, I tolerated it. And I had the xanax to help when I needed it. And frankly, I never had *any* psych problems till I got that Wellbutrin for quitting smoking. But, at the same time, my son was a heroin addict, and I just discovered it, and my (now) ex was gambling away the mortgage and abusing me verbally and emotionally. So, who knows? It doesn't really matter and it's all water under the bridge now.

But, the pdoc today wanted to up the dose of the Wellbutrin today. I had my appointment today with her. I asked her why? She said cuz my depression wasn't responding yet, at four weeks. And I pointed out that it had caused panic attacks in the past. So, she relented and said when I see her in a month, if it's no better, we'll look at something else. That will be eight weeks and it should be working then.
I suppose that's reasonable.
And it does show that she's willing to listen to me and work with me and my concerns. That's a very very good sign!!!

The crying is definately related to things going on in my life. Three very stressful years under the worst administrator in my career. It's a very long story, so I won't get into it, but, I've posted it elsewhere here, on my Topamax thread. And I'm still dealing with the stress of his incompetence, his lies and his underhanded attacks on my professional reputation. When the union is done with him, the lawyers will get started! Because a "hostile work environment" is putting it mildly!

I looked in your links about the Topamax.
Here's one that I found before I began taking it.

You will also find all the conditions treated "off label" on the right hand side.
Topamax - Drugs & Treatments - Medicine Chestô - Revolution Health
I did alot of research on Topamax before I approached my counselor and doc about taking it. Yes, it was *I* who asked them, especially do to my pre-diabetes condition. I won't take anything that can cause weight gain because of that. And that leaves very little available. Ironically, neither of them were aware of the use of Topamax for anxiety, either! LOL! So, I taught them something!

But, it's been effective for me. I've slept through the night, which I wasn't doing before. And that's a blessing!

And, I want to note that I, too, have enjoy your posts. I'm glad you're here, sharing your ESH!
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Old 03-20-2008, 11:53 PM
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Thanks, HistoryT, for your response post and needless to say, I do have my own recollections and past posts to remind me EXACTLY some of the things that you went through. Sometimes you look at a person's posts and think that they are superman or superwoman, and we forget that they cry also.

I always viewed you as that strong person and still do, but it is sometimes important to remember to sadness that has punctuated your life as well as the lives which are in your circle.

I can only tell you that I have experienced hostile work environments as well and sometimes these situations can be so wrenching. I recall going to the EEOC, which was an organization which was the alledged starting place to begin one's experience with violations such as hostile work situations. It used to be located in the World Trade Center, but upon more recent quieries, I have been unable to locate this agency since 9-11.

I hear your concerns about developing a dependency on Xanax, and I have to respect that, based on you son's experience. I pray for him, as well, and I mean that, since I am very close to his DOC and know how hard this must be on your family. I hope that there is success in reducing your anxiety, and I appraciate you posting the link, for I am interested in knowing about this off-label use, for although my Bi-polar Disporder has been in somewhat of a remission--maybe because I take Nuerontin for Pain Control, I know that I have struggled for close to 20 years with Bi-Polar. My noncompliance was always related to weight gain, as I have been as high as 350 LBs when on Depakote and thankfully, have lost nearly 150 pounds to date without this drug.

It sounds like your MD is listening to you and is giving the Wellbutrin one last try and that the Topomax has aided in sleep. I mean, it sounds like your anxiety has been positively managed based on the sleep issue, if not for anything else. Maybe the Welbutrin may start showing some benefit, too. I think that time span should be tell-tail indicator.

Be strong, my friend, and I know I will be praying for you~~
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Old 04-24-2008, 09:10 AM
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Iíve been told by doctors that Xanax taken PRN does not work well for panic attacks because, even if taken at the onset of the attack, the attack is pretty much over by the time the drug starts to work. I have been told that it is effective taken PRN for generalized anxiety or social anxiety, because the drug takes effect long before the symptoms of these run their course (perhaps not until one gets back home).

I do not promote the use of Klonopin or Xanax, but taken on a regular schedule, either of these has been effective in preventing panic attacks in me. I take Klonopin over Xanax for two reasons: 1) you donít feel Klonopin taking effect or wearing off Ė no inter-dose withdrawal; and 2) it is supposed to be easier to taper from. Iím not so sure about the latter.
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