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Author Topic: Vistaril vs Gabapentin  (Read 593 times)

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Offline Andrew90

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Vistaril vs Gabapentin
« on: January 26, 2014, 03:22:57 PM »
Hey all,

So a few weeks ago I discontinued taking Remeron; I had been on it for about 4 months and was up to 45 mg, then went down to 30, 15, then nothing. The good thing is that I barely have had any adverse discontinuation symptoms. The only ones I believe could be attributable to the Remeron have been a slight uptick in nausea (mainly subtle, mild waves of it that come & go fairly quickly) and some difficulty staying asleep. What I mean by this is that I will fall asleep at my normal bedtime, but then wake up an hour or two earlier than I need to, and I cannot seem to get back to sleep once this happens. This has been, however, improving over the past few days, so that I am now waking up closer to when I need to.

Now that I have been off of the Remeron, I am looking to replace it with another anti-anxiety medication. While I am doing overall fairly well with my daily regimen of Klonopin and Guanfacine, I am not where I would like to be. I still have some annoying hypochondria and obsessions that were less present when I was on the Remeron. During my last pdoc visit, he prescribed me Viibryd, but I have yet to start taking it. The reason for this is that I have had a mostly turbulent history with SSRI's, and I am not keen on having to likely experience the initial side effects of it, which could very possibly include increased anxiety. During this previous visit however, I had discussed with him about the option of gabapentin, and he seemed open to it, but at the time I couldn't make up my mind so I decided to go with Viibryd. Later that evening I decided that I would have preferred to go on the Gabapentin, because it's not an SSRI and it does seem to work quite well for some people, as my psychiatrist had attested himself.

So, I am currently researching whether I should talk with my pdoc about Gabapentin at my upcoming visit next week, or alternatively if I should go on Vistaril/Atarax. Both of these drugs appeal to me because a.) I have never tried any medications in their class before, and b.) they seem to be safe and well tolerated by most people for anxiety.

What I like about the Hydroxyzine is that it can be taken when needed, is fairly effective at mitigating acute anxiety (less so than a benzo, but I have plenty of those on hand), and doesn't produce any withdrawal or dependence unlike the benzos. The main negative side effect I have been reading about is that it can be heavily sedating, and probably will be when (and if) I first start taking it.

Gabapentin, while I know it's not a first-line or second-line anxiety treatment, works for different people, and for some it really is an excellent anti-anxiety medication. Furthermore, from what I understand, it can mildly potentiate benzodiazepines, so in my case it could help to augment my Klonopin. The downsides to Gabapentin that I'm aware of, are that it can cause cognitive impairment, and that it may in some people cause withdrawal reactions. But almost every medication causes a withdrawal of some sort, so that's not unexpected.

What I'm asking about is if any of you have had experience with these two drugs, and/or what your opinions are of them for treating anxiety. I suppose I have to be the ultimate judge by trying either of them, but I am just curious about them and would like to learn as much as I can before making a decision on which one to try.

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Re: Vistaril vs Gabapentin
« Reply #1 on: January 26, 2014, 09:46:56 PM »
What I'm asking about is if any of you have had experience with these two drugs, and/or what your opinions are of them for treating anxiety.

IME, hydroxyzine works for most people, though it is less effective than antidepressants and benzodiazepines and gabapentin only works well for a few. Pregabalin (Lyrica) might be a better bet because it's bioavailability is much higher - 90% versus 33-65% - and linear (as gabapentin doses increase the bioavailability drops so you need to take much more than double the dose to get twice the effect). However, it may cost more.

In the end the experience of others won't tell you much about what these meds will do for you. The only way to know is to try them.

Ian
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NOTE: I'm not a doctor, and particularly not yours, so there may be factors I'm unaware of. Therefore all advice is of a general nature and you should consult your doctor before following any of it, especially before changing med doses.

Offline Andrew90

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Re: Vistaril vs Gabapentin
« Reply #2 on: January 26, 2014, 10:36:39 PM »
Reiterating what you said, the effectiveness of a medication for an individual can only be determined by a trial or history with that medication. Lyrica appeals to me slightly more than Neurontin, but it's very expensive and the benefits of it over Neurontin are likely mild at best. At this time, the most realistic and cost effective approach would probably be for me to just give the gabapentin a try to see how I feel on it. I've read too that as the dosage gets increased, the bio availability decreases....I would definitely start out at a lower dosage at first, and see how I feel from there. What I like about gabapentin is that it is generally well tolerated and doesn't seem to cause significant side effects in most users. I shall find out for myself.

I may also see if I can get a month supply for hydroxyzine to see how I react to that. Either way, one of them will likely be what I try next. I will eventually post another thread on my experience with whichever drug I end up going on, or I may just revive this one.
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Offline AncientMelody

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Re: Vistaril vs Gabapentin
« Reply #3 on: January 27, 2014, 09:42:01 AM »
I took Vistaril for a couple of weeks, when I was discontinuing Zoloft.  I do feel it was beneficial initially, it helped moderate anxiety. What it did not help me with were panic attacks and near-panic level anxiety. I stopped it because my family doc and I suspected it may have been causing increased irritability for me, but looking back now I'm fairly certain this was a hormonal fluctuation issue as I had those symptoms recur when I wasn't on the vistaril.  I wouldn't mind trying it again as an adjunct to lexapro honestly, but we'll see.
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Offline Andrew90

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Re: Vistaril vs Gabapentin
« Reply #4 on: January 27, 2014, 08:43:51 PM »
Had an appointment today with my pdoc, he prescribed me up to 900 mg of gabapentin daily. It's crazy, I have 270 capsules of it (each one is 100 mg), but I'm starting out by taking 100 mg, then 200 mg, then up to 300 mg three times a day. Alternatively, I can take 5 pills at night, and 2 pills in the morning and afternoon. I kinda like the extreme flexibility in dosing with this med.

Will let you guys know how I do on this.
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Offline Andrew90

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Re: Vistaril vs Gabapentin
« Reply #5 on: January 28, 2014, 09:32:31 PM »
Update:

So I'm starting slowly with this med, now at 300 mg a day (100 mg 3x a day). I've noticed a mild 'loosening up' in my general thoughts, and do find it to be actually somewhat relaxing. However, I also find it somewhat sedating. Last night I was actually afraid of the med after taking my 1st dose, but that's very normal for me when trying any new medication for the first time. So far though, no real complaints. I suppose the mild side effects will dissipate with time? My doctor has also encouraged me to experiment with the dosing, to no more than 900 mg in a day. I think I will stay at 100 mg 3 times per day for a few more days, or perhaps go to 200 mg in the morning and afternoon, or something like that.

This drug has a lot of room for configuring the dosage!

Anyway, just wanted to post my update.
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Offline Jdwca123

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Re: Vistaril vs Gabapentin
« Reply #6 on: February 02, 2014, 03:40:41 PM »
Update us on how you are doing on the neurontin/gabapentin.
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Offline Andrew90

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Re: Vistaril vs Gabapentin
« Reply #7 on: February 02, 2014, 09:00:20 PM »
So far it seems to be helping my anxiety, albeit subtly. I'm now taking 900 mg per day, and all that I can really say is that it has been reducing some of my ruminations and overthinking that leads to my anxiousness. The nice thing about it is that it has been side-effect free for me, other than being mildly sedating. That has dissipated though. I anticipate going up on the dosage after my next pdoc appointment, but so far, so good.

It's certainly worth a try if SSRI's are not your thing.
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Offline snowmanrn

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Re: Vistaril vs Gabapentin
« Reply #8 on: February 04, 2014, 08:38:44 PM »
Sounds like you have had a similar experience with meds as me. I was on Remeron and Klonopin in the past among others. The mainstay of my anxiety treatment has been by and far Lyrica (pregabalin). The down side is it is very expensive but works great for me without side effects. In the beginning there is a slight euphoric feeling but nothing like SSRI's. I don't tolerate SSRI's because they make me feel cracked out and give me insomnia. I once gave a heroic effort to get of Lyriac and onto Neurontin (gabapentin) and it did nothing for me. I did it for a few months and decided it was worthless and went back to paying the price of the Lyrica. Get some free sample bottles and try it. It really really works. Helps me just feel normal.
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Offline Andrew90

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Re: Vistaril vs Gabapentin
« Reply #9 on: February 04, 2014, 08:57:21 PM »
Good to hear that Lyrica works so well for you! What dosage are you on?

So far I have to say that the Gabapentin has been definitely easing my anxiousness, particularly my symptoms of hypochondria. Everyone responds differently to these meds, but I do think that if someone has given their try at SSRI's/SNRI's and dislikes them, then gabapentin/pregabalin are worthwhile to try. Granted, I haven't taken Lyrica myself, but I would imagine that that would be the next medication I would try if the gabapentin were to poop out on me or something. I have heard that Lyrica is the more potent cousin of Gabapentin, so it definitely interests me.

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