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Author Topic: Prozac & Gabapentin & Buspar  (Read 136 times)

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Offline breadcrumb

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Prozac & Gabapentin & Buspar
« on: July 04, 2014, 01:24:03 AM »
Hi All...
I have GAD and hate it! Thankfully, for 12 years I was on Zoloft (200 mg) with buspar (60 mg) and it did great for me until it started "pooping out". Then I was switched to Paxil (60 mg) with buspar (60 mg) and was on it for 8 years and it recently started pooping out as well. My nurse practitioner tried me on Effexor which helped my anxiety, but it really did a number on my personality! I felt enraged and angry a lot and flew off the handle over the smallest things! That was not like me at all! So she got me off of the Effexor (NOT FUN!) and put me on Prozac along with Gabapentin and I'm continuing with Buspar (60 mg). The Prozac has been increased up to 60 mg a day and the gabapentin is at 600 mg 3x a day. The problem is that I am still getting some breakthrough anxiety! I know she can increase the Prozac to 80 mg a day, but that's the max. But with both zoloft and paxil I was at the max doses as well. I have been going to the same mental health facility for 20 years as it accepts medicaid. Sometimes I wish I could try elsewhere because I think I would do better if I could be prescribed klonopin or xanax (but ONLY as needed!) This facility NEVER prescribes a benzo in ANY circumstance any more! Twenty years ago, when I first started going there b/c of severe anxiety, that was not the case and my first psychiatrist had me on Xanax for a number of years. I never became dependent on it, never abused it. Actually, I took myself off of xanax on my own. Yet now I truly feel that it is wrong for them to treat ALL of their patients like criminals b/c perhaps some have abused the drugs, sold them, got addicted, etc. I read online all the time where patients like me have been using klonopin or xanax with an antidepressant for anxiety treatment and have no problems. So what should I do? Try to sweat out the rest of this month until my next appointment and see what my NP says? Go in sooner? Consider another healthcare provider?
You have to understand, I've been dealing with anxiety for 20 long years. I am not a stranger to the drugs, the treatments, etc. I am not a druggie. I just want some help and I must admit that it is scary to leave the only place I've ever went to also....
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Offline Never-Quit

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Re: Prozac & Gabapentin & Buspar
« Reply #1 on: July 04, 2014, 12:36:28 PM »
Hi  :action-smiley-065:

 Sending by HTC phone....

Sounds like kindred spirits in the fight with Anxiety Disorders.

I am also in 50's and have gone through numerous Drs and meds as u have....

So the AD meds are starting to not be as effective ad before...

I have already taken all the ADs meds you have mentioned... It's funny u mentioned Effexor causing - "agitation and anger" ... Same .. here... My wife was ready to kill me... I was angry and grumpy.

Are you battling OCD or Depression or us it mostly just Anxiety?


Tell more about your experience with Benzodiazepines - it appears you were do well with them :-)
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Never, never, never give up. -Winston Churchill

“You can’t live a perfect day without doing something for someone who will never be able to repay you."   ~ John Wooden

Offline insights

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Re: Prozac & Gabapentin & Buspar
« Reply #2 on: July 04, 2014, 06:10:57 PM »
Consider another healthcare provider?

Sure, but the attitude the benzodiazepines may not be any different, and even if it is today, it may not be tomorrow. Sad, but increasingly the way it is.

You could try Celexa (citalopram), which is the SSRI most likely to work when the others have pooped-out, however, IMHO, you've pretty much run your race with the SSRIs so should consider changing to one of the older tricyclic antidepressants (TCAs). They are much less likely to poop-out, I've been taking the same one for nearly 20 years, and another for 8 years before that (switched for better side-effects profile, not because it wasn't working anymore).

Their major drawback is that they tend to produce more ongoing side-effects such as constipation and dry-mouth, they are also less safe in overdose so not ideal for the forgetful. They may also be contraindicated if you have significant heart disease. The TCA least likely to produce these nuisance side-effects is desipramine (Norpramin), which mostly inhibits norepinephrine, aka noradrenaline reuptake. It is only a minor inhibitor of serotonin reuptake, which will make it easier to make the cross-taper switch, and also means the anxiety is being 'attacked' from an angle your brain isn't used to. Most need to take 100-150mg for good results, but as you've needed near maximum SSRI doses you may need to go up the the recommended maximum 200mg, possibly beyond. I have taken up to 350mg of imipramine for a year and have been on 225mg of my current TCA, dosulepine, for nearly 20 years without harm even though it is the most cardio-toxic antidepressant.

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 breadcrumb

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Re: Prozac & Gabapentin & Buspar
« Reply #3 on: July 04, 2014, 07:57:45 PM »
I mostly battle anxiety, but depression is always there to an extent. My anxiety type is GAD. I will feel overwhelming dread come over me and get very anxious to the point of feeling like I'm going to have a panic attack. I have had them, but do everything in my power to stave them off!
When I first went through the extreme anxiety 20 years ago, I did have clinical depression very severe and I almost became agoraphobic. Thankfully my first shrink was not afraid to prescribe xanax! He had me on 6 mg a day at one time!
I never knew back then what a high dose that was! But after he eventually left, I saw other doctors and they kept me on the same meds. Then I got one doctor that almost freaked out when she saw my dose of xanax! She started babbling about the DEA and all. So I went ahead and decreased the xanax on my own until I eventually didn't even use it any more!
The clinic I go to gets a few decent doctors and nurse practitioners and then they leave. No one seems to stay for long. I believe that they feel their hands are tied many times. And they have to hurry through their appointments with us patients. My current NP is very nice and I like her a lot, but she can't prescribe a benzo, so she has me on gabapentin. It is looking like I will have to go back sooner than my July 29 appt. I'm getting worn down by this feeling of constant tension pulling me down and the butterflies in the stomach. I'd rather take a beating and that's no exaggeration.
BC
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Offline breadcrumb

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Re: Prozac & Gabapentin & Buspar
« Reply #4 on: July 04, 2014, 08:03:10 PM »
Consider another healthcare provider?

Sure, but the attitude the benzodiazepines may not be any different, and even if it is today, it may not be tomorrow. Sad, but increasingly the way it is.

You could try Celexa (citalopram), which is the SSRI most likely to work when the others have pooped-out, however, IMHO, you've pretty much run your race with the SSRIs so should consider changing to one of the older tricyclic antidepressants (TCAs). They are much less likely to poop-out, I've been taking the same one for nearly 20 years, and another for 8 years before that (switched for better side-effects profile, not because it wasn't working anymore).

Their major drawback is that they tend to produce more ongoing side-effects such as constipation and dry-mouth, they are also less safe in overdose so not ideal for the forgetful. They may also be contraindicated if you have significant heart disease. The TCA least likely to produce these nuisance side-effects is desipramine (Norpramin), which mostly inhibits norepinephrine, aka noradrenaline reuptake. It is only a minor inhibitor of serotonin reuptake, which will make it easier to make the cross-taper switch, and also means the anxiety is being 'attacked' from an angle your brain isn't used to. Most need to take 100-150mg for good results, but as you've needed near maximum SSRI doses you may need to go up the the recommended maximum 200mg, possibly beyond. I have taken up to 350mg of imipramine for a year and have been on 225mg of my current TCA, dosulepine, for nearly 20 years without harm even though it is the most cardio-toxic antidepressant.

Ian

Wow....what you are saying is making me more scared than ever. :(
I will definitely need to go to my NP now. But I am thankful to you for the insight.
There is power in knowledge after all.
Thanks,
bc
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Offline insights

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Re: Prozac & Gabapentin & Buspar
« Reply #5 on: July 04, 2014, 08:41:56 PM »
Wow....what you are saying is making me more scared than ever

Why?
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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 Never-Quit

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Re: Prozac & Gabapentin & Buspar
« Reply #6 on: July 06, 2014, 10:31:24 PM »

Hi again Bread,   :action-smiley-065:


From reading your posts, it appears that Benzodiazepines seem to be the simple and logical answer for your GAD and Anxiety- after so many years of experience with medication.  I take both an SSRI and Valium 10 mg - because I have OCD, along with my Panic disorder and GAD.  I would seriously consider dropping the SSRI, if I didn't have OCD, and just switch to my Valium for my Panic Disorder and GAD.  (this would remove my sexual side effects, I had with Prozac  :sick0002:

The problem of course, that we are all experiencing right now, especially in the United States.  Trying to get your doctor to prescribe benzodiazepines:  >:(

I would like to share my experience and solution - It worked for me ... it might work for you   :happy0151:

Since we do have many people abusing Benzodiazepines - every patient is getting the 3rd degree - will you be responsible with medication :angry-smiley-034:

I received the following table from one of my doctors - because I was so afraid of becoming addicted, to point out the difference between Addicts vs. Pain Patients.   :happy0151:

I bring this chart with me to all my doctor visits  :grinning-smiley-003:

So, I can communicate with my doctor - showing him this chart - and discussing it with my doctor.

Addicts                                                                                       Pain Patients
=====================================================================================================================================================================
Addicts take drugs to get high and avoid life                                       Pain patients take drugs to function normally and get on with life.
Addicts isolate themselves and become lost to their families.             Pain patients get relief, they become active family members
Addicts are unable to interact appropriately with society.                   Pain patients get relief, they interact with and make positive contributions to society.
Addicts are eventually unable to hold down a job.                              Pain patients get relief, they are often able to go back to work.
The life on an addict is a continuous downward spiral.                       Pain patient gets adequate relief, their life progresses in a positive, upward direction.

                                                                                                     

I always have a printout of the chart above - which I would discuss with my with doctors who were hesitant with prescribing Benzodiazepines.

ADDITIONAL STRATEGIES I USED:  Be prepared for your Dr. Visit - (just like a job interview...)


I Created a "Master Medical File Folder" that I would take to all my doctor visits! - for the last 12 years!  :grinning-smiley-003:


 
My "Master Medical File Folder" Contains the following information:

a)  History of all medical records, Records of every medications, success and failures with medications, blood work, and all medical tests.

b) Completed self-quiz evaluations, with my own self-diagnoses, on Panic Disorder, GAD, Depression, OCD. 
       (can be found on this web site on the following links on the Anxiety Zone Website:)

                        http://www.anxietyzone.com/NIMHpanic.pdf - Self Test for Panic Disorder.
                        http://www.anxietyzone.com/NIMHgad.pdf  - GAD – Self Test
                        http://www.anxietyzone.com/NIMHdepwomenknows.pdf - Depression for Women – self test
                        http://www.anxietyzone.com/NIMHocd.pdf - OCD - Self-test


         Great self-tests and great information - print them out - fill them out - place them in your folder:

c)  Printout of all medications that I have used and currently using.  (Link of medication can found on following link AZ Website  http://psychiatricdrugs.org/ -Drug List)

d)  Brought my “Medical/How I feel” Journal to show my Dr. what meds and dosage I am currently usage. 

e)  I agreed that I would follow-up with my doctor every 30-60-90 days, or sooner, whatever would make my doctor feel more comfortable.

EXTRA Strategy - That I used, after hearing this from another doctor...

f) I even brought my own “WAIVER OF LIABILITY, INDEMNIFICATION, AND MEDICAL RELEASE”  to my doctor visit– you can find a general one on the internet.  This that worked very well with doctors, knowing that I would not hold the doctor legally liable – I would also agree to sign the doctor’s waiver – if it would make the doctor feel more comfortable in prescribing my medications.  :nature-smiley-016:

Apply ANY of the above will IMPROVE your chances of getting what you need from your doctor, as it has for me. :grinning-smiley-003:

Also,  From my experience, I would recommend a long-lasting benzodiazepine - Valium or Klonopin, it will last longer in your system to provide "a longer lasting Anxiety Shield - throughout the day"- you don't need to take take every 4 hours as with Xanax, or Ativan and doctors feel much more comfortable prescribing these versus Xanax or Ativan.   :yes:

By implementing any of the steps above - you greatly increase your chances of having your doctor work with you and feel comfortable prescribing benzodiazepines.


Just my 2 Cents... :twocents: :twocents:

Let me know how it works out for you!

We are all cheering for you  :action-smiley-065:
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Never, never, never give up. -Winston Churchill

“You can’t live a perfect day without doing something for someone who will never be able to repay you."   ~ John Wooden

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