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Posted on 7/9/20 at 10:54 am to td01241
quote:
I use Stimulants I believe in them more than benzos and SSRIs are the single most useless medications in psychiatry.
Ummmmm... what? SSRI's, especially Zoloft, are very helpful for anxiety. They've helped scores of people and have saved countless lives.
Stimulants for anxiety? I'm confused...
Posted on 7/9/20 at 10:55 am to td01241
quote:
I thought I made it clear I was a psychiatrist specializing in this. Xanax is fine to break infact every benzo but Klonopin is. It makes absolutely no sense. Scoring medications that need precise dosages (Oxy, Xanax, Klonopin, Desoxyn(yes meth is available as a pill form prescription) should always be scored so you know the exact amount instead of risking getting all of it or none of it
I may have breezed over you stating that. I assumed all benzos were scored, that’s not the case, so I’m wrong on that. I’ve kept my post but ETAd one about me telling OP how to ween off, I’m just a random guy on a message board. Even though I have a good understanding of drugs, it’s mostly emergency medicine, you seem very knowledgeable and I do believe you are actually a doctor. Hopefully your input as well as others gives him the info he needs. Along with him discussing this with his personal doctor most important.
It was an extremely embarrassing thing to go to a dr for to me. Wife made the call and made it happen.
This post was edited on 7/9/20 at 10:58 am
Posted on 7/9/20 at 10:58 am to lsut2005
Stimulants for treatment resistant depression, meaning two 1sr mine medications have failed already. Usually for me remeron is first unless a health issue prevents then a throwna dart and pick and SSRI because it’s all random what will work for who. If they come from a GP on and SSRI I know it is I’ll fail immediately because the dose will never be brought high enough to control their issues without me giving them benzos which just reinforces bad habits. Many many many studies have shown depression treated with 10-15mg XR adderall or more optimally 30-40mg Vyvanse is often he best case.
Posted on 7/9/20 at 11:00 am to lsut2005
Just shooting from the hip yeah Zoloft can be helpful for anxiety it has that reputation but the amount of people I see that allow the time and patience and difficulty with agitation over 6-8 weeks while the dose gets high enough to have a chance at being effective there is no such thing as an absolute with these medications it seems to be about 1 out of 20 people
This post was edited on 7/9/20 at 11:01 am
Posted on 7/9/20 at 11:01 am to td01241
quote:Because it has a short duration, wouldn't Xanax be useful for people that are claustrophobic and need a MRI or for someone that just takes it for a flight?
td01241
Posted on 7/9/20 at 11:03 am to td01241
Ahhh okay, makes sense. So you're saying that most people quit before the medication kicks in? As in, they don't allow for the pretty grueling 6-8 week period that allows it to fully work?
Posted on 7/9/20 at 11:03 am to saderade
That was often given in the 70s and 80s. For those rare PRN benzo needs we use Valium now
This post was edited on 7/9/20 at 11:04 am
Posted on 7/9/20 at 11:05 am to lsut2005
Exactly. Which is why benzo bridging SSRIs SNRIs is common practice. The hope is it will help tolerate the symptoms enough to see if the full effect at the high dose is efficient
Posted on 7/9/20 at 11:07 am to td01241
My wife has treatment resistant depression. Literally every SSRI she's tried either doesn't work or has intolerable side effects-if there's a weird side effect associated with a drug, she gets it. The only thing she can tolerate is a low dose of wellbutrin and I'm not sure it even works any more. She has xanax as needed for anxiety but doesn't take it much, always has more left over at the end of the month. The last new thing she tried was something to increase methylfolate levels. Her Dr said it would be completely benign but it made her so fatigued she couldn't get out of bed. She's pretty much given up on meds, just gets through it on prayer and willpower.
Posted on 7/9/20 at 11:07 am to Gcockboi
It's freaking hell man. You need to be very careful about seizures.
I would highly suggest you get medical assistance to taper off.
This is sadly something I am very familiar with.
I would highly suggest you get medical assistance to taper off.
This is sadly something I am very familiar with.
Posted on 7/9/20 at 11:09 am to Gcockboi
I mean no offense when I say this but why are so many of you in this thread on these meds? What are they for?
Posted on 7/9/20 at 11:09 am to td01241
But I don’t think that’s good medical practice. If you go exactly by the DSM two different type of antidepressant medications should be tried first line. Those are almost always SSRIs or SRNIs, the names you all know but there are a ton of different types. Each one require approximately 6-8 weeks to fully judge. I like remeron first because it’s a night time one that helps with sleep so no benzo bridge. But if the second one needs onetouce started something and once you start benzos it’s 10 billion times harder to take something away than having ever not given it. If I had free reign to ignore 1st line and the DSM is would start anyone presenting with major depression and a clean UDS on Vyvanse 7 day scripts at a time
Posted on 7/9/20 at 11:10 am to td01241
quote:Thanks for the info. I always gave Xanax for these patients because of the long half life of valium but I will have to rethink that.
That was often given in the 70s and 80s. For those rare PRN benzo needs we use Valium now
Posted on 7/9/20 at 11:10 am to Jim Rockford
Vyvanse man. I’m telling you it is the best treatment for depression we have medically. It works essentially on a chemical level just the same as SSRIs only it does it immediately and with effectiveness
Posted on 7/9/20 at 11:11 am to td01241
If someone also had anxiety would that make it worse?
Posted on 7/9/20 at 11:11 am to saderade
Generally the feeling in Med school was the longer lasting Valium was worth the trade off in how less potent it was
Posted on 7/9/20 at 11:13 am to Jim Rockford
Stimulants can increase anxiety, but they’re one of the most well tolerated medications worldwide on a global scale. They’re safer than many otc medicines. There are plenty to try, I just find Vyvanse works the best for major depression because it’s smooth and not really jumpy.
Posted on 7/9/20 at 11:14 am to td01241
quote:
Who knows. Like I said it has become very popular outside of its initial limited scope. I don’t like using it personally. I use Klonopin 95% of the benzos I write. Restoril rarely and maybe Valium if they have proven they can handle PRN scripts of 5-10 a monrh
Ativan is used a lot by dentists before procedures as well.
Posted on 7/9/20 at 11:18 am to reds on reds on reds
Yup it’s the most popular hospital benzo too. I was just saying it wa made for one very specific reason but blew up. Marketing is guess
This post was edited on 7/9/20 at 11:19 am
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