View Full Version : What's best?!


Koblin3426
07-11-09, 10:48 PM
Hello everyone. I'm looking to be put on a new med for anxiety as it's gotten to be quite a problem ever since I was put on adderall (although it was definitely a problem beforehand as well). The adderall has been working so well that I was afraid to tell my psych about the increased anxiety in fear she would take me off of it. I'm taking 25mg of adderall xr in the AM and 10 adderall ir at 2 or 3 pm. I'm also taking 50mg of Levothyroxine sodium for hypothyroidism if that makes a difference.

I'm deciding between just about every type of benzo (lol everyone suggests a different one) and effexor XR or prestiq (I read it plays nice with other meds?). I don't know what would be better but my anxiety mainly stems from a fear of not having enough time for things and some social anxiety as well. There's a lot more info on my other post I linked but I figured people might respond if I didn't make my post as large. Thanks for responses! I'm desperate here!

http://www.addforums.com/forums/showthread.php?t=70363

muldoon
07-19-09, 05:08 AM
I don't know what would be better but my anxiety mainly stems from a fear of not having enough time for things and some social anxiety as well. There's a lot more info on my other post I linked but I figured people might respond if I didn't make my post as large. Thanks for responses! I'm desperate here!

http://www.addforums.com/forums/showthread.php?t=70363

Think about trying a serotonin agent for your type of anxiety before a benzo. I had way too many side effects on SSRIs but it was because I needed such high doses to control my panic. You don't appear to have panic attacks, which is really what benzos should be reserved for.

Trazodone is often overlooked in today's flooded market of SSRIs. 25mg at night can do wonders for your sleep and anxiety. Look into it...

Koblin3426
07-19-09, 11:35 AM
Think about trying a serotonin agent for your type of anxiety before a benzo. I had way too many side effects on SSRIs but it was because I needed such high doses to control my panic. You don't appear to have panic attacks, which is really what benzos should be reserved for.

Trazodone is often overlooked in today's flooded market of SSRIs. 25mg at night can do wonders for your sleep and anxiety. Look into it...

Thank you muldoon :) I had an appointment with my psych and she put on Remeron after I asked for klonopin or avitan. I'm glad though because I hadn't noticed remeron and it SEEMS to be perfect for what I need in an anxiety pill. Weight GAIN, better sleep, and anti-anxiety (had major depression for a few years so I guess the anti-depressant couldn't hurt either).

I didn't want a regular SSRI because I was on prozac and it didn't help much even after increasing the dosage to the point where I'd shake and sweat often (that sucked lol). At the time, I hadn't realized that all SSRIs act differently (right?..). I still didn't want the SE's of normal SSRIs though (especially not ED!) and wellbutrin gave me terrible memory loss.

I'm hoping Remeron doesn't do that but I read somewhere it could. I also read it can improve memory though. Any input on that? Also, what is wellbutrin (obviously not just an SSRI)? How is it different?

tomlinson
07-19-09, 02:59 PM
Also, what is wellbutrin (obviously not just an SSRI)? How is it different?

Wellbutrin is an antidepressant which targets the neurotransmitters norepinephrine and dopamine.

SSRI antidepressants target the neurotransmitter serotonin.

The med you're taking, Remeron, is one of the few SNRI antidepressants. SNRI's target serotonin and norepinephrine.

hollywood
07-19-09, 03:08 PM
aren't their studies stating that effexor and or theoretically effexors son pristiq is unlike any other serotonin ne medication around and that in combination with stimulant therapy has been proven to help adhd symptom control?

Koblin3426
07-19-09, 03:11 PM
Wellbutrin is an antidepressant which targets the neurotransmitters norepinephrine and dopamine.

SSRI's target the neurotransmitter serotonin.

The med you're taking, Remeron, is one of the few SNRI's which target serotonin and norepinephrine.

Thanks for clearing that up :) My adderall does dopamine, right? I was going to increase my adderall XR dosage from 25mg to 30mg or change it to IR (seems to work MUCH better). However, since norepinephrine helps with ADD, is there a possibility I won't need the increase? I'm also wondering if there's a certain point in which the SNRI effect supersedes the antihistimine and therefor isn't an effective sleep aid? I just don't want to be taking it at night when I shouldn't since I have enough trouble sleeping as it is.


Right now I'm taking 30mg mainly for anxiety. Btw, the remeron has helped a lot with sleeping. I feel like I'm sleeping like I would when I was little kid. Feels much more natural than regular sleep aids :)

tomlinson
07-19-09, 04:16 PM
Thanks for clearing that up :) My adderall does dopamine, right?

Adderall definitely "does" dopamine and the general consensus is that it does some norepinephrine and possibly serotonin as well.
It's also seen as an MAO inhibitor which can help to alleviate depression.

I was going to increase my adderall XR dosage from 25mg to 30mg or change it to IR (seems to work MUCH better). However, since norepinephrine helps with ADD, is there a possibility I won't need the increase?


I think that's a really good question; I'd definitely ask the doc.


I'm also wondering if there's a certain point in which the SNRI effect supersedes the antihistimine and therefor isn't an effective sleep aid? I just don't want to be taking it at night when I shouldn't since I have enough trouble sleeping as it is.

I wouldn't be too concerned about that.
The fact is that Remeron is sedating. It makes you sleepy (& hungry too.)

Btw, the remeron has helped a lot with sleeping. I feel like I'm sleeping like I would when I was little kid. Feels much more natural than regular sleep aids :)

Glad it's helping you and hope it continues to do so.
I took Remeron for a while and found it very helpful. (Ultimately stopped it due to excessive weight gain.)

hollywood
07-19-09, 04:58 PM
research effexor pristiq hello

tomlinson
07-19-09, 05:58 PM
research effexor pristiq hello

Effexor, Pristiq, and Cymbalta are the SNRI's (in addition to Remeron) available today.
Of the 4, (IIRC) Remeron is generally perceived as the most sedating.
If it's helping you, and your doctor prescribed it for you, I'd stick with it for at least a while.

hollywood
07-19-09, 08:07 PM
well I was taking cymbalta 20mg for a bit , basically I am taking it to take away the anxious or generalized anxiety I have in certain environments...basically at work. I found cymbalta to help me at work and make me a bit more nice and found it helpful but then I started to feel tired and drowsy often.... I'm not sure if this is because the dose was only 20mg or what..... Basically I'm trying to find a med that evens out my stimulant and keeps things more even, ie " balancing the kinks of adhd stimulants" meaning over focusing at times and hyperfocusing on the wrong things which leads to anxiety. I was on cymbalta 20mg for 3 weeks and just started getting non productive... Not sure if this would have gone away? Is cymbalta sedating? Is lexapro sedating ? Is pristiq less sedating? Which med would help even my stim out without making me a lethargic mess and not bother my inattentiveness? I wish somebody would give me more accurate advice as I'm not sure if cymbalta is supposed to really be sedating?

muldoon
07-20-09, 04:00 AM
The med you're taking, Remeron, is one of the few SNRI antidepressants. SNRI's target serotonin and norepinephrine.

Remeron is not an SNRI. It's a tetracyclic antidepressant. It's main target involves serotonin via certain 5-HT receptors.

As previously mentioned, it's sedating, increases appetite, and decreases anxiety. This is to be expected with most serotonin agents. But apparently Remeron has a positive effect on one's sex life. This is quite atypical, especially when you look at the graveyard of libidos and sexual function SSRIs have left in their wake.

Koblin, keep me posted on how you do on this drug. I am looking for something better for sleep and to smooth out the rough edges my Xanax doesn't quite get to every day.

muldoon
07-20-09, 04:17 AM
research effexor pristiq hello

Hollywood, I've noticed that you are interested in the SNRI class. The main reason SNRIs were developed is because SSRIs have high likelihood to cause daytime sedation or somnolence. A norepinephrine reuptake inhibitor was added in an attempt to "cancel out" the fatigue that alot of people experience on SSRIs.

I personally haven't read or heard too many good things about Effexor. The norepinephrine to serotonin reuptake ratio is probably too lopsided and needs to attain a better balance. Pristiq is as close to new as you can get and probably doesn't have any solid long term research available yet.

SNRIs are basically just an attempt to combine a stimulant w/ an anxiolytic. Akin to taking Paxil w/ Adderall, Xanax w/ Dexedrine, Zoloft w/ Ritalin, etc...but the stimulant effects of an SNRI are most likely not going to generate therapeutic effects or relief from ADD. Just enough to keep the excessive somnolence side effects of the serotonin reuptake at bay...if that even.

The only way you'll know if Cymbalta or any of the other meds you've listed off are going to sedate you is to give them a try and see what happens. Generally, the lower the dose, the less the chance of sedation. If you give any of the serotonin agents a solid try and they do relieve your anxiety, but exacerbate your ADD, then attempt a balancing act w/ your doctor by raising the dose of your stimulant medication slightly.

hollywood
07-20-09, 08:44 AM
muldoon,

thanks that's a logical reply. Cymbalta helped lighten my mood and this decreased any obsessive thoughts but I did get tired on a low dose. Maybe thats because I was only on it for a month. Maybe I need more time, as for pristiq I only made it three days. The startup was strange and I have more anxiety for three days , but my attention was much better. Not sure what that means exactly. Maybe I should opt for cymbalta and give it more time. It was nice to have a lighter mood it helps my attention span.

tomlinson
07-20-09, 02:34 PM
Remeron is not an SNRI. It's a tetracyclic antidepressant. It's main target involves serotonin via certain 5-HT receptors.


Remeron is an SNRI. (It's tetracyclic as well)

See, for example:

http://www.umm.edu/patiented/articles/what_medications_used_anxiety_disorders_000028_7.h tm
http://www.webmd.com/depression/medication-options

tomlinson
07-20-09, 02:55 PM
The main reason SNRIs were developed is because SSRIs have high likelihood to cause daytime sedation or somnolence. A norepinephrine reuptake inhibitor was added in an attempt to "cancel out" the fatigue that alot of people experience on SSRIs.


Respectfully, this information is inaccurate.
For example, some SSRI's can be activating, while some SNRI's can be sedating.


SNRIs are basically just an attempt to combine a stimulant w/ an anxiolytic.
Akin to taking Paxil w/ Adderall, Xanax w/ Dexedrine, Zoloft w/ Ritalin, etc...

Again, respectfully, this information is simply inaccurate.

hollywood
07-20-09, 04:46 PM
anyways, hate to come between back and forth punches but I guess I may opt to try cymbalta for my generalized anxiety. Ironically I have been using wellbutrin but although it helps it doesn't help the anxiety component.

RestlessAbbey
10-25-09, 07:36 PM
I noticed that yall were talking about Remeron, here's a link about said med.
http://www.biologicalunhappiness.com/BuSpar_anxious.htm

This doctor believer that Prozac can make GAD worse, not better.
And weight gainn on how much Remeron you take? Anyway that's what his experience has been.