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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 10 of 10. This is the beginning of the thread.
Posted by Vincent_QC on December 4, 2009, at 14:42:00
Hi again!
I have some questions about panic disorder.I'm leaving a really bad moment with panic attacks who are trigger by things like driving the car... or that happen suddenly...
Before, I had only panic attacks... now I live in a constant anxiety state.
I have pins and needles pain in my left arm, dilated pupils in the eyes (big black circle),pain in my face, my chest... My hands and foots are always sweating, I have strong insomnia (difficulty to stay asleep), have burning eyes, strage pain in the head ( I always think that I have some peoples who play with my brains), constant fatigue, dizness, abdominal pains... and the list goes on...
I meet my PDoc next week and I don't know what to think about the situation. Don't know what to ask to try next, since I have a lot of anticipatory anxiety...
Someone have the same symptoms then mines from panic disorder? Are they normal or the numbless feeling in the chest and arm is not normal and related to a heart attack???
I'm so worried about the situation.... Living in a such high state of anxiety is really freaking!!!
Some idea for a good med who will decrease the constant anxiety feeling and panic attacks?
For now, i'm only taking 8mg of Rivotril/ady...divided in 4 doses of 2 mg... and that's not getting ride of my anxiety at all... seem that it's not effective at all... but if I decrease the amount of Rivotril I used, so less than 8mg, I feel more anxious!!! Strange...
No TCA's, MAOI's, SSRI's or SRNI's... I try all of them and they don't work at all, little exception to the Paxil but it make me fat... I also try in the past severals meds like Mirapex, Lyrica, Gabapentin, topamax, inderal, Clonodine, Sabril (only avaible in the Canada)...and others meds that I don't remember...nothing seem to work...
The only meds I don't try are things like Epival (acid valproic or sodium), Lamictal, Lithium...
Any good advises will be welcome!
Thanks!
Vincent :-)
Posted by Phidippus on December 4, 2009, at 15:09:46
In reply to Panic disorder symptoms, normal or not?, posted by Vincent_QC on December 4, 2009, at 14:42:00
> Someone have the same symptoms then mines from panic disorder?
All of the symptoms you listed sound like classic panic symptoms.
>Are they normal or the numbless feeling in the chest and arm is not normal and related to a heart attack???
Panic attacks can cause some of the symptoms of a heart attack, but I doubt you are having a heart attack as you would be in the hospital and not posting here.
> I'm so worried about the situation.... Living in a such high state of anxiety is really freaking!!!
Is your anxiety about specific things or is it a general anxiety? Do you have thoughts that you can't get out of your head?
If your anxiety is mood related, then you may be experiencing mania and you might do well to go on a mood stabilizer like Lithium or Lamictal.
>No TCA's, MAOI's, SSRI's or SRNI's... I try all of them and they don't work at all, little exception to the Paxil
Did you give these medications time to work? It takes about four weeks for these medications to build up in your system. Why not go back on Paxil?
P
Posted by RocketMan on December 4, 2009, at 15:29:54
In reply to Panic disorder symptoms, normal or not?, posted by Vincent_QC on December 4, 2009, at 14:42:00
> For now, i'm only taking 8mg of Rivotril/ady...divided in 4 doses of 2 mg...Hi Vincent,
I use to take 2mg/4x day as well, back in 1989. I found it will only mask the anxiety to a degree. It was not until I found an A/D that helped with the anxiety could i reduce the dose. Which I did..... clomipramine 150mg. It was a rocky road titrating up on the clomip. but eventually it did help.
> No TCA's, MAOI's, SSRI's or SRNI's... I try all of them and they don't work at all, little exception to the Paxil but it make me fat...
Unfortunately, you will have to decide which is worse, the crippling anxiety/panic attacks, or the added weight gain from paxil. If it were me, I would gladly get back on paxil!! I feel bad for you, severe anxiety is a 24hr disabling disease. I would continue with the rivitrol for now until you stabilize. It will also help with any start-up side effect from whatever A/D you decide to try next. I have been taking clonazepam for 21 years, currently taking 0.5mg 2 or 3 times a day so don't worry about using it if it helps. I hope you feel well soon and let us know what the p/doc says.
Take care,
Rick
Posted by Phillipa on December 4, 2009, at 16:57:35
In reply to Re: Panic disorder symptoms, normal or not?, posted by RocketMan on December 4, 2009, at 15:29:54
Vincent things must really be bad today. Will talk later. Love Phillipa
Posted by Vincent_QC on December 4, 2009, at 22:09:12
In reply to Re: Panic disorder symptoms, normal or not? » Vincent_QC, posted by Phidippus on December 4, 2009, at 15:09:46
> > Someone have the same symptoms then mines from panic disorder?
>
> Panic attacks can cause some of the symptoms of a heart attack, but I doubt you are having a heart attack as you would be in the hospital and not posting here.
>
Yeah, you're right about that one... even if I know that it's not related to the heart, I can't remove that idea from my head... and each time i'm doing a panic attack I think I will die... And now with the panic disorder, mean constant and hig level of anxiety, I always feel like I have something wrong with my heart, even if I had it checked 2 times this year and everything is normal... I have maybe just a faster pulse rate but it's mainly caused by bad habits like smooking cigarettes and the lack of exercises...>
> Is your anxiety about specific things or is it a general anxiety? Do you have thoughts that you can't get out of your head?
>I have the two types of anxiety you describe. Strange no? I have panic attacks who are trigers by things like driving the car or being exposed to a a lot of peoples at the same time. I don't know if it's general anxiety... but my main problem is the social phobia... I had panic disorder diagnostic 14 years ago and was put on the Paxil + CBT and get ride of it after 2 years of hard work... The panic disorder appear just recently (june)... I had panic attacks at school when it was time do to oral exposure works at the university or when I was taking the metro alone or walking on a street full of peoples, but I was used to this kind of panic attacks and was not worried about them... But this time it's different...
To be more clear and specific, I have a anemia problem with a low hemoglobin, who is not helping me to start with the fatigue and the fact that I feel weak all the time... I'm treat for that with intramuscular injection of iron and pills of iron that I take each days... just had also a surgery to remove the bloddy hemmorroids that was causing the loose of the iron and blood from my body...
Anyways, panic attacks become more and more present in my life back this summer... I had one panic attack while I was driving the car and after I was stuck with the idea that I will not be able to drive again alone... it took more than 2 months to be able to drive the car and don't fear of having panic attacks again while I was driving...
Those panic attacks are triger by the fact that I now that I take a huge amount of Rivotril each day, so I don't have a lot of concentration and i'm a lot distracted, so I fear of doing a car accident... or fainting ... and when the panic attack start, I fear of doing a heart attack and do a car crash...
I have also a lot of thoughts in my head ... not linked to the driving the car, but more related to the general anxiety type... I had a gastric by-pass to loose weight in 2001... I was at 450 and go to 180 pounds... was stable on 180 pounds... until my Doctor put me back on antidepressants meds... I gain weight again and i'm now around 220 pounds... and I feel not really well with myself... I feel fat again and that's making me a lot anxious when i'm going out of the house...
I also have a lot of others thougts... about my health... I smooke a lot but can'T stop since i'm so anxious... I have weight to loose but can't dieteting cause the anxiety make me eat a lot... I know that i'm not in a good physically shape but can't exercises since the low level of hemoglobin is making me tired all the times... I will see a Plastic Surgeon soon to have some extra skin remove from my body... so another painfull surgery... I need another one surgey to repair a hernia in my belly... I'm now 33yo and I don't finish school, I don't work since more than 6 years now, i'm disable from work... have no money... I really don't feel like a normal person of 33yo... I have to live temporary to my parents house... i'm gay... gay peoples are a lot superficials and the way you look and the body is more important than what you have inside your head... so I don't meet guys to avoid to being rejected like in the past... I dint had a BF since more than 3 years and for the sex it's the same... I just feel that I completly f*ck up my entire life...
So you see, my thoughts are a lot linked to my health... and I can't stop thinking about all those things... so the anxiety level is always high...
> If your anxiety is mood related, then you may be experiencing mania and you might do well to go on a mood stabilizer like Lithium or Lamictal.
>
CAn you call what I wrote above mood related??? Mania??? I know that I have a body dismorphic problem... as well as a bulemia problem... I tend to always want to loose weight and get frustrated cause I can't...>
> Did you give these medications time to work? It takes about four weeks for these medications to build up in your system. Why not go back on Paxil?
>
I always allow at least 2 months for a med... If i'm experiencing side-effects who are dangerous, like hypertensives crisis (not linked to food) on the Parnate in december and january 2009, that's sure that I will stop before the 2 months... But in general, I always allow a good 2 months to meds to be sure they are not effective...or effective...And the reason why I don't want to return on the Paxil is because I suffer a lot from my morbid obesity in the past... I had that gastric by-pass to loose weight... it's a painfull surgery... and trust me, nobody who will have lived the same experiences, will do the same as me... I mean not wanted to gain weight!!! I was 2 1/2 months on the Paxil last summer and I gain 30 pounds!!!! For me it's too much !!! That's certainly not normal, even my PDoc was surprise when he see on the scale the weight I was after 2 1/2 months... I don't want to be fat again, so that's why i'm looking for another solution!!!
I hope it's more clear now!!!
Thanks for your answer ;-)
Vincent ;-)
Posted by Vincent_QC on December 4, 2009, at 22:18:46
In reply to Re: Panic disorder symptoms, normal or not?, posted by RocketMan on December 4, 2009, at 15:29:54
> Hi Vincent,
>
> I use to take 2mg/4x day as well, back in 1989. I found it will only mask the anxiety to a degree. It was not until I found an A/D that helped with the anxiety could i reduce the dose. Which I did..... clomipramine 150mg. It was a rocky road titrating up on the clomip. but eventually it did help.
>Ok, Thanks !!! I feel less alone now... for me, I always think that 8mg of Rivotril was a too high dosage!!! And see peoples like you, who succeed to reduce their dosage is giving to me a lot of courage and hope!!!
I try the Clomipramine last winter... I give up at 50mg... it was too much for me... The pins and needles sensations in the head... the burning eyes... the insomnia... the constipation... the dizness... it was too much for me...
>
> Unfortunately, you will have to decide which is worse, the crippling anxiety/panic attacks, or the added weight gain from paxil. If it were me, I would gladly get back on paxil!! I feel bad for you, severe anxiety is a 24hr disabling disease. I would continue with the rivitrol for now until you stabilize. It will also help with any start-up side effect from whatever A/D you decide to try next. I have been taking clonazepam for 21 years, currently taking 0.5mg 2 or 3 times a day so don't worry about using it if it helps. I hope you feel well soon and let us know what the p/doc says.
>Hummm like I wrote in the last message... I don't want to gain weight again. The gastric surgery and the morbid obesity are the 2 main reasons why I don't want to gain weight again!!! I was fat for 25 years... had no friends at school, had a mysery life at school, all the others kids was laugthing at me... treating me like a piece of sh*t... so no, the weight gain is not an option for me and I can't accept that idea!!!
I'm sure that some meds who are weight neutral and who are very helping with panic disorder exist!!! I just need to find the good one...
And yes, I will stay on the 8mg of Rivotril when I will start again an AD... or any other med... will depend of the PDoc decision...
Will let you know what happen...
Thanks !!!
Vincent ;-)
Posted by Vincent_QC on December 4, 2009, at 22:24:33
In reply to Re: Panic disorder symptoms, normal or not?, posted by Phillipa on December 4, 2009, at 16:57:35
> Vincent things must really be bad today. Will talk later. Love Phillipa
Hi Phillipa!!!
Hummm it was another crappy day... but tonight I was able to drive the car and I Was ok... not comfortable... had fast pulse rate... but no panic... but in general, I had a bad evening too... Was not able to stop thinking about the pain inside my head and the numbless in my arm and my chest!!! That's driving me crazy!!!It's impossible to ignore those things... I feel them... and I try to change my minds and think about others things but unfortunally, I always return in my bad thoughts of heart problem, seizure, faint... that's hard...
The PDoc have to be ready for a special appointment next tuesday!!! I will have a lot of things to say and ask!!!
For now, i'm off to bed... will take 25mg of Seroquel, just to help me to fall asleep... it will help... that's what I do last night to fall asleep...
Inside my head I can't find the button to shut off the brain!!! Lol
Anyway... good night !!! We talk later!!!
Loves!
Vincent ;-)
Posted by emmanuel98 on December 5, 2009, at 2:49:39
In reply to Re: Panic disorder symptoms, normal or not? » Phillipa, posted by Vincent_QC on December 4, 2009, at 22:24:33
Anxiety stimulates the sympathetic nervous system, which makes your heart rate and blood pressure rise, slows down your intestinal tract and basically puts you in fight or flight mode. It's an actual physical reaction, so no wonder you have all these physical symptoms.
I don't know what meds would work at this point if benzos and anti-psychotics have been tried and failed. (both risperdal and seroquel lessened anxeity and panic attacks for me). But it might help to tell yourself that this is just your sympathetic nervous system in over-drive. You're not actually dying. It will pass.
Posted by Katgirl on December 5, 2009, at 10:04:26
In reply to Re: Panic disorder symptoms, normal or not?, posted by emmanuel98 on December 5, 2009, at 2:49:39
I was going to suggest Paxil but you said the weight gain made it not an option for you. Paxil really really really helped my anxiety, but it doesn't work for me anymore. I found that watching what I ate very closely on Paxil kept the weight gain to an acceptable 10 pounds. I would rather weigh 10 pounds more than live in constant anxiety!!
Posted by Phidippus on December 10, 2009, at 19:28:02
In reply to Re: Panic disorder symptoms, normal or not? » Phidippus, posted by Vincent_QC on December 4, 2009, at 22:09:12
Besides the panic disorder it would seem you have some obsessional as well as generalized anxieties. You really should be on an SSRI, SNRI or Anafranil. You could augment this treatment with Gabitril, Lyrica or Tramadol.
P
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