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Forum Name: Antidepressants
|ddx50 - Sun Apr 13, 2008 1:16 am||
Hi. I have been trying to find depression & OCD meds for the past 2 years. I see a psychiatrist for medication management every month. I have tried Clomipramine, Lexapro, Effexor, Seroquel, Geodon, Wellbutrin, Zyprexa, Paxil, and Risperdal. This without much to show for my efforts.
Before I went to a psychiatrist I used to self medicate with alcohol. When I had an anxiety attack or close to one I would do a couple shots to relieve the anxiety. Whenever I drank I was never depressed the next day either. However, I quit drinking for religious reasons and then I started going to psychiatrists.
I have an appointment with him this coming Thursday, and I wanted to find out some information before I went to him.
My Dr has me write down how I feel after changing dosages so I can make a report to him accurately. I have the prescription instructions to take 15 mg of Temazepam as needed for insomnia. I have also been allowed to make the dose 30 mg if I just can’t sleep. I have been reviewing these and I noticed a pattern. On the days that I have a decent to good day all occur after the days that I take 15 mg of Temazepam the night before. After I noticed this I tried taking the 30 mg three times, and three times I had good days following taking 30 mg. These were even better days than when I take the 15 mg. I have been trying to research this as much as I can.
Something I tried was 150 mg of diphenhydramine hcl. In the mornings after I did that I saw similar results to the benzodiazepines. From my limited knowledge on this subject it seems to me that depressants seem to help treat my OCD and depression.
So my question has a couple of parts.
1. I know benzodiazepines can be habit forming, but if they work would it be worth it to use them more frequently?
2. I learned that benzodiazepines, barbituates, and alcohol react almost identical to one another. Do they ever treat depression with barbituates? Like with something like Buspar that doesn’t have addiction potential?
3. I have read that Tricyclic anti-depressants react similarly to benzos‘, barbits’ and alcohol. Is this true?
4. From what I told above, is there any medications that I can recommend that are either benzos‘, barbits’, or act similarly to them?
Things are getting old so I thought I would ask
|Dr. E. Seigle - Wed Apr 16, 2008 7:39 pm||
I am unclear about what conditions you are referring to when you describe having a "good day" after taking temezepam at night. Do you mean the OCD, depression, or at one moment you mentioned anxiety attacks. Here are a couple of thoughts and issues:
1. What are the maximum doses of each of the medications that you have tried? Be sure that you have taken the maximum, tolerated, clinically appropriate doses.
2. benzodiazepines such as temezepam taken for sleep are largely worn off the next day. Do you think that the temezepam gives you a good night's sleep, which then has a positive effect on your mood? If so, perhaps it is poor sleep that should be treated.
3. The benzodiazepine Klonopin is sometimes used for OCD, mainly as an addition to another medication, but sometimes alone. Klonopin is an excellent medication for anxiety disorders in general, though as you know it has some addictive potential which needs to be thought through and monitored. Some people with depression seem to have it as a result of a primary anxiety disorder, and treating the anxiety disorder helps with the depression.
4. Benzodiazepines, while physiologically are central nervous system "depressants", this means that they reduce the firing of brain cells (called neurons), rather than activating them. While it is well known that benzodiazepines are capable of causing the clinical condition of Depression (which is different than saying it is a brain depressant), this does not always or even usually happen; it's just possible and needs to be thought through.
All of this being said, since you have had your conditions treated with SSRIs, SNRIs and "atypical neuroleptics", it may be reasonable for you to be treated with a benzodiazepine if your doctor thinks it prudent, in light of some small risk of addiction and the possibility of its causing or worsening depression. It would not be unreasonable to take temezepam instead nightly for a trial period; perhaps doing what seems to be working is a good idea.
Please discuss this carefully with your psychiatrist. Also, you should know that cognitive-behavioral psychotherapy is just as effective, and perhaps better in its preventing relapses, for depression, anxiety disorders and OCD. Often people are treated with the psychotherapy along with medication. Maybe it's time to give this a try if you haven't done so.
Best of luck!
-Eliot Seigle MD
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