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Drugs Found Ineffective for Veteransí Stress
NY Times ^ | August 2, 2011 | BENEDICT CAREY

Posted on 08/04/2011 5:30:02 PM PDT by neverdem

Drugs widely prescribed to treat severe post-traumatic stress symptoms for veterans are no more effective than placebos and come with serious side effects, including weight gain and fatigue, researchers reported on Tuesday.

The surprising finding, from the largest study of its kind in veterans, challenges current treatment standards so directly that it could alter practice soon, some experts said.

Ten percent to 20 percent of those who see heavy combat develop lasting symptoms of post-traumatic stress disorder, and about a fifth of those who get treatment receive a prescription for a so-called antipsychotic medication, according to government numbers.

The new study, published in The Journal of the American Medical Association, focused on one medication, Risperdal. But experts said that its results most likely extend to the entire class, including drugs like Seroquel, Geodon and Abilify.

“I think it’s a very important study” given how frequently the drugs have been prescribed, said Dr. Charles Hoge, a senior scientist at the Walter Reed Army Institute of Research, who was not involved in the study but wrote an editorial accompanying it. He added, “It definitely calls into question the use of antipsychotics in general for PTSD.”

The use of such drugs has grown sharply over the past decade, as thousands of returning soldiers and Marines have found that their post-traumatic stress symptoms do not respond to antidepressants, the only drugs backed by scientific evidence for the disorder. Doctors have turned to antipsychotics, which strongly affect mood, to augment treatment, based almost entirely on their experience with them and how they expect them to work.

To test those assumptions, a team of researchers affiliated with the Veterans Affairs medical system had 123 veterans with the disorder begin a regimen that added Risperdal to their treatment. Some of the patients served in Vietnam, others in...

(Excerpt) Read more at nytimes.com ...


TOPICS: Culture/Society; Foreign Affairs; News/Current Events; Testing
KEYWORDS: health; medicine; ptsd
It's a FReebie.

Adjunctive Risperidone Treatment for Antidepressant-Resistant Symptoms of Chronic Military Service–Related PTSD

Risperdal is the trade name of Risperidone, the generic.

The named drugs in the Times article are usually called atypical antipsychotics.

1 posted on 08/04/2011 5:30:05 PM PDT by neverdem
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To: neverdem
Disclaimer; ... I've never been in combat.

How can a drug eliminate a memory?

It is a strong man that stays 'sane' after seeing what he sees in combat ... feeling what he feels.

I have great respect for the returned warrior and pray for them almost daily ... there's daily mention, but sometimes prayer eludes me.

2 posted on 08/04/2011 5:42:01 PM PDT by knarf (I say things that are true ... I have no proof ... but they're true)
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To: neverdem

bfl


3 posted on 08/04/2011 5:43:47 PM PDT by smokingfrog ( sleep with one eye open ( <o> ---)
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To: knarf
How can a drug eliminate a memory?

They're trying to alter the reaction to the memory. Thanks for the prayers!

4 posted on 08/04/2011 5:48:37 PM PDT by neverdem (Xin loi minh oi)
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To: neverdem
Yet studies suggest that talk therapy, alone or in combination with antidepressants, can accelerate the relief of common symptoms, like nightmares and reclusive behavior. These psychotherapies tend to include relaxation skills; incrementally increased exposure to stress triggers; and challenging some inaccurate assumptions that fuel anxiety.

Time, too, should be taken into consideration, recent research has found. “We’re finding that about 24 months after a one-year deployment is about enough” for the body to reset itself physiologically, Dr. Hoge said.

5 posted on 08/04/2011 5:48:43 PM PDT by iowamark
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To: neverdem

bump


6 posted on 08/04/2011 5:49:16 PM PDT by Tainan (Cogito Ergo Conservitus.)
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To: Tainan

Dahhhhhh, most of us could have told them that 40 years ago.


7 posted on 08/04/2011 5:52:27 PM PDT by AGreatPer
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To: knarf
How can a drug eliminate a memory?

These drugs are not designed to eliminate memories, but to make them less distressing.

8 posted on 08/04/2011 5:57:31 PM PDT by Rudder (The Main Stream Media is Our Enemy---get used to it.)
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To: knarf

Iraqi combat has left me with an incredible startle reflex producing a jump with every sudden noise and sleep problems. I have to say that respiridne did not help but turned me into a zombie. Time is helping but after 12 months, the problem is hardwired. I know a USS Arizona surviver who still has this and Viet Nam Vets who are still plagued with this.


9 posted on 08/04/2011 5:58:53 PM PDT by jesseam (Been there, done that)
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To: neverdem; AdmSmith; AnonymousConservative; Berosus; bigheadfred; Bockscar; ColdOne; ...

The DoD is getting set to hire over 500 addiction counsellors at circa $53K a pop (this from a likely candidate) because there will be addicted vets (or soon-to-be addicted vets coming off various prescription meds they’ve been on to deal with sleep disorders and stress) coming home in large numbers soon.


10 posted on 08/04/2011 6:02:30 PM PDT by SunkenCiv (Yes, as a matter of fact, it is that time again -- https://secure.freerepublic.com/donate/)
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To: neverdem
1/1 CAV, AMERICAL RVN 68-69

I´m dubious of PTSD cause I´m one of the scarediest cats I know, but went through all heck in Vietnam and have never had any issues with it at all.

I´d say though that psychologists and quasi-hypnotic therapy really helped my wife out of agoraphobia following the birth of our daughter some 36 years ago when it wasn´t generally understood. And the only drugs involved were over-the-counter. I´d think there could be some benefit in this to the more severe PTSD patients.

11 posted on 08/04/2011 6:02:43 PM PDT by onedoug (¨Wire Congress! Wire Congress! Wire Congress!¨)
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To: neverdem
Thanks for the posting and your service. Interesting article on a subject near and dear to me personally.
12 posted on 08/04/2011 6:05:36 PM PDT by ImpBill ("America ... where are you now?" signed, a little "r" republican!)
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To: jesseam

Between you, me and the gate post, a heavy belt of vodka before going to bed helps. Don’t tell anyone I said this.


13 posted on 08/04/2011 6:05:44 PM PDT by jesseam (Been there, done that)
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To: jesseam
After my enlistment, '65-'67, I entered 'the world' of skirts up to here, drugs everywhere and sex for the fun of it at any time.

I've done most drugs available during the late '60's and early '70's, and if this is sanity, I thank God for it, 'cause I sure tried to do damage to myself.

Having said that .. I never got away from my mind ... I am ever present with me ... and THAT is what I'm refering to.

I can only offer my empathy and prayers, brother.

14 posted on 08/04/2011 6:07:50 PM PDT by knarf (I say things that are true ... I have no proof ... but they're true)
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To: knarf

Thanks buddy, I appreciate that.


15 posted on 08/04/2011 6:10:51 PM PDT by jesseam (Been there, done that)
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To: knarf

Our minds are so stinking complicated and then we have the fact that we are all different, yet the same, that makes this all seem impossible. I have read that depression is not a symptom of PTS but can be a great influence on those who have PTSD. (Not all who suffer have all the symptom.)

The problem with PTS is not the memory, it is the reaction to the memory. We cannot and refuse to forget, however the pain of the memory can be overwhelming. I would not be surprised if there were not phases that we would have to go through to heal, as in mourning.

There is an interesting treatment for PTSD called Neuro or Biofeedback therapy. Its been around for a while but only recently been given to PTSD sufferers. For those interested:

http://www.datehookup.com/Thread-151368.htm

http://www.eeginfo.com/newsletter/?p=317

http://www.healthnews.org/news/2010/11/biofeedback-helps-veterans-battling-ptsd-and-tbi

http://www.prweb.com/releases/2010/11/prweb4178094.htm


16 posted on 08/04/2011 6:25:45 PM PDT by huldah1776
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To: neverdem
I admit to listening to Dr. Roy Masters occasionally, and don't quite know what to think of him exactly. But I heard him talking about Patriot Outreach on the Rusty Humphries radio program and he did seem to make a lot of sense.

He has a series called Overcoming Stress, Fear and Pain, that is available for download.

http://www.patriotoutreach.org/downloads_pfs.html

I haven't listened to it but am curious if anyone else has ever tried it and what they think about it.

About War, Stress and PTSD

17 posted on 08/04/2011 7:29:30 PM PDT by smokingfrog ( sleep with one eye open ( <o> ---)
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To: smokingfrog

BE STILL AND KNOW!


18 posted on 08/04/2011 7:40:03 PM PDT by TsonicTsunami08
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To: smokingfrog

I’m not familiar with either name. Thanks for the links.


19 posted on 08/04/2011 7:52:55 PM PDT by neverdem (Xin loi minh oi)
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To: defconw

?


20 posted on 08/04/2011 8:13:12 PM PDT by cibco (I HOPE Obummers's CHANGE disappears...)
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To: cibco
"We’re finding that about 24 months after a one-year deployment is about enough” for the body to reset itself physiologically, Dr. Hoge said."

Well we know that's crap! 40 plus years has not reset.

21 posted on 08/04/2011 8:28:24 PM PDT by defconw
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To: jesseam
Iraqi combat has left me with an incredible startle reflex producing a jump with every sudden noise and sleep problems. I have to say that respiridne did not help but turned me into a zombie. Time is helping but after 12 months, the problem is hardwired. I know a USS Arizona surviver who still has this and Viet Nam Vets who are still plagued with this.

Were you around loud artillery? Yea stupid question maybe but important. The startle reflex may be pointing to Vestibular {Inner Ear} and Sensory Processing damage. No indeed those type of meds will not help in some cases because it is neurological damage involved which can be compounded by stress. It is damage most doctors are simply not checking for. If it isn't ruled out then in some cases like what I went through their text book protocol meds can do more damage because they are not treating the actual problem.

People might scream bloody murder for what I'm about to say but I know this beast real well. Medications like Xanax taken at a low dosage of say .5mg four times a day gives major relief. Antidepressants can make what I am describng far worse and I have seen what the worse can do. Antidepressants to some persons with sensory damage can be as bad as LSD. I've seen it. I've seen doctors miss it too.

Try to tell a shrink about Vestibular related sensory processing damage causing anxiety and a bad startle reflex and they'll likely say rubbish. A few won't but most will. Look up Anxiety +Vestibular Disorders. The Vestibular researchers like Harold Levinson made that connection back in the 1970's. The last thing needed is sensory enhancement as the sensory processing system is already overtaxed and the anxiety is the direct result of that. Xanax slows down the sensory processing too a manageable level so the brain and Vestibular sytem can handle it and somewhat function again.

I still reach a point where I have violent spasms hitting my upper torso from the shoulder blades up sometimes an involuntary jerking and yell. These spasms usually last a second or two and can be as many as several a minute. These are actually seizures and not spasms. The technical name Myoclonic Seizures caused by sensory stimulation. The wrong noise or certain visual stimulation sets it off. It can be auditory, visual, or both triggering it. Things like loud noises can cause the initial damage to the processing system. Add stress and it can really work on you. The way too deal with it so you can function also goes against the textbook protocol for PTSD. I control my sensory enviroment as much as possible. I get out and do things but I do it at times least likely too set me off. This includes even the hours I shop in stores.

I was born with what lead too most of it. But I was also in a Howitzer Battery in the guards and had a fully battery fire mission {155's} go off about 50 feet from my truck while I was asleep. I've had this since 1994 {10 years after my gaurd hitch} and I got hit with PTSD at the same time over non service related traumatic events happening in my life over a 10 year time frame. The PTSD requires therapy. Really that is the best long term answer for PTSD but from what you are saying it sounds like there is more too it than simple PTSD going on.

If this sounds like whats going on drop me FR Mail. Once you understand it you can learn to live with it although as far as working it can be disabling. I had to retire at age 34. There is no cure for what I am describing but you can get some relief if you can find a doctor who thinks outside the box.

Xanax taken correctly in low dosages can be safely taken for over two decades. My wife has been on it for 26 years and I have for 17 years. But you and your doctor must go with low but consistent level in the blood stream dosage.

22 posted on 08/04/2011 8:29:29 PM PDT by cva66snipe (Two Choices left for U.S. One Nation Under GOD or One Nation Under Judgment? Which one say ye?)
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To: jesseam

You hang in there! I am married to Vietnam Vet with PTSD. I know it never goes away, but I pray that you can find a way to live with it. Be kind to yourself. It should get less intense. Learn what triggers you and try to distract your mind during those times. I know what triggers my husband and it helps to know what to expect.


23 posted on 08/04/2011 8:33:28 PM PDT by defconw
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To: onedoug

I am glad that you don’t have issues. But I assure you this has nothing to do with courage or the lack there of.


24 posted on 08/04/2011 8:37:38 PM PDT by defconw
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To: knarf
Just a thought, but from what I have seen in my husband is not depression or psychosis, but rather anxiety. A great deal of anxiety over noises, ‘unsafe” situations and drama.
25 posted on 08/04/2011 8:52:05 PM PDT by defconw
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To: onedoug
I´m dubious of PTSD cause I´m one of the scarediest cats I know, but went through all heck in Vietnam and have never had any issues with it at all.

I think persons who have other undetected neurological problems are far more prone to PTSD. The problems seem to start when the the persons brain gets overloaded with events and believe it or not they don't all have too be bad events. Good events that still cause stress like a wanted promotion with more responsibilities can add too it.

When PTSD hit me I had done been through all the bad events. My job was turning around too decent pay and a position I had worked 5 years too get. But my brain was overtaxed from compensating for neurological issues and the traumatic events weren't being resolved while at the same time stress increased.

It's not just vets who can get it. You can go to the hospital for an operation and the stress of the operation and possibly some minimal damage from being put under is also known to trigger what they call Panic Attacks which can lead to Agoraphobia. For most persons it is short lived. For some the underlying neurological issues must be found and treated and that is where a lot of the falling through the cracks is happening in PTSD patients. PTSD and Anxiety Attacks very often co-exist with another or even one or several neurological things going wrong in the body. Those things can also feed the PTSD.

26 posted on 08/04/2011 8:56:39 PM PDT by cva66snipe (Two Choices left for U.S. One Nation Under GOD or One Nation Under Judgment? Which one say ye?)
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To: cva66snipe

I totally agree with everything you have said. I have had panic attacks and never been in combat. I totally understand the “feelimg”.


27 posted on 08/04/2011 9:14:53 PM PDT by defconw
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To: defconw

24 months for the average person going through a traumatic experience. PTSD occurs with car accidents, rape, abuse, etc. Those who experience more than one traumatic event have a proportionately higher chance of experiencing PTSD without recovering on their own. That reminds me, my sister-in-law’s mother lived through the Blitzkrieg and she might get help with the neuro/biofeedback therapy.


28 posted on 08/04/2011 9:20:57 PM PDT by huldah1776
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To: defconw
Just a thought, but from what I have seen in my husband is not depression or psychosis, but rather anxiety. A great deal of anxiety over noises, ‘unsafe” situations and drama.

What about Wally World? Does he usually just want the heck out of there becoming a little confused maybe even irratiable especially in busy hours where they are paging every minute at full volume? What about TV? Not being able to watch high action shows but shows formatted in the 70's and earlier are more tolorable? How about watching someone lets say climb a ladder? Is he scared of heights? If so that is classic Vestibular. It is a self preservation mechanism in the brain doing it and it is not an actual phobia. The brain is saying hey you have a balance issue stay off the darn ladder. But they brain doesn't want Joe acros the street on it either.

Any altered hearing? By that I mean the dripping faccet type problems. Where he is almost asleep and any small noise sounds much louder than it is? This is a filtering issue between the Inner Ear and the brain. All of this can trigger anxiety.

Don't be too shocked if you have to go pick him up while he's out sometime because he went into what I call brain fog. Scarey as hell but it's harmless. In a major attack the brain like a computer will start shutting down programs. IOW he may be driving on a street he drives say once a week. All of the sudden sense of where you are at, how you got there, where you were going, etc is gone. It won't kill you but first several times I thought I had major things wrong like a tumor.

Everyone is different bu have any of my post on this thread sounded like what is going on? How about ringing in the ears? Chronic ear infections as a child? Tubes in the ears as a kid? Sinus allergies? Partial deafness? I'm over 50% now. Poor balance? These are some things that can point too what I'm saying that doctors overlook and never consider when treating anxiety. Yet any of us over 50 can remember when persons had what was called Middle Ear infections and how they acted till it passed.

29 posted on 08/04/2011 9:22:21 PM PDT by cva66snipe (Two Choices left for U.S. One Nation Under GOD or One Nation Under Judgment? Which one say ye?)
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To: defconw

I did respond to your post in public but want to send the links I posted. Please read them all, it sounds very promising.

http://www.datehookup.com/Thread-151368.htm

http://www.eeginfo.com/newsletter/?p=317

http://www.healthnews.org/news/2010/11/biofeedback-helps-veterans-battling-ptsd-and-tbi

http://www.prweb.com/releases/2010/11/prweb4178094.htm


30 posted on 08/04/2011 9:23:39 PM PDT by huldah1776
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To: huldah1776
Good point. I don't think that antidepressants are the answer. I am a little dismayed that this article thinks that PTSD has much to do with depression. It's more about anxiety. When you are anxious you are stressed.
31 posted on 08/04/2011 9:25:22 PM PDT by defconw
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To: cva66snipe
He does have tenitis(ringing in the ears), as I am sure you know that provokes anxiety all on it's own. Crowds? Forget about it. He does not like crowds, fireworks, noisy bars restaurants etc.

As for brain fog. Yes this has happened. He forgets what he was saying or doing. But it's not an old age thing. He sleep walks and appears totally lucid when he does it, except that the situation is inappropriate for the middle of the night.

32 posted on 08/04/2011 9:33:36 PM PDT by defconw
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To: huldah1776

Thank You. I will I will try anything to help him. He is a bit more stubborn! I am sure you know what I mean.


33 posted on 08/04/2011 9:36:01 PM PDT by defconw
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To: huldah1776
What I take from these links and just to respond to lurkers, I firmly believe that PTSD is not merely an emotional problem. It's neurological and physiological problem. Concussions, minor traumatic brain injuries as well as other triggers that over load the veteran's sense of well being.
34 posted on 08/04/2011 9:45:15 PM PDT by defconw
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To: cva66snipe
Here are a couple of good articles. The first one especially is real good.

Cognitive Aspects of Vestibular Disorders

Panic disorder: the role of the balance system

I also think this needs to be said. To anyone experiencing PTSD you and your family need to look up Serotonin Syndrome. I say this because it might someday save someones life.

Sometimes when persons have underlying neurological issues which are the actual cause of the anxiety and they do not get addressed the wrong medications might be given. In those cases it is important that family and doctor catch this in it's early onset. It is an adverse medication reaction.

This is not Tin Foil Junk Science I have been a witness too it in my wife and almost myself. My wife has serious neurological damage that left her a quadriplegic. She has PTSD. A doctor gave her Trazadone and Zoloft. It ended up having the same effect as LSD would and she nearly died. Six doctors ignored medical history and were too busy having her take SSRI's. Xanax likely saved her life as she was also on it. When a person becomes a quad the first thing they must regain besides limb usages is their Inner Ear and balance.

I have an extensive sensory processing medical history almost from birth the shrinks ignored while insisting I take Paxil and other Meds. I got lucky in the fact I found a book that helped be understand what was wrong. It's called Phobia Free and anyone with a Vestibular medical history should read it. I also later on found a doctor who had seen what I have although there is still no name for it as such as it is several things combined.

Don't get me wrong. Stay on your meds never go cold turkey on any med either but also look at your life long medical history and do some basic detective work. If your doctor doesn't want too listen then find another. I fired 5.

35 posted on 08/04/2011 9:48:53 PM PDT by cva66snipe (Two Choices left for U.S. One Nation Under GOD or One Nation Under Judgment? Which one say ye?)
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To: defconw
He can be helped with the right medication. This is common in kids as well and shrinks pass it off as being ADD ADHD. It's actually Central Auditory Processing Disorders. Fireworks? LOL First clue my parents had something was wrong was when I was about 5-6. We were at the fair and it was time for fireworks. I went into hysteria plugging up my ears and closing my eyes. A couple years later they started finding things like I was single eye vision. I have poor eye-muscle coordination and had too take two years Occupational Therapy in 7th and 8th grade. It gave me the skills to where I even passed two armed forces physicals. Nope they didn't catch any of it either. I also have a long history of sinus allergies.

It really sounds like he is a Vestibular patient. You can do the searches with a search engine Vestibular disorders +anxiety. There is a lot more information out there than what I had in 1994.

I also very highly recommend the book "Phobia Free" by Harold Levinson. Don't let the title throw you off. In that book he puts the Vestibular triggering anxiety puzzle together. He is a Neurologist and Pyschratistist and was decades ahead of his time.

BTW I bet he can wear out a good pair of shoes pretty fast huh? Breaks over the sides unless he wears corrective insoles? That's due to walking of balance it makes the ankles turn in real bad. Concrete floors are the worse. I also have to use a cane now.

36 posted on 08/04/2011 10:05:01 PM PDT by cva66snipe (Two Choices left for U.S. One Nation Under GOD or One Nation Under Judgment? Which one say ye?)
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To: defconw

BTW at the bottom of the page of the first link is a link for Cognitive Aspects of Vestibular Disorders. You really need to read it as well. If this links here’s part 2 http://sci.tech-archive.net/Archive/sci.med.diseases.lyme/2005-08/msg00134.html


37 posted on 08/04/2011 10:14:17 PM PDT by cva66snipe (Two Choices left for U.S. One Nation Under GOD or One Nation Under Judgment? Which one say ye?)
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To: cva66snipe

Thanks for the link I am going to look into it. I will say that sense he has been taking the anti-anxiety med he is much better.


38 posted on 08/05/2011 4:01:33 AM PDT by defconw
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To: neverdem

bookmark


39 posted on 08/05/2011 7:58:41 AM PDT by FourPeas ("Maladjusted and wigging out is no way to go through life, son." -hg)
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To: defconw
Thanks for the link I am going to look into it. I will say that sense he has been taking the anti-anxiety med he is much better.

Benzodiazepines such as Xanax, Valium, Librium, and Klonopin work pretty good. Of those four Klonopin is the easiest to get a doctor to write for long term and should work as long as no seizure activity is involved. If seizure activity is involved then Xanax is the best IMO. The trick is a maintenance level of the lowest dosage of Xanax that works. That is usually .5mg for most persons. If a doctor writes it for lets say 1-2 mg twice per day that is a disaster waiting to happen and will eventually make things worse. But a 2mg pill split into four doseages a day usually every 6-8 hours will work.

Benzo's have a bad reputation mainly due to ignorance on the part of prescribing doctor writing too strong a dosage and too far apart or writing it too those who drink alcohol in excess. The doctor and patient have to understand how too take it. Yes there is a risk for dependency. On the other hand on some days I've gone up too 12 hours without it others I have too have all four doses that day.

The thing that burns me is persons with anxiety attacks and PTSD need help now. Antidepressants can take up too a month too fully work and usually no relief at all for the first week. A Benzo starts working in a few minutes or in the case of Xanax within 5 minutes when placed under the tongue. If there is an adverse reaction it takes the antidepressants up too several weeks to leave the body. The adverse reaction in a male can mean bladder blockage which is also very dangerous and requires imediate medical attention or you will go into shock. Been there done that too. A Benzo is usually gone within 12 hours at max. Benzo's also do not have the Serotonin Syndrome risk as they are actually the antidote for it.

40 posted on 08/05/2011 3:47:03 PM PDT by cva66snipe (Two Choices left for U.S. One Nation Under GOD or One Nation Under Judgment? Which one say ye?)
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To: cva66snipe

What bugs me most, is that they give you a pill and consider it dwalt with.


41 posted on 08/06/2011 8:01:06 PM PDT by defconw
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To: defconw
There's a lot of misconceptions about what psychiatrist do. Sessions on a couch with them listening is among the biggest one. They don't do that. They see you for 15 minutes every three months and write your refills in most cases. A good LCSW {therapist} specializing in PTSD is the one who helps you work through things. Ironically the psychiatrist I saw who did finally write me the correct medication was also one of the most messed up persons I knew LOL. My family doc writes the meds now.

For PTSD and anxiety a good therapist is a must and it usually takes years to be rid of the beast entirely.

42 posted on 08/06/2011 8:19:35 PM PDT by cva66snipe (Two Choices left for U.S. One Nation Under GOD or One Nation Under Judgment? Which one say ye?)
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To: cva66snipe
I would have to agree with what you have said. He see the doc every three months and they review meds. I guess the meds work BUT.... it's not the cure. The just knock the edge off.

Then there is the sleeping pill.

43 posted on 08/07/2011 3:51:56 PM PDT by defconw
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