jacques Posted October 7, 2017 Share Posted October 7, 2017 So I recently went to see a pdoc to get my prescription renewed, and I mentioned anxiety being a big part of my life. He was understandably hesitant to give me an antidepressant for anxiety, and instead said he'd increase my depakote to see if it'd help. Does anyone have any experience with a pdoc doing this? Did it help? Does depakote have some anti-anxiety properties? Link to comment Share on other sites More sharing options...
browri Posted October 9, 2017 Share Posted October 9, 2017 Usually for anxiety nowadays they just give you a benzo like Klonopin, Xanax, or Ativan (clonazepam, alprazolam, or lorazepam; respectively). Those drugs bind to the benzodiazepine site on GABA receptors and essentially "turn up" your response to the naturally occurring GABA in your brain. Depakote also works on GABA but in a different way. Instead of binding to GABA receptors and enhancing your response, Depakote inhibits the breakdown of the naturally occurring GABA in your brain. So theoretically speaking it should have anti-anxiety effects. I'm just starting on Depakote and find that my anxiety has lessened a bit. Then again I am pretty prone to the placebo effect so I'm not sure yet. I'm pretty sure 500mg is too low a dose for me to be noticing that much of a response. I go up to 750mg myself tomorrow night. Link to comment Share on other sites More sharing options...
phidippus Posted October 15, 2017 Share Posted October 15, 2017 Depakote is no good for anxiety, unless the anxiety is related to mania. 500 mg is a very low dose. I was taking 2000 mg back when I was on it and it did not help with anxiety. Link to comment Share on other sites More sharing options...
browri Posted October 24, 2017 Share Posted October 24, 2017 My anxiety really only happens during mixed states. If I can get the racing, intrusive thoughts under control, the anxiety disappears. It's a different kind of anxiety which is why antipsychotics can sometimes be effective. Link to comment Share on other sites More sharing options...
Iceberg Posted October 24, 2017 Share Posted October 24, 2017 Have you ever talked about a benzo? Link to comment Share on other sites More sharing options...
browri Posted October 24, 2017 Share Posted October 24, 2017 7 minutes ago, Iceberg said: Have you ever talked about a benzo? My pdoc does give me 0.5mg alprazolam to take as needed. I've just gotten really good at separating a mixed state or racing/intrusive thoughts from feeling jumpy or on edge, or having an anxiety attack with elevated heart rate maybe some hyperventilation. The symptoms I'm having dictate whether I take an extra 5mg of loxapine during the day or if I take the alprazolam. And occasionally I have taken both to really knock out a minor episode. but I usually don't find that to be necessary. I was given the alprazolam because I experienced a traumatic event that had me nervous and edgy, like sudden loud noises would startle me and I would jump or I would think about what happened and what's going to happen to me moving forward and it increases my heart rate and I start to panic. That's when I take the alprazolam. I usually go for the loxapine though. It's serene without making me yawn every 30 seconds like alprazolam. I don't usually need much alprazolam either. Doctor has prescribed 0.5mg daily as needed but I usually just start with 0.25mg and never take the other half. Link to comment Share on other sites More sharing options...
Iceberg Posted October 24, 2017 Share Posted October 24, 2017 For me it's Xanax or Thorazine kind of a similar situation Link to comment Share on other sites More sharing options...
browri Posted October 25, 2017 Share Posted October 25, 2017 14 hours ago, Iceberg said: For me it's Xanax or Thorazine kind of a similar situation I'd be curious to try Thorazine at least once. I've just found loxapine to be extremely effective and haven't had a reason to switch. My pdoc and I have given up making antipsychotics the primary med for my manic or mixed states. Originally we were using anticonvulsants as anti-manic background meds like lamotrigine, oxcarbazepine. But we decided to bring them to the forefront of the cocktail because the doses of APs I need to remain under control cause akathisia, and my doctor won't negotiate on that at all. He gave me Cogentin to help in a pinch but it was supposed to just be for that day. He only gave me 7-10 of them. So we reduced my loxapine from 25mg to 10mg and switched the oxcarbazepine to valproate. Now I just take the 10mg of loxapine at night with my 1000mg of Depakote and it's a much more tolerable anti-manic combo. I still occasionally "top off" on the loxapine during the day because of its short half-life like I said. Only like 7-9 hours with actual therapeutic effect that lasts for only 12 hours after a dose. The extra 5mg is sometimes needed to get better all-day coverage. @Iceberg Curious...with the 6mg of Vraylar, how often would you say you take Thorazine in a normal week? Does it cause you akathisia? I hear Vraylar is very well-known for its incidence of movement disorders. Link to comment Share on other sites More sharing options...
Iceberg Posted October 25, 2017 Share Posted October 25, 2017 No the Thor is only when things get bad enough that benzos don't work at all or if I have severe insomnia. When I'm not in an episode (severe) I only take 25 which is a nothing dose. When it's bad I take 25-50 every 4-6 hours until my body gives up and I chill. I would recommend it for mania but not by itself and the sedation is a killer Link to comment Share on other sites More sharing options...
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