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    Old 01-22-2004, 03:59 PM   #1
    windymoon
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    Bad anxiety attack when taking new medication?

    Anyone else do that? First you have anxiety and then the doctor gives you a new medication and you freak? I HATE THAT! My anxiety level has increase recent and I do feel depressed, so my Doctor gave me lexapro 10mg today. I've been sitting here on the computer reading about all the problems people have had with it and so far I haven't taken it. But I need something and will take it before bedtime. Maybe I shall break it in half the first day. I had a bad drug interaction with a sufer drug awhile back and went to the ER>> scary! Can't get past that! I HATE THIS!

     
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    Old 01-22-2004, 04:48 PM   #2
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    Re: Bad anxiety attack when taking new medication?

    I was like this when i started taking beta blockers a couple of months ago. I told the doctor i didnt want anything that messes with the heart, but i needed them. I got home and looked up the drug on the internet and it sent me into one of the worst attacks ive had. I was in bed for three days crying and begging the doctor to come out and reasure me they were safe. Luckily the only side effect i had was tiredness for a week, other than that they are the best tablets ive been on.
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    Old 01-22-2004, 08:02 PM   #3
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    Unhappy Re: Bad anxiety attack when taking new medication?

    Quote:
    Originally Posted by windymoon
    Anyone else do that? First you have anxiety and then the doctor gives you a new medication and you freak? I HATE THAT! My anxiety level has increase recent and I do feel depressed, so my Doctor gave me lexapro 10mg today. I've been sitting here on the computer reading about all the problems people have had with it and so far I haven't taken it. But I need something and will take it before bedtime. Maybe I shall break it in half the first day. I had a bad drug interaction with a sufer drug awhile back and went to the ER>> scary! Can't get past that! I HATE THIS!
    Dear windymoon,
    We all go though this at one time or another. Breaking a 10mg tablet in half would do nothing positive and make no difference negative. Let me just tell you a little theory and it is only a theory but a lot of doctors believe it to be true from what they have seen. Lets not get technical, lets just say that when you take a medication you need to make A in your brain add to B, to get the result of C, which is the result you need to bring you back to normal. If you do not take enough of the medication to let A + B = C, then you are going to create A + B = brain confusion and you will feel like crap. Take the dosage that the Doctor wants you to. It will either make you feel better or it will not. It will take time of feeling ill now and then to reach the proper dosage, if this is the medication for you and that is all there is to it. Don't be afraid of having a panic attack over taking the medication. It will not be the medicaion doing this to you, but yourself and it will pass. If the medication does not react well with you after a few days tell the doctor what symptoms you are having. The medication itself even if you had a reaction to it, and that is very, very rare, will not physically harm you. Don't be afraid as best you can and don't try to regulate the medications yourself. They effect everyone differently but all have a general dosage level to get results. If you take less then the beginning lower dosage, it can make you have more problems then if you take the dosage you are suppost to. You will be fine and you have to go though this sooner or later, there is no way out of it and your condition will get worse then any medication side effects will ever be. Be brave and take the dosage the doctor prescribed and try not be calm. I wish I could take on your fear for you for a few days to get you though this but unfortunately you have to do it yourself. Goodnight, and be positive about this please.

    Sincerely,

    Sickman

     
    Old 01-22-2004, 10:48 PM   #4
    dd78749
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    Re: Bad anxiety attack when taking new medication?

    Actually, dosage-related side effects are the primary reason why most people are non-compliant with their medications. Here's a great article on the subject. I read this doctor's book and came to understand what I had always privately thought; that is, that taking 1/2 or even 1/4 of the recommended dosage works well for me (and many people with panic disorder who are overly sensitive to side effects, such as myself) without the side effects being so burdensome that I (we) just quit taking our meds. Get this book from your library if possible...it's a great read and will explain why recommended dosages are much too high for most people. This applies across the board for nearly all medications except anti-infectives (antibiotics and antifungals).

    ANTIDEPRESSANT SIDE EFFECTS:
    In A New York Times Expose, A Doctor Describes Her Own Reaction To An Antidepressant Drug. But She Doesn't Explain Why Antidepressant Side Effects Occur and How to Prevent Them. -- This Article Does.

    In the Times' Sunday health section, psychiatrist Nanette Gartrell reveals her personal experience -- and lack of awareness -- about antidepressant side effects ("A Doctor's Toxic Shock").1 Grieving over a friend dying of liver cancer, Dr. Gartrell began taking buproprion, better known as Wellbutrin, but her reaction could just as easily have occurred with Prozac, Paxil, Zoloft, Celexa, Lexapro, Luvox, Effexor, Sarafem or other antidepressants, or Zyban, the smoking-cessation drug that's identical to Wellbutrin.
    "Within 10 days, I developed insomnia, agitation and tremors," Dr. Gartrell writes. "I lost the ability to distinguish between sadness and the drug's side effects.... panic attacks started... I needed every ounce of energy to concentrate at work.... I forced myself to eat but still lost 10 pounds. Sometimes I felt paranoid, and I wondered if I was delusional. When I wasn't working, I was curled in a fetal position, contemplating whether I should hospitalize myself."
    Antidepressants help millions of people, but antidepressant side effects can be wicked. Even worse, many doctors cannot identify even common antidepressant side effects and frequently give patients the wrong advice. Dr. Gartrell did what she told patients to do: stick it out until the drug's benefits kick in. That's the mainstream medical party line, but many side effects are so unpleasant or vicious, such advice is downright dumb.
    Worse, in a few patients, panic, agitation, sleep deprivation, and impaired judgment may reduce impulse control, and antidepressants have been linked to people acting out, sometimes violently. Thus, the headlines about homicides and suicides by people who never were violent before starting on antidepressants. Yet, although there's considerable literature on this problem 2-16, few doctors know about it because their information sources are heavily influenced by the drug industry, whose research somehow keeps missing the problem.

    The Devil Is in the Dosage
    Dr. Gartrell's side effects began shortly after starting buproprion. This is a common story. Why? I explained this in a previous newsletter:

    "These reactions are occurring because the standard starting doses of many antidepressants are excessively strong for many people. One clue is that most of these reactions occur shortly after people have been started on antidepressants or after the dosage has been bumped up. These are called `first-dose' reactions by mainstream medicine, and they almost always indicate a mismatch between the patient and the dosage 17."


    My book, Over Dose: The Case Against The Drug Companies, which received a glowing review by JAMA (Journal of the American Medical Association), explains that most side effects are dose-related and that the standard starting doses of many top-selling drugs are too strong for millions of patients.18 No doubt, Dr. Gartrell started with the standard dose of buproprion. It was too strong for her. Many standard drug doses, based on studies in which most subjects are male, are too strong for many women.
    Studies prove this. The standard starting dose of Prozac is 20 mg/day, yet even before Prozac was marketed, a large study showed that 54% of patients did fine with just 5 mg.19 But drug companies like to keep their dosage guidelines simple because that's what doctors prefer. So Prozac was marketed at a one-size-fits-all initial dose of 20 mg/day -- 400% more medication than many patients needed -- and the package insert made no mention of the safer, proven-effective 5-mg dose.
    Many experts besides me recognized the problem. A 1993 study concluded "that starting fluoxetine [Prozac] at doses lower than 20 mg is a useful strategy because of the substantial fraction of patients who cannot tolerate a 20-mg dose but appear to benefit from lower doses 20." An even earlier report warned: "Clinically, we have observed fluoxetine to be effective over a wide range with many patients requiring very low dosages... 21."
    With buproprion, the standard initial dose is 150 or 200 mg/day, which is often quickly increased to 300 mg/day. But 50 mg twice-daily is often enough, and doctors report that some patients tolerate only 50 mg/day.22-24 Similar problems plague other antidepressants, yet few doctors challenge drug company guidelines and instead follow them without question. This explains why doctors prescribe the same strong drug doses to young and old, big and small, healthy and frail. Or prescribe the same doses to people taking no other medications and people taking a dozen. Such methods defy medical science and common sense, but if that's
    what the drug company guidelines say, that's what most doctors do. And if drug companies claim that side effects are infrequent and mild, doctors believe this rather than believing their own patients.
    This is unfortunate, because so many side effects can be prevented by simply starting lower. If a lower dose isn't effective, it can be easily increased. I call this "precision prescribing," and my new nonprofit organization, the Center for the Prevention of Medication Side Effects, is dedicated to promoting this better, safer, patient-friendly paradigm and to providing information about lower, proven-effective drug doses to doctors and patients.

    An Indictment Of Mainstream Medical Education
    Dr. Gartrell says that she is now much more sensitive to patients' complaints about side effects, and she is quicker to adjust their medications to halt their reactions. But why did it take so long for her to learn this lesson? Why wasn't she trained to do this from the start?
    Dr. Gartrell's new attitude speaks well of her. But her previous approach, which her colleagues and most doctors share, speaks poorly of medical education, which provides no time for in-depth training in pharmacology and, in most cases, not a single lecture on identifying and handling side effects.25 So it's not surprising that when patients complain of legitimate side effects, their doctors respond with ineffective interventions or downright denial. Thatís why the New York Times deserves credit for publishing Dr. Gartrell's confessional, because it not only confirms that patients' complaints about side effects are legitimate, but it also reveals why their doctors refuse to believe them or take appropriate action. No wonder so many patients are dissatisfied, quit treatment, and seek alternatives.
    Yet, sometimes medications are necessary. What can you do? You must become your own researcher, using books and the Internet, learning enough to choose selectively from the information you see. Access my data on lower, safer medication doses via my published articles and books, and the MedicationSense.com website. Take your information, like Dr. Gartrell's and this article, to your doctors. Spread the word and help us change the system.


     
    Old 01-23-2004, 09:35 AM   #5
    Some12
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    Smile Re: Bad anxiety attack when taking new medication?

    Quote:
    Originally Posted by dd78749
    Actually, dosage-related side effects are the primary reason why most people are non-compliant with their medications. Here's a great article on the subject. I read this doctor's book and came to understand what I had always privately thought; that is, that taking 1/2 or even 1/4 of the recommended dosage works well for me (and many people with panic disorder who are overly sensitive to side effects, such as myself) without the side effects being so burdensome that I (we) just quit taking our meds. Get this book from your library if possible...it's a great read and will explain why recommended dosages are much too high for most people. This applies across the board for nearly all medications except anti-infectives (antibiotics and antifungals).

    ANTIDEPRESSANT SIDE EFFECTS:
    In A New York Times Expose, A Doctor Describes Her Own Reaction To An Antidepressant Drug. But She Doesn't Explain Why Antidepressant Side Effects Occur and How to Prevent Them. -- This Article Does.

    In the Times' Sunday health section, psychiatrist Nanette Gartrell reveals her personal experience -- and lack of awareness -- about antidepressant side effects ("A Doctor's Toxic Shock").1 Grieving over a friend dying of liver cancer, Dr. Gartrell began taking buproprion, better known as Wellbutrin, but her reaction could just as easily have occurred with Prozac, Paxil, Zoloft, Celexa, Lexapro, Luvox, Effexor, Sarafem or other antidepressants, or Zyban, the smoking-cessation drug that's identical to Wellbutrin.
    "Within 10 days, I developed insomnia, agitation and tremors," Dr. Gartrell writes. "I lost the ability to distinguish between sadness and the drug's side effects.... panic attacks started... I needed every ounce of energy to concentrate at work.... I forced myself to eat but still lost 10 pounds. Sometimes I felt paranoid, and I wondered if I was delusional. When I wasn't working, I was curled in a fetal position, contemplating whether I should hospitalize myself."
    Antidepressants help millions of people, but antidepressant side effects can be wicked. Even worse, many doctors cannot identify even common antidepressant side effects and frequently give patients the wrong advice. Dr. Gartrell did what she told patients to do: stick it out until the drug's benefits kick in. That's the mainstream medical party line, but many side effects are so unpleasant or vicious, such advice is downright dumb.
    Worse, in a few patients, panic, agitation, sleep deprivation, and impaired judgment may reduce impulse control, and antidepressants have been linked to people acting out, sometimes violently. Thus, the headlines about homicides and suicides by people who never were violent before starting on antidepressants. Yet, although there's considerable literature on this problem 2-16, few doctors know about it because their information sources are heavily influenced by the drug industry, whose research somehow keeps missing the problem.

    The Devil Is in the Dosage
    Dr. Gartrell's side effects began shortly after starting buproprion. This is a common story. Why? I explained this in a previous newsletter:

    "These reactions are occurring because the standard starting doses of many antidepressants are excessively strong for many people. One clue is that most of these reactions occur shortly after people have been started on antidepressants or after the dosage has been bumped up. These are called `first-dose' reactions by mainstream medicine, and they almost always indicate a mismatch between the patient and the dosage 17."


    My book, Over Dose: The Case Against The Drug Companies, which received a glowing review by JAMA (Journal of the American Medical Association), explains that most side effects are dose-related and that the standard starting doses of many top-selling drugs are too strong for millions of patients.18 No doubt, Dr. Gartrell started with the standard dose of buproprion. It was too strong for her. Many standard drug doses, based on studies in which most subjects are male, are too strong for many women.
    Studies prove this. The standard starting dose of Prozac is 20 mg/day, yet even before Prozac was marketed, a large study showed that 54% of patients did fine with just 5 mg.19 But drug companies like to keep their dosage guidelines simple because that's what doctors prefer. So Prozac was marketed at a one-size-fits-all initial dose of 20 mg/day -- 400% more medication than many patients needed -- and the package insert made no mention of the safer, proven-effective 5-mg dose.
    Many experts besides me recognized the problem. A 1993 study concluded "that starting fluoxetine [Prozac] at doses lower than 20 mg is a useful strategy because of the substantial fraction of patients who cannot tolerate a 20-mg dose but appear to benefit from lower doses 20." An even earlier report warned: "Clinically, we have observed fluoxetine to be effective over a wide range with many patients requiring very low dosages... 21."
    With buproprion, the standard initial dose is 150 or 200 mg/day, which is often quickly increased to 300 mg/day. But 50 mg twice-daily is often enough, and doctors report that some patients tolerate only 50 mg/day.22-24 Similar problems plague other antidepressants, yet few doctors challenge drug company guidelines and instead follow them without question. This explains why doctors prescribe the same strong drug doses to young and old, big and small, healthy and frail. Or prescribe the same doses to people taking no other medications and people taking a dozen. Such methods defy medical science and common sense, but if that's
    what the drug company guidelines say, that's what most doctors do. And if drug companies claim that side effects are infrequent and mild, doctors believe this rather than believing their own patients.
    This is unfortunate, because so many side effects can be prevented by simply starting lower. If a lower dose isn't effective, it can be easily increased. I call this "precision prescribing," and my new nonprofit organization, the Center for the Prevention of Medication Side Effects, is dedicated to promoting this better, safer, patient-friendly paradigm and to providing information about lower, proven-effective drug doses to doctors and patients.

    An Indictment Of Mainstream Medical Education
    Dr. Gartrell says that she is now much more sensitive to patients' complaints about side effects, and she is quicker to adjust their medications to halt their reactions. But why did it take so long for her to learn this lesson? Why wasn't she trained to do this from the start?
    Dr. Gartrell's new attitude speaks well of her. But her previous approach, which her colleagues and most doctors share, speaks poorly of medical education, which provides no time for in-depth training in pharmacology and, in most cases, not a single lecture on identifying and handling side effects.25 So it's not surprising that when patients complain of legitimate side effects, their doctors respond with ineffective interventions or downright denial. Thatís why the New York Times deserves credit for publishing Dr. Gartrell's confessional, because it not only confirms that patients' complaints about side effects are legitimate, but it also reveals why their doctors refuse to believe them or take appropriate action. No wonder so many patients are dissatisfied, quit treatment, and seek alternatives.
    Yet, sometimes medications are necessary. What can you do? You must become your own researcher, using books and the Internet, learning enough to choose selectively from the information you see. Access my data on lower, safer medication doses via my published articles and books, and the MedicationSense.com website. Take your information, like Dr. Gartrell's and this article, to your doctors. Spread the word and help us change the system.

    Dear dd78749,
    That was very inspirational for all of us I am sure. I'm sure you copy everything that fits your specific fear of medication also. I say spread the word to. Spread the word that this is a quote only of an opinion by a doctor and a poster only, not fact. And by the way, the New York Times will pring anything that sells magazines, that their job. I am sorry that you have such a fear of the possible or initial side effects of medications and that you try to create a separate class of people segregated from the rest of us. If that make you feel better, then that is your therapy and I am glad you have found it. We were talking of a very low dosage of a specific medication, not the drug companies general dosage peak level at this point. Spread the word, just please don't spread it on a post that it comes across as a scare tactic even if you meant it not to be. I will say one thing positive that I did see in your own writing about this. If you can lower your dosage to such a low level, then I think with other means you yourself can become medication free. You seem so strong in not taking the dosage that if you used that strength in another approach instead of wasting it on being afraid of the medication, maybe you can get off them completely. I hope for you that this may give you a reason to try. Look, I may have come on very strong here, but I don't want to see anyone suffer for any reason. And I don't want someone that is afraid of taking a medication that they need because of any reading that they do. It simply will not hurt them at that dosage physically and they might skip to something else and never find the right one, because they skipped it in the first place. Have a very nice day and know that I believe you meant well and of course others will agree with you as always.

    Sincerely,

    Sickman

     
    Old 01-23-2004, 03:58 PM   #6
    Natasha1981
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    Re: Bad anxiety attack when taking new medication?

    Quote:
    Originally Posted by windymoon
    Anyone else do that? First you have anxiety and then the doctor gives you a new medication and you freak? I HATE THAT! My anxiety level has increase recent and I do feel depressed, so my Doctor gave me lexapro 10mg today. I've been sitting here on the computer reading about all the problems people have had with it and so far I haven't taken it. But I need something and will take it before bedtime. Maybe I shall break it in half the first day. I had a bad drug interaction with a sufer drug awhile back and went to the ER>> scary! Can't get past that! I HATE THIS!

    SSRI's make people with panic disorder have more panic attacks or feel more anxious in the beginning. It's supposed to taper off. With me though, I was taking 10mg of celexa for 6 weeks and it didn't stop the panic attacks - it made them worse. Not to mention the completely loss of appetite and vivid dreams. No more SSRI's for me!

     
    Old 01-23-2004, 06:38 PM   #7
    windymoon
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    Re: Bad anxiety attack when taking new medication?

    Hi>>thanks for the posts sure food for thought! I took my pill last night and just again, I wanted to let everyone know I survive! Yeah! I did not any panic attacks today but I'm sure it can't be working yet, plus I think it more for depression anyway and I hope to feeling better soon. My Synthroid dose was also increase yesterday since I am hypothroidism. My endo said that could be making the panic attacks worse. I have always had them but feel the hypothryoidism is exacerbating it now. Thanks everyone!

     
    Old 01-23-2004, 11:25 PM   #8
    dd78749
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    Re: Bad anxiety attack when taking new medication?

    Quote:
    Originally Posted by Sickman
    Dear dd78749,
    That was very inspirational for all of us I am sure. I'm sure you copy everything that fits your specific fear of medication also. I say spread the word to. Spread the word that this is a quote only of an opinion by a doctor and a poster only, not fact. And by the way, the New York Times will pring anything that sells magazines, that their job. I am sorry that you have such a fear of the possible or initial side effects of medications and that you try to create a separate class of people segregated from the rest of us. If that make you feel better, then that is your therapy and I am glad you have found it. We were talking of a very low dosage of a specific medication, not the drug companies general dosage peak level at this point. Spread the word, just please don't spread it on a post that it comes across as a scare tactic even if you meant it not to be. I will say one thing positive that I did see in your own writing about this. If you can lower your dosage to such a low level, then I think with other means you yourself can become medication free. You seem so strong in not taking the dosage that if you used that strength in another approach instead of wasting it on being afraid of the medication, maybe you can get off them completely. I hope for you that this may give you a reason to try. Look, I may have come on very strong here, but I don't want to see anyone suffer for any reason. And I don't want someone that is afraid of taking a medication that they need because of any reading that they do. It simply will not hurt them at that dosage physically and they might skip to something else and never find the right one, because they skipped it in the first place. Have a very nice day and know that I believe you meant well and of course others will agree with you as always.

    Sincerely,

    Sickman

    Gee...where to start? First of all, I don't fear medications Sickman! Nothing in my post suggests such; only that I am sensitive to and annoyed by adverse drug reactions, which are nearly always dose-related. Let me ask you a question Sickman? Do you know that pediatric medication dosages are always based on an infant/child's weight and are not standardized as they are for adults? Would you agree that a dosage for a 105 lbs female should probably be quite different from that of a 250 lbs male?

    I'm not some idiot that fell off a turnip truck yesterday. I've been studying pharmacokinetic issues for more than ten years and I'm not nor is the doctor I quoted, the only persons who believe that the standardized drug dosages are too high for many people. Get a subscription to JAMA and Lancet and you'll find these issues raised by quite a number of doctors and scientists.

    You know maybe that NYT will print anything. Guess what Sickman? So will the pharmaceutical industry....they will do anything to bring to market a potentially profitable drug. Did you know that 12 drugs have been removed from the market in the past 10 years? I'm fairly certain that the people that were injured or died took standardized dosages of those drugs.

    I'm saying, be skeptical and be prudent. If 54% of people taking Prozac at a 5mg dosage report relief from their anxiety or depression (and these are from Eli Lilly's own drug trials mind you), doesn't that make you wonder why it's not offered in that dosage? Here's why....because the pharmaceutical industry wants to show to (and has to show the FDA) that their new drug is better than a previous medication used to treat the same illness. So in order to get a better than 75-80% showing, they have to increase the dosage until they achieve the percentage that they are seeking.

    I'm not making this stuff up Sickman. This has been documented for years by industry insiders who have blown the whistle in disgust over the pharmaceutical industry practices.

    Look, I'm not anti-meds nor am I anti-business. I'm just saying this...if you're med makes you feel worse than your illness, then there's a problem and chances are, it's dose related. Don't buy into the industry hype that their recommended dosages are the only ones that will work.

    As for me stopping taking meds because of taking low dosages, that's just silly. Let's take the example of aspirin. Do you think people taking low-dose aspirin for their hearts should switch to regular strength aspirin because that is the standard dosage for aspirin? Of course not. Studies have shown that low-dose therapy works just as well as regular strength aspiring with FEWER DOSE-RELATED SIDE EFFECTS.

    Common sense okay?

    As for your comment about meds not hurting anyone at standard dosages, let's see if Serzone comes to mind? What about Phen-Fen? What about the statins? As I said before, read JAMA and you'll find out that the drug injuries and deaths from these drugs could have been prevented if the standard dosages were not so high? That's what has caused the problems for these drugs and not the drugs themselves.

    I'm glad if you achieve symptom relief at standard drug dosage levels and are free of can cope with adverse drug effects at those dosages. Many people cannot; that's why you see so many people on this board and other boards that cycle through a slew of medications and eventually give up on most or all of them. If only someone had told them that they could actually lower the recommended dosage and likely receive good results without the common side effects associated with their meds, many people would actually stay on the meds and start to feel better.

    All I'm saying is that it's not a one-size fits all solution. If you're med is making you feel bad, lower the dosage. If you're not achieving symptom relief, increase the dosage. That's all.

    Sorry if I came on strong, but I'm not an illiterate noob. I know what I'm talking about. And if the poster is having trouble with med side effects, then the answer is not to increase it, but quite the opposite. And scientific data backs it up.

    SSRIs are rarely able to be tolerated well by people with anxiety and panic disorders because they increase the anxiety and panic in most people at standard dosages. Thus, people usually give up if their doc won't prescribe a benzo (the best med for anxiety/panic disorders). This board is full of people who are not able to tolerate SSRIs at standard dosages.

    Just give it some thought Sickman. I really am right on the money about this issue.

     
    Old 01-24-2004, 09:29 AM   #9
    Some12
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    Smile Re: Bad anxiety attack when taking new medication?

    Dear dd78749,
    You know I just spent and hour really going after this post and then I realized that I'm just not as mean as I would like to be sometimes, so I deleted it. I just have to conceed to this being your opinion but that you are wrong if your think that I support the drug companies and their profit making schemes or their information about the drugs and I have very good reason for this. I am just a guy that has been on several ssri's, other anti-depressants, anti-psycotics, benzos and the contriversal aspirin. I just don't have anything else really that I can do but do reseach myself and offer my experiences to try to help others. I do not take offense to your post, and it is okay by me to suggest in your opinion that one might lower a dosage. I just think that it is best to post only your opinion from you research or statistics or other information of medications rather then quoting the writings of someone else, especially a Doctor when someone may interpret it wrong and get hurt or suffer for it, that is all. Have a very nice day and I hope that there are no bad feelings or insults.

    Sincerely,

    Sickman

     
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