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Need an anti-anxiety med, but intimidated to ask? Advice needed

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Ulcerative Colitis
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Posted 12/19/2011 2:41 PM (GMT 0)
I have been on Pred for close to six months now, every time I hit 20mgs, I start to bleed, so I go back up to 40mg. Im on my third go round with this...Anyway, I haven't had any side effects except anxiety, and bursts of extreme anger (im usually really calm). I want to ask for an anti anxiety med to calm me down while on the pred. Should I just go to my GP for this? Is he going to think im just looking for pills or will he be sympathtic?...I just feel a little weird asking for it, or can I even take it with Pred? Thanks
Posted 12/19/2011 3:13 PM (GMT 0)
I had that as a side effect as pred, also. Your GI should be able to prescribe you a drug, start there.

Also, I recommend that you start talking about the next drug to treat UC. Prednisone isn't meant for long term use and anything over 4 months is considered long term. Prednisone can be very damaging and should only be used to get a patient into remission and tapered off.

Sue
Posted 12/19/2011 5:03 PM (GMT 0)
If you were "looking for pills" there are plenty more sought after than the fairly mild anti-anxiety meds (e.g., Xanax) that you doc is likely to start with. Also I would be very surprised if you were the 1st patient where he/she has had to manage Pred side effects.

Also you do not have to ask, you can let the GP suggest. Tell him/her that noticeable anxiety/agitation from the Pred is becoming problematic, and ask what options exist.

I'm OK mostly at 15mg/day but when I was above 25mg/day, I felt a lot of anxiety, and almost paranoid. Even though Xanax was prescribed 3x/day, I found that just one about 4 hours before bedtime, let me relax in the evening , and sleep better. After a few weeks of improved sleep, I didn't even need the Xanax every night.
Posted 12/19/2011 5:56 PM (GMT 0)
My GI has given me ambien to help me sleep but she never gave me an anti-anxiety medication although I am sure she would if I asked. I think while you're on prednisone, these issues you're dealing with are extremely common and you shouldn't feel strange about asking for something to calm you down. I ended up going to a psychiatrist while I was on prednisone to get an antianxiety. I was way too wound up and I was lucky to find a doctor who specialized in chronic illness. In fact, he had been on prednisone himself in the past for an injury and he was 100% undertanding. I took klonopin .5mg 2x a day for a while but now I am takign an anti-depressant for migraines and it seems to help with my anxiety.

What are you currently taking to treat your UC? What does your GI recommend? I don't think going up and down on prednisone is going to prove to be a very effective technique. Whatever your taking for maintenance at this point, isn't keeping you in remission and you need to find a new treatment that works for you.
Posted 12/19/2011 6:11 PM (GMT 0)
I asked my GP for something when I had these side effects. I has initially hesitant to ask, but it was no problem at all. She gave me Cipralex (Lexapro) for the long term, and Xanax for the initial few weeks.

And as others said, I think it is fairly common for those on pred.

Good luck.
Posted 12/19/2011 8:31 PM (GMT 0)
thanks for the information....I feel better now!
Posted 12/19/2011 8:32 PM (GMT 0)

notsosicklygirl said...
My GI has given me ambien to help me sleep but she never gave me an anti-anxiety medication although I am sure she would if I asked. I think while you're on prednisone, these issues you're dealing with are extremely common and you shouldn't feel strange about asking for something to calm you down. I ended up going to a psychiatrist while I was on prednisone to get an antianxiety. I was way too wound up and I was lucky to find a doctor who specialized in chronic illness. In fact, he had been on prednisone himself in the past for an injury and he was 100% undertanding. I took klonopin .5mg 2x a day for a while but now I am takign an anti-depressant for migraines and it seems to help with my anxiety.

What are you currently taking to treat your UC? What does your GI recommend? I don't think going up and down on prednisone is going to prove to be a very effective technique. Whatever your taking for maintenance at this point, isn't keeping you in remission and you need to find a new treatment that works for you.

As of now I am on 40mg of Pred
Lialda X4
Rowasa

I have left side coltis.....for some reason doc thinks imuran/6mp is not warrented yet???
Posted 12/19/2011 8:41 PM (GMT 0)
I think it is definitely warranted if you can't get below 20mg of prednisone, unless you've been tapering very quickly and that's the reason for relapsing. By quickly, I mean 10mg a week each time. My 2nd taper, I went at 5mg probably every 10 days. I had a lot of difficulties around 15mg and started 6mp with good results. Have you tried using steroid rectals? Have you tried other 5ASAs? Rectals 2x a day? I think it's definitely time to start trying to find something that works for you.
Posted 12/19/2011 8:48 PM (GMT 0)
Same thing happened to me the last time I was on pred. My anxiety was through the roof. I took the lowest dose of Effexor XR. I felt sooo much better within a week. I stayed on Effexor for about a year. It made me feel great and I think it had a part in helping me achieve remission. Best of luck.
Posted 12/19/2011 11:14 PM (GMT 0)
I was on lexapro and xanax
Posted 12/19/2011 11:22 PM (GMT 0)
I'm on lexapro. It has really helped me not get so crazed on pred this time.
Posted 12/19/2011 11:30 PM (GMT 0)

notsosicklygirl said...
I think it is definitely warranted if you can't get below 20mg of prednisone, unless you've been tapering very quickly and that's the reason for relapsing. By quickly, I mean 10mg a week each time. My 2nd taper, I went at 5mg probably every 10 days. I had a lot of difficulties around 15mg and started 6mp with good results. Have you tried using steroid rectals? Have you tried other 5ASAs? Rectals 2x a day? I think it's definitely time to start trying to find something that works for you.


Yeah about 10 months ago I was on 15 mg and rectals, and canasa which worked, and I was able to actually taper all the way down, but within 2 weeks of tapering both pred and rectals, it came right back so went straight to 40mgs with Hycortisone suppositories, and this is where I have been since(trying to get off the pred)...My last tapper I did 40 for three weeks, 30 for a month, 20 for a month, and the second week of 20 I relapsed, so back up to 40. Its getting really frustrated, because I can't seem to find the combo yet that will give me a good remission. I have been in and out of this flair for over a year and a half, and before this I had remission for 8 years!

I have also tried asacol, and sulfasalizine

I haven't tried rectals twice a day because with work monday-friday, Im not sure how I would do the morning Rowasa without it leaking out too much, from the previous night enema? sorry to be gross :-)
Posted 12/19/2011 11:41 PM (GMT 0)
I hate to say it but 6mp/Imuran may be the best option. I can't say with 100% accuracy, I am not a doctor but in my opinion, for me, it did get me into remission after a long fight with flaring and steroids. Have you tried tapering in smaller doses? 10mg jumps are a lot. When I was on 10mg, I went at 1mg and 2.5mg per week. I had to or I would start having symptoms and it put my anxiety through the roof. That's why I think my antidepressant has helped me a lot. I was so freaked out anytime I thought I had a symptom, now I am less wound up. Definitely get something for the anxiety but also, if the doctor doesn't mention alternatives, ask if you can try another 5ASA, colazal, apriso and see if you can get a script for Canasa. Canasa is great for during the day because they are suppositories and they are not a lot of fluid and easy to retain. Did you have stool tests to check for bacteria that may be making the flare more difficult to treat? Would your GI consider some antibiotics? Have you ever tired flagyl or similar?
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