Q&A – Page 2 – Wayne C. Jones MD

Bipolar Disorder Medication: Best Meds Q&A

My 15 year old daughter has been put on Risperdal to "glue" her thoughts. She is severely depressed and worries constantly. Her doctor added Lexapro to the Risperdal. How do we know if the Lexapro is working or just helping the side-effects of Risperdal?

I don’t use Risperdal because of the increased risk of neurological side-effects, and increased prolactin interfering with hormones, including estrogen. Lexapro is good for anxiety, obsessiveness, and depression, especially sadness, but if your daughter is manic depressed/bipolar the Lexapro can make her more emotionally unstable. Effexor XR is a broader […]

Panic Disorder Q&A

I have been taking 3mg of Xanax daily for anxiety for 2 years. I have been diagnosed with agoraphobia. Are there any options for medication besides SSRI’s and SNRI’s? They seem to make my anxiety worse. I’ve also had cognitive behavioral treatment with little success. Please help me with any options for overcoming my fears.

Recovery from agoraphobia requires a good understanding of what it is, proper breathing test.askdrjones.com/wp-content/uploads/2006/06/Anxiety_Handout.pdf and complete desensitization. SSRI’s/SNRI’s are not required unless you are unable to progress with CBT, breathing correctly, and benzodiazepines – including as needed extra doses. Some patients do better on Clonazepam, or Xanax XR, or Niravam. If […]

Bipolar Disorder Q&A

I need information on Geodon. Is it anti-anxiety or mostly an antidepressant? My doctor wants to put me on it but I am worried about side-effects.

Geodon is a medication with a lot of issues so that it is not one of my first choices. It is a good antimanic mood stabilizer if taken in higher doses (120-160mg). At lower doses it can destabilize mood. It is not an anti-anxiety medication. It usually requires twice daily […]

ADHD Q&A

I have Mitral Valve Prolapse and also have ADD. I have just been prescribed Vyvanse. In the afternoon I have experienced difficulty getting a deep breath and also tiredness in my left arm. I have also had pain in my lower abdomen. I take Toprol for the MVP. I have been taking Vyvanse for 2 weeks. Could the Vyvanse be causing these side-effects?

Vyvanse has less effect on the cardiovascular system than Adderall but all stimulants have possible cardiovascular side-effects. You should stop taking it and see if the symptoms go away. If not you need to see your cardiologist or internist. If the side-effects do go away you may want to discuss options […]

Addiction Q&A

Is Benadryl addictive? How can you wean off of it? Can it cause gastrointestinal problems?

Addiction means continued use in spite of negative consequences. In this sense Benadryl addiction is not known to be a common problem. Since it can cause weird reactions at high doses I guess that is possible. People who abuse downers are usually trying to be somewhat emotionally “numb” – so […]

ADHD Q&A

I am a 40 year old woman who has finally decided to do something about my ADHD. A psychiatrist has prescribed Vyvanse, but I haven't filled the prescription because of side- effect concerns.

Vyvanse is a new delivery system for a medication we have used for 70 years. Extra precaution needs to be taken with CV issues like Mitral Valve Prolapse. I’m not aware of a specific study with MVP, but a study was done at Harvard of patients with ADHD and high blood pressure. […]

ADHD Q&A

I don't know why I am still on Adderall. I am so tired and depressed, unexcited, and don't even feel like reading the Bible, much less have the energy or passion to make the world a better place. I have been on Adderall for 14 years and I feel a little frazzled. Does long term use of amphetamines cause brain damage?

I have many patients who do great on 60-90 mg of Adderall per day and have for up to 13 years. Anybody like yourself who is not doing well needs to make changes. You need to start with a re-evaluation with a physician. One simple option may be to […]

Generalized Anxiety Disorder (GAD) Obsessive Compulsive Disorder (OCD) Panic Disorder Q&A Stress Management

Will I always need Lexapro and Klonopin if I successfully go through cognitive behavioral therapy?

It partly depends on what you’re taking the medications for. Uncomplicated panic disorder without agoraphobia has the highest rate of complete remission. Severe obsessive compulsive disorder, agoraphobia, or social anxiety disorder may require some long term medication to maintain remission. Generalized anxiety without serious depression may respond fully to CBT. […]

Bipolar Disorder Medication: Side Effects Q&A

I am bipolar two and when I started taking Lamictal it worked great. But it may have caused vasculitis of my skin. I had acne bumps all over my legs and also encountered a "break out" on my face.

Serious adverse rashes can occur with Lamictil but it is rare. Most reactions are mild – they go away when the Lamictal is stopped and many people tolerate Lamictal okay when it is restarted. If a week or more goes by before skin clears you have to start back at 25mg […]

ADHD Q&A

Is it safe for a 5 year old to wear the patch (Daytrana) and is it safe to cut the patch in half to reduce the dose?

I have just posted an article on preschoolers and ADHD: test.askdrjones.com/2007/09/06/behavioral-treatment-for-adhd-in-preschoolers/ Most research in preschoolers is with methylphenidate even though it is only FDA approved down to the age of 6. The patch works fine if cut in half. Be aware that after six weeks of daily use blood levels […]