(Dr. Shipko's 7th visit to Power Surge) Dearest: My guest tonight is Psychiatrist and Neurologist, Stuart Shipko, M.D., one of the nation's leading experts on the adverse effects of psychiatric drugs, who tells the real story behind the widespread overuse of psychiatric medication and the negative consequences that have followed. Dr. Shipko has treated over 2500 patients with panic disorder. Founder and Medical Director of PDI, The Panic Disorder Institute, Dr. Shipko is in private practice in Pasadena, California. His specialty is in the area of panic disorder and stress- related medical conditions, stress and trauma-related disorders and also covers psychiatric injury, psychosomatic medicine, general psychiatry. Dr. Shipko also completed a series of studies on stress related gastroenterologic problems. He found a wide variety of stress-related medical problems such as vertigo, non-cardiac chest pain, fatigue syndromes and myofascitis and is published in the area of psychosomatic medicine. An outspoken expert in the area of psychopharmacology, Dr. Shipko will answer your questions about anxiety, panic attacks / disorder, hormonal connections and the pros and cons of anti-depressants/SSRI's and anti-anxiety medications, such as Paxil, Zoloft, Prozac, Celexa, Xanax, Serzone, et al. It's wonderful to have you back in Power Surge, Dr. Shipko :) Dr. Stuart Shipko: Thank you. Dearest: I know you're interested in discussing Paxil. What's the status of the class action suit that's been brought against Paxil manufacturer, GlaxoSmithKline, and briefly, what is the impetus behind the suit? And, please share any other information you'd care to about Paxil. Thank you. Dr. Stuart Shipko: The judge needs to decide whether or not to grant class action status to the case, and this will happen in November. This same judge did agree that it was misleading for GlaxoSmithKline to advertise directly to the public that Paxil is not "habit forming". Unfortunately, the federal government asked for a stay until they could review the case, and the ruling was overturned, in favor of the drug company. The FDA asserts that only they have the right to approve or disapprove of advertising. Of course, the whole case depended on the definition of addiction and was not at all realistic in the common person's understanding. The bottom line is that Paxil is probably going to cause withdrawal in about 75% of the people who take it for more than a month. In some people withdrawal can last for months. Of course, the biggest secret with Paxil is that it has a very high incidence of causing suicidal or homicidal behaviors. I guess that's enough didactic for now. Dearest: I guess it's money talking again, yes? Dr. Stuart Shipko: Yes. The drug companies are really playing the people for suckers. Dearest: Thanks for the candid answer, although the news is disappointing. We'll come back to this in a bit. Girlie: Will Zoloft help with heart palpitations caused from anxiety? And does it have withdrawal problems if I want to discontinue using it? Dr. Stuart Shipko: Zoloft can help with anxiety, and if your palpitations are due to anxiety it might help, but often Zoloft and other drugs in its category will make anxiety a lot worse before it gets better, and you will have withdrawal when you try to stop. Of course, nobody will want you to stop. The effects, if they work, are transient, and the dose keeps getting elevated. I vote for a beta blocker like Inderal or Atenolol for anxiety related palpitations. Dearest: Dr. S., didn't they also say Xanax was non-addictive when it first came out? Dr. Stuart Shipko: Exactly. The history of psychiatric drugs is to say that they have no side effects and are not addicting. The first big drug to be sold to the public was morphine. The non-addicting replacement for it was -- heroin. And, the replacement for that was -- cocaine. They paid Freud to advertise the virtues of cocaine. Cindy: I am recovered from panic disorder (15+ years) and am now starting to experience peri-menopause symptoms. How likely is it that the panic will return? Dr. Stuart Shipko: The symptoms of menopause are usually distinct from the symptoms of panic disorder. The usual return time is in perimenopause, about 7 or 8 years earlier. It can return, but it is most likely to pop up at 40 and not at 50. Dearest: Can we now say with certainty that panic attacks are often hormone- related? Dr. Stuart Shipko: Absolutely. Just today I saw a woman in her 30's who was taking just a select sample of her monthly birth control pills, just the first week and throwing away the rest, because it made her feel better. It is extremely common for women with panic disorder to have a tough premenstrual time. Judy: I have vertigo and have been tested by specialist - I have a prescription for Zoloft - what do you believe helps Vestibular Migraine Disorder? I will not stay long as chats cause vertigo. Thank you for your answer. Also on the Paxil issue, my 24 year old son takes Paxil and drinks with it - is this dangerous? His liver enzymes were elevated. Dr. Stuart Shipko: Judy: I just published an article in a major ENT journal. Zoloft causes vertigo when first taken and again when withdrawn. As for your son, some people get really "happy" on the alcohol, Paxil combo. It is not lethal in the sense of overdose, but it does lead to alcoholism. Dearest: Cindy in the UK (where it's 2 in the morning now) asked if I could please ask you the following: "Why is it that I get an aching, heavy feeling in the middle of my rib cage under the breast bone with stress? There is nothing medically wrong with me. I have been to a gastric specialist and a heart specialist. I do have MVP, but the specialist said that aching would not be a symptom. It has been put down to nerves. But I have never come across anybody else who has this symptom with nerves. Dr. Stuart Shipko: This is complex. In panic disorder there are a lot of nerve entrapment syndromes and one of them involves the nerves that are on the rib cage. This is one possible explanation, and gastro-esophageal reflux is another. Dearest: Could she have costochondritis? I've lived with it for years. Dr. Stuart Shipko: Yes, but that is easy to diagnose by touching the inflamed area. Dearest: Right. Thanks. Cindy will appreciate your answer, Dr. S. HollyD: I was just on Zoloft for 5 months and felt numb, weird thoughts and the doctor thought I needed more. I went up to 100 mgs. and felt so much worse and finally just stopped it. I have been very achy since stopping it. Could this be a withdrawal symptom, and if so, for how long will this last? Mentally, I feel better. And why does it take away your orgasms? Dr. Stuart Shipko: Good questions. SSRIs make people feel numb and this is their best feature. If your life is hell, then numbness is preferable. The weird thoughts -- can you tell me what they were? HollyD: Worried about stupid stuff mainly. Dr. Stuart Shipko: Okay. Anyway, the achyness is a withdrawal symptom. Flu-like feelings are also common. HollyD: YES! Dr. Stuart Shipko: They can persist for up to a year, but will go away. You might try some SAM-e for this. As for orgasm, this is due to the effects of SSRI's on the adrenergic system responsible for them. It usually returns, although not always. HollyD: It's back! Thank you! Chile: I have been diagnosed with Sjögren's syndrome, but in the past few months have had incidences of Irritable Bowel Syndrome, acne, feeling anxious and alone and several crying jags. I live in Chile and have been taking the HRT - Livial (Tibolone) for the past several months. Could that have anything to do with my problems? Dr. Stuart Shipko: I really don't know. Kay: I have been very anxious since my husband started working grave yard and I am alone now that my kids are gone. Is there something besides drugs I can do for my fear? My doctor gave me Busperin and it made me like a zombie for 6 days and I couldn't work so I threw them away. Dr. Stuart Shipko: How about psychotherapy? Kay: You mean counseling? Dr. Stuart Shipko: No, I mean psychotherapy. Tried it? It has become an alternative therapy. Kay: I am not sure what that is. Dr. Stuart Shipko: That's understandable. You may have unconscious conflicts or experiences from your past that are influencing how you feel. Therapy is the drug alternative -- besides SAM-e which I am increasingly using for non-panic anxiety. Dearest: I've heard many women in Power Surge say that SAM-e doesn't work for them. Dr. Stuart Shipko: Work for what type of problem? Dearest: Depression. You're recommending it for anxiety? Dr. Stuart Shipko: Yes. I have been using an Australian product called "MoodLift" that has enteric coating, government insured quality and cofactors of B vitamins. I have been doing some preliminary research and find it to be good for excessive worry as well as depression. The major side effect is poverty. It is not standardized in the US and many preparations have less than 25% of the stated active ingredients. I don't think that it is good for PMS or for menopausal symptoms. Dearest: While you're talking about not standardized in the US, I see so many drugs coming out of Mexico - they're being sold all over the Internet without a prescription. What's going on? Dr. Stuart Shipko: Dearest, we are on a drug wilding. You barely need a doctor visit to get drugs in the US anyway. I think that the drugs bought via the Internet, based on my practice, do not have quality problems. And, it is not much different than going in to your busy HMO doctor and asking for a script. Dearest: Fascinating. Thanks. MARSBAR: I take Elavil and Xanax for panic attacks and a beta blocker for high blood pressure. I have heartburn almost every night. Would it be due to the beta blocker or panic syndrome and what can I do for it? Dr. Stuart Shipko: It is due to the panic disorder. Heartburn is a result of abnormal bile flow which occurs, usually at night. In panic disorder. I recommend Sucralfate (Carafate). It binds bile and forms a protective bandage over the eroded gastric mucosa. Do you get it mostly at night? MARSBAR: Yes, but sometimes in the day, too. Dr. Stuart Shipko: Try two grams before sleep. One gram in the AM and one gram in mid afternoon. MARSBAR: Is it a prescription? Dr. Stuart Shipko: It is not absorbed into the blood. It does what Pepto Bismol wishes it could do. Yes, it is by script only. PNB: I am on Zoloft and Wellbutrin and only use Xanax when under extreme stress I have never abuse drugs and my doctors know it. During perimenopause I suffered greatly with migraines for many years, but they never related the two. I currently use Zomig when needed, but they are rare now. I have had total hysterectomy in 2000 and am on Estraderm patch twice a week it has helped me greatly and I am also on Nexium for gerd/hiatal hernia has helped me greatly. I understand the HRT patch I am on is made from plant estrogens and is safe for long term use. Is this correct? Dr. Stuart Shipko: I don't know. They have not studied phytoestrogens. PNB: Is it safe to stay on my SSRIs for a long period of time? They are working for me. Dr. Stuart Shipko: PNB, I think not. The natural history seems to be that they stop working over time. The longer you take them, the worse the withdrawal later. When they stop working, the doctor increases the dosage. When that no longer works, they add in a second drug, later a third drug. I say, get off them after a few months. There are no studies that say what happens longer than a 6 month trial. SturdyWoman: I am weaning myself off Serzone. It hasn't been of much help to me, so I would rather not be on it. I am down to 75mg twice a day; however, I'm not sure how slowly I should go. Looking for a new doctor because this one just prescribes one drug after another. I would like to handle this more naturally. Perimenopause has thrown me a curve with anxiety and depression! Dr. Stuart Shipko: This is the new disease, that is called "psychopharmacology." If you are going to a "neruopsychopharmacologist" or a "psychoneuroenodcrinologist" then run in the opposite direction. They try one drug and then the next, ignoring side effects and drug interactions. Many patients contact me because they are unable to find a doctor that will ever take them off medications. Only to add more medications. This is because the medications all have withdrawal and withdrawal is being denied by the "educational forces" in psychiatry. Serzone has a definite withdrawal syndrome. You need to find a schedule that is comfortable for you. And you need to find a doctor that is comfortable stopping drugs. See if you can find someone in your area from alternativementalhealth.com Dearest: Dr. S., will you be able to stay a little longer to answer the questions in the queue, please? Dr. Stuart Shipko: You know I will. Dearest: Wonderful. Thank you :) Petra: I take HRT and Atenolol. I still have panic attacks at night and they keep me awake. What can I do? I also have heart palpitations at night and during the day sometimes. My blood pressure is only borderline. I would like to go off HRT and Atenolol and go all natural. Dr. Stuart Shipko: Natural is tough. I really favor Xanax for often, intractable panic attacks. You only need to take it at 0.5 mg before sleep, once or twice a week. But you need a doctor who knows how to work with Xanax. Natural? You can try taurine, and amino acid at a dose of 1000 mg. It helps some people. It needs to be taken on an empty stomach. Dearest: And you know you must not ever, ever go off the Atenolol (Tenormin) abruptly. Petra: Thanks, should I stay on the blood pressure medicine? Dr. Stuart Shipko: claro que si. Yes. Dearest: What does claro que si mean? Dr. Stuart Shipko: En español, la lengua de Los Angeles, it means "of course". Dearest: Ah, okay. I know it can be very dangerous to go off beta blockers abruptly. Thanks, Dr. S. Val: I had a pituitary tumor removed 2 years ago from Cushing's by Power Surge. All Rights Reserved.