(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 Disease and 
been on and off almost every anti-depressant. They stop working, my psychiatrist 
calls it the SSRI poop out syndrome. 

I am still weaning cortisone which is hell. I take Xanax, which I'm trying to wean, 
Clonipin, which I will start to try weaning, and Zoloft which I am going to wean off 
because it's not helping. My psychiatrist is putting me on Trileptal for sleep, I 
have terrible sleep problems. 

I have cortisone withdrawal symptoms, horrible, and insomnia and depression, that is 
why I need drugs to sleep and make numb.  SAM-e didn't work for me or TMG or St. 
Johns Wort. Prozac worked before my Cushing's and the next drug the doc wants to try 
is Effexor. I'm thinking Prozac since it worked before Cushing's instead of trying 
another anti-depressant. I have so many side effects. 

I am tired all the time and need energy. My doc says the cortisone is causing the 
depression. I'm adrenal insufficient and unable to further wean the Cortef, I'm at 
12.5mg per day. I have a great psychiatrist who understands Cushing's and the 
withdrawal from cortisone.


Dr. Stuart Shipko:   I don't think that you have a problem that needs to be treated 
with psychiatric medications.  After a problem like yours, you expect a lot of 
somatopsychic problems.  In the long run, you will probably do best off of all 
drugs. 


Dearest:  Apropos of what Val said, I had a question ... I've been reading that
there's more widespread use of anti-seizure drugs, such as Neurontin and 
Trileptal, in treating panic attacks/disorder and even anxiety. What are 
your thoughts on these drugs, as opposed to the SSRI's and drugs like Xanax?  


Dr. Stuart Shipko:   Glad you asked. This is the great snake oil of our era. No evidence
whatsoever in the scientific literature that these drugs do anything beneficial 
in panic attacks or anxiety. Purely anecdotal. You can add Topamax to that list. 


Dearest:  Aren't they mood stabilizers for bi-polar disorder? 


Dr. Stuart Shipko:   Not by the literature. The drug companies marketed these drugs as
mood stabilizers without FDA approval and without good science behind them, 
and they have gotten their hands slapped, but if they do work, there is no 
scientific evidence that they do. 

You need to realize that the placebo effect is very high for all neuropsychiatric 
conditions, and that this fools doctors into believing what the the drug companies 
tell them. 


Dearest:  I have to tell you, this is your 7th visit with us and I'm always so
pleased and amazed at how honest you are (for a doctor) and knowledgable! Thanks so much 
for your refreshing candor and exemplary advice. 


Girlie:  From your comments, it sounds like you are not a big fan of anti-depressant 
pills at all?  My doctor wants me to start out with 25 mil Zoloft - will that cause 
withdrawal problems- I don't want to feel numb and now I'm afraid to take it. 


Dr. Stuart Shipko:   You are right.  My opinion is that the SRI category of drugs 
is almost never worth the risks and downside.  Suicide, getting obese, sexual 
numbing (even if you don't have sex, sexuality is a dimension of your persona), 
and they never warn you about addiction, they never monitor for side effects. 

No, I am not in favor of using these drugs, particularly without warnings. 


Dearest:  I recently watched a TV interview with a liver specialist who said there's 
an epidemic of liver disease in this country and you wouldn't believe how many 
transplants are needed. Don't you think there may be some connection between 
all the medication we're taking and this liver disease epidemic? 


Dr. Stuart Shipko:   Absolutely. 


Dearest:  I love the way you think when you agree with me.


Dr. Stuart Shipko:   The statins that are used for cholesterol are of particular 
interest in this regard. Also, look at Rezulin, for diabetes, this trashed the liver 
for years before they took it off the market.


Dearest:  After my gall bladder surgery last April, I developed pancreatitis, 
jaundice and auto-immune hepatitis. They were feeding me all this garbage through IV, 
a number of antibiotics, etc. I told them to pull the IV out of my arm because I was
getting sicker and sicker. It's all those drugs that were making me sicker!. 
Then I started getting better. 


Princeton:  What about nutrition? I have recently changed my eating habits and 
observed a tremendous relief from a lot of symptoms I have been suffering from. 


Dr. Stuart Shipko:   Nutrition is important.  It is the great, unexplored ocean of 
health. 


MCP:  I had a Anterior Lateral MI 6 years ago followed by single angioplasty. 
On 12.5 mg Atenolol & 5mg Zestril 1qd for both. I have horrible anxiety/worry, etc., 
been through therapy and even too anxious to take Paxil or Prozac, cause I worry 
about the side affects. I know I am a real case and no one at my HMO seems to care. 
(largest HMO in CA.) What are my other options?  By the way, I do take 10mg Serax 
at night, but waste half it.  


Dr. Stuart Shipko:   Ok.  I like the Serax. Take the prescribed dose and see how 
you feel.  Medicine no longer seems to be serving the patient so much as the drug 
companies, the insurance companies and the hospitals. 


Dearest:  Yes, Dr. S., but the patient sometimes has to take charge of her own 
situation, or be killed instead. 


Dr. Stuart Shipko:   In all cases.  I now advise all people going into hospitals to 
have a person there around the clock to question what is going on and to insure 
proper care. 


Dearest:  Oh, I questioned what was going on. If I didn't insist they remove all 
that garbage from the IV, I probably wouldn't be here now with my bilirubin levels 
climbing and climbing over 20.  But ... enough of that.


Dr. Stuart Shipko:   No, never enough... 


Dearest:  Thanks, Dr. S. (I always feel compelled to speak out when I see stupid
things being done).


Susan:  My doctor said I need a hysterectomy due to a 9.3 cm fibroid on the uterus 
and cyst on both ovaries.  Does this seem logical at age 48 and, if so, what about 
hormones afterwards? Thank You.


Dr. Stuart Shipko:   My observation is that after hysterectomy women do badly in 
general, even if the ovaries are left intact.  9.3 cm fibroid? Isn't that small? 
Ovarian cysts?  Is that a disease?  Ask your doctor about that. 


Petra:  Ok, so give us some advice on vitamins, natural herbs, relaxation exercises 
and such.  I also feel that all the meds have side effects for which we then take 
more pills.  How do we go off that wagon? I would like to sleep well, be cool at 
night, not have heart palps and not have panic attacks.


Dr. Stuart Shipko:   What do you want as far as what you are trying to help? 
I do have some great supplements for energy. The concept is that you can use a group 
of supplements that enhance the production of energy within a cell using: Coenzyme Q10,
30 to 60 mg, Carnitine, 500 to 1000 mg, alpha lipoic acid 200 to 400 mg to boost energy 
production, and then SAM-e 200 to 400 mg with B-complex to enhance the hundreds of 
reactions dependent on this energy. This has been the real finding in my practice 
recently. 


Dearest:  I've been recommending all those things in Power Surge for years. It can
all be found in the recommedations area. 
Thanks, Dr. S. We think alike! 


Dr. Stuart Shipko:   Wow!  


Princeton:  I have been taking low dose of Effexor since 2 years and want to stop 
now. How bad are the withdrawal symptoms? What if my anxiety and depression get
worse and I want to go back on again? Is it a bad idea? 


Dr. Stuart Shipko:   Effexor is probably the most addicting of this category.  Of 
course, not all people will have withdrawal.  When you try to stop and then return 
to the drug it can be unpredictable. 


Dearest:  What classification of drug is Prozac? In an article I read, it called 
Prozac a "tricyclic."  


Dr. Stuart Shipko:   It is an SSRI.  


Dearest:  Thanks. 


MoochyBug:  What affect does progesterone have on women, and is it safe? I have 
cracks on sides of mouth how do I get rid of them? 


Dr. Stuart Shipko:   The cracks I am not sure about. I think a good multivitamin 
might help. 

Progesterone has been called nature's Xanax.  In general it is calming although this 
is not the case for everyone. 


Dearest:  Moochybug, I have a good article on dryness if you want to E.mail me at 
Dearest@aol.com. 


MoochyBug:  Ok, thanks. 


Dee:  I am currently taking 20 Mg of Serafem a day. I have gained about 15 pounds. 
How do I go off this drug safely? 


Dr. Stuart Shipko:   Serafem is Prozac.  It has a really long half life, and you 
can stop it all at once. 


Dee:  Cold turkey? 


Dr. Stuart Shipko:   Cold turkey.  (In general) do it with your doctor, please.  


Dee:  Is it responsible for the weight gain? 


Dr. Stuart Shipko:   Hard to say. 


Dee:  Ok, thank you 


Dearest:  One last question from me ... Women on the Power Surge boards have been 
discussing their reluctance to tell their families and friends about their panic 
attacks / anxiety because of the humiliation and shame. How do you suggest someone 
who's suffering with panic/anxiety issues deal with issues like this? 


Dr. Stuart Shipko:   In general, I don't advise asking for understanding on the 
basis of a mental illness. Our society is not nice to people who claim this. 
I would suggest that they ask their families and friends to understand each problem 
as it arrives. For example, if a trip to the theatre is planned and the person has 
a lot of anxiety in the theatre, then it may be best to say that the theatre is not 
comfortable rather than to say that "my panic is worse in the theatre". 


Dearest:  Thank you. Is there anything you'd like to say in closing - some message 
you want to share with everyone - we're hanging onto your every word :) Please feel 
free to use this forum.  


Dr. Stuart Shipko:   I'm pretty drained. I think I'm getting carpal tunnel. 


Dearest:  Dr. Shipko, thanks, once again, for another open, honest and very 
informative discussion about anxiety, panic and the side effects of the various 
medications prescribed for stress-related disorders. Dr. Shipko's Web site, PDI, The 
Panic Disorder Institute, can be found on the Web at: http://www.algy.com/pdi/ 
 


Dr. Stuart Shipko:  It was swell to be here tonight. Thanks for having me.



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