Stuart Shipko
M.D.
Psychiatrist
Pasadena, USA
Answers questions in Addictions · Alternative Therapies · Anxiety
About Stuart Shipko
Initially I was an emergency medicine physician, and later went into psychiatry because of an interest in the patients with stress related disorders. Years later these patients were considered to have panic disorder - a diagnosis that did not even exist back then. I think that the emergency medicine background was so important. Back then there were no CT scanners or MRIs and the doctor had to really examine the patient and make observations. I think that this gave me the background in observation that was needed to draw good conclusions concerning the beneficial effects and adverse effects of the psychiatric medications that later became so popular. I have completed original, peer reviewed research in psychosomatics, stress and panic disorder. My approach to patient care involves a lot of listening and common sense.
What I do
I am a psychiatrist in private practice for 34 years, currently in Pasadena, CA. Sub-specialty interests include adverse effects of prescription psychiatric medications, withdrawal from psychiatric medications, psychosomatic medicine and panic/anxiety disorders.
My story
Initially I was an emergency medicine physician, and later went into psychiatry because of an interest in the patients with stress related disorders. Years later these patients were considered to have panic disorder - a diagnosis that did not even exist back then. I think that the emergency medicine background was so important. Back then there were no CT scanners or MRIs and the doctor had to really examine the patient and make observations. I think that this gave me the background in observation that was needed to draw good conclusions concerning the beneficial effects and adverse effects of the psychiatric medications that later became so popular. I have completed original, peer reviewed research in psychosomatics, stress and panic disorder. My approach to patient care involves a lot of listening and common sense.
Why life is worth living
of the holiness of the heart's affections and the truth of imagination (Keats)
Treatment Offered
Specialties
Therapy approaches
Patient population
Modalities
Answered Questions(36)
Panic attack after starting Effexor
Major Panic Attack or Seritonin Syndrome.. I started Effexor xr 75 mg on Thursday May 17th. By Monday morning I noticed I was weighing in a few pounds light, thought it was great at the time. Abs were cracking more than usual so I was happy. I felt great, happy and clear until about 4pm I took 3 hits of strong marijuana and had a massive panic attack that put me in an ambulance. The attack lasted nearly an hour. The syncopy started as I stood up and I just couldn't gain my ground. I took Xanax the night before if that matters. Im ok now, but don't know how to proceed. I stopped taking the Effexor. I guess my question is, would I have had this attack if I had waited for my body to adjust to the Effexor, or is this a sign that this medicine isn't for me.
Read answer →Tinnitus after stopping marijuana
I quit marijuana 2 weeks ago and my tinnitus is through the roof. When will it go away?
Read answer →Klonopin Withdrawal
Dr. Shipko, I have been off .5 mg./day of Klonopin for 8 months now. I had been on Klonopin (various doses) since 1995, weaned off with great difficulty and stayed off for 20 months before reinstating. I have been experiencing anxiety and in particular stomach problems (no ulcer) that just haven't quit over the past 8+ months. I would be happy to be reassured that this withdrawal process just takes time and that over time I will be feeling more back to normal. I am 65 now and recently retired. Can't find an understanding GP or psychiatrist but do see a therapist every so often.
Read answer →I need help in tapering my Ativan
Hi I was taking 2mg of lorazepam for months and I start to taper off in July this year, so far the withdrawal was insomnia. now I am down to 0.5mg for 1 and a half month. Tonight I am unable to fall asleep at 0.5mg of lorazepam I do not know why ( I do not know if it is still withdrawal since I have been stable for 1 month or I am addicted to it and I need more to sleep?) )I need to wash off lorazepam since I have to return to work in Feb2015. Please advise thanks amy
Read answer →Will Klonopin increase my risk of Alzheimers?
There is a history of early onset Alzheimer’s in my family. I have anxiety problems and am prescribed clonazepam to take as needed when I feel panic but I am concerned about how this could have a long term impact on my memory. Will this drug increase my risks for Alzheimer’s in any way shape or form?
Read answer →Question on how to wean off of Ativan (a benzodiazepine). addendum
Hello Dr. Shipko! Thanks so much for your quick answer. I got a bit of relief from just getting and answer ::-) I am still tapering off the Metoprolol. I am cutting smaller and smaller doses. It has taken me about 7-8 weeks to get from 50 mg 2x a day to about 10 mg. The sizes are progressively smaller for the 7 day container i have. I was planning to end it when it is done next week at about 6 mg. I was thinking of staying on the Lorazepam until the Metoprolol side effects are done. It has been a beast getting off and tired of thinking of having to get off another. I wish he would have told me ahead of time but i think he saw me on them for the rest of my life ( i am 54 now). I know why i have not seen a Doctor for 25 years previous. I guess they worked for the purpose he had in mind...but i am so glad to be getting my mind back. After reading everything on Lorazepam...i am starting to wonder if maybe some of the side effects have been from Lorazepam. Of course now the newest Dr. i saw ran a bunch of blood tests and i tested positive for Hashimoto's. He said it is very complicated. Yep it is but i want off the meds to see how bad the Hashimotos is. So maybe stay on Lorazepam for 3 more weeks or so and then start to wean. I will get your book. And although you live 11 hrs drive from me...are you taking new patients?
Read answer →Question on how to wean off of Ativan (a benzodiazepine).
Hello Dr. Last November i had a high blood pressure experience 230/120. Saw a Dr. and he gave me Amplodipine, Benazapril, and Metoprolol, 1mg Lorazepam as needed and a diuretic and Potassium Cloride 10 mg ER. Was a Zombie for 6 months couldnt work and saving down to about nothing. I lost weight,eating right,exercising and lost 50lbs. BP was getting better avg. 140-150/-85-95. I have to workto support my family so i weaned off of Amlodipine 2-3 weeks no problem started to think better. Then the benazapril and didnt notice much but as i started to get off the Metoprolol very slowly my anxiety went through the roof and needed more lorazepams. I initialy would take a lorazepam a few times a week...but it got so bad with the Metoprolol with anxiety and palpitations that the only thing that would help is the lorazepam. I have stablized at 12.5 mg per day of Metoprolol but my lorazepam usage has gone to 1.5 a day and i am barely making it throughout the day on that dose. I realize i am dependent and want off of them before i need more to get me through the day. The other day i felt amazing without a lorazepam until 3pm and i got a panic attack out of the blue. Took a lorazepam and i was fine. Yesterday i took 1 in the AM and it lasted all day. This morning i started to go for a walk and couldnt breath alll of a sudden and had another panic attack. took a 1 mg of lorazepam and evened out but not like it used to do for me. Not sure what to do? Maybe see if i can get a Dr. to prescribe equivelent of Valium and wean off of it using the Ashton (UK) method. I am in Ca. near Oregon Border and could use a Dr. who understands this. Any help is well appreciated. Thank You!
Read answer →How long is inpatient treatment for a painkiller addiction?
Dr. I have a painkiller addiction and will abuse any controlled substance to avoid withdrawals. I know I need in patient treatment, but cannot have my employer find out. How many days is typical for in patient treatment?
Read answer →I'm having problems stopping Klonopin
trying to find a rehab that is long term. I take klonopin for anxiety daily at a low dose and do not abuse it, however I cannot get off of it. I have tried many times and failed. i tapered over 3 months got down to .0625mg (which is 1/8 of a .5mg) once in the morning... stabilized there for 4 weeks and then stopped taking it.. I lasted two days before the anxiety came flooding back and had to updose to stabilize at .5mg twice a day.
Read answer →Is Effexor the Cause of my RLS?
I have suffered for some time with Restless legs and am not on any medication as I taking Effexor for depression and to date have been unable to find any one that can offer a solution. Is there a medication that I can take for RLS while on Effexor and is Effexor the cause of my RLS, need some help please.
Read answer →My new therapist lowered my Xanax by half and its not working
Hi There, Okay I have been diagnosed with major depression and severe anxiety. I have had the same therapist for 6 years. My medications are trazodone 100mg at bedtime, Celexa 40mg in am, xanax 1mg 3 times a day. This has been working for years. Right now I'm going thru a tramatic time medically in my life. Last month my therapist left the practice to start her own. She is not up and running yet. So I'm seeing another therapist from facility. Right off without knowing me or what I'm going thru. She lowered my dosage of xanax by half. It's not working, I've been very close to going to the hospital. HELP
Read answer →Did cocain almost give me a heart attack?
If cocaine made my heart pound and skip beats does that mean that it almost gave me a heart attack?
Read answer →Is it possible to get addicted to Ativan after only using it 2 to 3 weeks?
Is it possible to get addicted to Ativan after only using it for 2 to 3 weeks? I had a bottle of about 50 1 mg tablets that I took over this period. I was going through a difficult break up and sleeping problems sadness are why I used them but I didn’t plan on using them after I ran out. I ran out about 36 hours ago and I have not slept and feel incredibly anxious ever since? How long will this feeling last. It is really horrible.
Read answer →Can long term tramadol permanently deplete my serotonin?
I am 4 and a half weeks out of a 3 year Tramadol habit. I went cold turkey which was a bad idea. I was feeling pretty depressed for a while but that is slowly lifting but I still feel less positive than normal. Is there anything I can do to speed up the PAWS from tramadol? Do diets that are supposed to increase serotonin levels really make any difference? Could a long time use of tramadol permanently deplete my serotonin levels to a point where I would need to us an SSRI just to get back to baseline?
Read answer →I am addicted to benzodiazepenes but my doctors won't taper them because I am on methadone.
I have been on benzodiazepines since about 2007. I started with 2.5 mg of Xanax a day then that got switched to 2mg of clonazepam and 4 mg of lorazepam a day. that got switched to just 2mg of clonazepam a day and I got off of the clonazepam once about 2 years later and my doctor tapered me off in a week. I was in hell. I begged her to help me and she began prescribing it again. 2mg of clonazepam a day. I could sleep and function again. That was the only time (about 3 weeks) that I have not been on benzos. Now I am on 5mg of nitrazepam and 3mg of clonazepam a day and its been like this for at least 4 years and Im so thin I cant gain weight, food tastes different I don't like foods that I used to like.. I get nauseous and get sick very often. I found out I have severe GI disease and Im terrified. Im only 25. Im also on methadone and Im tapering off that at the moment. I know Im addicted to these pills but I don't know what to do about it. I know the right thing is to probably get off of them but I have school and work and coming off methadone is difficult as it is. My doctors refuse to talk to me about changing my benzo doses because Im on methadone. what should I do?
Read answer →Can Cocaine Use by the Father Cause Birth Defects?
We are trying to start a family and I have had 2 miscarriages in a row. My doctor says I am physically healthy in my womb so I should not worry about it too much its just bad luck. The one thing my doctor does not know is that my husband takes cocaine 3 or 4 times a week. Do you know if this can lead to miscarriage or birth defects?
Read answer →If You Take Effexor with MDMA Can You Get Serotonin Syndrome?
I have this friend who is on Effexor. She does MDMA sometimes. I thought this was a dangerous combo. She has done MDMA about 10 times already and says it is fine. How dangerous is this combination? Is this like a 1 in a million chance to get serotonin syndrome or is she really taking a big risk when she does this. If she gets serotonin syndrome, as long as she gets to a hospital in time will she be OK. So as long as she took the MDMA with other people who knew what to watch for then would that minimize the risks?
Read answer →I am tapering and stopping my Prosom. How long untile I return to normal after stopping it?
I have been taking Prosom for years. Am 65...I have tapered my self from 2 mg down to 0.5 mg. Have insomnia-a little shaky-When I stop the 0.5 mg dose how long will it take for the GABA centers ( am an RN ) to return to normal and for me to feel normal..I asked my doctor and all he did was suggest staying on it...am tired of the pharmacy acting like " here is another druggy" and really do want to stop. Am using OTC Melatonin and it does seem to help a little.
Read answer →What is this high pitched sound I hear since stopping pot?
I have not smoked pot for 7 days and I was a huge stoner so 7 days is a long time for me the longest I’ve been straight for 4 years pretty much since I started smoking at 15. My friends can’t believe I am passing on joints and I feel really good except for being a little testy the first few days it has not been as hard as I was worried it would be. The one seriously bothersome thing that I am dealing with is that I have this buzzing sound in my ears that comes and goes on and off all day long. No one else hears it so it is coming from my mind and since it never happened before I quit pot I think it has got to be because of quitting smoking. It is like a high pitched whining sound. What is up with this?
Read answer →Will getting drunk on weekends affect healing from a concussion?
My son was in a bicycle accident in July. He was not wearing a helmet and he got a concussion. It is unclear if he lost consciousness or not. He cannot remember but his friends think he was out for a few seconds. Since that day we thought he had made a full recovery from the dizziness and headaches but his personality seems altered. He is more questioning of authority and he has been drinking on the weekends. He is 18. I am so worried about this but I have been staring at him for months hypervigilent for any long term damage and so I am not sure if I am making something that’s just normal teenage behavior into a concussion symptom. His doctors say he is fine and that any lingering symptoms will go away on their own. What I am really wondering is if he is getting drunk on the weekends is this going to affect his brain healing?
Read answer →Switching to Valium to stop a serious drinking problem
I have been using 10 mg of valium per day for the past 3 weeks as a tool to keep my anxiety under control while I try to get a handle on a serious drinking problem. I think I originally developed an alcohol problem in part because I self medicate social anxiety with a few drinks – and then it grew into something much more from that starting point. I do understand that valium is a very addictive drug but right now my focus is firmly on just trying to stay sober. This is my first real period of sobriety after a decade or so of hard drinking. I understand that I should not stop using the valium very suddenly. How long do you think I should continue to use the valium for before it is safe enough for me to start tapering off it without causing undue risk of an alcohol relapse?
Read answer →Should I tak antioxidants to prevent harm from marijuana?
I read this study on telomeres. Shortened telomeres happen with age and they are associated with disease and some things that we do can accelerate our telomere shortening (as you probably already know…sorry). In any case, this study mentions all casual-like that marijuana increases oxidant activity and decreases antioxidant activity (and in a stretchy leap of assertion they say that this may cause telomere shortenings - and hence marijuana is linked early death, I suppose.) http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3607895/ This study feels a little sketchy, if you know what I mean…But to be prudent…Do you know if this is a reasonable concern for a person who smokes marijuana multiple times per day? If it is so that heavy marijuana use causes significant oxidative stress, can this stress be offset with the use of antioxidants? If so, would it be a sensible form of harm reduction to incorporate antioxidant therapy into my daily routine? If so if so, which types of antioxidants would be best?
Read answer →Do Herbs work for anger management?
I have an anger management problem. I am working on it. Some sites that I visit advertise herbal anger management remedies. I am skeptical. Is there anything to these types of products which seem to be just a mishmash of different roots and berries etc etc in a capsule that is supposed to make me feel calmer the next time some guy cuts me off while I am driving?
Read answer →I ran out of Xanax. What's the Xanax withdrawal like?
I used Xanax .5 mg for sleep and anxiety..I am now out and scared to dearth of withdraw. What am I in store for that way with the withdraw.? I work full time and can't take time off work. Thank you
Read answer →What is the best way to reduce my Xanax dosage?
If I want to make a Xanax tapering plan is it better for me to gradually reduce the dosage I am taking or to gradually lengthen the interval between doses; or maybe some combination of the two. As a practical matter, it seems easier to lengthen the intervals, because when I start splitting up pills I am always left with pills that are never exactly equal and then it’s just guess work about how much I am really taking.
Read answer →Is Marijuana Actually Addictive?
Is marijuana actually addictive or do people with addictive personalities just end up getting addicted to marijuana because they use it. But if they didn’t end up getting addicted to marijuana they would end up getting addicted to something else, like sex or food or alcohol so it is not the marijuana that is addictive it is just some people are going to get addicted to something no matter what.
Read answer →I'm 80 years old and my doctor wants to put me on an antidepressant and a benzodiazepine
I had severe back pain going down into the leg. My doctor put me on Tramadol. I took it for 18 days, but had to get off because I became very suicidal. He later put me on Lexapro for depression. I couldn't take that either as it gave me esophageal spasams. MRI shows that I have a synovial cyst on 1 on the lumbar spine that was on the large nerve. Somehow it moved and I am fairly pain free. However I have some anxiety problems and the doctor wants to put me back on an anti-depressive med along with valium or xanax. I might add thaqt I'm 80 years old, have always been susceptible to bad reactions to certain meds. I was on valium many years ago and know that I can tolerate the 5mg especially if I take it only as needed. This doctor insists on 2mg X 3 daily. Do you think I should go along with him on the anti-depressent meds?
Read answer →I quit Xanax cold turkey
I have been taking Alprazolam 1MG twice daily as needed for about 6 months. I quit COLD TURKEY. This is my "5th" day. I am jerky, twitchy, nervous, and at times have trouble with what I want to say. I start stuttering. It is my mouth doesn't even want to work. It is very embarassing. What should I do? Resume taking the medication and taper off? It seems to me that since this is my 5th day, it would be best to NOT go back on the medication that I want to STOP taking. Any information you can share with me would be appreciated. I want these symtoms to get better NOT WORSE.
Read answer →My perceptions have changed after smoking stronger pot
My friends and I bought from a new guy on the weekend and the pot was a lot stronger than I am used to. I was actually feeling kind of freaked so I ducked out and went upstairs to bed. The next day I woke up feeling really weird and I was sure the weed was laced with something but none of my friends who smoked it noticed anything unusual. For the last few days everything around me looks really weird to me. Nothing has changed but everything seems to look way different like the colors are all drained and like my perspectives is all screwed up. I am also totally anxious and I get these thoughts repeating in my brain that I can't get out. It's been like this for 4 day and it is not getting any better. What is going on with me? Is it the weed that did this? I am honestly really scared right now.
Read answer →Should I take Valium for my marijuana withdrawal?
I'm having a really hard time with marijuana withdrawals. I am anxious and restless and I haven't slept in 2 days and I keep crying for no real reason at all. I no it won't last forever but I have tried to quit so many times over the last 10 years and I never have been able to and now I am really motivated to make it through. Should I take valium for a week or 2 to help me relax and then make sure to stop using it before I get addicted? This is what is recommended on some marijuana addiction support forums but I just wanted to get an expert opinion on it before taking another thing that is also addictive to get over the first addiction.
Read answer →After 6 months on cocaine - when will the craving stop?
How long does it take to stop craving cocaine? I was only using it daily for about 6 months. I haven't had any for 2 days and I swear I am done with it. I am craving some very badly. When are the bad cravings going to go away, approximately?
Read answer →Self-Conscious in Social Situations
Whenever I am I a social situation it feels like I am an actor playing a script of me...I don't know how better to explain it, but its almost like I am looking at things from an outside perspective (not really, but I am always thinking about how everyone around me is perceiving everything I am doing) and the instead of just being able to act naturally and enjoy myself I feel like I am in a spotlight all the time or like I am on stage in a play and that everyone is watching me and judging me on everything I do. I don't know why, but I feel this especially when I am out with my kids and I am talking to them in public. Whenever we are at home and alone it's just very natural and fun but as soon as there is an 'audience' I start feeling really self conscious about everything I say and I am always feeling like people are constantly judging me on my parenting skills. Why am I like this and how can I stop being like this?
Read answer →Looking for low-cost group home
Hello Dr. Shipko, I apologize that this message is so long. But I will try to summarize the best I can. I have a 24 yr old son, who we've been trying to help for the last 10 years with his mental health issues and addiction problem. My husband and I have never had drug/alcohol addiction, however my dad and my grandfather have been alcoholics. My son's problem started when his older brother (who had an opiate addiction) relapsed and tragically died of an overdose at the young age of 20. Our remaining son who at the time was 14 spiraled into a deep depression and debilitating anxiety kicked in shortly after (prior to this, we did notice that he had anxiety issues, but exaserbated). He isolated himself and threw himself into an online game that he used to cope. He would stay up all through the night playing and would have little communication with anyone. Despite our efforts of counseling, drug therapy prescribed by a psychiatrist, SPECT scan by the Amen Clinic, (which showed that he had anxiety disorder and mood disorder) etc. nothing seemed to work. He would have out of control rage and take it out on my husband and I. After a 1 1/2 years of this he went back to school, but when he did he started using alcohol first and then it turned into other drugs. He eventually was arrested at the age of 18 for posession of ecstasy and stolen property. He was ordered to a 6 month program, which he did and seemed to be doing better once he was out. Unfortunately, he soon got back into the drug scene and started using opiates. He has been on suboxone, which he has weaned himself off of just recently. He is sober now, but his addictive behavior goes into other areas of his life. Prior to giving notice, he worked in Las Vegas for a well known magician. After 8 months he decided to leave because of addiction to gambling and anxiety issues. He's now home with us (in California) and needs help to get his life on track. My husband and I have depleted all our savings, retirement, etc. to try to help our boys. My husband left his lucrative position when Aaron was 16 because we felt that we were losing him, too. Now we are at a point where we both are without work and financial means to help him. If you have any suggestions of low cost group home for young men who have mental health issues along with addiction issues to get some life coaching and possibly medication to help with debilitating anxiety would be so much appreciated. Or if you have any other suggestions? We are at a point where we know there's not more we can do, but want to try to reach out to other experts in this matter. Thank you so much - CC
Read answer →I am smelling and tasting crack smoke, after six weeks clean.
I am six weeks clean from cocaine, crack, alcohol and meth, basically the only things I still do is smoke cigarettes. I am holding on but there have been some pretty close calls. One thing that is really bothering be is I keep getting this taste in my mouth and smell like crack smoke and whenever this happens I start to really want some and it is hard to resist the cravings. Why does this happen since I have not smoked in 6 weeks? Is there anything I can do to make it stop?
Read answer →Opiate Dependency and Panic Anxiety
I have GAD and panic disorder and I am addicted to lortabs and somas. I would like to try to wean myself off by tapering because I do not think i could handle a full on detox. My question is concerning controlling my anxiety while I reduce my daily dosage. The opiates work well to control my anxiety and when I take less my anxiety goes up quite badly. Is there anyway I can reduce the anxiety that comes with tapering? My friend recommended xanax but I think it is going to take me at least a month to taper and the last thing I want it to get addicted again to any kind of benzo. I have been through that before and I will never do that again.
Read answer →I can't stop using crack. What should I do?
I am a crack addict I guess because I can't stop using. I thought that because I only binged on weekends I had it under control but after enough Monday mornings feeling like death and promising myself and my girlfriend who also indulges that I'd never do it again I made a serious try at actually not smoking this last weekend and by Friday midnight I was calling my dealer every five minutes demanding a meet up and then it was at home all weekend with the curtains drawn, as usual. I can't afford rehab and I can't stop so what do I do? Should I try to cut down by buying less or by limiting my access to money on weekends in advance? Does this ever work?
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