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Re: Anti Anxiety drugs?

Posted by Elizabeth on January 8, 1999, at 15:30:40

In reply to Re: Anti Anxiety drugs?, posted by Toby on January 6, 1999, at 16:38:59

Hi. Some comments on these:

BuSpar: good for GAD, doesn't work for panic disorder. Personal opionion: the recommended doses may not be high enough for many people. Higher doses also work for depression, BTW.

clonidine: sedating for most people, supposed to help increase frustration tolerance. May cause dry mouth, constipation, low blood pressure.

hydroxyzine: an antihistamine. I think its supposed anxianxiety properties are overrated - haven't heard much good about it. Can be pretty sedating.

propranolol (and other beta blockers): can be good for certain specific types of anxiety (such as "stage fright") and physical symptoms associated with panic attacks. There isn't so much evidence that it works particularly well for the emotional experience of anxiety, though.

tricyclics: good stuff, better for panic perhaps than for GAD. Too many side effects (constipation, dry mouth, orthostatic hypotension, lowered seizure threshold, sexual problems, sedation, blurred vision, weight gain, tremor, ....)

calcium channel blockers: never heard of using these for anxiety, just for mania. ?

Depakote: heard about some success with this (including with panic), lots of people complain of weight gain, tremor, nausea, and drowsiness though.

Remeron, Serzone, trazodone: not sure how much of the antianxiety effects are just due to sedation. May also have other side effects (orthostatic hypotension, weight gain with Remeron, vivid dreams with trazodone).

Zyprexa: this can be pretty sedating for many people, even at very low doses. Also a major offender in the weight gain department.

Risperdal: also notorious for weight gain, but may be less sedating than Zyprexa.

Wellbutrin: I've *never* heard of this helping with anxiety, only of making it worse!

MAOIs: can be amazingly effective in both GAD and panic disorder. Why not Nardil with a. nervosa? It seems to me Nardil would be the perfect antidote to this. They can cause serious insomnia, though.

ReVia: how does this work for dissociation? I was talking to a doctor who's used opiates (both agonists and antagonists) in mood disorders a lot and he wasn't too impressed with the mood effects of this - said it tends to make people feel lousy, basically.

Oh yeah, and the antihypertensives may cause - guess what - sexual dysfunction!

Surprised you didn't mention the SSRIs, as they are frequently used in mixed anxiety/depression with success. Have to start low/go slow, though.

Good luck!




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