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Re: New to Board - Anxiety & Depression

Posted by Matt on February 25, 1999, at 2:46:56

In reply to New to Board - Anxiety & Depression, posted by Paul Frank on February 20, 1999, at 10:02:38

2. If one or two SSRIs are unsuccessful, does it make sense to go to another drug in the same family
such as Paxil (this is what my doctor wants to try me on if the Zoloft doesn't work) or should we be
trying another class of drug ie an SNRI ( I have been reading a lot of good things about Effexor and
especially Serzone)? I would really like to avoid TCAs and MAOIs if possible.

TCAs have been given a bad rap, I think. They have their place, and are many quite effective on depression and anxiety. So I would't rule out TCAs totally. But I'd probably not look to them as first-line drugs, either.

As I mentioned, I'd try Celexa, Remeron, and Effexor (and probably a TCA) before trying Serzone.

3. I have been reading a lot of good things about BuSpar, both as an anti-anxiety agent and anxiety
accompanied by depression. My doctor indicated she does not normally prescribe this drug, as she has
questions about its effectiveness. My pharmacist indicated that the SSRIs are now more commonly
prescribed for chronic anxiety than is BuSpar. Any thoughts on this?

This is probably correct. BuSpar is another BMS product. Read about it via their slick advertising, you'll form one opinion. Talk to those who have taken it, and you'll probably form another. It certainly has helped some, and some people a great deal. But, as one p-doc put it, "All BuSpar has ever done for my patients is made them dizzy."

Seriously, Paul, I'd add Klonopin (or if that doesn't work, perhaps Ativan), as much as you need (I mean, don't take 15mg or anything, but if it takes 2 or even 3 mg for relief, why not take it? Quite often with benzos the dose it takes to initially control the anxiety is much greater than the dose needed to stay anxiety-free. So, you might try going up as far as you need to with the K, staying at that dose for 4-6 anxiety-free weeks, and then taper down to a lower dose. Hopefully the Zoloft will be working well by then.

I and many others to whom I've talked have strong prefs for the brand-name Klonopin. I've not heard this sort of thought expressed with respect to the other benzos. Brand name K is almost the same price as generic K.

On your benzo fears, try expressing them on and see what sort of answers you get there. Most people there have pd, though some have GAD. Most are on benzos and a) know lots about them and b) have good things to say about the whole dependency issue.






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