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Re: Seeing Pdoc.. want med advice!!

Posted by JohnL on October 10, 2000, at 4:02:31

In reply to Seeing Pdoc.. want med advice!!, posted by NikkiT2 on October 9, 2000, at 11:10:31

Nikki,
I'm glad you're doing pretty well with Effexor. That's definately good news. As for the panic, there are quite a few meds that could treat it. As to which med, it all depends on what the underlying chemistry is that's causing it. Probably only through trial and error will you find what works best for you.

Some possibilities...
If serotonin receptors are overactive, then Remeron might work. Serzone might too, but it's record is a little more finnicky.
If dopamine is overactive, then a tiny dose of Zyprexa or Risperdal could work.
If GABA is underactive, then a small dose of a benzo would do the trick. If Xanax isn't available, surely there must be other choices. As with everything else, one may work when another doesn't.
I know of life-long sufferers of panic who found complete results when they finally tried Lithium, and in other cases Depakote. Again, as with the others above, only very small doses were necessary when the right med was found.
And believe it or not, there are actually some people (smaller population than the above meds) that find panic relief with stimulants. I know that sounds all backwards, but it's true.
If norepinephrine is overactive, a beta blocker would be helpful.

At this point we don't know which of the above chemistries is causing your panic. Just have to compare different meds and find what works. When one does work, then with the benefit of hindsight you'll know what chemistry was at fault.

In a population of 250 patients with panic/anxiety who found complete long lasting results with a medication, here are statistics of what worked. What's interesting is that some of these meds worked where there was no clinical suggestion to think that they would work.

Serotonin antidepressants 48%
Other antidepressants 11%
GABA meds (benzos) 24%
Lithium 22%
Stimulant 14%
Antipsychotic 13%
Depakote 11%
Tegretol 3%
Thyroid 24% (even tho blood tests indicated only 13% of these needed thyroid treatment)
Blends of the above 35%
Stimulants needing antipsychotic with it 21%

You'll have to see what direction your doctor wants to take.
John


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poster:JohnL thread:46003
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