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Anxiety - what else is left?

Posted by Jenna S. on December 11, 2001, at 18:15:28

My bf has anxiety and depression which seem to have resisted all attempts to treat them. The anxiety is the more unbearable of the two and he really needs to find something to alleviate it. The problem is, that he has taken everything we can think of! Can anyone think of anything else that is left to try?!

Here is the list of drugs he has already tried:
Benzos - lorazepam, diazepam, chlordiazepoxide - no help.
Tricyclics - amitriptyline, clomipramine, trimipramine, dothiepin - marginal assistance.
Antipsychotics - thioridazine, chlorpromazine, droperidol, risperidone, olanzapine, sulpiride, amisulpride, flupenthixol. These all caused increased agitation and anxiety, paradoxically. Doses of risperidone below 1mg per day lowered anxiety but not sufficiently. Increasing the dose leads to increased anxiety.
SSRIs - fluoxetine, fluvoxamine, paroxetine, citalopram - all made anxiety worse. Sertraline was neutral.
Venlafaxine - very much worsened anxiety.
Reboxetine - as for venlafaxine but worse.
Bupropion - up to 150mg per day helps a bit, more than that increases anxiety.
Mirtazapine - helps but not enough.
Mood stabilisers - carbamazepine - no effects at all.
MAOIs - moclobemide, phenelzine - moclobemide was generally neutral, phenelzine caused anxiety and dangerously high blood pressure so had to be withdrawn.
Hypnotics - temazepam, nitrazepam, zopiclone, zolpidem, chloral hydrate, various antihistamines - the benzos sedated, others did not, none reduced anxiety.

Various combos of the above have been tried, which didn't really help either. Combos were generally antidepressants with benzos and /or antipsychotics, and some antidepressant augmentations, eg sertraline and mirtazapine.

Even Kava and St John's Wort have not worked, but made anxiety worse....

Help!

Jenna


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poster:Jenna S. thread:86605
URL: http://www.dr-bob.org/babble/20011202/msgs/86605.html