Posted by Viridis on October 23, 2003, at 14:05:12
In reply to Re: Agitated depression; anxiety bad in morning, posted by dannen on October 23, 2003, at 13:17:26
Hi Dannen,
Xanax seems to be one of the worst benzos for building tolerance -- I've had that experience too, so now just use it occasionally. Klonopin (clonazepam) seems to be quite different; I've been on the same dose for a long time, and my pdoc has lots of other patients who have been on the same dose for many years. He's very cautious with Xanax, and based on his experience much prefers to prescribe Klonopin. It's very subtle, but really works for anxiety. It also has mood-stabilizing effects for some people (like me). Of course, you are likely to become dependent on it, as you would with most antidepressants, so need to discontinue it gradually if you decide to stop using it.
Strattera isn't stimulating for me, but I do take it (and Adderall, an amphetamine) primarily for ADD, so I could be a special case. With Strattera, I'd definitely recommend starting with a low dose (say, 25 mg) and working up gradually. So often, the doctors want you to try a full dose of these meds right from the start, and the side effects from many can be intolerable that way. I always like to start low and go slow. Having an anti-anxiety med like Klonopin in place first can help the transition greatly.
I haven't tried tricyclics, but know several people who have really benefitted from them. I'm not aware of any evidence that the newer ADs are any better (on average) than the older tricyclics that are now off-patent (and so not heavily marketed).
Good luck!
poster:Viridis
thread:271647
URL: http://www.dr-bob.org/babble/20031021/msgs/272352.html