Posted by 4WD on May 29, 2005, at 17:29:42
In reply to Re: Is Lexapro more effective for anxiety than Cel, posted by med_empowered on May 29, 2005, at 0:47:48
> If you're currently on Celexa for anxiety and the dose is relatively high (you should probably try a drug in mid-range dose, if you can, before you scrap it) I wouldn't try Lexapro personally. From what I understand, lexapro is just an isomer of celexa--the company just isolated the most effective and potent parts of the celexa molecule and marketed this as lexapro. Milligram per milligram, lexapro is more potent and has fewer side effects, but it is basically super-duper celexa. If you want to go the anti-depressant route for anxiety treatment, you might want something a little stronger, but still clean...paxil and zoloft are the 2 most potent serotonin reuptake inhibitors available...Paxil has a pretty bad reputation for causing problems when you withdraw from it, and it has a short half-life, but other than that its good stuff...you just need to take it every day, at the same exact time. Tricyclics can help a lot, too...Surmontil and Doxepin are the 2 used most often for anxiety specifically...if you have bipolar, schizophrenia, or schizoaffective disorder, your doc may want to avoid tricyclics. Effexor is considered useful for anxiety, and Cymbalta is being used for anxiety, too. Personally, I've found that BuSpar helps tremendously...the only problem I had were mild headaches when I started and mild headaches again when the dose was adjusted upwards. BuSpar seems to work best if you take it with an anti-depressant...it may also help the anti-depressant work faster. Even if you're not bipolar, mood-stabilizers **might** help with anxiety...this may be the way to go if you need anxiety control but don't want to use benzodiazepenes or Miltown. Depakote is considered the most soothing, anti-anxiety/panic of the mood-stabilizers, but I personally have found that an adequate dose of trileptal (for me, its 600mgs under normal conditions, 900mgs under more stressful ones) helps with anxiety. Some people swear by Neurontin, but results are kind of mixed. Propranolol and other beta blockers can help with the physical symptoms of anxiety, but they can also have side effects--such as depression. If all else fails, you'll probably want to use either benzodiazepenes, anti-psychotics, or both. Zyprexa, Abilify, and Seroquel are used "off-label" to help treat anxiety, usually in conjunction with a newer anti-depressant; this kind of combo can also help depression immensely. Good luck!
Hi. Thanks. But here's the thing. The following AD's increased my anxiety. Prozac moderately. Zoloft a lot. Paxil actual panic and freak outs. Doxepin had a weird effect, I lost my ability to perceive things acurately couldn't tell if water was hot or cold etc.Low dose (37.5) Effexor worked great for anxiety for years. But when it quit working for depression, I started trying other drugs. Every time I'd switch to Paxil, terror within a week. Same with Cymbalta. Now the same with Celexa (although I was able to switch from Effexor to Celexa with no problems several years ago.) Now even the Effexor doesn't help with the fear.
I've tried Seroquel, Geodon, Risperdal and Zyprexa. Zyprexa helps a lot but as a recovering bulimic I can't take it. It sends me right back into bulimia.
So now I'm on Klonopin, which I hate. But it does remove the terror. Then I just feel apathetic unmotivated and uncomfortable in my skin. Maybe the next step is Nardil.
I guess I was just thinking Lexapro might work better than Celexa. But if SSRIs in general don't help with my anxiety, I guess there's not much chance a different one would.Nortriptyline made it much worse.
poster:4WD
thread:504522
URL: http://www.dr-bob.org/babble/20050527/msgs/504868.html