Posted by med_empowered on December 25, 2006, at 22:56:36
In reply to Re: What is this anxiety that comes out of nowhere? » UgottaHaveHope, posted by Phillipa on December 25, 2006, at 22:41:55
First, I'd look at your life itself--stressors, problems, etc. Consider counselling along with whatever else you're doing, or at least reflect on your existence. This helps a lot.
Seroquel really isn't the best thing for anxiety--my guess is that if you react well to neuroleptics for anxiety, it means there's more agitation and other factors involved than with "simple anxiety". I think you might want to try a benzo, but maybe not klonopin--its cool for a while, but it really is a depressing drug long-term. My vote would go for Ativan, which you would need to take either as-needed or on a regular dosing schedule, several times daily. Its not as potent as Klonopin, but it goes to work faster and is pretty neutral with regards to effects on mood (neither lifts nor lowers for a lot of people). Plus, unlike Klonopin, it wears off after several hours and does so gently (unlike xanax) so its the cleanest benzo I can think of. Dosages vary; you might do OK with 2mgs a day; if you're having mixed-episode level anxiety, you might end up more in the 6-10mgs/day range.
A beta blocker might help, too. I personally wouldn't use one for a long time (depression) or in high doses (just a bad idea), but they can help with other stuff, especially with benzos (you get synergy there). Propranolol is the major one for this kind of thing, but others are available.
Neuroleptics really aren't a good idea long term, since you could end up making your mood worse (neuroleptic induced dysphora) and you run all kinds of risks (diabetes, obesity, tardive dyskinesia, etc.) but they might be good PRN. A mood stabilizer might help; personally, I'd go for Trileptal, since the blood work is minimal (check your blood sodium ever now and then) and the side effects are relatively mild. Dosages vary, but personally I found that it wook 600mgs to work, 900mgs to work on intense problems, and 1200mgs made me stupid. Your results will vary, of course.
Diet is important. Nutrients are important. I appreciate this even more now that I'm off all medications than I ever did while I was on them. B-Vitamins help a lot; huge niacinamide doses bind to benzo receptors and may help anxiety and ((possibly)) schizophrenia, so that's something to consider. Taurine, fish oils, and choline are examples of other supplements that might help.
Good luck.
poster:med_empowered
thread:716355
URL: http://www.dr-bob.org/babble/20061224/msgs/716399.html