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Re: The new way of calming people down » your#1fan

Posted by yxibow on March 16, 2008, at 4:10:12

In reply to The new way of calming people down, posted by your#1fan on March 16, 2008, at 0:58:10

> I've been reading articles that Zyprexa, and MANY of people i know take Seroquel, for anxiety.
> Those days of real anti-anxiety things are gone. We need to have revival.
> But at the same time, during the the 1970's and 1980's benzo's where prescribed (1975- diazepam was one the most widely prescibed medication)
> In 1985 the banned Quulude, and took a diffrent way of treating anxiety by using SSRI's and now today, its mostly Nueroleptics.

Benzodiazepines actually date to 1962 (1959 or so in the lab) and can be said to be among the safest psychiatric medication when used exactly as directed. They replaced barbiturates which had a low safety profile, and are rarely used, at least in the US.

Quaaludes turned out to be rather dangerous, and similar to barbiturates.

Miltown also went out of favour and became scheduled -- its rarely used if even obtainable today. Soma converts into miltown.

> What next for anxiety?
> fan

Well severe anxiety conditions are still handled by Zyprexa or Seroquel for their low potency and relative safety in lower doses.

Yes, what is next for the future. A recovery model for one is gaining rounds in psychiatry -- not aggressively treating the patient with medications but using the minimum effective medications and outpatient therapy. Unfortunately most insurance companies don't pay for a lot of therapy. Its an underused model and a focus of NAMI as well.

For that that can't be controlled otherwise, of course there's the usual panoply of AEDs, but one has to be cautious because a few, like Keppra apparently can make some patients more psychotic, and Gabitril can cause seizures ironically. These are generalisms, some people out there may be perfectly fine on them.

A small number of patients respond to BuSpar, although the dose may have to be somewhat high and it can cause dizziness.

There are TRIs in the pipeline (triple reuptake inhibitors -- SE, NE, and DA), although they are a ways off and probably more angled towards depression.

Tertiary agents such as propranolol are sometimes used to control the symptoms but not the root cause, as is clonidine or guanfacine often for rage in ADHD, but sometimes anxiety. The two shouldn't be mixed particularly (heart issues).

But as said before, ultimately, "calming people down" in a pill can be like chasing rainbows. A lot of hard work and maybe it sounds new age or non-psychiatric, but they are actually tools, relaxation therapy, guided imagery, deep breathing, and other exercises to help a patient help themselves calm down.

Now this isn't naiveté for the catatonic patient on PCP who really needs a hospital stay and an antipsychotic to stabilize themselves. Some things have to be solved a bit aggressively. But not everything

-- Jay




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