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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 14 of 14. This is the beginning of the thread.
Posted by sam K on February 4, 2009, at 15:49:13
ive taken all the ssris and they all cause nervousness it seems like. Is there anything that doesn't cause this nervousness and panicky stuff. I don't really want to take benzodiazipines. What anti depressant is good for anxiety and depression? I took paxil and it made me sleeepy.. and at 12.5 mg I could hardly get an erection. I don't think nardil would be good because it has the effect on dopamine. I have a feeling that would make me very paranoid. (maybe Im just going off my judgment) I have mild paranoia at night and some of the antidepressants make it worse. I feel like people are walking in and if Im in the dark I feel like someones behind me and going to get me. Or if I walk past open doors I feel like someone is going to pop out. But I dont respond to anti psychotics at all..
I just trully need to get on with my life. I mean Im getting better as time goes on but at this point I wouldnt be able to get a job. One day I'm calm the next I'm agorophobic and my hearts pounding. Well anyway good luck to yall and I love ya!!(not in a wierd way ahahahha)
Posted by SLS on February 4, 2009, at 17:31:04
In reply to which antidepressants dont cause anxiety, posted by sam K on February 4, 2009, at 15:49:13
Maybe nortriptyline.
- Scott
Posted by sam K on February 4, 2009, at 17:52:54
In reply to Re: which antidepressants dont cause anxiety, posted by SLS on February 4, 2009, at 17:31:04
doesnt that only hit norepinepherine? So interesting how does that make anxiety better. all the drugs these days hit serotonin
Posted by SLS on February 4, 2009, at 18:36:42
In reply to Re: which antidepressants dont cause anxiety, posted by sam K on February 4, 2009, at 17:52:54
> doesnt that only hit norepinepherine?
It is a mild-to-moderate inhibitor of serotonin reuptake as well, having a dissociation constant of 18-60 Ki (nM). By comparison, desipramine is 200-4250 Ki (nM). The larger the number, the weaker the binding. Desipramine is more selective for NE than is nortriptyline.
> So interesting how does that make anxiety better.
The best answer to your question is to say that it just does. Years of experience. Amitriptyline would probably work better for anxiety acutely, but not necessarily long-term if the anxiety is part of the depression. Amitriptyline has more potent side effects. Other TCAs that are good for anxiety are doxepin and trimipramine.
- Scott
Posted by raisinb on February 4, 2009, at 18:48:32
In reply to which antidepressants dont cause anxiety, posted by sam K on February 4, 2009, at 15:49:13
Neither Zoloft nor Lexapro caused anxiety for me, but if SSRIs cause you anxiety, a commonly prescribed AD that's supposed to help anxiety (according to my pdoc) is Remeron.
Posted by Incubusfan on February 4, 2009, at 19:58:04
In reply to Re: which antidepressants dont cause anxiety » sam K, posted by SLS on February 4, 2009, at 18:36:42
> > doesnt that only hit norepinepherine?
>
> It is a mild-to-moderate inhibitor of serotonin reuptake as well, having a dissociation constant of 18-60 Ki (nM). By comparison, desipramine is 200-4250 Ki (nM). The larger the number, the weaker the binding. Desipramine is more selective for NE than is nortriptyline.
>
> > So interesting how does that make anxiety better.
>
> The best answer to your question is to say that it just does. Years of experience. Amitriptyline would probably work better for anxiety acutely, but not necessarily long-term if the anxiety is part of the depression. Amitriptyline has more potent side effects. Other TCAs that are good for anxiety are doxepin and trimipramine.
>
>
> - ScottWhat do you think of Anafranil for a combination of anxiety, depression, and OCD? Also, is it possible to combine multiple TCAs?
Posted by SLS on February 4, 2009, at 20:14:13
In reply to Re: which antidepressants dont cause anxiety » SLS, posted by Incubusfan on February 4, 2009, at 19:58:04
> What do you think of Anafranil for a combination of anxiety, depression, and OCD? Also, is it possible to combine multiple TCAs?
If you can tolerate the anticholinergic side effects, Anafranil is the best TCA out there for what you suffer from. If anxiety persists, I would then treat that separately and aggressively.
POSSIBLE side effects include: dry mouth, pupilary dilation, blurred vision, constipation, elevated heart rate, reduced libido, dizziness, difficulties in urinating, sweating...
Since you have OCD, I would encourage you to give serious consideration to trying Anafranil. It is the "gold standard" for treatment of that illness. This drug is also the best TCA for depression. It is the side effects that often limits its usefulness. What would you have to lose by trying it? If you don't like it, you just stop taking it. However, there is no guarantee that side effects will get in your way. You might as well start at a low dosage and titrate gradually. This should make the drug more tolerable in the beginning. If you can stick with it for awhile, the side effects should diminish over time.
One step at a time.
- Scott
Posted by sam K on February 4, 2009, at 21:13:37
In reply to Re: which antidepressants dont cause anxiety » Incubusfan, posted by SLS on February 4, 2009, at 20:14:13
What are anticholigeric side effects, is this the one that makes you feel slow and stupid? That'd be interesting because Ive never experienced tcas.. new set of side effects and efficiency. its a bit exciting, yet Im sure some of the side effects wont be pleasant.
Posted by Incubusfan on February 4, 2009, at 21:14:20
In reply to Re: which antidepressants dont cause anxiety » Incubusfan, posted by SLS on February 4, 2009, at 20:14:13
Posted by Phillipa on February 5, 2009, at 0:40:59
In reply to appreciate responses thanks, posted by sam K on February 4, 2009, at 21:13:37
Sam SSRI's don't make me tired for some reason think it's because my main symtom is anxiety. Pdoc said Gad is primary for me. I take low dose luvos only ad that doesn't make me anxious but do combine with a low dose of benzos. Phillipa
Posted by jms600 on February 5, 2009, at 14:12:07
In reply to which antidepressants dont cause anxiety, posted by sam K on February 4, 2009, at 15:49:13
I personally would stay well clear of Remeron/mirtazepine. To me, it was the worst antidepressant for anxiety I have ever had the misfortune to be prescribed. At low doses it didn't do a thing to help either my anxiety or moderate depression. At higher doses (45mg +) it made my anxiety a lot worse. Not only this, it gave me a ravenous appetite and caused me to gain over a stone in weight. Worse of all it made me far more aggressive and irritable - which almost destroyed my relationship with my girlfriend.
Other people on here seem to have better experiences with it, but personally, I wouldn't want to go anywhere near it.
I've been on amitriptyline for the past 8 months. It's a very effective antidepressant to many people; however, it hasn't been a huge help for my anxiety. Don't get me wrong, it has helped a little - but that's it, just a little. It's took the edge of the anxiety and panic, but the anxiety is certainly still there. On top of this the side effects are uncomfortable.
Have you considered Venlafaxine? Cipralex is another one to think about. Clomipramine, is also supposed to be beneficial for anxiety although I haven't tried it myself. I know you want to avoid benzos but they can be a great help for periods of intense anxiety and despairing panic. Buspirone is another to consider but it may not be the most effective.
Posted by Pete1968 on February 6, 2009, at 23:09:19
In reply to Re: which antidepressants dont cause anxiety » sam K, posted by jms600 on February 5, 2009, at 14:12:07
Having read all the posts here and being able to relate to your particular brain cootie, i can say that if your main thing is anxiety, stay the F*** away from SSRIs. There Ive said it. Despite the hype these things are STIMULATING I have been there and believe me it wasnt pleasant. Big Pharma has a lot to answer for IMO. For GAD try Venlafaxine, titrate up from 75 to 150mg, no higher. Too much = jittery angst as it gets all NRI at that dose. Effexor is mellow at around 150mg. BUT and this is a big butt ; ) You could try an Atypical Antipsychotic as I have, and to be honest, Olanzapine at doses below 5mg a night just removes anxiety big time! I mean really remove 'the fears', I really cannot recommend enough. Only trouble with the Olanzapine is weight gain and slight dopiness, I personally am thinking about changing to Quetiapine. In fact Im on here asking about the differences. Good luck and stuff anyway, and avoid Mirtazapine IMO, been there seen it and done it, nastiest two weeks i ever spent. ; ) Pete
Posted by sam K on February 7, 2009, at 2:07:34
In reply to Re: which antidepressants dont cause anxiety, posted by Pete1968 on February 6, 2009, at 23:09:19
ya thanks pete.
I took effexor and had terrible heart palps and high BP. I have taken zyprexa before and ya that stuff is real relaxing and good for anxiety but it made me alot worse socially and it makes me want to avoid contact with anyone. But you think if effexor did the BP thing and palpitations that trycyclics will? who knows though.
effexor seriously had so many side effects it was ridiculous lol. I had literally every single one in the sample pamphelt thing. I was soooooo constipated and if I went it would be diarrea. well good luck to ya
cya
Posted by JadeKelly on February 9, 2009, at 4:09:11
In reply to which antidepressants dont cause anxiety, posted by sam K on February 4, 2009, at 15:49:13
> ive taken all the ssris and they all cause nervousness it seems like. Is there anything that doesn't cause this nervousness and panicky stuff. I don't really want to take benzodiazipines. What anti depressant is good for anxiety and depression? I took paxil and it made me sleeepy.. and at 12.5 mg I could hardly get an erection. I don't think nardil would be good because it has the effect on dopamine. I have a feeling that would make me very paranoid. (maybe Im just going off my judgment) I have mild paranoia at night and some of the antidepressants make it worse. I feel like people are walking in and if Im in the dark I feel like someones behind me and going to get me. Or if I walk past open doors I feel like someone is going to pop out. But I dont respond to anti psychotics at all..
> I just trully need to get on with my life. I mean Im getting better as time goes on but at this point I wouldnt be able to get a job. One day I'm calm the next I'm agorophobic and my hearts pounding. Well anyway good luck to yall and I love ya!!(not in a wierd way ahahahha)Hi Sam!
Well, it seems you've become quite popular! You won't need me anymore....sniff sniff...lol.
"Well anyway good luck to yall and I love ya!!(not in a wierd way ahahahha)"
Thats okay, you can love us in a wierd way, were easy to get along with, haha
I only read afew posts but it sounds like you have some options. A lot of people are using Seraquel off label I think for all kinds of things, even sleep. My son takes 300mg for Bipolar 1, It works like a charm. He has to get a little extra sleep but that has significantly reduced itself as a s/e. It also has a/d properties. I wonder what would happen if you took a really small amount? It should help with anxiety, sleep, and depression. I think if you tried it you would know right away. Just tell PDoc very small dose. And if your scared or sensitive cut that in half (if the pill allows for that)
Whatever you choose, good luck, you sound good!
~Jade ;-)
This is the end of the thread.
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