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Dr. Bob is Robert Hsiung, MD,
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Posted by SLS on April 1, 2012, at 6:16:25
In reply to Re: Anxiety medication, posted by MelanieG on March 31, 2012, at 21:06:27
> But I worry I will become dependent and my 'nerves' will never level off on their own.
CBT psyhcotherapy is often helpful, but might not be sufficient to treat severe GAD.
People who have Major Depressive Disorder rely on (are dependent on) antidepressants. So what? People with diabetes rely on (are dependent on) insulin. So what? Will your nerves "settle" down so that you can remove the GAD drug treatments? It is very much possible. For now, take things one step at a time and make decisions as you go along depending on the path your symptoms take.
I forgot to mention propranolol. This drug can help with the physical automomic symptoms of anxiety: hand tremors, heart palpitations, elevated heart rate, dry mouth, blurred vision, chest pain, sweating, fellings of suffocation, muscle tension, headaches, back pain, dizziness, etc.
Posted by gadchik on April 1, 2012, at 9:02:42
In reply to Re: Anxiety medication » MelanieG, posted by SLS on April 1, 2012, at 6:16:25
Hello Melanie,I am 48.At 44,I experienced severe anxiety,even had a heart cath,because i went to the er so much w/chest pain(it was all anxiety,panic).I was prescribed zoloft,remeron,klonopin-small doses,but taken daily,at night.Once I calmed down,I benefited from therapy.But I coudnt tolerate therapy until I got my nervous system under control.I eventually stopped the zoloft,remeron,but klonopin remains.I take .5mg at night.It has really controlled my gad,panic and I have no more depression.I will take a little piece of remeron occ for sleep.But I had to get over my fear of benzos to try the klonopin,and that is what works for me.I also hike daily for miles,and eat good food,get massages.Take care of yourself,I hope you find the answer.I know how terrible it feels to have anxiety so bad you cant breathe.
Posted by Shes_Initforthemoney on April 1, 2012, at 14:26:49
In reply to Anxiety medication, posted by MelanieG on March 30, 2012, at 21:42:25
> Hi - I am a 46 year old female, in excellent physical health - but dealing with what has been diagnosed as anxiety. I've had some bad 'life events' over the past 8 years. Divorce after a brief/abusive marriage. Then a loved one was seriously injured in an accident that altered their life leaving them severely debilitated forever. I also lost a job. I dealt with each event with the support of a wonderful family and close friends. But then it all caught up to me one day while at work. I began to experience intense dizziness which then caused my heart to raise, my hands to tingle, out of breath. I didn't know it at the time but was having a panic attack.
>
> I had a bunch of tests run to rule out MS, brain tumor etc. Major bloodwork run to rule out immune disorders, etc. But nothing was found and it was quickly determined it was all due to anxiety. I see a therapist - who surmises that it is a form of post traumatic in a way as I did witness and see a lot of bad things happen to people I loved.
>
> I have dizziness every day - but I try to control it and try not to let it cause me to panic. But it's hard. I get relief from moderate doses of xanax which i take only when absolutely necessary.
>
> I been on Ambien for three years - a very slow dose. I was wondering if it's possible that the Ambien is now causing these sensations. The dizziness has been going on now for about 10 months.
>
> I was prescribed Paxil which initally made me feel less anxious and almost like my old self. But then it started making me very sick to my stomach. I was told to stop for a day and then go back on if I felt better - I did but then a few days later it started again. I was on a VERY low dose - I believe it was 5mg! I had to stop taking it.
>
> I have also tried Cymbalta and I had to rush home after taking only one dose because I was so nauseated and felt like I'd vomit for 2 hours. And the remainder of the day I had raising thought - mind would not shut off.
>
> I took Lexapro with minimal side effects for 6 months about 5 years ago. That was for depression NOT anxiety.
>
> I have never felt this anxious in my entire life. Every day I'm on edge and very jumpy, my nerves are shot - I feel like a basket case. And THAT depresses me.
>
> If anyone has any suggestions or can relate to how I feel - please reach out.
>
> Thanks. MelHi,
A small dose of Compazine with the meds that caused your stomach distress may work very well. Compazine can take out the nausea, and in small doses, can even help a bit with anxiety.
A few other suggestions as an alternate or add-on to the Ambien...Clonidine (in small doses) and Prazosin both help with restless sleep.
Let us know how you make out...
Best,
Jay
Posted by emmanuel98 on April 1, 2012, at 18:34:00
In reply to Re: Anxiety medication, posted by MelanieG on March 31, 2012, at 21:06:27
i would suggest you take a higher dose of xanax - like 0.5mg. For me, taking that for a few days got my body back to baseline. I think anxiety can be physically reinforcing. Your cortisol shoots up, you feel panicked, your cortisol shoots up higher, you start to fear the sensation and that gets your fight or flight reaction going and on and on. For me, even a few days relief from this got it under control.
Posted by MelanieG on April 1, 2012, at 20:14:45
In reply to Re: Anxiety medication » MelanieG, posted by SLS on April 1, 2012, at 6:16:25
Hi Scott and thank you for your responses - one of the folks on here mentioned you had a lot of experience and I really appreciate your sharing this with me.
I've been depressed in the past - but I'm really not now. Well - - - I feel DOWN at times because I am concerned I will have a panic attack so that prevents me from getting out there and living my life. I don't feel STRONG - or like myself. Previously I dealt with a great deal of 'stuff' - and whatever was thrown my way, I handled it! Now - I have this anxious feeling and I am shaky a lot. I don't like that feeling. So THAT bugs me.
I've had a few periods over the past 9 months where the anxiety was reduce but any little thing - gets it going again. And I am hyper sensitive to noise, various sensations etc. Like I am now claustrophobic - never was before! I hate elevators - never did before. I don't like getting on an airplane - never had an issue before.
Anyway - I have an incredibly sensitive stomach, always have. It seems to me that I am very sensitive to the SSRI's. And it's not just because I know the 'can' cause nausea and vomiting. I was diagnosed with Irritable Bowel Syndrome 20+ years ago. I've always had a 'nervous' stomach. But the anti-depressants I've tried definitely cause an increased nausea in me and really reduce my appetite. I've finally got my weight up to a decent amount (I'm almost 5'8 and weigh 120 lbs and I am small framed) - but when I am on an SSRI, I will lose. I was on Lexapro about 6 years ago for 6 months. I recall doing okay on it but I also recall it definitely reduced my appetite. That said - I don't really care to go on one that will cause me to put on 20 lbs either. (lol) The Paxil made me super sick to my stomach - do doubt.
So I'm wondering if I should stop trying the SSRI's? The therapist is open to me trying whatever I am comfortable with. I see her tomorrow night - I'm wondering if I should suggest going on Klonopin rather than the Xanax OR the Xanax CR. I actually have a bottle of Xanax CR .5mg, can't recall how it affected me. But lately I've just been so exhausted. BUT I think that might also be the Ambien - which I am weening myself off of. I am now taking ONE QUARTER of a 10mg Ambien, started that this past weekend and slept each night just fine. I am dreaming again - and I never had dreams on Ambien, so I think my sleep cycles were not 'normal'.
Anyway - maybe I should just suggest that I stick with a Benzo. Especially given I am not depressed - except for the fact that I am bothered by feeling this way. If I could just feel myself with no anxiety - I'd be happy.
As for CBT - - basically when I go to see her, I just vent about how I am feeling. I like the therapist a lot - but I'm not really finding she is giving me any ideas on how to work through all this or change it. Maybe it just takes time.
I'm going to talk to her tomorrow night about next steps. But - I am a bit nervous about trying yet another SSRI. I have to go to work every day and the last time when we tried Paxil it really was affecting my work day and I can't afford to jeopardize my job. If I had a few weeks to take off from work and see how the drug made me feel - then yes, I might be more apt to try it, but I do not.
Thanks again - keep you posted.
Posted by MelanieG on April 1, 2012, at 20:17:33
In reply to Re: Anxiety medication, posted by gadchik on April 1, 2012, at 9:02:42
> Hello Melanie,I am 48.At 44,I experienced severe anxiety,even had a heart cath,because i went to the er so much w/chest pain(it was all anxiety,panic).I was prescribed zoloft,remeron,klonopin-small doses,but taken daily,at night.Once I calmed down,I benefited from therapy.But I coudnt tolerate therapy until I got my nervous system under control.I eventually stopped the zoloft,remeron,but klonopin remains.I take .5mg at night.It has really controlled my gad,panic and I have no more depression.I will take a little piece of remeron occ for sleep.But I had to get over my fear of benzos to try the klonopin,and that is what works for me.I also hike daily for miles,and eat good food,get massages.Take care of yourself,I hope you find the answer.I know how terrible it feels to have anxiety so bad you cant breathe.
Thank you so much for this response! It really helps to hear I am not alone and to hear from people who eventually were able to control their anxiety. How long did it take your to settle down? My fear is of SSRI's - not so much the Benzos. The Benzo is what has helped me - but it does make me tired. Does the Klonopin do that to you? I'd really like to get back into my exercise routine - but I'm always so wiped out at the end of the day. It's like fighting the anxious feelings makes me so very tired.
Thank you again for sharing with me!! It helps a great deal.
Posted by MelanieG on April 1, 2012, at 20:23:49
In reply to Re: Anxiety medication » MelanieG, posted by Shes_Initforthemoney on April 1, 2012, at 14:26:49
> A small dose of Compazine with the meds that caused your stomach distress may work very well. Compazine can take out the nausea, and in small doses, can even help a bit with anxiety.
>
> A few other suggestions as an alternate or add-on to the Ambien...Clonidine (in small doses) and Prazosin both help with restless sleep.
>Thank you Jay. Great idea about the Compazine, I will suggest to my therapist. I'm actually trying to get off the Ambien as I've been on it for three years and feel it is time to come off. I only take 5mg a night, and this weekend began taking half of that along with one (3mg) of Melatonin. Slept great Fri and Sat nights - so I'm pleased about that. I'm hoping that I can take something during day for the anxiety (my anxiety gets worse as the day goes on) and sleep at night with nothing.
Thank you again - I will keep you all posted.
Posted by MelanieG on April 1, 2012, at 20:28:00
In reply to Re: Anxiety medication, posted by emmanuel98 on April 1, 2012, at 18:34:00
> i would suggest you take a higher dose of xanax - like 0.5mg. For me, taking that for a few days got my body back to baseline. I think anxiety can be physically reinforcing. Your cortisol shoots up, you feel panicked, your cortisol shoots up higher, you start to fear the sensation and that gets your fight or flight reaction going and on and on. For me, even a few days relief from this got it under control.
Thanks very much. I've taken the Xanax at full strength previously - for days on end because I was concerned I'd have a panic attack at work. Then on the weekends I'd try to go without or just take half. It also can make me very tired. I've had periods where it was under control and then if I have a cumulation of things - I am back to square one. And these are simply 'life events' - my nervous system goes into overdrive. Things that didn't use to bother me - do now.
Thanks again!
Posted by MelanieG on April 1, 2012, at 20:40:03
In reply to Anxiety medication, posted by MelanieG on March 30, 2012, at 21:42:25
My concerns with going on a Benzo longterm is because I've read the following on Wikepedia - remember I WORRY, hence I have GAD! lol -
"Long-term use of benzodiazepines can worsen underlying anxiety,[13][14] with evidence that reduction of benzodiazepines can lead to a lessening of anxiety symptoms."
"Benzodiazepines (or "benzos") are fast-acting hypnotic sedatives that are also used to treat GAD and other anxiety disorders.[24] Benzodiazepines are prescribed for generalized anxiety disorder and show beneficial effects in the short term. The World Council of Anxiety does not recommend the long-term use of benzodiazepines because they are associated with the development of tolerance, psychomotor impairment, cognitive and memory impairments, physical dependence and a withdrawal syndrome.[29][30] Side effects include drowsiness, reduced motor coordination and problems with equilibrioception. "
Posted by Phillipa on April 1, 2012, at 21:04:03
In reply to Re: Anxiety medication, posted by MelanieG on April 1, 2012, at 20:40:03
I've been on them since the 70's I haven't increased the doses. Right now cutting back as sleeping well. Phillipa
Posted by MelanieG on April 1, 2012, at 21:13:53
In reply to Re: Anxiety medication » MelanieG, posted by Phillipa on April 1, 2012, at 21:04:03
> I've been on them since the 70's I haven't increased the doses. Right now cutting back as sleeping well. Phillipa
On what? Benzos or SSRI's?
Thanks!
Posted by SLS on April 2, 2012, at 5:29:45
In reply to Re: Anxiety medication, posted by MelanieG on April 1, 2012, at 21:13:53
Hi Melanie.
I thought I would point out that you can direct your reply posts to the previous poster by checking the checkbox located above the composition window. "add name of previous poster". This will add the arrow and poster's name to the end of the subject line. You can get more consecutive posts that way. Otherwise, we are limited to 3 posts in a row without using names at the end of the line. No biggie.
I'm glad you received some good advice. The people here are really smart and compassionate.
Klonopin + Lyrica sounds interesting to me.
- Scott
Posted by Emme_v2 on April 2, 2012, at 6:13:45
In reply to Anxiety medication, posted by MelanieG on March 30, 2012, at 21:42:25
Hi. I've found a very low dose of a beta blocker (atenolol) to cut out the physical "fight or flight" aspects of anxiety, ultimately leaving me with a bit more energy because I'm not worn out from the anxiety. At the dose I take, it doesn't seem to drop my blood pressure, which can tend to run on the low side of normal. It really works well.
Also, if the xanax is making you tired, I suggest titrating the dose yourself very carefully, subdividing the tablets until you get relief but before you get too zonked.
When I've needed a bigger gun than xanax, I've found a low dose of Seroquel (6.25 mg; splitting up a 25 mg tablet) to be superb for anxiety. Again, you really have to titrate your dose to avoid making yourself to sleepy. But it's extremely effective.
Good luck,
emme
Posted by MelanieG on April 2, 2012, at 6:18:58
In reply to Re: Anxiety medication » MelanieG, posted by SLS on April 2, 2012, at 5:29:45
> Hi Melanie.
>
> I thought I would point out that you can direct your reply posts to the previous poster by checking the checkbox located above the composition window. "add name of previous poster". This will add the arrow and poster's name to the end of the subject line. You can get more consecutive posts that way. Otherwise, we are limited to 3 posts in a row without using names at the end of the line. No biggie.I thought I did that a few times - but I don't see the arrow. Testing it now.
>
> I'm glad you received some good advice. The people here are really smart and compassionate.
>
> Klonopin + Lyrica sounds interesting to me.
>
>
> - Scott
Posted by MelanieG on April 2, 2012, at 6:21:33
In reply to Re: Anxiety medication, posted by MelanieG on April 2, 2012, at 6:18:58
> > Hi Melanie.
> >
> > I thought I would point out that you can direct your reply posts to the previous poster by checking the checkbox located above the composition window. "add name of previous poster". This will add the arrow and poster's name to the end of the subject line. You can get more consecutive posts that way. Otherwise, we are limited to 3 posts in a row without using names at the end of the line. No biggie.>
> I thought I did that a few times - but I don't see the arrow. Testing it now.
>
>
> >
> > I'm glad you received some good advice. The people here are really smart and compassionate.
> >
> > Klonopin + Lyrica sounds interesting to me.
> >
> >
> > - Scott
>
>
Scott - for some reason it is not working when I try to do this and post to your reply.
Posted by SLS on April 2, 2012, at 6:58:43
In reply to Re: Anxiety medication » MelanieG, posted by Emme_v2 on April 2, 2012, at 6:13:45
> Hi. I've found a very low dose of a beta blocker (atenolol) to cut out the physical "fight or flight" aspects of anxiety, ultimately leaving me with a bit more energy because I'm not worn out from the anxiety.
I am somewhat surprised by this, but happy that it works. Perhaps atenolol is a better choice than propranolol because it doesn't cross the blood-brain barrier (get into the brain). There are some people who feel that propranolol can be depressing. There has been quite a bit of debate about this over the years, though. So, I guess atenolol is sympatholytic (anti-fight or flight) without being depressogenic.
Here is some interesting reading regarding the depressogenic potential of various drugs:
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3181967/
- Scott
Posted by SLS on April 2, 2012, at 7:02:30
In reply to Re: Anxiety medication Scott?, posted by MelanieG on April 2, 2012, at 6:21:33
Are you clicking on the checkbox located directly below the subject line? It should read "add name of previous poster".
- Scott
Posted by gadchik on April 2, 2012, at 9:55:11
In reply to Re: Anxiety medication, posted by MelanieG on April 1, 2012, at 20:17:33
http://bearpaw8.tripod.com/pd.html this is an excellent article about panic and treatment,you can scroll down to the benzos to read about them.A poster on here originally put up the link.As for my experience,I was so terrified of meds,I refused all,until I became psychotic and almost got committed.Had stopped eating and sleeping.I lost 30lbs.If only I had found a psychiatrist at the beginning who could have helped me with my fear of meds.But I did finally find one,and she convinced me to give klonopin and remeron a try first.Remeron helped my nausea and sleep right away,and klonopin calmed my nervous system immediately.After I felt better,and could get cbt,I then tried a little zoloft.Added in exercise,nutrition.I remained on that combo about 2 yrs.The klonopin dose is so low and I take it at night,so I dont feel tired.It lasts all day for me.But I dont drink any alcohol either,and I think that helps.I always worry about being on k for yrs and wonder about tapering it.But I was so anxious and miserable before.Now,Im doing so well,and I hope the same for you.Once you get control of things,just remember to walk,get out in the sun,lay in a hammock,take time to enjoy everything around you.
Posted by Emme_v2 on April 2, 2012, at 16:34:33
In reply to Re: Anxiety medication » Emme_v2, posted by SLS on April 2, 2012, at 6:58:43
>
> I am somewhat surprised by this, but happy that it works. Perhaps atenolol is a better choice than propranolol because it doesn't cross the blood-brain barrier (get into the brain).Yes! That is exactly why my psychiatrist chose it.
Posted by MelanieG on April 2, 2012, at 17:37:59
In reply to Re: Anxiety medication » MelanieG, posted by gadchik on April 2, 2012, at 9:55:11
> http://bearpaw8.tripod.com/pd.html this is an excellent article about panic and treatment,you can scroll down to the benzos to read about them.A poster on here originally put up the link.As for my experience,I was so terrified of meds,I refused all,until I became psychotic and almost got committed.Had stopped eating and sleeping.I lost 30lbs.If only I had found a psychiatrist at the beginning who could have helped me with my fear of meds.But I did finally find one,and she convinced me to give klonopin and remeron a try first.Remeron helped my nausea and sleep right away,and klonopin calmed my nervous system
immediately.After I felt better,and could get cbt,I then tried a little zoloft.Added in exercise,nutrition.I remained on that combo about 2 yrs.The klonopin dose is so low and I take it at night,so I dont feel tired.It lasts all day for me.But I dont drink any alcohol either,and I think that helps.I always worry about being on k for yrs and wonder about tapering it.But I was so anxious and miserable before.Now,Im doing so well,and I hope the same for you.Once you get control of things,just remember to walk,get out in the sun,lay in a hammock,take time to enjoy everything around you.Thank you so much - that link and all the info on panic disorder was awesome!!!!! Lots of excellent information for sure. And because I've had some bad reactions to SSRI's and I'm not clinically depressed, we are going to stick with the Xanax for now. The difference will be I am going to take it consistently every day in a very small dose, which works for me. It does not zonk me out but it controls the sensations. And I am going to keep taking it rather than 'as needed' because often when I take it - the panic is already here, and i think it takes me days to try to go back into 'remission'.
We are going to try this for a month and see how I do. Klonopin could be an option in the future but for now the Xanax is working for me - I'm just going to try taking it consistently which I was hesitant to do in the past.
Thank you all - keep you posted!
Posted by gadchik on April 2, 2012, at 19:22:34
In reply to Re: Anxiety medication » gadchik, posted by MelanieG on April 2, 2012, at 17:37:59
Good for you,Melanie,give the xanax a chance,we are lucky we have meds to help.Anxiety is such a scary thing.I cant believe I put myself thru all that agony when I could have treated it.I was a stubborn fool.No more!
Posted by Phillipa on April 2, 2012, at 20:50:41
In reply to Re: Anxiety medication, posted by MelanieG on April 1, 2012, at 21:13:53
Benozs and you have made a wise choice in my opinion. Too many fear addiction. You will only take what you need to feel normal so to speak. Phillipa
Posted by Phillipa on April 2, 2012, at 21:05:50
In reply to Re: Anxiety medication » MelanieG, posted by gadchik on April 2, 2012, at 9:55:11
Gadchick great article and so on target. Phillipa
Posted by phidippus on April 3, 2012, at 19:25:31
In reply to Anxiety medication, posted by MelanieG on March 30, 2012, at 21:42:25
I suffer from severe OCD and panic attacks. I've been through many medications.
The best way to get anxiety under control is with a long acting benzodiazapine, neurontin or lyrica. Once you have something in your system a better long-term solution, like an SSRI should be started. A new one, Viibryd, is excellent for anxiety.
Sometimes it takes a trial or two...
Eric
Posted by MelanieG on April 3, 2012, at 20:06:08
In reply to Re: Anxiety medication » MelanieG, posted by phidippus on April 3, 2012, at 19:25:31
Thanks for the response - I don't think I need a longterm benzo though. I get total relief all day from one half of a .25mg of Xanax. Tiny tiny dose.
The plan is for me to take it every day - which I hadn't been doing. No need for an SSRI - I'm not depressed. So my preference is to stay with the Benzo. Reading more and more that SSRI's are not as effective for anxiety - and I've had some bad reactions to them.
Keep you all posted and thanks again.
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