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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 jms600 on January 14, 2008, at 12:16:27
Hi
I'm currently going through the ravages of a fairly bad bout of depression along with severe anxiety and panic.
I'm taking 45mg of Mirtazipine for my depression but it's not really helping the anxiety and panic.
I've read that low doses of antipsychotic drugs can alleviate drug resistant anxiety and panic disorder. I have taken Stelazine (Trifluoperazine) in 2mg doses several years ago which did help a little.
Has anyone else found that taking low doses of antipsychotic drugs has killed the anxiety and feelings of 'despair'? If so which are the most effective and can they be taken on a long-term basis (e.g. years)??
Thank you all for you advice and support!
Posted by bissie66 on January 14, 2008, at 13:20:52
In reply to Antipsychotic drugs for anxiety and panic, posted by jms600 on January 14, 2008, at 12:16:27
I feel for you. I've been having a hard time myself, and with the anxiety, same as you. I have a prescription for Seroquel and it has actually helped a lot to calm my mind during the day and help me sleep through the night. I hope you find something to help.
> Hi
>
> I'm currently going through the ravages of a fairly bad bout of depression along with severe anxiety and panic.
>
> I'm taking 45mg of Mirtazipine for my depression but it's not really helping the anxiety and panic.
>
> I've read that low doses of antipsychotic drugs can alleviate drug resistant anxiety and panic disorder. I have taken Stelazine (Trifluoperazine) in 2mg doses several years ago which did help a little.
>
> Has anyone else found that taking low doses of antipsychotic drugs has killed the anxiety and feelings of 'despair'? If so which are the most effective and can they be taken on a long-term basis (e.g. years)??
>
> Thank you all for you advice and support!
Posted by Phoenix1 on January 14, 2008, at 13:32:05
In reply to Antipsychotic drugs for anxiety and panic, posted by jms600 on January 14, 2008, at 12:16:27
> Hi
>
> I'm currently going through the ravages of a fairly bad bout of depression along with severe anxiety and panic.
>
> I'm taking 45mg of Mirtazipine for my depression but it's not really helping the anxiety and panic.
>
> I've read that low doses of antipsychotic drugs can alleviate drug resistant anxiety and panic disorder. I have taken Stelazine (Trifluoperazine) in 2mg doses several years ago which did help a little.
>
> Has anyone else found that taking low doses of antipsychotic drugs has killed the anxiety and feelings of 'despair'? If so which are the most effective and can they be taken on a long-term basis (e.g. years)??
>
> Thank you all for you advice and support!People really seem to like Zyprexa combined with an antidepressant for panic/anxiety/despair (I would say feelings of despair count towards depression?)
Also, Seroquel might be helpful. Avoid those old AP's if possible. They can cause some real problems in the long term.
The new APs like Zyprexa and Seroquel also have their share of side effects. I don't know much about the short term side effects other than sleepiness and lethargy. In the long term, they all CAN have serious metabolic side effect like weight gain, elevated prolactin levels, and type 2 diabetes. They also carry a small risk of causing irreversible extrapyramidal syndromes - weird movement disorders. But those risks are pretty small.
Maybe you need a different AD, or a different combo. Whether that includes an atypical AP is up to you and your doctor. There are other meds for anxiety that might work well. What have you tried besides the Mirtazapine?
I only take Seroquel at very low doses for sleep, for which it works wonders. I'm not sure how good it would be for my anxiety. That is treated with Nardil and Klonopin.
Hope this helps,
Phoenix1
Posted by Phillipa on January 14, 2008, at 13:44:06
In reply to Re: Antipsychotic drugs for anxiety and panic » jms600, posted by Phoenix1 on January 14, 2008, at 13:32:05
Phoenix l great answer I've read the same thing too instead I use valium. But xanax has slight antidepressant properties. I didn't have a problem escalating dose or weaning off xanax. Love Phillipa
Posted by garyengelm on January 14, 2008, at 16:06:16
In reply to Antipsychotic drugs for anxiety and panic, posted by jms600 on January 14, 2008, at 12:16:27
JMS, can you turn on your email ?
Posted by bleauberry on January 14, 2008, at 17:21:19
In reply to Antipsychotic drugs for anxiety and panic, posted by jms600 on January 14, 2008, at 12:16:27
The new atypical antipsychotics can definitely work on your symptoms, and fast. My favorite, and probably most people's favorite, is zyprexa. Others can work, but zyprexa is good ole faithful. I think the risks and side effects are overdone. I was on it for 8 years (low dose 5mg) without apparent side effects except I slept good and my weight was about 10lbs more than baseline. For me, zyprexa could totally block any anxiety or panic or nervousness in about 1 to 2 hours and last most of the next day. Seroquel also kind of worked, but in a more drugged stoned sedated kind of way.
Not sure what the synergy of zyprexa with remeron would be. Zyprexa usually does best with an ssri, especially prozac. Another good combo for depression/anxiety/panic is celexa+risperdone.
You may need a low dose ssri as a base. Not enough to create serious sexual problems or anything, but just enough to act as a base for others things to work better, and to synergize with other things.
Posted by jms600 on January 14, 2008, at 18:27:05
In reply to Re: Antipsychotic drugs for anxiety and panic, posted by garyengelm on January 14, 2008, at 16:06:16
> JMS, can you turn on your email ?
Hi garyengelm,How do can I turn my e-mail on? Is there an option on this site to do that??
I can forward you my e-mail address if that's any use?
Thanks!
Posted by Jamal Spelling on January 15, 2008, at 7:18:32
In reply to Re: Antipsychotic drugs for anxiety and panic, posted by bleauberry on January 14, 2008, at 17:21:19
Do you have any thoughts on augmenting SSRIs with low doses of older neuroleptics?
Posted by Phoenix1 on January 15, 2008, at 8:23:48
In reply to Re: Antipsychotic drugs for anxiety and panic » bleauberry, posted by Jamal Spelling on January 15, 2008, at 7:18:32
> Do you have any thoughts on augmenting SSRIs with low doses of older neuroleptics?
Hi Jamal,
What is the rationale for this approach? I've been on it, and all I can say is that the old school AP made me very, very uncomfortable, on top of the general unwell feeling SSRI's cause for me personally. Akathisia I think they call it? Seems like the atypical Zyprexa + an SSRI is a more common. (and probably more comfortable) approach.
Phoenix1
Posted by garyengelm on January 15, 2008, at 15:51:59
In reply to Antipsychotic drugs for anxiety and panic, posted by jms600 on January 14, 2008, at 12:16:27
forgot how to turn on babble mail, but just send me and email to GARY1RN@YAHOO.COM
Posted by bleauberry on January 15, 2008, at 18:24:46
In reply to Re: Antipsychotic drugs for anxiety and panic » bleauberry, posted by Jamal Spelling on January 15, 2008, at 7:18:32
> Do you have any thoughts on augmenting SSRIs with low doses of older neuroleptics?
I don't have any personal experience with the older ones. I have read a lot about them, that's all. The risks are higher, in terms of movement disorders or neurological disorders. Of all the old ones there is one stand-out that was recommended in a major psychiatric book. It is trifluoperazine? Not sure of the spelling. In low doses it is similar to amisulpride.
The new ones such as zyprexa, seroquel, risperdal, amisulpride have fewer side effects and fewer risks with equal or greater benefit compared to the old ones.
Posted by Jamal Spelling on January 16, 2008, at 1:09:35
In reply to Re: Antipsychotic drugs for anxiety and panic » Jamal Spelling, posted by Phoenix1 on January 15, 2008, at 8:23:48
> What is the rationale for this approach?
Just curious. Thanks for the information.
Posted by Jamal Spelling on January 16, 2008, at 1:10:21
In reply to Re: Antipsychotic drugs for anxiety and panic » Jamal Spelling, posted by bleauberry on January 15, 2008, at 18:24:46
Posted by Dr. Bob on January 19, 2008, at 12:47:38
In reply to Re: Antipsychotic drugs for anxiety and panic, posted by garyengelm on January 15, 2008, at 15:51:59
> forgot how to turn on babble mail
See:
http://www.dr-bob.org/babble/faq.html#babblemail
Bob
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