Psycho-Babble Medication Thread 1093458

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Daily Panic Attacks, lyrica, valdoxan ,mirtazapine

Posted by thefan on December 7, 2016, at 18:48:43

Hi

I have panic disorder, i have had this for more then 12 years already, and i have been on lyrica for the most part of it, maybe 8 years, on a rather high dose of 750mg (150mg above max).

First when i started i was only on remeron.

Remeron was the "wonder" drug for me, which caused most of the anxious feeling go away, and worked very well in the beginning (the tiredness is what helped me), but when the "activation" part outweighted the tiredness, it failed me, and im only using 7,5mg for sleep as it is.

Azona was in the same category basicly, i mean it helped me in the beginning, with a very small dose, but it was discontinued after i stopped using clonazepam 4 years ago.

After i stopped clonazepam, i continued using lyrica, and mirtazapine , and they added valdoxan into the mix, and things have been pretty stable for the past about 4 years, but now my anxiety , and panic attacks are again trough the roof.

These minor tranquilizers like clonazepam, do not work for me at all. I mean they kind of work for a couple of days, but then no matter how much i consume i get no help from them, just awful withdrawals, i mean it took me maybe 2 months to get that poison out of me or more, with tiny tiny lowering in doses each day.

The recent feelings of doom, almost feel the same as clonazepam withdrawals felt for me, but i am kind of in the same time thinking that i dont think it is lyrica related, though it could be, but i have been using it for so many years with no issues. I mean i still kind of feel it would calm me, but i get these panic attacks nevertheless.

I have been trying all kind of ssri medications in the past, and one of them was cipramil , also tried buspar, and i think zoloft.

I have come here seeking for advice, since most of you guys know the meds so to speak, on what i could try next, and if there is some kind of hope i could find peace. The lyrica is not making the panic attacks go away , but its just helping me a bit , so that they will not go to an unbearable level, atleast that is what i think. As for me, as always when i get panic attacks, they occur several times a day, maybe around 3-5 attacks a day if not more, and can last a very long time. I think i might get even more then mentioned 3-5, it kind of feels like an ongoing panic attack at all times. Benzos are really not the long term answer and i do not think i should propably even try them since my last very bad bout with them 4 years ago, but i am really starting to be without options here.

Are there any drugs, that would help me go slower like remeron and azona (and maybe even valdoxan does, or are they all going to activate me even more, because i think the activation is what makes me go haywire even more. My current valdoxan is only at 12,5mg, and i don't really know if it is helping me or not , or maybe i should try to increase the dosage to know if i get the benefit, and then lower it if i don't get any benefit).

 

Re: Daily Panic Attacks, lyrica, valdoxan ,mirtazapine

Posted by thefan on December 7, 2016, at 18:58:32

In reply to Daily Panic Attacks, lyrica, valdoxan ,mirtazapine, posted by thefan on December 7, 2016, at 18:48:43

Forgot to say that the ssri medication has made my life always worse, because of the activation it causes, since i do not feel i am having a depression, maybe the other way around, that i am maybe too happy or something like that, hard to describe.

I mean i am not happy at all when the panic attacks come , the panic attacks do make me kind of sad and all that if they occur frequently, but they are not the main cause of issue here , so im basicly looking for some kind of "downers" rather then uppers. I tried seroquel too i think , but it did not help in anything. Truxal in small doses makes me a total zombie, so it kind of slows me down, but the panic attacks are still there, so no help there either.

I think i am constantly shaking, and it is pretty hard to breathe.

 

Re: Daily Panic Attacks, lyrica, valdoxan ,mirtazapine

Posted by rjlockhart37 on December 8, 2016, at 1:26:20

In reply to Re: Daily Panic Attacks, lyrica, valdoxan ,mirtazapine, posted by thefan on December 7, 2016, at 18:58:32

you could add an anti-convulatant to you medications, but it wouldn't really stop panic attacks, but if you took like depakote or trileptal they would have a passive calm but still you could get have a panic attack, you could look into beta-blockers - like propranolol or similar beta-blockers because they block noradrenaline causing you to feel much less on edge, and less panic mode

don't think anti-psychotics would help, they could calm your mind down but i think beta blockers and some anti-convulatant medication would work, but I am not a doctor - just my view because they do calm certain areas down that could cause over excitation (panic)

xanax xr also could help because that is the long acting-all day form of it, but if you can't take it, i would look more into off-label medications

 

Re: Daily Panic Attacks, lyrica, valdoxan ,mirtazapine

Posted by rjlockhart37 on December 8, 2016, at 14:53:58

In reply to Re: Daily Panic Attacks, lyrica, valdoxan ,mirtazapine, posted by rjlockhart37 on December 8, 2016, at 1:26:20

but also taking anticonvultants with beta blockers can make you feel tired, and spaced out, but if it's serious ask your doctor about his/her thoughts about it, but here's some quick info on beta blockers:
https://en.wikipedia.org/wiki/Beta_blocker

 

Re: Daily Panic Attacks, lyrica, valdoxan ,mirtazapine

Posted by thefan on December 8, 2016, at 21:00:09

In reply to Re: Daily Panic Attacks, lyrica, valdoxan ,mirtazapine, posted by rjlockhart37 on December 8, 2016, at 14:53:58

Hi again

I for the past 4 years i did not have any symptoms or panic attacks, just the calm feeling when on lyrica.

Now i kind of feel the same, but not as strong as before, meaning about an hour later when i take one 150mg dose of lyrica, i feel fine for a couple of hours, and then the havoc starts again (panic attacks).

I do not know if it psychological, that the panic attacks are less after the dose, i mean it might well be, but your recommendation of depakote is not vefy far fetched, since it might really help my panic symptoms, and it is somewhat similar to lyrica, even though the mechanism of action is a bit different, from what i have read about it.

However, i was wondering, if i do try depakote can i take it while i am also taking lyrica, or should i somehow switch my lyrica to depakote (and if , how exactly should i do that).

 

Re: Daily Panic Attacks, lyrica, valdoxan ,mirtazapine

Posted by rjlockhart37 on December 8, 2016, at 22:23:28

In reply to Re: Daily Panic Attacks, lyrica, valdoxan ,mirtazapine, posted by thefan on December 8, 2016, at 21:00:09

lyrica is good for anxiety, its an off label med somtimes used by doctors, i've been on it for a period and also nuerontin, if you took depakote it would cause some sedation and maybe calmness with nerves.......how i view panic attacks is first a onset that causes release of electricical stimulation and then tons of epinephrine along with panic nuerotransmitters, you could add depakote to lyrica but it's may just delay panic or anxiety, not totally treat it like a benzo does, but it does increease GABA trasnmission in the brain, just not the direct way that benzo's do....it's more for reducing electric voltage that causes siezures (and also can reduce anxiety by doing that) but still you may ask about adding depakote or trileptal to your regimen

but still ask about long acting propranolol, the exteneded release version, it could work for a long period and prevent over excitation

depakote would increase lyrica's effect

 

Re: Daily Panic Attacks, lyrica, valdoxan ,mirtazapine thefan

Posted by Horse on December 11, 2016, at 18:03:46

In reply to Re: Daily Panic Attacks, lyrica, valdoxan ,mirtazapine, posted by thefan on December 8, 2016, at 21:00:09

My first thought is that you need a thorough workup if you haven't had a recent one or a second opinion. Anxiety is one way bipolar illness manifests, at least for me, so consider my view here a bit biased. Something else you described was having an adverse (activating) reaction to ssri's. This response could be the basis for a bipolar spectrum diagnosis.

I take Lyrica for anxiety as well, and panic attacks can still occur. I don't find that it helps with that kind of anxiety. Nothing beats xanax, but I'm off that class of meds, too.

Still, if you are experiencing that level of anxiety, you need a consultation with an expert if you can afford or find one. Other issues can create anxiety, like the years before menopause did for me, but I imagine you know this.

I take lamotrigine (lamictal) along with 400-600 Lyrica, and the combination helps considerably.

 

Re: Daily Panic Attacks, lyrica, valdoxan ,mirtazapine

Posted by thefan on December 12, 2016, at 17:23:49

In reply to Re: Daily Panic Attacks, lyrica, valdoxan ,mirtazapine thefan, posted by Horse on December 11, 2016, at 18:03:46

Yeah, i spoke to a pdoc today, and he said that lamictal and depakote are possibilities for me to take with lyrica, but did not write them for me yet, maybe because i am also thinking about the possibility here, that time could take the recurring panic attacks away (have had this before, that the attacks only happened daily for a few weeks), so i have not started any extra medication yet.

You know when you get these attacks about every day like i do at the worst, times it feels like a never ending cycle, that will just go on and on and on, and then you come to these forums, to try and find instant help to your condition. I actually think i am a bit better today, but it has been like this for a few days, that i get very bad days, and a bit better ones in between.

Normally im actually really calm, and do well with my lyrica, half a pill of valdoxan, and 7,5mg of mirtazapine), this has basicly become the normal me because of pretty long uses with all of these drugs. I kind of thought that it could be that lyrica had run its course, and its the withdrawal symptoms from that which are causing me to have these symptoms, but after further evaluation, i highly doubt it since it has helped me for nearly a decade already. The attacks just started to happen ouf of the blue so to speak.

He wrote to me a script of 5mg zyprexa to take if i cant sleep (which has been really f*ck*d up lately), and i dont want to go back on the benzos, because they really can make a persons life even more bad. I have avoided them , since my last withdrawal 4 years ago. I mean i am not saying everyone should stop taking them, i mean for some people they work for decades even, but for me they worked for maybe a week, and then i was just dependent on taking them. I think it must be just the way im built or something.

I mean the possibilities for my little bit calmer mood, might be that i took maybe 100mg of atarax (hydroxyzine or something, and a tab or two of clonidine) besides my normal medication.

If i do start to take some new medication, which should i consider first, regarding the side effects and everything, lamictal or depakote?

I have been having these pretty strange physical symptoms like trembling / shaking, and a very tight chest, so maybe the clonidine is also helping a bit atleast regarding the sweating and all.

So regarding the most important question, thorough work up! Which tests do you guys think would fit the profile for anxiety? Thyroid, asthma, something else? I think i would wan't to have some say in what they test me for . Last work up was done 16 years ago ;).

 

Re: Daily Panic Attacks, lyrica, valdoxan ,mirtazapine

Posted by thefan on December 13, 2016, at 15:38:11

In reply to Re: Daily Panic Attacks, lyrica, valdoxan ,mirtazapine, posted by thefan on December 12, 2016, at 17:23:49

Blah, today has not been really good, slept pretty well only waking about 2-3 times, so it was a plus, but after i woke up omg what anxiety. Almost feel like the more i have rested the more anxious and manic/panic i feel. Thoughts are racing really often.

About lyrica. Would i know somehow if it has stopped helping, or if it still is really helping me even though i have panic attacks and restlessness. I mean i think i feel pretty good, and my spirits are up even though i have panic attacks and tremble/shake all the time. Its just so strange how i can feel good and bad at the same time if you know what i mean? ;)

Now that you guys pointed out the possibility of mania , i think it could actually fit the description pretty well, considering i felt pretty damn good and almost invincible a few weeks before this "meltdown" happened, and i could manage well with less sleep sleeping on average about 5-6 hours a night. Also my circadian rhythm is really f'ed up i mean i sleep at about 6am to 2pm, i think that is also something i should fix? And maybe that is the reason the andidepresasnts at normal doses make my mind go really crazy.

Anyway regarding a full work up, what tests should be taken ? Any ideas about that?

I am a male (38 years old).

 

Re: Daily Panic Attacks, lyrica, valdoxan ,mirtazapine

Posted by rjlockhart37 on December 13, 2016, at 19:15:10

In reply to Re: Daily Panic Attacks, lyrica, valdoxan ,mirtazapine, posted by thefan on December 13, 2016, at 15:38:11

you could havae your thyroid tested, people with hyperthyroid have problems with anxiety, on the edge all the time, over active adrenal glands....simple blood tests i don' think will bring much evidence, there's of course the psychical CAT/MRI scans but those don't really scan the nervous system

if you started depakote, it will produce minor sedation but what depakote does is basically lower the electrical voltage in the brain, it could theoretically help anxiety, but still anxiety is more than electrical firing, its nuerotransmitters and deregulation......
mania can pleasant and unpleasant, i know exactly what it feels like.....you going and your "on" but at the same somewhere there's dysphoria, benzo's are the obvious treatment, but a beta blocker and anticonvulant and lyrica could help this.....

i would ask your doctor just in case to get a thyroid test, people who have low thyroid (hypotension) have low energy and difficult to get goingif it's over active that's why on edge and shaky......

 

Re: Daily Panic Attacks, lyrica, valdoxan ,mirtazapine

Posted by rjlockhart37 on December 13, 2016, at 19:21:31

In reply to Re: Daily Panic Attacks, lyrica, valdoxan ,mirtazapine, posted by rjlockhart37 on December 13, 2016, at 19:15:10

https://www.urmc.rochester.edu/encyclopedia/content.aspx?ContentTypeID=85&ContentID=P00403

over-active adrenal glands can cause high anxiety and blood pressure too....overactive meaning your stressed out all the time when there's nothing to be stressed about (cortiol levels increase)

still explore more options for testing, and medications

 

Re: Daily Panic Attacks, lyrica, valdoxan ,mirtazapine

Posted by thefan on December 14, 2016, at 14:06:15

In reply to Re: Daily Panic Attacks, lyrica, valdoxan ,mirtazapine, posted by rjlockhart37 on December 13, 2016, at 19:21:31

Ok, i am going to get those tests done. Also if someone has any other thoughts on what could be tested then thyroid , please let me know.

Do antipsychotics like olanzapine also raise the levels of serotonin in the brain? Im feeling pretty strange on the olanzapine, i mean i just took first 5mg, and i kind of feel that it is maybe calming me down a little, but it feels like taking a benzodiazepine, im seriously thinking that there is some binding to the bzd receptors on olanzapine , because there is this calm that comes over me, and lasts for an hour or two upon taking it, maybe it has something to do it being a thienobenzodiazepine. And regarding reading peoples comments on how hard it is to stop, i think i will propably stop taking it alltogether, and find a safer option meaning depakote or lamictal. My doc actually said that he think that lamictal is better of the two, but it takes longer to start acting.

Today has been such a strange day too, i mean at one moment i am desperate, the second im apatchic, the third im extremely happy, almost euphoric meaning i feel kind of too happy. Almost the same feeling when i took some ssri, it made me feel horrible AKA too happy, i just could not take the feeling, and thats why i only use 5-7,5mg mirtazapine for sleep. Im maybe dropping valdoxan, maybe it is making me "too happy" , other possibility is my pretty high dose of lyrica, or olanzapine, thats why i wanted to know if it has some effect similar to ssri's, even though it should not be notable since i have only used it for a day at 5mg. Kind of scared to use olanzapine, after reading peoples comments, on how hard it is to withdraw, and regarding my previous history of benzodiazepine withdrawal, i mean i became highly addicted to them in only a few weeks of use. Both physical and psychological, i think its pretty rare, but happened to me.

 

Re: Daily Panic Attacks, lyrica, valdoxan ,mirtazapine

Posted by rjlockhart37 on December 17, 2016, at 23:42:31

In reply to Re: Daily Panic Attacks, lyrica, valdoxan ,mirtazapine, posted by thefan on December 14, 2016, at 14:06:15

not sure.....i take zyprexa (olanzipine) and yes i have noticed it's improvement effects in depression, along with fluoxetine it has defeintly been a improvement, it's kinda like california rocket fuel but it's calming and antidepressant effect, Zyzac (zyprexa, prozac) i guess you could call it

everything just seems calm and stable, with me it does, other people can have other reactions and feel impaired....but one thing about olanzipine is it's significant weight gain side effect, like you have excerise more to keep the weight off, sometimes zyprexa can be used occasionally, you could have another antipsychotic like abilify or geodon and keep zyprexa handy when you feel manic and irrtible, that would keep the weight gain off......

not sure how it works in the receptors in the brain, maybe it does stimulate a serotonin receptor, but mainly its a blocker of serotonin and dopamine, yet has proactive effects

 

Re: Daily Panic Attacks, lyrica, valdoxan ,mirtazapine

Posted by thefan on December 18, 2016, at 17:50:25

In reply to Re: Daily Panic Attacks, lyrica, valdoxan ,mirtazapine, posted by thefan on December 14, 2016, at 14:06:15

I tried zyprexa, but the problem with it was that it felt like i was taking a benzo. I think it is because it is listed as thienobenzodiazepine. It somehow affects the gaba aswell. I have heard its a good drug for mania, but i really think there is more to it, i mean i think it may also cause dependency.

 

Re: Daily Panic Attacks, lyrica, valdoxan ,mirtazapine

Posted by chumbawumba on January 13, 2017, at 3:18:02

In reply to Daily Panic Attacks, lyrica, valdoxan ,mirtazapine, posted by thefan on December 7, 2016, at 18:48:43

> Hi
>
> I have panic disorder, i have had this for more then 12 years already, and i have been on lyrica for the most part of it, maybe 8 years, on a rather high dose of 750mg (150mg above max).
>
> First when i started i was only on remeron.
>
> Remeron was the "wonder" drug for me, which caused most of the anxious feeling go away, and worked very well in the beginning (the tiredness is what helped me), but when the "activation" part outweighted the tiredness, it failed me, and im only using 7,5mg for sleep as it is.
>
> Azona was in the same category basicly, i mean it helped me in the beginning, with a very small dose, but it was discontinued after i stopped using clonazepam 4 years ago.
>
> After i stopped clonazepam, i continued using lyrica, and mirtazapine , and they added valdoxan into the mix, and things have been pretty stable for the past about 4 years, but now my anxiety , and panic attacks are again trough the roof.
>
> These minor tranquilizers like clonazepam, do not work for me at all. I mean they kind of work for a couple of days, but then no matter how much i consume i get no help from them, just awful withdrawals, i mean it took me maybe 2 months to get that poison out of me or more, with tiny tiny lowering in doses each day.
>
> The recent feelings of doom, almost feel the same as clonazepam withdrawals felt for me, but i am kind of in the same time thinking that i dont think it is lyrica related, though it could be, but i have been using it for so many years with no issues. I mean i still kind of feel it would calm me, but i get these panic attacks nevertheless.
>
> I have been trying all kind of ssri medications in the past, and one of them was cipramil , also tried buspar, and i think zoloft.
>
> I have come here seeking for advice, since most of you guys know the meds so to speak, on what i could try next, and if there is some kind of hope i could find peace. The lyrica is not making the panic attacks go away , but its just helping me a bit , so that they will not go to an unbearable level, atleast that is what i think. As for me, as always when i get panic attacks, they occur several times a day, maybe around 3-5 attacks a day if not more, and can last a very long time. I think i might get even more then mentioned 3-5, it kind of feels like an ongoing panic attack at all times. Benzos are really not the long term answer and i do not think i should propably even try them since my last very bad bout with them 4 years ago, but i am really starting to be without options here.
>
> Are there any drugs, that would help me go slower like remeron and azona (and maybe even valdoxan does, or are they all going to activate me even more, because i think the activation is what makes me go haywire even more. My current valdoxan is only at 12,5mg, and i don't really know if it is helping me or not , or maybe i should try to increase the dosage to know if i get the benefit, and then lower it if i don't get any benefit).
>

A longer acting benzo like Valium will give you less heartache in the long run because it's got such a long half life your blood levels won't fluctuate as much from day to day and should you decide to quit it is to an extent self tapering. Don't know why Doctors have such a hard on for Klonopin. Seems like these short acting, high potency benzos cause a lot of grief.

But other than that the antihistamine Hydroxyzine is frequently used in people who do not want to take benzos.

In terms of sedating antidepressants, besides Remereon there are also Trazodone and Doxxepin. Sometimes very small doses can be added to your rexisting regime just to promote sleep.

Seroquel is also commonly used to augment antidepressants and at low doses acts more like a very strong antihistamine, like Benadryl on steroids. A dose of 50-100mg is usually very sedating and can boost the effectiveness of your other medicatioss.

 

Re: Daily Panic Attacks, lyrica, valdoxan ,mirtazapine

Posted by Lamdage22 on July 27, 2017, at 9:17:34

In reply to Re: Daily Panic Attacks, lyrica, valdoxan ,mirtazapine, posted by chumbawumba on January 13, 2017, at 3:18:02

zyprexa is hard to come off of, thats for sure. I once was at 25mg. Back to 20 and some time soon i am going 19. 5% steps


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