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Author Topic: Concerns about medicine  (Read 180 times)

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Offline LawlietShoujo

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Concerns about medicine
« on: March 05, 2014, 02:54:48 AM »
Hi, guys!
I'm 18, and I've been struggling with GAD for quite some time now. My psychologist never mentioned anything about me getting medicine for my anxiety, but then again, my treatment was interrupted a month after it started, due to financial issues. But regardless, my family doesn't want me to take any medicine for this particular issue. The thing is, a lot of people have recommended it to me.
I do, however, have two major concerns in regards to this topic. First off, I fear addiction. I read somewhere that with time people need to start taking stronger medicine each time and eventually they cannot function without it. Secondly, I fear that they might not work with me, y'know? Because even though I don't wanna take medicine, I have a lot of faith in it and think it'd help me deal with my anxiety more smoothly, so I fear giving in, taking the medicine, only to have failure as a result. What do you guys think? Do you take medicine? Does it work? Do you fear addiction?
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Offline insights

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Re: Concerns about medicine
« Reply #1 on: March 05, 2014, 06:12:26 AM »
I'm 18, and I've been struggling with GAD for quite some time now. My psychologist never mentioned anything about me getting medicine for my anxiety, but then again, my treatment was interrupted a month after it started, due to financial issues. But regardless, my family doesn't want me to take any medicine for this particular issue.

So how do they propose your disorder be treated? And it does need to be treated as it is probably not just going to go away. Indeed, the longer it is left to fester the harder it will become to resolve.

Quote
First off, I fear addiction. I read somewhere that with time people need to start taking stronger medicine each time and eventually they cannot function without it.

None of the meds used to treat anxiety disorders are addictive, but most do cause dependence which means you will have to wean off them slowly if you decide to stop taking them. Addiction and dependence are not the same thing, perhaps best illustrated by this study: Hirschowitz BI, 1998. It is unlikely that anyone taking antidepressants or benzodiazepines would act as the patients in that study did if the consequences of doing so were the same.

Quote
Secondly, I fear that they might not work with me, y'know? Because even though I don't wanna take medicine, I have a lot of faith in it and think it'd help me deal with my anxiety more smoothly, so I fear giving in, taking the medicine, only to have failure as a result.


Benzodiazepines are almost guaranteed to work, however, because of the increasing reluctance of doctor to prescribe them they should no longer be considered primary, taken daily, meds for anxiety and are best used occasionally for breakthrough anxiety, IMHO.

Antidepressants are the preferred meds and can be very effective, but they don't work for everyone with only 60-70% getting enough benefit to make them worth taking. While no antidepressant is intrinsically better than any other, often one or two will be for an individual and it may take several med changes to find the best fit. You should also know that they don't work instantly, typically taking 3-12 weeks to kick-in. This is because they work by encouraging the growth of new brain cells to replace those damaged by chronic stress hormone exposure and this takes a few weeks to get underway. They may also produce unpleasant side-effects in the first few weeks, however, there are ways of moderating these though they can't be eliminated entirely.

One final point, anxiety disorders are mostly chronic conditions that vary in intensity over time, but which don't often completely go away though long remissions are possible. Neither meds nor therapy are cures, they are only treatments.

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Do you take medicine? Does it work? Do you fear addiction?

I have been taking antidepressants for panic disorder pretty much continuously since early 1987. While I have been dependent on them for all that time I have not had to increase my dose since I stabilized on my current med about 18 years ago, nor have I had a panic attack since it kicked-in.

Ian
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NOTE: I'm not a doctor, and particularly not yours, so there may be factors I'm unaware of. Therefore all advice is of a general nature and you should consult your doctor before following any of it, especially before changing med doses.

Offline LawlietShoujo

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Re: Concerns about medicine
« Reply #2 on: March 05, 2014, 06:56:21 PM »
Well, they don't really propose anything. They see it as me lacking self control, something I should know how to do by now. Whenever I bring it up, they say "you're an adult, you should be over this by now". I know they mean well, I just don't think they think the disorder seriously, you know? If it was something physical, they would be doing their best to help me out, but since it's psychological, they believe I can just "magically" get rid of it.
And sorry, dependence is what I meant. Thank you. I'll see if I can contact my former psychologist to talk about starting to take medication for my anxiety.
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Offline insights

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Re: Concerns about medicine
« Reply #3 on: March 05, 2014, 09:29:54 PM »
I just don't think they think the disorder seriously, you know? If it was something physical, they would be doing their best to help me out, but since it's psychological, they believe I can just "magically" get rid of it.

One of the worst things medicine has ever done is to call anxiety, depression, schizophrenia, etc, "mental" disorders. They are as physical as a broken leg.

Chronic stress hormone exposure kills brain cells in the hippocampi, inhibits new ones from growing and destroys interconnections between the hippocampi and other areas of the Limbic system, and also the frontal lobes. Those of us with anxiety and depression have hippocampi which are up to 20% smaller than in people without these disorders. Antidepressants and therapy boost hippocampal neurogenesis, encouraging the growth of new brain cells and strengthening interconnections.

Nor is this the only difference found in our brains. We also have fewer benzodiazepine-GABA complex binding sites and the ones we do have are less sensitive1. The BZD-GABA receptor complex regulates neuron excitability, slowing firing rates by increasing the negative charge of cells. Epileptics have similar BZD-GABA binding site deficits (and hippocampal atrophy) 2. There are other brain differences seen in brain scans of anxiety patients, too.

Quote
I'll see if I can contact my former psychologist to talk about starting to take medication for my anxiety.

A psychiatrist may be better. Meds are their specialty.

Ian


References:

[1]
Hasler G, Nugent AC, Carlson PJ, et al. (2008)
Altered cerebral gamma-aminobutyric acid type A-benzodiazepine receptor binding in panic disorder determined by [11C]flumazenil positron emission tomography.
Arch Gen Psychiatry. Oct;65(10):1166-75 (Abstract)

Geuze E, van Berckel BN, Lammertsma AA, et al. (2007)
Reduced GABAA benzodiazepine receptor binding in veterans with post-traumatic stress disorder.
Mol Psychiatry. 2008 Jan;13(1):74-83 (Abstract)

Cameron OG, Huang GC, Nichols T, et al. (2007)
Reduced gamma-aminobutyric acid(A)-benzodiazepine binding sites in insular cortex of individuals with panic disorder.
Arch Gen Psychiatry. Jul;64(7):793-800. (Abstract)

Bremner JD, Innis RB, Southwick SM, et al. (2000)
"Decreased benzodiazepine receptor binding in prefrontal cortex in combat-related posttraumatic stress disorder."
Am J Psychiatry Jul; vol 157(7):1120-6 (Abstract)

Bremner JD, Innis RB, White T, et al (2000)
"SPECT [I-123]iomazenil measurement of the benzodiazepine receptor in panic disorder."
Biol Psychiatry  Jan 15; vol 47(2):96-106 (Abstract)

Malizia AL.  (1999)
"What do brain imaging studies tell us about anxiety disorders? "
J Psychopharmacol Dec; vol 13(4):372-8 (Abstract)

Morimoto K. 1999
Benzodiazepine receptor imaging in the brain: recent developments and clinical validity
Kaku Igaku. May;36(4):307-13. (Abstract)

Malizia AL, Cunningham VJ, Bell CJ, et al. (1998)
"Decreased brain GABA(A)-benzodiazepine receptor binding in panic disorder: preliminary results from a quantitative PET study."
Arch Gen Psychiatry Aug; vol 55(8):715-20 (Abstract)

Tokunaga M, Ida I, Higuchi T, Mikuni M. (1997)
"Alterations of benzodiazepine receptor binding potential in anxiety and somatoform disorders measured by 123I-iomazenil SPECT."
Radiat Med May-Jun; vol 15(3):163-9 (Abstract)

Uchiyama M, Sue H, Fukumitsu N, et al. (1997)
"Assessment of cerebral benzodiazepine receptor distribution in anxiety disorders by 123I-iomazenil-SPECT: comparison to cerebral perfusion scintigraphy by 123I-IMP."
Nippon Igaku Hoshasen Gakkai Zasshi Jan; vol 57(1):41-6 (Abstract)

[2]

Vivash L, Tostevin A, Liu DS, et al. (2011)
"Changes in hippocampal GABAA/cBZR density during limbic epileptogenesis: relationship to cell loss and mossy fibre sprouting."
Neurobiol Dis. Feb;41(2):227-36. (Abstract)

Morimoto K.  (1999)
"Benzodiazepine receptor imaging in the brain: recent developments and clinical validity."
 Kaku Igaku May; vol 36(4):307-13 (Abstract)

Savic I, Pauli S, Thorell JO, Blomqvist G. (1994)
"In vivo demonstration of altered benzodiazepine receptor density in patients with generalised epilepsy."
J Neurol Neurosurg Psychiatry. Jul;57(7):797-804. [Abstract]
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NOTE: I'm not a doctor, and particularly not yours, so there may be factors I'm unaware of. Therefore all advice is of a general nature and you should consult your doctor before following any of it, especially before changing med doses.

Offline LawlietShoujo

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Re: Concerns about medicine
« Reply #4 on: March 05, 2014, 09:34:50 PM »
I'll keep that in mind! Thank you a lot.
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