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Offline Natsab87

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Suggestions for anxiety medication
« on: August 26, 2014, 04:32:39 AM »

So I have been posting here alot recently with regards to my struggle with health anxiety and just generally feeling on edge. I have tried CBT and didn't really find it useful, mainly because I think I am quite strong willed and the negative side of me is very overpowering and I am having trouble 'training' my brain to think in a positive way. Right now I am anxious re health issues i.e. headaches, heart palpitations and general lethargy and lack of 'get up and go'. I wonder if anyone can recommend any medications they feel might help me.

I feel like i'm in a bubble a lot of the time, i'm tripping over my words, i'm having tension headaches, palpitations, diziness, aching shoulders and neck, fatigue and generally no inclination to do anything!

I don't want to be on medication but after nearly a year of feeling this way, I feel now might be the time but I am terrified of the side effects I might experience with medications. I eat a healthy diet, lots of water, I generally sleep well (barring lastnight as dog sitting so had three hours sleep!!). I haven't exercised in a month now because of the fear of something bad happening, having a headache most of the time and having NO energy.

Can anyone recommend something mild that might help relax me but that doesn't have too severe side effects? I doubt anything exists but I thought it might be worth asking!!

Thanks in advance  :fragend005:
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Offline insights

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Re: Suggestions for anxiety medication
« Reply #1 on: August 26, 2014, 05:16:58 AM »
Can anyone recommend something mild that might help relax me but that doesn't have too severe side effects? I doubt anything exists but I thought it might be worth asking!!

The closest to what you're asking for would be Buspar (buspirone) which is sometimes effective for GAD, but it only works well for a few. There are also the benzodiazepines which are very effective anti anxiety meds with few side-effects, often just some drowsiness in the first few weeks. But more and more doctors are unwilling to prescribe them because of the dependency issue which can make them risky primary meds in some places.

However, I think your best shot might be an antidepressant because some of what you write suggests depression may also be an issue. All antidepressants may produce side-effects in the beginning, some may also have ongoing ones. Most people have either none or only mild side-effects, but they can be severe for a few. The best way of dealing with this is to start on a small dose and gradually increase it by small increments until the initial target dose is reached. The two antidepressants with generally the best side-effects profile are Celexa (citalopram) and Lexapro (escitalopram). They both contain the same active chemical, Celexa also contains a mostly inactive form of it, however, because this gives it a wider dose range it is the one I suggest you try first should you decide to try antidepressants.
Other things that may help some are fish oil capsules and moderate exercise. Both work by the same mechanism as antidepressants, but are less potent so probably won't be the complete answer.

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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 suggestions are general in nature and you should consult your doctor before following any of it, especially before changing med doses.

Offline Never-Quit

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Re: Suggestions for anxiety medication
« Reply #2 on: August 26, 2014, 05:04:12 PM »
Hi  :action-smiley-065:

Here are my two cents  :twocents:

If you are only trying to treat anxiety,GAD  (not Depression, or OCD) - Benzodiazepine Therapy  is by far the most effective and fastest treatment available. 

If you have Depression, or OCD - along with Anxiety/GAD - then SSRI/AD Therapy is the most effective therapy in the long run.

Using BZD Therapy

Among the BZD I have used - Xanax, Lorazepam, diazepam, Klonopin,  - IME of 20 years - Klonopin is the best for the Anxiety and Panic Disorder - and it works best when used daily - usually before bedtime.  Klonopin (is not very effective for me, when I used it as PRN (as needed) it works best when taken daily, it appears to become more effective at the same dosage over time.  Found very effective of quickly controlling my GAD and panic attacks.

I have used Klonopin for at several years and consider this the best BZD for Anxiety and Panic Attacks:
1) Potency
2) long-half life - can last 24 hours in your system - blocking any anxiety or panic attacks BEFORE they occur.
3) Easy discontinuation - I have tapered off and on - without any difficulty when working with my dr.
4) No Tolerance Issues - This is the one medication were -  I actually started using lower dosage in long term therapy.

Using BZD therapy - will avoid the multiple side effects and weight gain of the SSRIs and AD and you will not need to wait 4-12 weeks to see results, I noticed results within a couple of days  :yes:

SSRI/AD Therapy

The best and easiest to tolerate SSRI - I have actually taken with good results is Celexa - this is from among 10+ AD and SSRI I have taken.

Whichever SSRI or AD you select - My only recommendation to help you get through the first 2 weeks of side effects is to make sure your Doctor also prescribes a small dose of a benzodiazepine.  Most SSRI and AD I have taken have given me an "Anxiety Spike" as a temporary side effect, that can be controlled by BZD - until the SSRI kicks in - which is going to be 4-12 weeks (which is unfortunately a long time  ::) )

My doctor explained to me that "Combination Medication Therapy*" would accomplish the following:

1.   My doctor used both an Antidepressant/SSRI and a low dose of Benzodiazepine - which really helped me immensely. :yes:

2.   My doctor explained that the Antidepressants will take up to 4 to 8-12 weeks  ::) to begin relieving anxiety symptoms and in some people if used alone - it can actually increase anxiety initially during the first few weeks  (as It did with me…) .  Which is one reason I had such a hard time staying on antidepressant.

3.   My doctor, further explained to me that the benzodiazepines are fast acting anxiety blockers (bringing me relief within 30-60 minutes) to stop my Panic Attacks caused by a Panic Disorder, and could also  help shield me from additional anxiety that may initially arise from the SSRI or Antidepressant that I was taking (Prozac) . :happy0151:

You may want to ask your doctor about this, It really made a world of difference for me!  :grinning-smiley-003:

Remember, the benzodiazepine is to help you stay on your SSRI by offsetting the side effects - so you can complete the full 4-12 week - that is required for these ADs and SSRI to work, and give the medication a fair trial to work! 

Also, you are NOT REQUIRED to take the benzodiazepine if you don't need it or want it, It is just nice to have it available if needed- to ensure you stay on your SSRI/AD for the next 4-12 weeks.

*Combination Medication Therapy -
The strategy is to hold the individual on low-dose benzodiazepines (e.g., alprazolam 0.25 to 0.5 mg tid or qid plus antidepressant) for four to eight weeks. When the patient's panic has abated and antidepressant levels are adequate, the benzodiazepine can be slowly withdrawn.

As always, discuss this with your doctor on what is the best and most appropriate treatment for you  :yes:

Hope that sharing my experience helps, please feel free to ask me any questions or concerns.

Good Luck  :action-smiley-065:

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