Posted by Cam W. on February 17, 2000, at 7:31:29
In reply to Re: Drug Interactions and Anxiety, posted by bob on February 16, 2000, at 22:24:16
> Hi Rick
>
> > I am new to this arena of being treated for anxiety/depression...
>
> Then remember the first lesson you already learned -- don't change your meds without talking to your doctor! That includes going off of them. If you feel they're affecting you in some adverse way, then talk to your doctor before making any decisions.
>
> For the remeron, what time were you taking it? Right before bedtime? A change in WHEN you took your meds might have worked out fine. I went through the same thing with Nortriptyline. If I take 100mg or more after 10PM (I'm on 125mg/day right now), it takes me 30 minutes and five alarms to get me out of bed by six the next morning. It was worse when I was first at that level -- I'd fall asleep literally standing on my feet, but that passed after a week or two.
>
> One other thing to remember about psychotropic meds -- some of them don't "settle in" to their therapeutic effects for a few weeks to even a month or two. Anti-anxiety agents, I imagine, are on the shorter end of that range or they wouldn't be of much use in acute situations. I take klonopin myself-- on occasions when I forget it at breakfast and my panic starts creeping in on me at noon, 1 mg and 20 minutes puts me back on an even keel
>
> The point, tho, is to stick with something and let it get to work. If it doesn't help (and doesn't hurt) then atleast you'll know you gave it an honest trial ... now, if it DOES hurt ...
>
> > ... I took the first half that day, another that evening, and another half the next day at noon, and I immediately went into some form of shock...I started shaking uncontrolably, feeling sick to my stomach, and having the absolute worst anxiety I have ever felt in my life...I was just sure that I was going to die (I obviously didnt...)
>
> That sounds like a panic attack, Rick.
>
> (It also sounds like most of my last semester as an academic ... get in to my office, close the door, shake uncontrollably for several hours (and be thankful that they give junior faculty the offices without windows) and then pull things together in time to teach, then go home.)
>
> Anyway, lovely things, aren't they? ;^)
>
> > Do ANY of these medications actually relieve the symptoms of anxiety?
>
> Well, it sounds like remeron did exactly that for you.
>
> Anyone know if remeron has any potential for rebound effects? No point going back if it won't be effective the second time around.
>
> I guess the best advice I can give you is:
>
> (1) Did you get your meds from your GP (it sounds like it)? If so (and nothing against him by it), you may want to consult a psychiatrist or a psychopharmacologist. Psychotropic meds are a completely different ballgame from antibiotics. Talk to an expert. This is particularly true if (a) this potentially traumatic event is just bringing into focus an awareness of being depressed/anxious for sometime and bringing you in to get it treated, or (b) this *potentially* traumatic event unfortunately becomes a real traumatic event.
>
> Go see an expert on psychological medications.
>
> (2) Meds aren't the only way to deal with this stuff. See a therapist! If it is the case that this is just this one event that you need to deal with, find someone who deals in short-term therapy. If you really feel fine and in control about the rest of your life and you just need to get by this event, someone who does cognitive-behavioral therapy might be best -- she could teach you how to recognize signs of heightened anxiety and give you specific techniques to help you psychologically fight back and cope with it.
>
> If you need help for a longer term, why wait another day? See a talk therapist.
>
> (3) You have a health plan? See if it supports alternative therapies. Particularly for some acute episode, approaches such as acupuncture, massage therapy, or hypnotherapy (which I've done to learn to relax, and it works great for me) could be covered as part of the plan.
>
>
> Sorry if I'm sermonizing a bit, but most of all you need to pick a plan of action and STICK TO IT if it shows some promise -- switching from one approach to another sounds like just another manifestation of your anxiety, and one that will get you caught in a feedback loop. You try something, it doesn't work immediately, you jump to something else, IT doesn't work, and you just feed the Beast more and more fuel to tie your nerves in knots. Don't become your worst enemy and skip from one idea to another -- instead, plan on getting yourself THROUGH the event and include what you'll need to do to recover from it AFTER.
>
>
> What do the folks on remeron think? Should he give it another go?
>
> my 2 cents,
> bobRick - My experience with BuSpar is that it is a good drug to test new drugs against if you want to get a new drug to market. Although I have seen some success with it, overall it has not panned out as a good anxiolytic. bob is right in saying that it does really start to work for about a month and what you were experiencing was probably the initial side effects that do decrease as your body adjusts to the drug. There is something a little sadistic about an anti-anxiety drug that can cause anxiety for the first 2 to 4 weeks of use. Perhaps give the Remeron another try, but drowsiness is a problem with it that probably will decrease. Paxil is another choice. All of these meds, like most antidepressants take a while to work. Unless you have addiction problems a short-term course of a benzodiazepine (Ativan or Rivotril/Klonapin) may help, until the antidepressant kicks in. Of course you run the risk of extra sedation, but a small prn (as needed) dose may take the edge off the anxiety.
poster:Cam W.
thread:21885
URL: http://www.dr-bob.org/babble/20000209/msgs/22019.html