Posted by mattdds on January 11, 2003, at 6:47:36
In reply to Lexapro v. Buspar, posted by jesus on January 11, 2003, at 1:27:04
Jesus,
For me, and so many others on this board, SSRI's like Lexapro didn't work to get rid of panic attacks and anxiety. For me, they had an effect of making my panic symptoms worse. This may have been OK, if I had gotten a decent elevation in mood, but the truth is that I didn't.
Most pdocs will tell you that 6 weeks is an appropriate trial length for a drug, to give it a fair chance to start working. So you will probably have a fairly good idea by now of how this drug is going to work out for you.
You asked if there is anything that worked better. Absolutely. For me, high potency benzodiazepine drugs like Klonopin and Xanax are vastly superior to antidepressants for anxiety and especially panic anxiety. I know that in a lot of studies, SSRI's aren't much better than placebo for panic, and can often worsen it. The response rate is something like 30-50%, which really is not that great. Sometimes, if you give people placebo (sugar pills), roughly 30-50% get better, which is interesting to me. I think probably 75% or better respond to benzodiazepines like Klonopin for panic. I suspect that if patients were properly selected for panic symptoms, and adequate dosages were used, this number would approach 100%.
I think Viridis, who posts here, takes Adderall and Klonopin together with quite a bit of success, and his symptoms sound a lot like yours.
Also, CBT (cognitive-behavioral therapy) has a very good success rate with panic disorder, with about 75% of people ending up with little or no panic symptoms after treatment. You should definitely give that a trial in your treatment plan. CBT alone reduced about 70% of my panic and anxiety symptoms. Klonopin as needed wipes out the remaining 20-30% of "residual" anxiety.
So, in short, the "big guns" against panic are the benzodiazepines and CBT, both of which offer about a 75% chance of wiping out your panic attacks. Panic disorder is probably believed by many pdocs (who know how to treat it) to be one of the most readily treatable psychiatric conditions, so you are lucky. With a judicious combo of benzos and CBT, I rarely have panic attacks anymore, maybe once a year. Also, after treating the panic, nearly all of my secondary depression went away. I would mainly get depressed about anxiety.
So ask your pdoc about those things, as they really represent the standard of care, rather than antidepressants, which have IMO very limited chance of succeeding. The research, at least for panic disorder, really shows that CBT and benzos (or both, ideally) really are the way to go to get good relief.
Best of luck!
Matt
p.s. I am surprised that your pdoc prescribed Wellbutrin before, as that drug tends to lower the anxiety and seizure threshold, and you mentioned that you get both of these. In other words, it makes it easier for you get anxious and have a seizure. Wellbutrin was a terrible experience for me. No mood improvement, but my anxiety was unbearable!
poster:mattdds
thread:135271
URL: http://www.dr-bob.org/babble/20030106/msgs/135299.html