Posted by Leor on February 3, 2003, at 11:35:19
In reply to Re: Buspar for anxiety » Lynnae, posted by Elizabeth on June 27, 2001, at 6:57:34
Hello Elizabeth.
Just read the old post (copied below) on psychobabble and decided that I would be most grateful for any info you might have about
natural approaches to the treatment of general anxiety disorder. Many thanks for your help. Hope
that 2003 finds you in good health and good spirits.Blessings,
Leor
> Hi there.
>
> Can you describe your anxiety symptoms in more detail, like what type of thoughts you have when you are feeling anxious, and are there any triggers? Do you feel anxious all the time, or does it come in spells or attacks?
>
> Ihe reason I'm asking these questions is that there are a few different types of anxiety and the treatments are not the same for all of thems (although there is some overlap). What you described sounds more like panic disorder than any other anxiety disorder, but obviously that's not certain. I'll go ahead and tell you about treatments for panic disorder, but just be aware that this info doesn't necessarily apply to other anxiety states like generalised anxiety disorder, posttraumatic stress, social phobia, etc.
>
> > I have taken Paxil, Zoloft, and Celexa along with Ativan and another nerve pill (I can't remember it's name).
>
> Klonopin, Xanax, Valium, Librium, Serax, Tranxene, ... ?
>
> Do you remember what dose of Ativan you were taking, by any chance? Also, were you taking it on an ad-lib (or "as needed") basis, or on a regular around-the-clock schedule (e.g., thrice daily or every 6-8 hours).
>
> > Does anyone have any experience with Buspar for anxiety?
>
> I tried BuSpar (buspirone) in the typical low dose range used for mild to moderate anxiety and antidepressant augmentation: up to 45 mg/day, I think. In this dose range, it is *not* effective for panic disorder (which might be what you have), nor (by itself) for depression. In higher doses (more like 60-90 mg/day) it is effective for depression; I'm not sure about panic disorder. (60 mg or more
>
> Unlike the benzodiazepines (what you call "nerve pills," also known as "minor tranquilisers"), BuSpar takes several weeks to work. It sometimes causes increased anxiety in the beginning. It's basically an antidepressant, like most of the other ones you mentioned (Paxil, Zoloft, Celexa). The way it works is a little different, though: instead of increasing the amount of serotonin available, buspirone imitates one of the actions of serotonin. (It's thought to be what's called a "partial agonist" at type 1a serotonin receptors.)
>
> > Also, what about Effexor XR?
>
> Like the other antidepressants, it takes several weeks to work and may make you more anxious during those first weeks. Also, if you had weight problems from the SSRIs (Paxil, etc.), then Effexor may cause weight gain for you too.
>
> SSRIs and Effexor do usually work for panic disorder, but a lot of people have a very hard time tolerating them long enough (they take several weeks to work, as I mentioned). The best appproach if increased anxiety is a problem starting out is to start out at a very low dose and increase it gradually, as tolerated. It can also help to take a benzodiazepine during the time when you are waiting for the antidepressant to work. Klonopin and Xanax are probably the most effective benzodiazepines for anxiety (especially panic anxiety).
>
> Besides benzodiazepines, some other options for panic disorder are the older antidepressants -- "tricyclics" (imipramine, nortriptyline, desipramine, clomipramine) and monoamine oxidase inhibitors (Nardil, Parnate). People who have anxiety often find these more tolerable, although the newer ADs are marketed as having fewer side effects (really, they have *different* side effects). There are also two newer, non-SSRI antidepressants -- Serzone and Remeron -- that may work for panic disorder. Non-cardioselective beta blockers (such as propranolol) can also alleviate some of the symptoms, like tremor, difficulty breathing, and palpitations.
>
> Sometimes, if a person has an abnormal EEG or if more conventional treatments (like antidepressants and benzodiazepines) don't work, anticonvulsants may be used. Depakote and Neurontin seem to work for true panic disorder as well as for some types epilepsy; Tegretol may be preferable for people who have temporal lobe epilepsy that manifests as panic-like attacks. Panic-like epilepsy is unusual, but not unheard of, and it should be considered if the usual treatments don't work. There are a few other conditions that can mimic panic disorder, such as asthma and cardiac arrhythmias, and these should be ruled out, especially if you are considering a tricyclic antidepressant or a beta blocker.
>
> I hope this helps. Don't get discouraged: there are lots of different approaches to anxiety, as you can see; you just have to keep trying stuff until you find what works for you. (If you're interested, I can also tell you about a few different non-medical approaches. These tend to be less reliable, in my opinion, but they are often very helpful, especially if used with medication.)
>
> -elizabeth
poster:Leor
thread:13781
URL: http://www.dr-bob.org/babble/20030130/msgs/139113.html