Posted by yxibow on May 9, 2006, at 14:41:17
In reply to Which comes first, anxiety or depression?, posted by UgottaHaveHOPE on May 9, 2006, at 12:56:14
> The pdocs keep saying its like flip sides of a coin. But how do you know which one is your primary? And do you take meds for your primary or both?
Aye, there's the rub, said Shakespeare.
When I didn't have this complicated ** of a disorder, I had dysthymia (least depressive of conditions) and some social phobia, homesickness, and various other things that contributed to anxiety feelings.
This is the big cointoss of SSRIs -- only the most sedating would probably treat both -- Luvox, and possibly Paxil. Otherwise, and one may discover neither of those two also do the same, the only combination is really an SSRI + a small dose of long acting benzodiazepine such as Klonopin (some find depressing) or Valium or possibly Ativan.
Otherwise, its a chase trying to treat both at the same time. I agree its a big problem, especially if you are not an SSRI responder. Then you probably need more stimulating things like Cymbalta or Effexor or whatever and the dose of benzodiazepine has to be even more.
A low dose of a low potency atypical like Seroquel might also be added in adjunct or instead of a benzodiazepine. If you're one of the few who responds to Buspar, that might work, though I wouldn't count on it. And then there's the gamut of AEDs -- one might respond to Neurontin or Lyrica as an adjunct to the antidepressant, but that also is a lower percentage.
just a thought-- Jay
poster:yxibow
thread:641774
URL: http://www.dr-bob.org/babble/20060504/msgs/641813.html