Posted by torachan on March 25, 2008, at 14:50:05
In reply to GAD and Panic Disorder - new meds?, posted by mamalaw on March 25, 2008, at 14:09:36
First off, welcome to the club, unfortunately as you surely know. I'll give you my take on the state of current medicinal treatment for GAD/panic as I have about 15 years or so of experience with the disorder.
My strong belief is that the so called first line treatment option of SSRI/NRI's for GAD/panic is based upon some very suspect clinical trial results, and even with them being actually meant for depression there is also some weak clinical efficacy results, IMO. I mean, in these clinical trials, when they identify a patient as having an anxiety disorder it's likely based on subjective reports which are very unreliable. I don't believe there is any actual physiological measurement available to indicate anxiety, although for panic , heart rate and baseline muscle tension would be high.
It's been my experience that SSRI's are very stimulating, hence their effectiveness with depression, so I've always been hesitant to consider them effective for anxiety. Anxiety requires a reduction in overall brain reactivity especially in the emotional center of the brain. A general reduction in synapse firing.
Therefore, to be quite honest, the only medications that for me have proved extremely effective in accomplishing this are benzodiazepines. But of course, doctors are wary of prescribing them because of supposed addiction, but I feel you can become just as "addicted" to SSRI's. It's actually dependency, not addiction.
So, I would suggest increasing the dosage of your benzo. Of course consult with your doctor, but I'm certain he'll want to exhaust other avenues before agreeing to an increase with your benzo.
Hopefully one day something will come along to properly replace benzos for long term anxiety with less ill effects, but that day has yet to arrive, IMO.
poster:torachan
thread:819833
URL: http://www.dr-bob.org/babble/20080316/msgs/819842.html