Posted by jms600 on December 20, 2008, at 12:17:09
In reply to Re: Cymbalta and anxiety » jms600, posted by bleauberry on December 19, 2008, at 19:37:07
Benzos, unfortunately aren't a long term option for me. Even with using them only once or so a week, I still developed a tolerance. Therefore I keep them now only for very bed episodes when I'm in deep despair.
I don't mind the 'addictive side' to them - it's the tolerance I want to avoid again. Although I need a daily anxiolytic - I also need something to fall back on as a last resort. Something that GUARANTEES me relief. If I use benzos every day, not only will I become tolerant to their beneficial effects and consequently my anxiety will get worse, but I will also have nothing to fall back on when my anxiety is severe.
I've also worked my way through every SSRI. They either didn't help much or 'pooped out'.
> There is no way to predict in any individual whether a particular drug will address their anxiety or panic disorder. Cymbalta has been shown in clinical studies to be an effective choice. But of course, it only takes 50% improvement in clinical studies to be called success, and usually only 30% to 60% of patients get there. Here and in other forums some people have found cymbalta very effective, some not. It is like anything else. Very individualistic.
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> I wonder why something like low dose Klonopin, Xanax, or Ativan hasn't been tried? Your symptoms are what those address better than anything other choices. While some doctors frown on them due to potential tolerance or addiction, they are the most commonly prescribed meds on the planet and have been for decades.
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> Did you ever consider that maybe Buspar is contributing to the symptoms? While generally effective (50% improvement in 60% of people), it does have a possible side effect of...anxiety. When Buspar is metabolized in your system, one of its byproducts is a powerful norepinephrine stimulator. For people with susceptible chemistries, that spells anxiety, not anti-anxiety.
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> The amitriptyline by itself might have worked better than with buspar.
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> In any case, doctors seem to allow patients to suffer one ssri/snri after another hoping to get lucky eventually. Sometimes years go by. All this when a respectful tactful use of low dose benzo can end the symptoms immediately.
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> Back to cymbalta, it is worth a try. But I would consider putting a low dose benzo in there right away. For anxiety, the antidepressants with the strongest/longest track records are probably celexa, paxil, lexapro, zoloft.
poster:jms600
thread:869699
URL: http://www.dr-bob.org/babble/20081214/msgs/869842.html