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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 13 of 13. This is the beginning of the thread.
Posted by jms600 on May 18, 2008, at 8:12:52
Hi everyone
Can anyone please make some some recommendations for a good anti anxiety medication where other mainstream drugs have failed??
Each time I go back to my psychiatrist he complains that I've tried everything and he can't think of much else to try.
I'm currently on Stelazine (Trifluoperazine) but it isn't having much effect on my anxiety. Also taking Cipralex 20mg per day.
Apart from the above two drugs I've also been on:
Seroxat
Prozac
Lustral
Effexor
Remeron
Zyprexa
Seroquel
Amisulpride
PromazineI'm also taking Valium on an as needed basis - which is quite a lot considering how bad my anxiety is!
Can anyone give me some idea of what I can ask my psychiatrist to try me on as he doesn't seem to have a clue!
Thanks for your help everyone!
Posted by Phillipa on May 18, 2008, at 10:29:52
In reply to Treatment resistant anxiety, posted by jms600 on May 18, 2008, at 8:12:52
Maybe a second opinion. What is your diagnosis. Hope some of the experts answer your thread. Have you tried klonopin? Some say it is stronger. Love Phillipa
Posted by ncrainbow on May 18, 2008, at 12:19:24
In reply to Treatment resistant anxiety, posted by jms600 on May 18, 2008, at 8:12:52
Please excuse bad spelling----
I do not know a lot about some of the newer meds you listed but from my layperson's eye, it seems you have only tried one traditional (old school) SSRI. In clinical trials, SSRI's are often very effective against anxiety for long term relief.
I had tremendous anxiety about 8 years ago, including debilitating panic attacks and frequent anticipatory anxiety. I was tapered up to 40 mg Celexa and it put my panic attacks and anxiety completely into remission for 8 years. I have only recently switched off of it to try to find a med that will address some other issues.
I do encourage you to consider Celexa as well as its more focused sister Lexapro. I did not have any fatigue or sexual side effects from the Celexa but Lexapro knocked me out so that I felt like a zombie. I know each person responds differently but I just add that because if your doc has you try Lexapro and it makes you zombie like, don't rule out Celexa.
I am sure some more educated and med-sophisticated folks will jump in and add that Lexapro is just Celexa without the unneccessary additives but regardless, I found that I couldn't get to the equivalent of 40mg of Celexa on Lexapro without a strong sedative result.
Another suggestion from the old school is that an effective benzo against resistant anxiety that is not as sedating as valium is Librium. I know it is rarely used these days but when I needed a gentle-loading pleasant benzo that was a smooth anti-anxiety agent, I was pleasantly suprised by librium. ***** I will give this warning that I have heard (just anecdotaly) that Librium is partiuclarly addictive so if you struggle from addiction and the tendency to develop tolerance, it might not be the benzo for you.
That's my two cents. :)
Posted by Guy on May 18, 2008, at 12:52:38
In reply to Treatment resistant anxiety, posted by jms600 on May 18, 2008, at 8:12:52
I've been having quite a bit of success with a high dose of Remeron (60 mg) combined with Valium and gabapentin. I get a good night's sleep which is the most important thing for me. Remeron is OK at 60 mg or even higher. Have you tried that?
Posted by Racer on May 18, 2008, at 19:40:16
In reply to Treatment resistant anxiety, posted by jms600 on May 18, 2008, at 8:12:52
It may be that medications won't be a first line treatment for your anxiety. You may be better off looking at options such as neurofeedback, biofeedback, CBT, psychotherapy, or othter behavioral interventions.
Also, I'm curious about what results you've had from the medications you've tried? I'll second the vote for SSRIs as a reasonable option -- they do tend to reduce anxiety. You might try Risperdal, or even Haldol. Maybe a combination involving Remeron, which is often mentioned as effective against anxiety. You may respond to it in combination, where you didn't respond to it alone.
How long have you tried the medications you've tried so far? Have you been able to give an adequate therapeutic dose a good six to eight weeks?
And lastly, I have heard great things from people about Lexapro for stage fright, and Celexa for anxiety. It's worth trying one, and if that one doesn't work -- it's still worth trying the other.
Posted by rickoshay on May 18, 2008, at 21:53:43
In reply to Treatment resistant anxiety, posted by jms600 on May 18, 2008, at 8:12:52
> Hi everyone
>
> Can anyone please make some some recommendations for a good anti anxiety medication where other mainstream drugs have failed??
>
> Each time I go back to my psychiatrist he complains that I've tried everything and he can't think of much else to try.
>
> I'm currently on Stelazine (Trifluoperazine) but it isn't having much effect on my anxiety. Also taking Cipralex 20mg per day.
>
> Apart from the above two drugs I've also been on:
>
> Seroxat
> Prozac
> Lustral
> Effexor
> Remeron
> Zyprexa
> Seroquel
> Amisulpride
> Promazine
>
> I'm also taking Valium on an as needed basis - which is quite a lot considering how bad my anxiety is!
>
> Can anyone give me some idea of what I can ask my psychiatrist to try me on as he doesn't seem to have a clue!
>
> Thanks for your help everyone!
>
>ehh, has the good doc tried xanax in higher dose range? Seems to me, since IT REALLY WORKS, it might be a viable option...at least in most cases. Of course if he wants to listen to the drug reps, he can continue using an elephant gun to shoot mice, i.e. using anti-psychotics like solian instead. maybe a good stiff dose of ole Thorazine might be the next strategy. Please remember it's your pain that you are unsuccessfully shelling out big bucks for useless treatment. Nuff daid.
Posted by ncrainbow on May 18, 2008, at 22:42:24
In reply to Re: Treatment resistant anxiety » jms600, posted by rickoshay on May 18, 2008, at 21:53:43
While I am all for benzos like xanax, I did not find relief by taking them when I was in an intense period of frequent anxiety and panic attacks.
For me, xanax (or other benzos) eased anxiety or panic attacks when they occurred but did nothing to prevent them. At that time in my life, trying to plan my days in dread of the attacks was as disabling as the attacks themselves so I needed something to prevent as well as treat.
As a little ray of hope, I will share that I remember well the SALIENT feeling of anxiety during that time period and being unable to believe that one little pill was going to ever help since Anxiety and Panic was my "reality" at that time.
Yet, after a week or so for me on Celexa, the attacks were just gone and by two weeks, the anxiety lifted. So, it can work at times even when you are in a place of despair as far as ever getting relief.
I am probably going to get flamed, tarred and feathered for saying this but....sometimes starting SSRI's is like praying, because even at times when you are sure it won't work, it is possible to do it anyways and be pleasantly suprised at the results.
Peace,
NCrainbow
Posted by Maria3667 on May 19, 2008, at 12:22:59
In reply to Treatment resistant anxiety, posted by jms600 on May 18, 2008, at 8:12:52
Hi JMS,
You could try taking Valium on a constant basis and over a longer period of time. Reason being Valium has a long half life (stays in the bloodstream long) and therefore it will stash each time you add a new pill. You will probably need to go to a higher dose (30 - 40 mgs/day) and be on this for a WEEK before any difference is felt.
This works for me with another benzo with a long half life, namely Klonopin, only big trouble I have with this med is darn anorgasmia!
But if your goal is to kill the anxiety devils out there, this could be a useful option.
Take care,
Maria> Hi everyone
>
> Can anyone please make some some recommendations for a good anti anxiety medication where other mainstream drugs have failed??
>
> Each time I go back to my psychiatrist he complains that I've tried everything and he can't think of much else to try.
>
> I'm currently on Stelazine (Trifluoperazine) but it isn't having much effect on my anxiety. Also taking Cipralex 20mg per day.
>
> Apart from the above two drugs I've also been on:
>
> Seroxat
> Prozac
> Lustral
> Effexor
> Remeron
> Zyprexa
> Seroquel
> Amisulpride
> Promazine
>
> I'm also taking Valium on an as needed basis - which is quite a lot considering how bad my anxiety is!
>
> Can anyone give me some idea of what I can ask my psychiatrist to try me on as he doesn't seem to have a clue!
>
> Thanks for your help everyone!
>
>
Posted by johnj on May 19, 2008, at 17:13:54
In reply to Treatment resistant anxiety, posted by jms600 on May 18, 2008, at 8:12:52
What about tricyclics like nortryptline, or elavil, etc.? Lower doses than what is normally used for depression seem to help people. I may go that route too. regards
johnj
Posted by francineus on May 20, 2008, at 7:14:53
In reply to Re: Treatment resistant anxiety » jms600, posted by johnj on May 19, 2008, at 17:13:54
Yes, TCA's like imipramine. What about lithium? That may help.
Posted by Trotten on May 20, 2008, at 22:58:16
In reply to Re: Treatment resistant anxiety, posted by francineus on May 20, 2008, at 7:14:53
Nș1 to me is clonazepam. This is the only benzo that worked for me.
Posted by undopaminergic on May 21, 2008, at 7:26:40
In reply to Treatment resistant anxiety, posted by jms600 on May 18, 2008, at 8:12:52
>
> Can anyone please make some some recommendations for a good anti anxiety medication where other mainstream drugs have failed??
>First, stimulants and bupropion (Wellbutrin) are worth trying. In some people, they cause anxiety, whereas in others, they treat it.
After that fails, codeine or another opiate is a good choice of a medication to try. If tolerance becomes a problem, try adding memantine.
Finally, try phenelzine (Nardil).
Posted by blueboy on May 21, 2008, at 7:52:41
In reply to Re: Treatment resistant anxiety » jms600, posted by Phillipa on May 18, 2008, at 10:29:52
> Maybe a second opinion. What is your diagnosis. Hope some of the experts answer your thread. Have you tried klonopin? Some say it is stronger. Love Phillipa
I agree 100%. When I started running out of med options, my pdoc actually insisted that I see another doctor.
This is the end of the thread.
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