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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 10 of 10. This is the beginning of the thread.
Posted by Mike_Cohen_2 on June 19, 2008, at 19:27:19
My brother passed away 15 mos. ago. We were best friends and he was 39, me 38 y.o. This is when my anxiety problem started. I was on Serzone for about 3 years for panic attacks I would get infrequently, but I never had GAD. After my brother passed away, even with the Serzone on board, I started getting sick, GI problems, Nausea all the time, anxiety, crying spells, etc. All labs and testing came back normal. MD decided to get me off Serzone and switch to Lexapro. I took me forever as I had an interaction with both meds on board, so I weaned off the Serzone over 2 mos. and then had no problem getting on the Lexapro. Two months after starting the Lexapro, she switched me to Zoloft 100mg, BTW, I was up to 30mg on the Lex prior to the switch.
psych doc. added Lamictal and Respirdal and I'm off them now as they did nothing for me. I'm still on the Zoloft 100mg, but my anxiety persists, even with Xanax 0.5mg-1mg prn and Klonopin 1mg twice/day and Xanax XR 1mg twice/day. I'm well covered with benzos, but the anxiety persists.
Current Symptoms:
I'm irritable, get short of breath and tachycardic at times. BTW, I'm also on a beta blocker and still get the tachycardia with little exertion at times. My carotids feel full. The anxiety doesn't have me freaking out as I'm kind of use to it and I havn't had a single panic attack since getting off the Serzone. The worst part is when I get up in the morning. I feel shaky, out of sorts, and very anxious. This goes away with an hour or so after taking am meds.So, my question is: Since the Zoloft nor the Lexapro didn't help a single bit and it's been 6 months of being on them, not at the same time, is it possible that an SSRI can actually cause anxiety after all this time. They talk about downregulatiuon of the receptors, etc. and initial anxiety is normal and goes away. I just feel like it has all gotten worse since starting the meds.
Had Cortisol and a ton of thyroid tests done, and also adrenal glands checked. All labs normal, Cardiologist testing is all normal.
My cholesterol is 389 and I suffer from Vitiligo, which is depigmenting of the skin and an autoimmune disorder, but thyroid antibodies were negative. I just started taking Cytomel to boost up my T3 even though it was normal mid range on the scale, but that has done anything either.
I'm just wondering what would happen if I ditched everything but the Benzos, and then taper off them if everything went away. My depression is pretty much in check, so that isn't an issue. And I get some days where I feel totally fine for a few hours, but this is far and few between.
Any thoughts would be appreciated, you too Phillipa :-)
Thanks as always,
Mike
Posted by chiron on June 19, 2008, at 23:29:13
In reply to SSRI's, can the cause Long Standing Anxiety ??????, posted by Mike_Cohen_2 on June 19, 2008, at 19:27:19
Hi Mike.
So did you notice if the meds made any anxiety changes and how they differed?(serzone->lexapro->zoloft)?It is very possible that the drugs can be increasing your anxiety (I haven't experienced it personally, but others have). I guess you don't have a baseline to compare it to because you've been on meds since the anxiety began.
Your comment: "This goes away with an hour or so after taking am meds." Are you referring to just the benzo or the whole gammet?
So are you thinking they may have helped in the beginning but exacerbated them over time? Hopefully they offered support during the most difficult time. If so, maybe your body just needed them at that time.
From your story, I would choose myself to taper off of the Zoloft (while staying on the benzos). Then your nagging question will hopefully be answered.
Posted by Mc Comfortable on June 20, 2008, at 5:53:21
In reply to Re: SSRI's, can the cause Long Standing Anxiety ??????, posted by chiron on June 19, 2008, at 23:29:13
A SSRI causing anxiety issues is maybe a possiblity. Personally, a SSRI is the only thing that takes my anxiety issues away to the the degree I need to function, be stable and be well. I know that's not a popular spin here but that is how it is for me.
Benzo's alone can work but one does need to be aware of the slippery slope they can have and the drawbacks they may carry. I'm not speaking just of their potential abuse but when they are used solely in theapeudic ranges. If that plan works, great. But, if treating the anxiety alone with a benzo is not making one well, one has to be willing to change plans. So, just a work of caution from one who has done that.
Have you looked into therapy specifically to deal with intense grief. The loss of your brother - my condolences - is the preface to most of your posts. I suggest a thought in using therapy as resource also.
I also suggest you follow the policy regarding your name changes. We all must do that per policy. Some of us (uh, me for example) have been blocked over problems regarding changing our posting names. I don't quite know why your situation seems to be different.
I am sorry for your loss and I am sorry for your challenges.
Posted by Mc Comfortable on June 20, 2008, at 5:54:26
In reply to Re: SSRI's, can the cause Long Standing Anxiety ?????? » chiron, posted by Mc Comfortable on June 20, 2008, at 5:53:21
Posted by Phillipa on June 20, 2008, at 12:14:02
In reply to SSRI's, can the cause Long Standing Anxiety ??????, posted by Mike_Cohen_2 on June 19, 2008, at 19:27:19
Well you know they cause anxiety for me but we're different. I do think Grief couselling is in order as that is a huge loss. Love and still condolensces Phillipa
Posted by bleauberry on June 20, 2008, at 16:51:55
In reply to SSRI's, can the cause Long Standing Anxiety ??????, posted by Mike_Cohen_2 on June 19, 2008, at 19:27:19
If ever in doubt as to whether a med can cause a particular side effect or adverse reaction, just spend some time looking at the hundreds of posts by people who rate their drugs at places like revolution health and askapatient. Long story short, yes, ssris can cause anxiety or fail to improve it. As with anything, mileage varies, and for some people the mileage goes in the wrong direction.
I never had any anxiety issues until several years into prozac. I didn't even know what anxiety was. Strange it should pop up while stabilized longterm on an ssri.
I think part of what you are feeling is the ongoing readjustments post-serzone. That could take months. For me, post-prozac took about 2 months. Post-zyprexa took minimum 3 months. And still, a couple years later, the same nagging symptoms persist, though not as intense.
I do think somehow the meds change some kind of rhythme within our biology. I have noted it here several times from others in the last few months, and myself as well, about that waking anxiety thing that goes away in an hour or two. I don't know what that is. But clearly, it was not there before the drugs.
I was pretty sure cortisol was to blame. But you had a cortisol test? Was it a 24 hour saliva test with 4 samples spread out over the day and evening to see the pattern? If not, then it was a useless test.
I have discovered several things that make that waking anxiety thing go away within 3 days, with a slight increase the first day or two. They are any of the following: Milnacipran 12.5mg morning; Duloxetine 5mg morning; Hydrocortisone 1.25mg-2.5mg morning. Note they all have one thing in common...they do something to norepinephrine. Somehow, I do not know how, I believe that waking anxiety thing is tied into the adrenergic circuitry. And it takes nowhere near a therapeutic dose of anything to correct it. 5mg duloxetine or 1.25mg cortisone are miniscule, yet work like a charm. I don't get it.
Posted by seldomseen on June 20, 2008, at 17:24:30
In reply to SSRI's, can the cause Long Standing Anxiety ??????, posted by Mike_Cohen_2 on June 19, 2008, at 19:27:19
Yeah, I'd say you are well covered with the benzos. I would talk to your doc about tapering off (or down) on the zoloft and seeing how you feel.
Along with the others I wonder if you are in any therapy of counseling since the death of your brother since that seems to be the start of your symptoms.
I'm sorry for your loss.
SSRIs worked for me, but not everyone.
Seldom
Posted by linkadge on June 21, 2008, at 14:00:45
In reply to Re: SSRI's, can the cause Long Standing Anxiety ?????? » Mike_Cohen_2, posted by seldomseen on June 20, 2008, at 17:24:30
Yes, I do believe SSRI's can cause persistant anxiety syptoms for some people.
Citalopram made my anxiety worse as did zoloft.
Linkadge
Posted by sdb on June 23, 2008, at 10:55:02
In reply to Re: SSRI's, can the cause Long Standing Anxiety ??????, posted by linkadge on June 21, 2008, at 14:00:45
> Yes, I do believe SSRI's can cause persistant anxiety syptoms for some people.
>
> Citalopram made my anxiety worse as did zoloft.
>
> Linkadgeyou once said that prozac was the best ssri for you (among the bad probably). is zoloft not the most similar ssri to prozac?
warm regards
sdb
Posted by linkadge on June 23, 2008, at 11:20:09
In reply to Re: SSRI's, can the cause Long Standin }} linkadge, posted by sdb on June 23, 2008, at 10:55:02
I don't recall saying prozac was good for me. I know blueberry has said that prozac+zyprexa was the best for him/her.
If I did, I don't recall it being all that effective for anxiety.
Anyhow, my memory for which drugs did what and when is unfortunately not terrably good. Sometimes they do so many things that its hard to conclusively rate the net effect.
Linkadge
This is the end of the thread.
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