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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 5 of 5. This is the beginning of the thread.
Posted by Martin Spassoff on July 15, 2012, at 8:29:03
*I'd like to not that all of the information I receive will be treated as informative only and any advice received on this forum will be discussed with my current doctor.*
Also if you do read all I've written below, you deserve a medal.Hi everyone. First off I'd like to apologize for the long post that will follow, but I believe this is a way to better understand my condition and hopefully someone can guide me in the right direction.
I am a male, 26 old and I live in Europe.
I started having panic attacks when I was 14 years old (but I was diagnosed at 18), which quickly turned into agoraphobia.
Back then I was put on Maprotiline (Ludiomil) which didn't help at all and only made my heart rate go above 120 bpm. I took it for about a month. I resumed my life without any help or medication.
It only got worse, to the point where my anxiety was so high for days, I was in bed in agony, physical, emotional and mental. The anxiety manifests itself with irritability to sound, chest tightness, sweaty palms/feet, tightness in my whole body in the extreme levels.
There doesn't seem to be a precursor to my anxiety. I just wake up having it with severe levels. During sleep, my mother has noticed that my facial expression is as if I'm suffering.Back then I didn't have a diagnosis and some random doctor prescribed me Orap forte (Pimozide), together with some other drug Biperiden (Akineton). My anxiety disappeared, but so did my mind. For 2 months on a low dose of those drugs, I didn't know who I was, what I was doing, etc. They caused me permanent night blindness and I recovered from their effects with supplements for over an year, except for the night blindness.
I turned 18. I had not left the neighborhood since I was 14. Then a doctor finally diagnosed me with Panic disorder with agoraphobia.
I was put on Escitalopram (Cipralex) 10mg and Rivotril 0.25mg all in the morning.
Those drugs worked fairly well, because I found the strength to ask for help for exposure therapy by a relative (being driven around town in a car). I was able to go around town with a companion I trusted, I never experienced severe anxiety, but the pills never got me completely rid of my agoraphobia. When I had a drink or two I would be able to go further.
After about 6 years they just started working less and less, but I stood by them, maintaining a somewhat decent life around my neighborhood, without severe anxiety.
At 24 I had to take Ciprofloxacin - an antibiotic, which I never knew is an anxiety causing medication, due to it's GABA binding properties. The anxiety and derelization I experienced nearly made me commit suicide. No benzos would work, because of the GABA sites being overflowed by the Ciprofloxacin.
I stopped all my meds cold turkey, not knowing that the antibiotic can do that and thinking that the antidepressant and klonopin cause the anxiety.
That made me bedbound for 20 days with symptoms that are hard to describe, but if hell is something like that - we should all start going to church right now!
My doc gave me a ton of meds during and after that period (approximately 6 months period). Here they are, but not in the order I took them as I cannot recall exactly:Zoloft with Xanax - one month with no change in any condition; 4/10
Coaxil with Klonopin - good results on panic scales for two weeks, depression was the same, anxiety slightly improved - pooped out; 6/10
Paxil with Klonopin - took it for 5 days, panic attacks were quite weaker, but I was agitated and with racing thoughts and very dizzy. Quite activating too. I believe at that time I was so exhausted physically and mentally, that I couldn't tolerate anything anymore and I had to give it the mandatory 2 weeks, but I couldn't handle it; 5/10
Ixel (Milnacipran) with Klonopin - for a week. Made my heart rate go over 130 bpm, derealization due to my anxiety was way worse. Anxiety state didn't change; 1/10
Fluanxol (Flupentixol) - 2 days. Caused incredible worsening of my condition, with tremors and worse anxiety and inability to express myself. 0/10
Deanxit (Flupentixol/melitracen) with Klonopin - 1 month. No change in condition and feeling worse on every scale; 0/10
The last drug I tried was Agomelatine (Valdoxan).
At that point I had just given up on everything.
My whole system was a mess from all the drugs during that short period, and I took it for 3 days and put it away. No notable effects other than confusion and a good night sleep occurred.After the 6 months of lab experiments ended, I got back on Lexapro with Klonopin for the next 6 months. My exposure therapy was doing quite poor. I didn't feel any effects from the drugs and then, when my doc had given up, I decided on my own to try Citalopram. That sort of did the trick of getting me back on my feet so I can walk around my neighborhood. I even moved out of my home (to an apartment 500 ft away,lol). In time I was able to restore my exposure therapy and I had some success with it, but the panic attacks were VERY severe when they occurred. It was nothing like when I was on Lexapro for 6 years. I tried increasing the dosage to 30mg a day for a month, but my anxiety only got worse.
Now I am still taking the Citalopram 20mg with the Klonopin (0.5mg), but I'm afraid that after an experiment I did 10 days ago, it has pooped out too (or maybe it never worked too well). I tried "flooding". It wasn't too bad, but I guess the anticipatory anxiety was too much for Citalopram to handle.
It has been 10 days now that I suffer from very bad anxiety.
I cannot sleep at night and only sleep when the sun rises to avoid "life".
The anxiety is very severe and I cannot handle it anymore.
I'd hate to commit suicide and leave the woman I live with to deal with a scar like that, also my family, but I really cannot take this anymore.Now I'm stuck with Citalopram 20mg and I take a higher dose of klonopin 0.5 in the morning and 0.5 in the evening to help me relax my chest and whole body. It does help with the physical symptoms of anxiety, but it doesn't attack the root of it. Actually, the more Klonopin I take, the worse I feel after the effect wears off.
To try to summarize, I cannot take drugs that have a moderate/strong effect on norepinephrine.
Antipsychotics are a complete no-no for me.
Benzos are just a very temporary solution.
My currents SSRI doesn't help me deal with anxiety,panic and agoraphobia - depression either.
I have been browsing and reading a lot online during the past week for meds that might help.
The one that sort of stuck with me is called Clomipramine (Anafranil), but I'm unaware how potent it is on noradrenaline.How come SNRIs are prescribed to people with panic disorder and agoraphobia ? Isn't norepinephrine the main cause of the fight-or-flight response ?
Any drug recommendations of drugs for severe anxiety - nervous tension, panic and agoraphobia are very welcome.
I wish to make a list to bring to my doc and talk about those meds.
If you have read all of this...... wow, thank you!
Posted by Phillipa on July 15, 2012, at 10:07:00
In reply to GREAT MINDS HELP! PD with Agoraphobia + anxiety, posted by Martin Spassoff on July 15, 2012, at 8:29:03
I did read it all but I'm not familiar with a lot of the meds used in Europe. Hoping the great minds answer this thread with great advise. Phillipa
Posted by gadchik on July 15, 2012, at 10:27:01
In reply to GREAT MINDS HELP! PD with Agoraphobia + anxiety, posted by Martin Spassoff on July 15, 2012, at 8:29:03
How come SNRIs are prescribed to people with panic disorder and agoraphobia ? Isn't norepinephrine the main cause of the fight-or-flight response ?
I feel the same and would like to know why.i read your entire post,and you have been thru tough times.All I can advise is that i had to go thru cognitive behavioral therapy,remeron 7.5mg,zoloft 25mg,and klonopin .5mg,for sev years.I think the longer you wait to treat anxiety,the longer it takes to get well.(i tried higher doses of rem and zo,but anxiety got worse).I sometimes think lower doses are the way to go.I also had to get outside,walk,eat nutritious food.Time passing,helped too. good luck to you.
Posted by novelagent on July 17, 2012, at 10:10:07
In reply to GREAT MINDS HELP! PD with Agoraphobia + anxiety, posted by Martin Spassoff on July 15, 2012, at 8:29:03
After a week or two, the dose of Klonopin needs to be doubled, and then it will stay at that dose and be effective for the rest of your life-- it sounds like your doc didn't know that, which he should have.
Posted by gadchik on July 17, 2012, at 11:40:31
In reply to Re: GREAT MINDS HELP! PD with Agoraphobia + anxiety » Martin Spassoff, posted by novelagent on July 17, 2012, at 10:10:07
that's exactly what Ive experienced. I began on .25mg klonopin,then after 2 weeks,went up to .5mg.It has remained effective in the 4 yrs Ive been on it,and I dont do well if I decrease the dose.
This is the end of the thread.
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