Posted by JohnL on March 10, 2001, at 5:09:32
In reply to GAD Advice badly needed, posted by pete on March 9, 2001, at 21:19:12
> I have been suffering from the physical symptoms of anxiety for the last year brought on by 3 years of worry about misdiagnosed peripheral neuropathy and the loss of ability to walk properly. I feel incredibly anxious most days with pronounced dizzyness/lightheadedness, mild agoraphobia and panicky episodes as well as some fear of social situations. I also suffer insomnia. This is something ive never really experienced till now although ive had periods of depression all my life. My doctor doesnt really listen and keeps trying various SSRI's including Prozac, Paxil and Nefazodone(serzone) but all these make me extremely agitated and increase anxiety after only a few days use. (Serotonin overload or something). Ive read some of the posts here and looked around the web for info/help but Im still confused. I could really use some advice about all this as Im desperate to try to find some relief from my symptoms. I try to maintain a positive outlook and rationalise it away but its like something taking me over which I cant control or fix. My doc dont seem to realise that im finding it difficult to cope, I could do with some advice about anti-anxiety drugs that work. Thanks.
Hi there Pete,
I think your doctor is making a very common mistake. That is, he is focusing too much on just one brain chemistry responsible for anxiety, and ignoring all the others. There are many different chemical root causes of anxiety, and he is only focusing on serotonin. Obviously that is not the correct route for you, or else you would have experienced better results by now.When a doctor sees a patient with depression, they automatically think "antidepressants". When a patient shows up with anxiety, they automatically think "serotonin antidepressants, or benzos". In my frame of thinking this is all wrong. I think they should instead be asking, "which chemistry is at fault here?" And then sample for a couple weeks each several totally different drugs to try to narrow down which chemistry needs attention. The results of each trial will provide clues as to which chemistry to focus on.
With that in mind, it would be safe at this point to assume that increasing serotonin chemistry is not going to cure your anxiety. The cause is somewhere else. What are other causes? Low GABA, treated with a benzo like Xanax, Klonopin, Valium, etc. Excess dopamine, treated with antipsychotic. Chemical instability, treated with Lithium. Electrical instability, treated with Tegretol or Depakote. Excess noradrenaline, treated with an antihypertensive drug.
One doctor I know keeps records of which medications worked completely with his anxiety patients. It is amazing to see that all drugs worked, though each patient responded to a different one, depending of course on which chemistry was at fault with the particular patient.
You might tell your doctor firmly that you want to try drugs from other classes. Remind him you've already beaten the serotonin thing to death. Specifically I think your best bets will be in the benzo class and the antipsychotic class. Statistics are in your favor with those. You might also need to hunt for a more cooperative open minded doctor who is more interested in getting you well rather than stroking his own ego.
John
poster:JohnL
thread:56076
URL: http://www.dr-bob.org/babble/20010310/msgs/56108.html