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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 17 of 17. This is the beginning of the thread.
Posted by Jackster on July 7, 2001, at 4:25:35
I was on 40mg of Paxil for 3 years for Panic attacks. When I stopped and started it again - it was no longer effective. Since then I have tried Celexa (got a rash), Imipramine, Prozac & now Zoloft without much success. Both the Prozac & Zoloft seemed to increase my panic attacks (presumably because they are activating SSRI's). I have been on Zoloft 50mg for 2 months and have now gone up to 75mg. It doesn't seemed to have helped - although I realise the dosage may not be high enough. Every time I up the dosage I get worse panic attacks. (and it's costing me a lot of money). Can anyone recommend whether I should continue with the Zoloft or if there is another medication I should try?
Posted by SalArmy4me on July 7, 2001, at 8:15:21
In reply to help - no meds working for Panic Disorder, posted by Jackster on July 7, 2001, at 4:25:35
I would recommend either Serzone or Effexor XR.
Here are the benefits of Serzone:
*It increases REM sleep
*It has no anticholinergic side-effects
*Sexual side-effects are reported less than SSRIs.
*It can be taken once a day, conveniently
*No blood tests are required
*It is less expensive than SSRI's
*It can be combined with most other antidepressants.
*It has become a first-line medication choice due to its efficacy and benign side-effect profile.
Posted by SalArmy4me on July 7, 2001, at 8:20:05
In reply to Re: help - no meds working for Panic Disorder » Jackster, posted by SalArmy4me on July 7, 2001, at 8:15:21
http://www.dr-bob.org/tips/split/Switching-from-an-SSRI.html
www.serzone.com
Posted by Joy on July 7, 2001, at 8:24:42
In reply to help - no meds working for Panic Disorder, posted by Jackster on July 7, 2001, at 4:25:35
Xanax works best for panic attacks; Paxil did not work a 2nd time for me either. I just take Xanax at night for sleeping. However, small doses as needed help panic attacks quickly for most people. You can take it while trying different ADs if your feel you need an AD. I know everybody is different, but Serzone agitated me to the point of constant crying jags. Try a little Xanax [generic Greenstone Labs very good].
Joy
> I was on 40mg of Paxil for 3 years for Panic attacks. When I stopped and started it again - it was no longer effective. Since then I have tried Celexa (got a rash), Imipramine, Prozac & now Zoloft without much success. Both the Prozac & Zoloft seemed to increase my panic attacks (presumably because they are activating SSRI's). I have been on Zoloft 50mg for 2 months and have now gone up to 75mg. It doesn't seemed to have helped - although I realise the dosage may not be high enough. Every time I up the dosage I get worse panic attacks. (and it's costing me a lot of money). Can anyone recommend whether I should continue with the Zoloft or if there is another medication I should try?
Posted by Mitch on July 7, 2001, at 12:59:03
In reply to help - no meds working for Panic Disorder, posted by Jackster on July 7, 2001, at 4:25:35
Jackster,
It sounds like you need a more sedative AD (like Sal mentions-Serzone) and/or a benzo (like Joy mentioned). I have heard that Remeron works well for panic. Have you tried that or Elavil(amitriptyline)? BTW, amitriptyline is dirt cheap!
mitch
> I was on 40mg of Paxil for 3 years for Panic attacks. When I stopped and started it again - it was no longer effective. Since then I have tried Celexa (got a rash), Imipramine, Prozac & now Zoloft without much success. Both the Prozac & Zoloft seemed to increase my panic attacks (presumably because they are activating SSRI's). I have been on Zoloft 50mg for 2 months and have now gone up to 75mg. It doesn't seemed to have helped - although I realise the dosage may not be high enough. Every time I up the dosage I get worse panic attacks. (and it's costing me a lot of money). Can anyone recommend whether I should continue with the Zoloft or if there is another medication I should try?
Posted by Elizabeth on July 7, 2001, at 21:32:27
In reply to help - no meds working for Panic Disorder, posted by Jackster on July 7, 2001, at 4:25:35
Xanax or Klonopin.
Posted by stjames on July 7, 2001, at 21:34:05
In reply to help - no meds working for Panic Disorder, posted by Jackster on July 7, 2001, at 4:25:35
Then try meds specific to panic, the benzos.
James
Posted by Elizabeth on July 7, 2001, at 21:37:48
In reply to Re: help - no meds working for Panic Disorder » Jackster, posted by SalArmy4me on July 7, 2001, at 8:15:21
> Here are the benefits of Serzone:
> *It increases REM sleepWhy is this a "benefit?" Why do you feel this would be helpful to someone trying to treat panic disorder?
-elizabeth
Posted by Pattisun on July 7, 2001, at 22:08:42
In reply to help - no meds working for Panic Disorder, posted by Jackster on July 7, 2001, at 4:25:35
Sounds like your attacks are out of control. You may need to take Klonopin or I don't know about the other meds suggested here to get them under control.
I could not control my attacks with just zoloft or paxil.
May need something else until you get them under control. Also, go to COGNITIVE therapy. It helped me 100% with mine, but after 6 years I still get them. But, used to be confined to the home have come a LONG way since then.
Good luck
Posted by Sunnely on July 8, 2001, at 1:20:36
In reply to help - no meds working for Panic Disorder, posted by Jackster on July 7, 2001, at 4:25:35
This may not apply to you. Just trying to add something related to your post.
Patients who have panic disorder that is not responding to treatment, especially if accompanied by joint pain, significant fatigue or atypical, long-lasting panic attacks, and living in endemic areas, think of Lyme disease.
*************************
> I was on 40mg of Paxil for 3 years for Panic attacks. When I stopped and started it again - it was no longer effective. Since then I have tried Celexa (got a rash), Imipramine, Prozac & now Zoloft without much success. Both the Prozac & Zoloft seemed to increase my panic attacks (presumably because they are activating SSRI's). I have been on Zoloft 50mg for 2 months and have now gone up to 75mg. It doesn't seemed to have helped - although I realise the dosage may not be high enough. Every time I up the dosage I get worse panic attacks. (and it's costing me a lot of money). Can anyone recommend whether I should continue with the Zoloft or if there is another medication I should try?
Posted by NikkiT2 on July 8, 2001, at 8:31:00
In reply to help - no meds working for Panic Disorder, posted by Jackster on July 7, 2001, at 4:25:35
I hasven't time to read all the replies, so this may have been mentioned already, but I have low dose anti-psychotic to be a huge help with the panic i suffer. I have just been moved onto olanzapine which seems to be better than the risperadone i was on (this caused much toi annoying restless leg syndrome)
good luck
nikki
> I was on 40mg of Paxil for 3 years for Panic attacks. When I stopped and started it again - it was no longer effective. Since then I have tried Celexa (got a rash), Imipramine, Prozac & now Zoloft without much success. Both the Prozac & Zoloft seemed to increase my panic attacks (presumably because they are activating SSRI's). I have been on Zoloft 50mg for 2 months and have now gone up to 75mg. It doesn't seemed to have helped - although I realise the dosage may not be high enough. Every time I up the dosage I get worse panic attacks. (and it's costing me a lot of money). Can anyone recommend whether I should continue with the Zoloft or if there is another medication I should try?
Posted by tina on July 8, 2001, at 8:36:00
In reply to Re: help - no meds working for Panic Disorder » Jackster, posted by NikkiT2 on July 8, 2001, at 8:31:00
Try the MAOI's too jackster. Parnate, Nardil, Manerix/Aurorix. If the SSRI's don't help, you might want to try something completely different.
I had good results on moclobemide but when I restarted it, no luck but it might work for you for awhile at least.
Do you take benzo's? Klonopin helps alot with panic attacks. It's addicting but not if you use it carefully.
good luck
tina
> I hasven't time to read all the replies, so this may have been mentioned already, but I have low dose anti-psychotic to be a huge help with the panic i suffer. I have just been moved onto olanzapine which seems to be better than the risperadone i was on (this caused much toi annoying restless leg syndrome)
>
> good luck
>
> nikki
>
> > I was on 40mg of Paxil for 3 years for Panic attacks. When I stopped and started it again - it was no longer effective. Since then I have tried Celexa (got a rash), Imipramine, Prozac & now Zoloft without much success. Both the Prozac & Zoloft seemed to increase my panic attacks (presumably because they are activating SSRI's). I have been on Zoloft 50mg for 2 months and have now gone up to 75mg. It doesn't seemed to have helped - although I realise the dosage may not be high enough. Every time I up the dosage I get worse panic attacks. (and it's costing me a lot of money). Can anyone recommend whether I should continue with the Zoloft or if there is another medication I should try?
Posted by Elizabeth on July 8, 2001, at 15:32:10
In reply to Re: help - no meds working for Panic Disorder » Jackster, posted by Sunnely on July 8, 2001, at 1:20:36
> This may not apply to you. Just trying to add something related to your post.
>
> Patients who have panic disorder that is not responding to treatment, especially if accompanied by joint pain, significant fatigue or atypical, long-lasting panic attacks, and living in endemic areas, think of Lyme disease.Good point. There are a number of other conditions that can look like panic disorder: angina, limbic epilepsy, pheochromocytoma, cardiac arrhythmias, etc. Of course, panic patients tend to be hypochondriacal and become convinced that they have one or more of the above! < g > But even if it looks like panic disorder, the doctor should rule out other possible conditions before making this dx.
-elizabeth
Posted by jimmygold70 on July 8, 2001, at 19:17:04
In reply to help - no meds working for Panic Disorder, posted by Jackster on July 7, 2001, at 4:25:35
Sure, there are.
Nardil is a sound option. So is Parnate.
Another effective option is to use Xanax or Klonopin on a regular basis. This approach has Pros (effective without much side effects) and Cons (Dependence).
All the best !
Jimmy
Posted by Vanessa Wells on July 17, 2001, at 18:01:57
In reply to Re: help - no meds working for Panic Disorder » Sunnely, posted by Elizabeth on July 8, 2001, at 15:32:10
I have only had a couple of panic attacks in my life and fear them no longer. What I am left with instead is generalized anxiety. I have found no meds. to work for that. Actually, they all made it a lot worse. I'm going on natural and getting to the bottom of why I feel anxious all the time. I think this is the key to anxiety/panic.I read a great thread about a person who handled their anxiety with just acknowledging it, having fun with life and not trying to make it go away. I'm going to try it myself.
Good luck. I think meds. suck personally.
vw
Posted by AmyM on July 18, 2001, at 9:54:52
In reply to help - no meds working for Panic Disorder, posted by Jackster on July 7, 2001, at 4:25:35
Hey Jackster,
I can really empathize with you. I have been suffering from Panic Disorder and depressison for at least 10 years now. After many attempts with meds, I finally found my fix. Klonopin along with Paxil. You'll have to figure out the dosage yourself...it's different for everyone. I prefer Klonopin over Xanax, 'cause Klonopin has a longer half life...it last longer.
Good luck, no one should have to suffer from Panic or Depression. As I'm sure you know, untreated it can debilitate your life.
//Amy
> I was on 40mg of Paxil for 3 years for Panic attacks. When I stopped and started it again - it was no longer effective. Since then I have tried Celexa (got a rash), Imipramine, Prozac & now Zoloft without much success. Both the Prozac & Zoloft seemed to increase my panic attacks (presumably because they are activating SSRI's). I have been on Zoloft 50mg for 2 months and have now gone up to 75mg. It doesn't seemed to have helped - although I realise the dosage may not be high enough. Every time I up the dosage I get worse panic attacks. (and it's costing me a lot of money). Can anyone recommend whether I should continue with the Zoloft or if there is another medication I should try?
Posted by JohnL on July 19, 2001, at 16:21:29
In reply to Re: help - no meds working for Panic Disorder, posted by Vanessa Wells on July 17, 2001, at 18:01:57
> I have only had a couple of panic attacks in my life and fear them no longer. What I am left with instead is generalized anxiety. I have found no meds. to work for that. Actually, they all made it a lot worse. I'm going on natural and getting to the bottom of why I feel anxious all the time. I think this is the key to anxiety/panic.I read a great thread about a person who handled their anxiety with just acknowledging it, having fun with life and not trying to make it go away. I'm going to try it myself.
>
> Good luck. I think meds. suck personally.
> vwYeah, I think meds suck too. Too darn expensive. Too darn hard to find the right one. I wish I didn't need them. But I do. Life without my meds though sucks a lot worse.
Anyway, dealing with anxiety naturally has worked for a lot of people. It can be done. But there is a trick you could carry in your back pocket for those real troubling panic times. That is, beta blockers. When a bad panic situation sets in, a beta blocker can work wonders. The cool thing is that you only need to take it when you need it, not all the time. This is a very much overlooked, but highly successful, method to deal with anxiety and panic.
John
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