![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 11 of 11. This is the beginning of the thread.
Posted by jms600 on May 4, 2004, at 17:12:11
Hello everyone,
Just started a new job, and my anxiety has gone from bad to worse. My main symptoms are GAD and social phobia.
My doctor has started me on 50mg Amisulpride twice per day - but its just not working. Been on it for a week now. I am constantly crying, nervous, worried and really uncomfortable at work. My appetite has vanished too.
I have been taking Valium, but I seem to have grown quite tolerant to it, so I want to avoid benzodiazepines where possible. I am also on Prozac 20mg per day (just come down from 40mg as it was exacerbating my anxiety).
Any suggestions for medication to try (non-benzo)?
Yhanks!
Posted by cherylann on May 4, 2004, at 20:45:12
In reply to Severe anxiety - help, posted by jms600 on May 4, 2004, at 17:12:11
Oh my gosh, you must be feeling awful! I've been exactly where you are and have tried a lot of meds. Some worked and a lot didn't. The ones that seemed to work best for me are the sedating meds, i.e. tricyclics, remeron. They do increase your appetite, which might help you. But, along with the increased appetite is weight gain.
The only other med that worked somewhat and didn't cause weight gain was effexor. The side effects sucked, but once it kicked in the panic and anxiety vanished. Unfortunately, it never helped my depression and eventually pooped out.
There is something out there for you and I hope you've got a good doc to help you through this.
Best wishes
Posted by chemist on May 4, 2004, at 22:51:58
In reply to Severe anxiety - help, posted by jms600 on May 4, 2004, at 17:12:11
> Hello everyone,
>
> Just started a new job, and my anxiety has gone from bad to worse. My main symptoms are GAD and social phobia.
>
> My doctor has started me on 50mg Amisulpride twice per day - but its just not working. Been on it for a week now. I am constantly crying, nervous, worried and really uncomfortable at work. My appetite has vanished too.
>
> I have been taking Valium, but I seem to have grown quite tolerant to it, so I want to avoid benzodiazepines where possible. I am also on Prozac 20mg per day (just come down from 40mg as it was exacerbating my anxiety).
>
> Any suggestions for medication to try (non-benzo)?
>
> Yhanks!
>
>
hello, chemist here...have you looked into buspar for a non-benzo anxiolytic? takes time to fully kick in, and i've heard/read mixed reviews, but it might do you some good to check into it....all the best, chemist
Posted by harryp on May 6, 2004, at 23:20:04
In reply to Severe anxiety - help, posted by jms600 on May 4, 2004, at 17:12:11
Anxiety like you're experiencing is horrible. I hope you find relief soon!
cheryl's advice is good. With respect to chemist, even if Buspar worked for you, I'm not sure it would be strong enough for the kind of anxiety you are describing.
These are my suggestions:
1. Prozac can make anxiety worse. I'd replace it with something else. Possibly one of the drugs cheryl mentioned. Nardil would be my first choice, since it is known to be great for depression, GAD, and social phobia. You would have to watch your diet, though.
2. I would quit the amisulpride. AP's can have weird effects, and they're no point in taking one if it isn't doing you any good.
3. I would try klonopin instead of the valium. It's longer acting and less sedating.
4. I have found that Zyprexa (olanzapine) to be very effective with unbearable anxiety. It might be worth a try.
Good luck!
Posted by chemist on May 6, 2004, at 23:27:18
In reply to Re: Severe anxiety - help, posted by harryp on May 6, 2004, at 23:20:04
> Anxiety like you're experiencing is horrible. I hope you find relief soon!
>
> cheryl's advice is good. With respect to chemist, even if Buspar worked for you, I'm not sure it would be strong enough for the kind of anxiety you are describing.
>
> These are my suggestions:
>
> 1. Prozac can make anxiety worse. I'd replace it with something else. Possibly one of the drugs cheryl mentioned. Nardil would be my first choice, since it is known to be great for depression, GAD, and social phobia. You would have to watch your diet, though.
>
> 2. I would quit the amisulpride. AP's can have weird effects, and they're no point in taking one if it isn't doing you any good.
>
> 3. I would try klonopin instead of the valium. It's longer acting and less sedating.
>
> 4. I have found that Zyprexa (olanzapine) to be very effective with unbearable anxiety. It might be worth a try.
>
> Good luck!hi there, chemist here...you are spot on with buspar: i recommended it for a person who is reluctant - or their doctor, as the case may be - to go down the benzo route. haven't heard a single success story out there with it, but thought i'd throw it into the mix, given the circumstances...as for zyprexa, i defer to those in-the-know...i agree on allpoints and apologize for the buspar, but it seemed appropriate given the history......thanks much, and all the best to you, chemist
Posted by harryp on May 6, 2004, at 23:54:24
In reply to Re: Severe anxiety - help » harryp, posted by chemist on May 6, 2004, at 23:27:18
Your advice was perfectly good! We are dealing with a very imprecise field. For all I know Buspar might work great in this case, IMHO, it just probably wouldn't be enough.
You don't have anything to apologize for! It's not as if you told jms600 to use PCP as an anti-anxiety agent! :-)
Posted by chemist on May 7, 2004, at 0:36:32
In reply to Re: Severe anxiety - help » chemist, posted by harryp on May 6, 2004, at 23:54:24
> Your advice was perfectly good! We are dealing with a very imprecise field. For all I know Buspar might work great in this case, IMHO, it just probably wouldn't be enough.
>
> You don't have anything to apologize for! It's not as if you told jms600 to use PCP as an anti-anxiety agent! :-)yes, phencyclidine would not be prudent....i do agree with you on buspar, although there must be some people out there who have had success....thanks for all! with best wishes, chemist
Posted by Keith Talent on May 8, 2004, at 3:46:01
In reply to Severe anxiety - help, posted by jms600 on May 4, 2004, at 17:12:11
> GAD and social phobia
>
> My doctor has started me on 50mg Amisulpride twice per day - but its just not working.Drop the amisulpride.
> I have been taking Valium, but I seem to have grown quite tolerant to it
Substitute clonazepam (Klonopin) twice daily for diazepam (Valium). Clonazepam is a much more potent, longer acting benzodiazepine, with a reputation for causing both less tolerance and less sedation than diazepam.
> also on Prozac 20mg per day (just come down from 40mg as it was exacerbating my anxiety).
If you have no depression, maybe you could drop the fluoxetine (Prozac). Unfortunately, SSRIs (such as fluoxetine), when used to treat anxiety disorders, usually need much higher dosages than those used to treat depression. Also, antianxiety benefits tend to take at least three or four months to be felt; however, anxiety often gets worse before it gets better. Patients with anxiety disorders often need 80 or 100 mg per day of fluoxetine to get relief. Fluoxetine (in the short term - the first few weeks) can cause worse anxiety than other SSRIs because it antagonises serotonin-2 receptors, which causes release of noradrenaline and dopamine in the cortex. So perhaps Zoloft or Lexapro would be more acceptable to you.
> Any suggestions for medication to try (non-benzo)?
I don't know anything about buspirone, but people here have said it negated the benefits of their antidepressants. I don't think it's widely prescribed. It may be a "failed" drug - not sure. Benzos have been "politically incorrect" for at least 15 years, but they have their place. Don't be put off something that maybe be life-transforming just because of horror stories in the media.
Posted by zeugma on May 8, 2004, at 7:22:34
In reply to Re: Severe anxiety - help, posted by Keith Talent on May 8, 2004, at 3:46:01
> Any suggestions for medication to try (non-benzo)?
I don't know anything about buspirone, but people here have said it negated the benefits of their antidepressants. I don't think it's widely prescribed. It may be a "failed" drug - not sure. Benzos have been "politically incorrect" for at least 15 years, but they have their place. Don't be put off something that maybe be life-transforming just because of horror stories in the media.>>
Buspirone seems to have augmented my AD. I consider it a drug that is "failed" in the sense that no one has figured out what to do with it- it seems to have weak antidepressant, anxiolytic, and neuroleptic properties, but does not reduce psychosis, doesn't block panic attacks, and has never pulled anyone (by itself) out of a deep depression (to my knowledge). It tastes awful, has pro-sexual effects, and somehow improves my mood in the morning if I take it the night before. It is the strangest psychotropic I have ever taken, with the possible exception of bupropion.
Posted by Viridis on May 9, 2004, at 3:37:55
In reply to Severe anxiety - help, posted by jms600 on May 4, 2004, at 17:12:11
Unless your doctor won't prescribe them, it seems a big risk to take non-benzo meds. You can try other routes, and various drugs might help, but why play with fire? I'd go with something safe like Klonopin. There are alternatives, but for someone with anxiety problems, the risks are high. Why not take a med that has a long-term record of safety instead of taking a chance on something that's essentially experimental?
Valium is not a good representative of benzos (I hate it), but going the exotic route seems risky. I would take something safe and proven, like Klonopin, if you're suffering from serious anxiety. Other meds could help, but these are a roll of the dice and I'd try something that's safer and more reliable.
The anti-benzo thing is silly and without any evidence of harm, so to experiment with potentially dangerous drugs seems counterproductive to me. I'd recommend you play it safe until you get the anxiety under control.
Posted by jms600 on May 9, 2004, at 16:21:19
In reply to Re: Severe anxiety - help, posted by harryp on May 6, 2004, at 23:20:04
Thanks for the advice everyone! I've tried Buspirone for about six weeks - it did absolutely nothing! Maybe I should ask my doctor about Klonopin??
Thanks!
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.