Opinions - SSRI's Used to Treat Anxiety

[ironmics]

Swim went into his usual doctor for a pain level check up and had been to a psychologist the day before. The psychologist recomended some kind of medication to relieve my anxiety. Swim finished his pain check up and mentioned his anxiety diganoses. Swim's doc recomended prozac for long term anxiety treatment??? This seemed really weird because anything that I've read indicated if anything will cause more anxiety. Since swim thought this was crazy he also requested something to deal with short term anxiety, and the doc gave him lorazepam...ok he's not completely crazy and he must not think swim's a drug seaker. This is through the student health services at his school which has cheap meds and free visits. He's going in for a check up in two weeks with the same doctor. Should swim go somewhere else for medical advice about this prozac situation, because swim is not entirely comfortable being on prozac especially since it's indicated for depression...the result of the anxiety and not the cause, which is the anxiety. Oh also swims doc only gave him 15mg total of lorazepam so even this correct treatment will not last very long. Finally, he knows that other SSRI's are indicated in the treatment of anxiety, but he knows that prozac works differently than most.

[Broshious]

SWIM was on paxil which is another SSRI and it did work on anxiety somewhat, but it just made SWIM too weird. SWIM would advise caution when dealing with SSRIs.

[ironmics]

Yeah swims brother was on paxil for social anxiety but prozac seems a lot different

[Nagognog2]

Fluoxetine - Prozac - is a lot different. It takes 3 weeks to kick in, and many months to clear if it doesn't work. Most doctors only know what they read - and that is what is published from the drug manufacturer in the PDR. The horror stories about SSRI's such as Prozac keep rolling in. But the maker keeps spending a fortune to squelch them - lawsuits are pending. Prozac was so highly advertized that one doctor (at least) was prescribing it to dogs to make them stop barking at the Moon.

If I were in your boots, I'd try everything else first - aside from an addiction to benxodiazepines such as lorazepam (Ativan). Find a therapist who teaches such "hippie-dippie" things as breathing techniques and meditation. Getting off a long course of the SSRI's can cause some truly horrific times. And for many people - being on them can lead to even worse.

Rather like being told that the cure for a stubbed toe is to have the leg amputated.

[ironmics]

Thanks swims going to tell his doc he isn't comfortable taking them. Swim does not easily get addicted to things and knows only to take when he needs. He was taking vicodin for 3 months off and on for back pain and at first needed it every 6 hours or so for a couple weeks. But easily moved down to once every few days then stopped all together with no withdrawls. The ativan is working awesome for the stress that pops up every once and awhile, so far has only needed it 3 times, and it seems to be kinda teaching how to deal with the situation without a lot of anxiety arising out it.

Quick background, SWIM has had horrible insomnia for a while now, as long as he can remember falling asleep was a difficult task even when he was much younger. Its not every night, but on 3 or 4 nights out of the week it will take SWIM 2-4 hours to fall asleep, he is just unable to relax his mind, this is torture when one has to be up at 6 for work the next day. SWIM also experiences anxiety and mild panic, he is always nervous, worrying about something and cannot relax, because of this SWIM also developed OCD when he was much younger. SWIM still has the OCD but he has learned to control it to the point where it does not bother him too much, IE compulsions are not taking up over an hour of his day and only seem to be really bothersome when SWIM is super anxious. As a side note SWIM is not depressed, he is usually happy, tries to take a positive outlook, likes his job and the track his future is on. Sure SWIM has a few days here and there where he lacks the motivation to do anything and feels useless, but never for more than a day or two at a time, and he considers this normal, something that everyone experiences from time to time.

With that said in the past SWIM has never been medicated or seen a physiatrist, up until last week, SWIM got fed up with not being able to sleep and feeling irritable and zombie-like at work all the time. and made an apt. Well the visit went pretty well, SWIM told the doc that he was reluctant to be on something he has to take every day, and would rather have something that can be taken on an as needed basis, because some nights SWIM can fall asleep ok naturally, and can also naturally cope with his anxiety at times. But there are other times where it becomes too overpowering and makes SWIM feel sick and panic stricken. The doc gave SWIM a prescription for Ativan .05 mgs. SWIM has had experience with Benzos in the past and he fears/respects them, yet they work so well for him. If SWIM is tossing and turning for an hour in bed he takes one and soon after he will be able to slip into sleep. If SWIM is feeling panic he takes 2 and it feels like weight has been taken off his shoulders, he feels normal, how he imagines most people who are not riddled with anxiety do everyday.

So the pills work for SWIM great, but SWIMs Doc does not believe in prescribing benzos long term, due to the obvious reasons of the high abuse and addiction potential with the drug. She advised SWIM that an SSRI, either Prozac or Zoloft would be worth looking into and trying for. Again SWIM is very hesitant for many reasons, a few being, don’t want to have to take a pill every day to feel “normal”, don’t like the idea of SWIMS brain chemistry being played around with and altered, SWIM is afraid of them changing who he is, and most importantly you cant take them forever, at some point you will have to get off them and them SWIM will prob be worse off since his brain chemistry has been messed with so much. SWIM also does not see how it will help with insomnia, although he guesses if SWIM was no longer anxious due to taking them, he would be able to sleep. SWIM also understands that you can’t just take benzos forever, but SWIM feels that he can use them without abusing them. He is very aware of the withdrawal hell that can occur and this scares him. So he does not plan to take them everyday, only when he feels he really needs them and so far this is working perfectly and SWIM feels so much better during the days because he is sleeping better, just that reduces his anxiety. SWIM does not want to become too dependant on them and plans to take weeks off to keep tolerance lower. Should SWIM just tell his doc all this? The ativan is working so well SWIM is very reluctant to try an SSRI, he has just heard too many mixed stories about it, but then again he is also curious, maybe it would help SWIM? But that is a risky trial that could end up doing much more harm that good. What do you SWIMMERs think of using an SSRI to treat anxiety, do you think it’s possible to use benzos responsibly long term without getting physically dependant on them? SWIM has heard it only takes two weeks of constant use, but again he does not plan to use them every day. Sorry for such a long post, but SWIM felt he need to type it all out, thanks to anyone who reads it all.

[kazix]

About 3 1/2 months ago SWIM gave up smoking nicotine and dope and since then had real trouble sleeping and bad anxiety too. Sometimes only getting one hour's sleep a night. Then GP suggested sleeping pills, started with Temazepam but these only seemed to work for a couple of hours so he then prescribed zopiclone that were meant to last 7 hours. But these didn't work very well either and SWIM felt awfully groggy in the mornings so SWIM stopped these. But then SWIM still wasn't sleeping so after a couple of weeks took them again every few days. This became every night about 3 weeks ago. But although SWIM now fall asleep ok on them, SWIM still wake up about 4-5am every morning. So, 10 days ago GP prescribed Citalopram as a way of avoiding addiction to sleeping pills (he says they are only addictive after a few months?!?) but side effects have been terrible. Users on net say they suddenly have been waking up in the middle of the night on them so why was SWIM prescribed them when they actually cause what SWIM was trying to get rid of!! Also, SWIM had had other side effects, horrible headaches and more anxiety/jitteryness than before. Would recommend not taking SSRI's!! Hope this helps.

[Nagognog2]

Yes - for many people. Doctors read the ads for the SSRI's, but I don't think they interpret the info correctly. When the drug company says the SSRI's are good for anxiety, they must mean that they are good for causing it! That's what effect they have on a great many people. Yuck!

Thanks for the input, I am sure it may work for some people, but SWIM has come to the conclusion based on what he has read that its not worth it for him to risk screwing around with. If it was something SWIM could try for a week fine, but the fact that SWIM has to take the pills for three weeks before noticing effects does not sound cool, and by then the chemicals in SWIMs brain will have certainly been changed around and if he decides he does not want to stick with there will certainly be some negative withdrawal effects at that point.

As for an update on the Ativan, SWIM has had his script for three weeks now, and it seeing the doc again a week from now, he still has pills left and feels that he has not been abusing them. Defiantly not taking them everyday, manly using them for sleep, but SWIM can still fall asleep naturally and does not feel like he is dependant on them and has no withdraw symptoms when he does not take them for a few days. He feels that they are working perfectly for his condition and if the doc does not want to prescribe more he will seek out a different doctor, as he does not want to continue to see one that believes SSRIs are the cure for anxiety.

SWIM is wondering if any SSRI better geared towards the treatment of anxiety rather than depression? SWIMs doc will not continue to prescribe Ativan for SWIMS occasional anxiety and insomnia, instead she is trying to push an SSRI on him. SWIM does not want to go on one at all, he has heard too many negatives things and too little positive about them, esp in the treatment of anxiety and he has expressed this to his doc. It makes SWIM angry because he does not abuse his ativan script either, it has been a mouth since he has seen the doc and gotten his script for 30 .05mg pills, he still has 12 of them left. SWIM has an apt. with the doc tomorrow and may say he will try an SSRI to make her happy, but only if he has some ativan on the side, maybe he can get both this way and just not take the SSRI. But back to the original question, she was trying to say Celexa is more “calming” than some other SSRIs and helps with anxiety and putting your mind to rest at night, is any of this true? From what SWIM understands they are all pretty much the same. Also aren’t SSRIs somewhat chemically similar to stimulants like amphetamine? This is the last thing SWIM needs, stims (even coffee) make him feel extremely jittery, sweaty, and more anxious and uncomfortable then normal.

Well SWIM went to his apt. the doc gave him Celexa (20mg) and did agree to refilling his Ativan (0.5mg). So far SWIM is undecided on what he wants to do with the Celexa, half of him wants to just give it a shot for a few weeks, the other half wants to just not touch it at all.

[wellhelm]

Well, swim takes celexa and used to take anxitey meds as well. Now he takes only celexa and will hopefully be off this soon as well. With this shit its to each his own at its finest though so good luck.

Originally Posted by wellhelm

Well, swim takes celexa and used to take anxitey meds as well. Now he takes only celexa and will hopefully be off this soon as well. With this shit its to each his own at its finest though so good luck.

Would SWIY mind explaining their experience on Celexa a little? Does it help with your anxiety? Have you noticed any negative side effects? If you want to get off its pretty clear you don’t think it’s worth it overall, just wondering why.

[seanman05]

Hello, Swim plans to take paxil starting at 10 mgs a day for a week a 2, then moving up to about 20 mgs a day for social anxiety. Swim is 18, about 5'5" and 130 pounds. Swim has heard of the side effects and possible depression and increased suicidal thought. Swim isn't too afraid of the side effects though because he's not really depressed, he just wants something for his social anxiety. Are these side effects bad enough to where he shouldn't take paxil, and if so what should he take instead? He has tried herbal stuff like kava kava and st. johns wort but they don't work. So now he's looking for non-herbal, prescription drugs that might work a little better. Thank you for your help.

[Zee]

SWIM has personal experience with Paxil. Swim started for the reason that swim has previous Post-Traumatic stress experiences and Paxil is an SSRI that is supposed to specialize in helping that. It also should help with depression and social phobias; however, in SWIM's experience Paxil did not help. Paxil did develop suicidal behaviors and an increase sense of hopelessness. So, the simple solution was to talk to SWIM's psychiatrist and get off the damn thing. The withdraws are pretty nerve-wrecking if taken off too abrubtly.

SWIM recommends that SWIY should consider benzodiazepines like Xanax and Clonapin because these are known to be powerful stress reducers. Give Paxil a shot though and see where it takes you. It may help (everyone's different). If it doesn't work than SWIM should give some benzo's some thought.

One of the best method for reducing stress in social situations is to take deep breaths. And slowly... exhale... Good luck. Hope this helps.

[seanman05]

Thank you Zee.

Swim was actually considereing benzos but he wanted a long-term solution and not a short-term one. And with benzos, it wouldn't really help unless the drug is in your body. Also, he's heard about the the dangerous withdrawals of benzos. He knows paxil withdrawal can be pretty bad, but with benzos it sounds even worse with death and all. Swim will probably start off with paxil low dosage like stated and see how it works, and if he does get a feeling of hopelessness, he'll switch to a different ssri and possibly with the addition of a benzo. What other ssri's are helpful with social anxiety/shyness?

[FrankenChrist]

swim would try a different SSRI or SNRI before benzos. Benzo tolerance and addiction grow up on you real fast, swim's been told.
Plus, on SSRI's you can still function reasonably. I wouldn't drive a car on benzos.

[toe]

Newer evidence shows that a risk of suicidal ideation emerging on anti-depressants for patients up through age 30. History of suicidal ideation is irrelevant.

Paroxetine is unquestionably the most hardcore SSRI out there, due to its short-half life and IIRC its two active metabolites. It's not as simple as "switching to a different SSRI." My houseplants cannot overstate the importance of educating oneself as much as possible. They applaud SWIY for looking at all the angles and hope SWIY are also looking into talk therapy.

Since SWIY asked, flouxetine (aka Prozac) is really the only anti-depressant recommended for use in younger folks. My houseplants think that there are fewer side effects due to the drug's insanely long half-life. Flouxetine is probably the best place to start, but only under the supervision of a doctor.

[seanman05]

Only problem is that prozac isn't that effective against social anxiety, which is what swim wants the paxil for. Paxil seems to be the only viable answer to social anxiety.

[toe]

Citalopram, escitalopram and sertraline are all approved to treat anxiety disorders. Prozac is also approved to treat an anxiety disorder.

[seanman05]

Awesome. Thanks toe.

[Zee]

Out of curiousity SWIY--

Does SWIY find any relief with Cannabis? A dog of mine finds a great degree of social comfort from the herb except for the slight drawbacks: lack of focus, forgetfulness, and forgetfulness. This dog doesn't have any history of paranoia, thankfully. The only problem with weed is that he says the 'grace' period of social comfort will only last an hour or so and coming down can suddenly throw him into a depressed/nervous wreck state.

The other drawback with grass is the availability and legal issues.
SWIM brought it up though because in California where there are some 300 medicinal ganja dispensaries, receiving a prescription is supposedly as simple as telling a licensed doctor, "I have a lot of stress... think I can get some pot?" At least that's the word around the campfire.

Anyway, good luck and keep us posted!

[FrankenChrist]

Originally Posted by toe

Citalopram, escitalopram and sertraline are all approved to treat anxiety disorders.

Someone swim knows also thinks escitalopram is better than paroxetine (paxil) because of fewer side-effects but experiences can differ from person to person ofcourse.

[Lehendakari]

Originally Posted by seanman05

Only problem is that prozac isn't that effective against social anxiety, which is what swim wants the paxil for. Paxil seems to be the only viable answer to social anxiety.

SWIM has experience with paxil. He took it for social phobia and it did a great job. He considers paxil a life saver. SWIY should wait for at least a month for results to become apparent.

The only problem with paxil is that when you're off it your previus state comes back after a few weeks too. It's not a cure, but it changed SWIM, made his social life much less painfull.

Be ready for some nasty side effects including insomnia and low sex drive. In two weels side-effects are barely noticable but low sex drive remains. If you plan to have a sex you can stop for a few days with no consequences.

He still have issues about social anxiety but his time with paxil made him view things from another point of view.

Be carefull with alcohol, you can make very stupid decisions when you're drunk on paxil.

For more info you can check the threats "rate your ssri" and "paxil+alcohol"

Out of curiousity SWIY--

Does SWIY find any relief with Cannabis? A dog of mine finds a great degree of social comfort from the herb except for the slight drawbacks: lack of focus, forgetfulness, and forgetfulness. This dog doesn't have any history of paranoia, thankfully. The only problem with weed is that he says the 'grace' period of social comfort will only last an hour or so and coming down can suddenly throw him into a depressed/nervous wreck state.

SWIM is also a regular smoker and finds MJ doesn't help at all in social situations. It just makes everything worse. That's why he only smokes on his own or with very trusted people.

[toe]

Read this post (and would recommend seeking out the site of the author). But above all, please, for the love of god do not base SWIY mental health decisions on a bunch of talking houseplants, raver labrats, psychedelics monkeys, and tweaking flamingos on an internet forum. There are meds besides anti-depressants/benzos that can help with anxiety disorders but SWIY really need to be in the hands of someone who can provide actual real-time support and monitoring.

Many people find that certain anti-convulsants are helpful with anxiety, as well as somewhat unique buspirone. I know links aren't allowed, but I'm just going to suggest that googling "Crazy Meds Suck Donkey Dong."

Mods. . . I hope I haven't been too explicit here, homeboy really appeared in need of explicit directions.