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.

[staples]

Originally Posted by smithdogg1

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.

This is a little backwards; it is my understanding that the benzodiazpeines (generally, but ativan/lorazepam in particular) become hypnotic at slightly higher theraputic doses, while they are anxiolytic at lower theraputic doses.

Originally Posted by smithdogg1

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.

... but benzos don't mess with your brain chemistry or cause dependence??

Originally Posted by smithdogg1

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?

Yes, I do believe (know) that some people can use benzos long-term responsibly.

SSRI's, despite the heresy you'll find, have a logical basis for treating anxiety. Consider:

Originally Posted by Fundamentals of Psychopharmacology

The three neurotransmitters that appear to be most directly involved in different aspects of anxiety are noradrenaline, 5-hydroxtryptamine (5-HT) and gamma-aminobutyric acid (GABA).

Noradrenaline is the neurotransmitter most closely associate with the peripheral and central stress response. There is experimental evidence to show that drugs such as yohimbine that block the noradrenergic autoreceptors (e.g. on cell bodies and nerve terminals) and thereby enhance noradrenaline release cause fear and anxiety in both man and animals. Conversely, drugs that stimulate these autoreceptors (as exemplified by clonidine) diminish the anxiety state because they reduce the release of noradrenaline. Benzodiazepines have been shown to inhibit the fear-motivated increase in the functional activity of noradrenaline in experimental animals, but it is now widely believed that the action of benzodiazepines on the central noradrenergic system is only short term and may contribute to the sedative effects which most conventional benzodiazepines produce, at least initially. Nevertheless, altered noradrenergic function may underlie certain forms of severe anxiety such as that seen in patients with panic attacks or anxiety states associated with major depression. Such forms of anxiety generally respond to treatment with antidepressants or benzodiazepines that also have some mild antidepressant properties (e.g, alprazolam).

Several experimental studies have suggested that a reduction in the activity of 5-HT in the brain results in anxiolysis, and therefore the anxiolytic effects of the benzodiazapines may be at least partly mediated by a reduction in central serotonergic neurotransmission. Other studies have shown that benzodiazepines inhibit the firing of serotonergic neurons in the midbrain raphe region, an area that contains serotonergic cell bodies which send projections to the limbic and cortical regions of the brain.

The link between the serotonergic pathways and the control of anxiety has been further strengthened by the introduction of non-benzodiazepine anxiolytics such as buspirone, ipsapirone and gepirone, which decrease central serotonergic function by stimulating a subclass of 5-HT receptors (5-HT1A), leading to a decrease in serotonergic release. Despite the connection between the decreased functional activity of the serotonergic system and the anxiolytic effects of the benzodiazepines, it would appear that their effect on serotonergic transmission is indirect and probably mediated via a facilitation of the principal inhibitory neurotransmitter, GABA.

Then it talks about GABA of course, which it sounds like most are already familiar with the reasoning there so I won't type it out also.

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.

[Daniel Lioneye]

Today, SWIM was prescribed a drug called Lexapro(escitalopram oxalate), although for depression mainly, and some lighter anxiety..

This appears it may be be what SWIY are looking for, SWIM just started taking it today, so SWIM has no input on the drug.

Here is some info SWIM found on another site -

What are FDA Approved Uses: Lexapro (escitalopram oxalate) is approved and used for:

• Major Depressive Disorder (a.k.a. feeling like Whale Shit at the Bottom of the Ocean) August 2002
• Generalized Anxiety Disorder (GAD) December 2003

Pros: Lexapro is the most selective of all the Selective Serotonin Reuptake Inhibitors (SSRIs). Many people who take Lexapro have reported that it has better effects and lower chances for side effects than other SSRIs. When side effects do strike they tend to be less harsh. Lexapro gets rave reviews from the Panic/Anxiety community.

Cons: The dosage of Lexapro is such that discontinuation can be more difficult than with other SSRIs. Not because Lexapro is more addictive, it's not. Paxil (paroxetine hydrochloride) holds that honor (for true SSRIs that is, Effexor (venlafaxine hydrochloride) is not a true SSRI). It's just that you don't have many dosage options with Lexapro. The same goes with its use in bipolar, making it way too easy to trigger mania. Although to be fair, fewer people in the bipolar community reported manias when starting Lexapro (escitalopram oxalate) than with other SSRIs.




Here is some info that compares the drug with Celexa.



Lexapro vs. Celexa vs. Placebo This review pools the results of studies comparing Lexapro (escitalopram oxalate), Celexa (citalopram hydrobromide) and good old Placebo. So not much in hard numbers, other than 56% of the people taking Lexapro responded to it, vs. 41% of the people taking Celexa.
Lexapro vs. Celexa for suicidal ideation (thoughts). You know you're really depressed as fuck when you're sitting around all day thinking about offing yourself. So what's the better drug for you, Lexapro (escitalopram oxalate) or Celexa (citalopram hydrobromide)? And how much of either should you be taking? Fortunately someone decided to do a study on just that. Well, they just wanted to do the study on how much of either was more effective and sort of stumbled on the suicidal ideations as the best way of measuring how well things were working. In the end the data are kind of weird. Compared with Celexa, Lexapro works better right aware and in the long-run (after 8 weeks). But between two and eight weeks there doesn't seem to be much difference between 20mg of Lexapro and 40mg of Celexa.
Lexapro vs. Celexa for old people's panic attacks. They're messing with Social Security! The supermarkets rearranged all the aisles! Everyone over 70 has to live in a home whether they want to or not! Those kids won't get off the lawn! Every day Matlock is on at a different time! OK, enough with the old jokes. Studying the effects on geriatric patients is actually important science. The result of this study - Lexapro (escitalopram oxalate) works in half the time. Surprised? Otherwise there's no appreciable difference.


How Lexapro Works In Your Brain: Lexapro (escitalopram oxalate) is the most potent and most selective of all Selective Serotonin Reuptake Inhibitors (SSRIs) on the market. According to this study it's 30 times more potent and selective than Celexa.

Hope this helps.

[tayo]

yeah usually celexa is great after initially loading up, since panic attacks and anxiety can increase until the drug is in the system, benzos are used while starting out, but with the SSRIs swim has tried Prozac and Celexa and both made SWIM feel emotionally numb, and zombie-like which swim didnt like at all. Celexa also had caused change in libido so swim got away from that.

[RealGanjaMan]

Hi all.
SWIM is currently prescribed at 20mg (1 pill) of fluoxetine per day. SWIM was originally prescribed this medication for anxiety, but SWIM notices that it seems to help with other anxieties and depression more than social anxiety. It feels to swim like it doesn't help social anxiety much at all.

So to all you SWIY's that have had experience with SSRI's, in your opinion what is the best method and medication for social anxiety? SWIM will be speaking to a doctor about this as well, but he want to get your opinions first.

[toe]

They really work differently for everybody.

[spacelord]

Maybe switching to another SSRI might do the job. SSRI help with a lot of disorders and different types of anxiety. So i would recommend talking to your psychiatrist. As toe said: They really work differently for everybody.

[Micklemouse]

Threads merged.

[LexaproHo]

Citalopram and Escitalopram in swim's opinion were and are the best for anxiety when it comes to SSRI's. Venlafaxine was THE worst for swim! SSRI's are nowhere near as fast and effective as benzo's but they actually do help for most anxiety types in the long run. Swim has suffered from GAD for many years and hasn't had bad anxiety for 2 years since swim started Cipramil/Celexa then Lexapro, which is even better IMO.

[fireflywa]

Paxil worked absolutely great for swim when he had horrible social anxiety. He was off the drug for four years, then started it again...and had only negative results. Swim has heard talk about Paxil failing to work as it did before if one has stopped for a while and then started again.

[dizzylizzy]

Swim has tried every ssri on the market over the last twenty years. None of them worked for swim;s anxiety until a new drug came out, "Symbyax". It's a combination of prozac, an ssri, and olanzapine, a benzo/anti-psychotic. Swim has no racing thoughts, and life is wonderful compared to before taking this drug. Swim took prozac years ago, and it made swim think terrible thoughts, but this combination has really worked. But as it has been previously noted, different things work for different ha people. You just have to not give up, even if you have to switch dr.'s. Keep trying. But Swim highly recommends this for those who have tried everything else, especially those with manic depressive disorders who abhor lithium and other mood-stabilizing drugs.

[imyourlittlebare]

swim had great luck with celexa for a while but found the best way to deal with his anxiety was a glass or two of kava tea a day. natures GABA agonist it has alot of the features of benzos without some of the side effects. before you become pot committed to celexa perhaps give that a try? its much milder than something as strong as a ssri. dont mix benzos and kava though. bad. mmk

[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.