Opinions - SSRI's Used to Treat Anxiety

[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.

[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]

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

[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.

[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!

[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.

[Laudaphun]

Anti-depressants work terrific for SWIM's daily anxiety! In fact they couldn't releive it any moreso. Anti-depressants time and time again, as they begin to gradually take effect over days, weeks, a month... start to make SWIM not want to get out of bed in the morning. SWIM starts to just not care enough about anything to bother getting out of bed, hence his anxiety is totally gone as he is without a care in the world. There becomes nothing for SWIM to be anxious about as he just doesn't care anymore.

The doctors kept telling SWIM it was just a matter of finding the right one, but after they had all but exhausted every single SSRI/SNRI they decided these were not the drug for SWIM to be on. On a side note, SWIM was never being treated for depression. Just being given everything in the world to avoid giving SWIM more benzos. As far as social anxiety goes... that's a totally different beast for SWIM. None of the anti-depressants helped with social anxiety.

In the end, SWIM decided to see a psychiatrist who suggested a TCA which surprising, in SWIM at least, lacked most of the weird feelings of the SSRI/SNRIs that SWIM despised so much. Problem was that they relieved anxiety without causing SWIM to cease caring about life in general, but again they totally ineffective for social anxiety. SWIM can deal with everyday anxieties and such, but social anxiety is where she has troubles. So, SWIM has since discontinued the TCA for the simple fact that they only helped anxieties that SWIM could have coped with on her own, but lacked effectiveness, like all the other AD's for social anxiety which is SWIM's biggest obstacle.

Crazy as it sounds, ADD medication works as good as anything "most of the time" for SWIM's social anxiety. SWIM guesses that this is resulting from an increase in confidence provided by the drug and making SWIM slightly more assertive. ADD meds obviously aren't helpful in acute situations, just an overall reduction in social anxiety while taking them regularly.

SWIM's opinions are that it's stupid to spend 3 years trying each of the different SSRI/SNRIs to treat anxiety, when you are not depressed. Maybe they help some, but SWIM felt like she was beating her head against the wall. Perhaps anti-depressants should be reserved for what they were originally intended for.

[truth]

SWIM hates SSRIs and Actually prefers benzos. Prozak and Wellbutrin never worked for SWIM. SWIM is now on Lexapro and feels better then usual. SWIM is also on xanax and smokes cannabis often though to help with his panic disorder. But Lexapro is the Only one that worked for SWIM. and SWIM is pretty hard to impress.

Reputation Comments on this post:

pretty much how i feel, although i don't take lexapro anymore

[welshmick]

SWIM has tried Citroplex - made me much worse, cold turkied and stuck to Diazepan.

The doc then tried SWIM with 'Trazodone' , they did help get my diazepan use down from 40mg per day to 2mg a day, so thats good I guess.

Have giving up the Trazodone, generally made me feel hypnotised and confused, SWIM now struggling on just 2mg of Diazepan a day.

SWIM also drinks too much, and likes MJ ............ wish I had never used anything now. Life is a mess.

[jb2008]

Right. Prozac (Fluoxetine) in theory should work for anxiety because it is an SSRI. Remember that serotonin, amongst its many functions, is a fundamental component of feelings of relaxation, comfort and contentment. However, the other (and often contradictory) thing to remember about SSRIs is that they can often simply 'not agree' with people, for reasons thus far unknown (a lot of this field is a very much inexact science).

Though SWIM is not a psychiatrist, he has extensive experience with SSRIs/SNRIs, serotonin and dopamine as well, and he would firstly not recommend benzodiazepines as a line of treatment. They should only be used as a last resort. People say that SSRIs give one a 'false' sense of happiness but they are in fact meant to recorrect the brain's natural balance. Often people who take these don't have physiological problems with their brains, it is simply that, something in their life sucks balls and thus Paroxetine/Venlafaxine/Fluoxetine or whatever will in fact do nothing for them, and their hopelessness will persist or even get worse due to the adverse effects of the drug, especially at the beginning of the cycle.

SWIY, however, seem to be anxious and I also note the history of OCD. SWIM thinks that your doctor has a very general and hazy idea of these medications. SWIM finds that you will only find true competence with a specialist in any given field, for example, if your back/joints are injured, going to your GP is more often than not quite useless. You would go to an osteopath/chiro instead. That might be an option SWIY might want to consider, though SWIY might have to pay for private consultation.

SWIM can give you his opinion, however, though SWIY should read once again that SWIM is not a psychiatrist.

SWIY should firstly start safe. Eat well, a diet high in animal protein (milk, yoghurt, beef, chicken, fish, egg etc. 70g+ per day), slow release carbohydrates (oats, grains, brown bread etc.) and healthy fats (olive oil, fish oil). 2500+ calories/day. Take a multivitamin/mineral tablet: make sure you get your zinc and magnesium. Exercise well. Go for a run until you are completely beat. Take 3-6 mg of melatonin 1 hour before bed. Along with this take 100mg of 5 HTP before bed. If that doesn't work, go up in 100mg increments per day until you reach 500 mg. If that does nothing, stop 5 HTP as it clearly isn't working.

In terms of an SSRI for anxiety, SWIM would recommend Escitalopram (Lexapro) simply because it is very well tolerated and is proven for anxiety. If it doesn't work, the withdrawal to get off it will be relatively easy. Be patient with this. Spend 4 weeks on the initial first dose and move up every 2 weeks until you reach a fairly high dose, as recommended by SWIY's psychiatrist. Go for another 4 weeks (should be around 3 months total to try it all out). It should work. Take some 5 HTP with that and SWIY should be calm.

[cnsns2ccl2]

Swim agrees that Paxil is extremely effective for treating anxiety. Swim has also tried Zoloft and Ciprilex. Paxil is the best swim would say but ciprilex is also effective. The thing about any SSRI is that they take about a month to start working and swim felt even worse at first when she started taking them. If you can get through the first few weeks, it does get much better. The only problem with Paxil is that it causes a lot of weight gain!

Swim didn't have any problems with withdrawl coming off paxil. The first time she stopped taking it all together becuse she no longer had any anxiety but stopping any SSRI suddenly is a BAD BAD idea. Swim was weaned off paxil under the care of her doc. This took about a month to do. Of course after the paxil was out of her system, the anxiety came back full force so she went back on paxil. After gaining 30 lbs, decided to try zoloft and was again weaned off paxil by slowly decreasing the doses of paxil and slowly increasing the doses of zoloft.

From swims experience and the people swim knows, swim thinks SSRIs are more effective for treating anxiety than depression. In fact, they may contribute to depression somewhat it seems. They are not nice drugs and are not to be taken lightly but if one is having anxiety to the point where it is interfering with one's life, it is a better route to go than to treat with benzos on a constant basis as a benzo addiction is much much worse and happens quite easily. One's tolerance to SSRIs does not go up and one doesn't tend to have the desire to take more than their one daily dose as it does nothing good for them. There will be side effects but in swims opinion, not nearly as bad as constant anxiety or panic attacks.

[spacelord]

SWIM is happy being treated with citalopram for anxiety, well actually OCD and not benzos. I'm sure it's possible to use drugs responsibly but SWIM might not have been able to use them responsibly when always having an easy fix at hand every time he gets anxious.