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Anxiety Community
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best sedating ssris anxiety dysautonomia?
by captainhook619, May 30, 2007 12:00AM
i have a general question about which ssris are the most sedating. about 2 and 1/2 years ago i went to my doc for some random palps and she prescribed alprozolam. i had no idea what they were and my dosing was 1-2 milligrams a day 2 times a day. so i took the pills as directed. Prior to the pills my symptoms were only intermittent palpitations.well after a few days on the pills, i started getting the strangest symptoms-muscle twithcing and jerking all ove my body, ringing of ears constant heart pounding, vibrations in the body and head, sun burn sensations. this continued on for a few weeks and i finally contacted my doctor. she put me through a myriad of tests and all was clear. but my symptoms were geting worse and worse. a couple of weeks later i went and saw my doc again and this time she told me to get on lexapro-again not knowing what it was. she told me that after a few days my symptoms would go away. well they didn't. in fact i started feeling like i was on a boat and my head began to feel as if there was liquid sloshing and slamming from side to side and i had this crazy head pressure and 24/7 adrenaline surges i finally went online and realized what she had given me.
I was furious and told her that i wanted to get of the meds right away. she said that i should stop taking them and that everything would be ok. big mistake. all my symptoms became more intense and i had fill blown rotary vertigo. then i developed electric shock sensations throughout my body-like the ones you get from carpets- but they were constant and all over. fast forward to today and i still have the same nasty symptoms. i have done the full battery of tests and everything is normal. my docs seems to thing that it could be tied to anxiety from what i went through or dysautonomia. some docs have suggested that i go back on an ssri level off then come off. a top balnce specialist on the wes coast uses ssris as a first line to treat my kind of equilibrium isues
in the groups experiences with the ssris, which have been the most sedating on the nervous system??? most of my problems came from being accidentally addicted to the alprozolam and getting interdose withdrawals. i was only on the ssris for 3 weeks and the generic xanax for 2 months but at 4 mg a day i need my life back. thanks johnny
I was furious and told her that i wanted to get of the meds right away. she said that i should stop taking them and that everything would be ok. big mistake. all my symptoms became more intense and i had fill blown rotary vertigo. then i developed electric shock sensations throughout my body-like the ones you get from carpets- but they were constant and all over. fast forward to today and i still have the same nasty symptoms. i have done the full battery of tests and everything is normal. my docs seems to thing that it could be tied to anxiety from what i went through or dysautonomia. some docs have suggested that i go back on an ssri level off then come off. a top balnce specialist on the wes coast uses ssris as a first line to treat my kind of equilibrium isues
in the groups experiences with the ssris, which have been the most sedating on the nervous system??? most of my problems came from being accidentally addicted to the alprozolam and getting interdose withdrawals. i was only on the ssris for 3 weeks and the generic xanax for 2 months but at 4 mg a day i need my life back. thanks johnny
First line treatment is the combination of two drugs: (1) A Benzodiazepine, and (2) A non-selective Beta-Blocker.
The two work in concert to supress endogenous catecholamine release, and to "balance" the autonomic nervous system during periods of upset.
The typical treatment would consist of Klonopin 1/2 mg BID, and Inderal 20 mg BID (must be indivdualized).
I personallly would avoid all SSRI's if Dysautonomia is a potential etiology for your symptomatology.
IF you have any cardiac related manifestations (elevated blood pressure, tachycardia, ECG changes), SSRI's are contraindicated.
-Ryan
Ryan, my cardiac workup has been normal. My blood pressure is 100/70 and my resting pulse is between 60-70. but i do have the pounding heart issues. I saw a cardiologist at UCLA who knows about dysautonomia and he said that i don't have it. this possibility was mentioned by one of my neuros.
being that my blood pressure is low to begin with, would the beta blocker have an impact to lower my blood pressur even more. also with the benzodiazipines, i quickly became addicted to the xanax so the potential is there for some tolerance and addiction issues.
were you ever diagnosed with dysautonomia and if so what tests did they do to come up with the diagnosis.. i looked up some dysautonomia websites and some of them say that ssris are an option. its just frustrating when there is so much info out there.
also if it is just unrelenting underlying anxiety, would ssris then be viable option. thank you for both of your responses particularly Ryan
Captain,
Good numbers there (BP and pulse). Palpitations can be a physiological or psychological manifestation (an awareness of ones heartbeat). In light of the normal cardiac work-up, it is probably safe to assume that the palpitations are from a psychological cause.
Beta-Blockers do lower blood pressure, but they are lousy choices for the control of hypertension. They mostly affect the rate. If your rate is 60-70 bpm, beta blockade wouldn't be desirable.
Xanax is the worst Benzodiazepine for the "management" of long-term anxiety disorders, and is probably why you had a problem with it. The four hour half-life causes trouble.
On the other hand, for occassional use, Xanax is the best Benzo.
Dysautonomia is more of a clinical diagnosis (one based on symptomatology), rather than laboratory results (largely because there are very few tests specific for it). It usually presents with some form of mild cardiac defect or manifestation. In my case, it was dilated cardiomyopathy (which isn't mild).
Would SSRI's be a viable option for unrelenting *anxiety*? Maybe, but you may need to try a few different ones until you find the best one for you.
I'd also consider a Tricyclic (Sinequan, Tofranil, Anafranil, Elavil). These are older 70's drugs, but they are highly effective.
If those two classes fail, Librium 25 mg TID or QID should work well. You won't have the tolerance and addiction problems with it. If Librium fails to work, Klonopin 1/2 mg BID would be a good choice as well.
So, you have three possible choices to explore (SSRI/SNRI's, the Tricyclics, and the Benzodiazepines).
-Ryan
Let me tell you my story.
My name is Crystal, and as like you, as of October 31st at 3am, I began having the WORST bout of chest pains, heart palps, you name it!! I thought I was going to die or have a heart attack. I knew I had mitral valve prolapse, and thought I was having a heart attack as a result of that. However, little did I know what really lay in store.
I went to ERs (like 3 different ones??), all of whom told me it was "stress reaction," "anxiety attacks," and most often just injected me with a benzo and sent me home. I was then put on a cardiac-specific beta-blocker (which Ryan has made you aware of), and it worked WONDERS!! Nevertheless, it still wasn't enough to get rid of all of my attacks, so I went again to see my GP.
She then put me on Zoloft....OHHHH BOYYYY, was that the WORST 2 MONTHS OF MY ENTIRE LIFE!!! The first DAY I took it, I felt EXTREMELY TIRED, WOOZY, LIGHTHEADED to the point I cannot even describe, almist a sickening lightheadedness that would've made me barf or pass out, but I didn't...
I stopped, scared of taking the pill after that one day, and waited a few more weeks...
Yet still getting the heart palps and chest pains, I was DESPERATE for something to cure my ailments!! So I went ahead and started the Zoloft...and it was the worst 2 MONTHS OF MY LIFE!!
I was on the drug for about a month (4 weeks), and that month was the 1st of the two of my worst months in my life. 2 Days into taking the med., I was lying in bed waiting for my fiancee to get ready for bed, and all of a sudden I felt this ELECTRICAL SURGE/JOLT/TEN-FOLD PINS AND NEEDLES feeling surge through my brain. I also just felt "sick" and "blah" in the head, a feeling I cannot fully describe. It jolted me out of bed, that's for sure!! Well, before I knew it, it was a full-blown attack, and it even caused me to sweat profusedly and have hot flashes like no tomorrow, the electrical surges continued, and I began seeing blothes in my field of vision. I FREAKED, thinking I was going to pass out or something, and ended up going into full-blown PANIC. I just wanted whatever it was to STOP mostly, and I tried to keep my calm. It passed after several off-and-on bouts for about 45 min., then I was able to go to bed for the night, drained from the attack.
The following day, I just felt BLAH, sluggish, and barely able to bring myself to talk, probably exhausted from the attack before on my poor brain. Unfortunately, the following day was my Grad. ceremony day from college, so I had to miss it due to how horrible I felt. :(
I then had another attack the following Wed. that lasted off-and-on for 2 1/2 hours, similar to the first attack, but not as draining or severe.
I then went 2 weeks without problems, but the med. caused me some occassional weird mood feelings, like anger that didn't feel right and whatnot. It only happened once in awhile.
Anyway, after those initial 2 weeks, I then started having 2 ATTACKS EVERY DAY!! Since I was on the Zoloft and it was improving my mood mainly, it at least HELPED ME TO SURVIVE WITH MY SANITY!!! I was shocked at how optimistic I was through it all, even though the med. was causing my brain and body physical hell.
After those 4 weeks/month, my nice yet dimwitted GP FINALLY told me to stop the med, but told me to QUIT IT COLD TURKEY!! OHHHH BOYYY....now it went from HELL TO WORSE!!!
I was still getting attacks, and the attacks seemed to progressively get WORSE!! They got SO bad to the point where it felt like my brain felt like it was going to cause me to go into convulsions or have a stroke someday or SOMETHING!! It at times felt like my brain was going to split in two, what a HORRIBLE feeling!! And sometimes I woke up in the middle of the NIGHT from it!!! It truly was the worst months of my life!!!
One time it was SO bad: I was sitting at my computer, typing or working on an artwork, and all of a sudden I felt the weird feeling in my head that I was about to get an attack. I at first sat and prepared to stand, when I felt it HIT!! My right side of my brain felt like it was going to go haywire, like it was going to cause me to have a STROKE or SEIZURE or something...I didn't know what the hell what, yet I was able to stay calm and sane, mostly. I did call 911 though, frightened of what was happening. I felt this painful electrical surge up and down my spine, through my brain, and knot pains in my back and neck. I walked down stairs of my apartment and waited outside for the ambulance, praying for the attack to pass and for me to be OK. I could STILL feel my brain going haywire, and my right leg, while on the phone with the EL, began to go NUMB, then kind of bent upward and went COMPLETELY LIMP!!! OMG!!! The person on the other line thought I was having a TIA or mini stroke