Member Comments are provided by individuals and reflect their personal opinions only. Under NO circumstances should you act on any advice or opinion posted in this forum. ALWAYS check with your personal physician before taking any action regarding your health! MedHelp International and our partners, sponsors and affiliates have no obligation to monitor any comments posted on this site, or the content and/or accuracy of such exchanges. MedHelp International does not endorse the views of any user.
Mental Health (Expert Forum)
ANXIETY/FAILED MEDS/DESPERATTION/PLEASE HELP ME
Answered by
Roger Gould, M.D. - Mental Health, Wellness
Questions posted in the Mental Health forum are being answered by Dr. Roger L. Gould, author of the Mastering Stress and Depression program and affiliated with the UCLA. Department of Psychiatry. Topics covered include anger, attention deficit disorder (ADD), bipolar disorder, dementia, electroconvulsive therapy (ECT), learning disabilities, memory, obsessive compulsive disorder (OCD), panic, personality disorders, phobias, post-traumatic stress disorder (PTSD), schizophrenia, stress, transitions, and work problems.
ANXIETY/FAILED MEDS/DESPERATTION/PLEASE HELP ME
by 13tiger, Oct 19, 2003 12:00AM
Dear Dr.and anyone!!!I recently wrote about my PDoc putting me on Neurontin and wanting me to try Lexapro. You wrote me back now Here is what has happened. Short refresher of my problem:
I started having "DURING THE NIGHT ANXIERY ATTACKS" 14 MONTHS AGO; (WHICH WAS MANAGED, till now, BY 1 MG. LORAZ.in PM and on rate occas.I would take 1/4mg.in day) After learning my Husband has to have Valve Replacement surg. on his heart;Two weeks ago I started having severe DAILY ANX. 24/7 WHICH LANDED ME IN THE ER LAST WEEKEND; Next day, My Psyc. Med. Spclist. suggested Neurontin It was horrible; then they asked me to try Lexapro on Friday(.05mg.) and it was worse! I was a basket case and fell into a deep despair. My Husband took me to see the med specialist she and Psyc. told me to stop all of the above. I stopped prozac after 9 years 4 months ago and was functioning pretty well on 1 mg. loraz. at bedtime until two weeks ago. After I was told I had Prozac Poopout I have, over the Last 4 months, they tried Paxil, Traz.,Celexa, Serenity, and SAM-e all with the same side effects of the lexapro or worse. Now they prescribed Ambien as Loraz. won't get me thru the night like it always has. (I didn't want to increase the dose more and more).Ambien is giving me 4/5hrs sleep . The First nt. 1/2 tab.no loraz. then 1 mg. lorz. at 4am I was exhausted. I wok up a mess and was a mess all day depressed/crying awful! I took meclazine 25mg. for nausea and it made me feel worse/asthma etc. Desperate for sleep last night my husband sugg. I take 1 whole Amb. tab.w/1/4mg. loraz. got 6hrs - woke up took another Ambien 1/2mg. loraz. 5hrs. sleep. Woke up groggy, wobbly, Feel weak, hungover. I did force food down today; had not eaten since Thurs. I feel undelying anxiety don't know what to do for it I am so confused and just want my life back so I can function during the day. Can Ativan start causing depression even on this "low" dose over time. Is it working against me? Can I switch over to low dose Xanax without going off Ativan would it help me more and or longer. I want to go back to Prozac next weekend; want other meds out first. Will Prozac work again???? Please tell me it will I am desperate. I never had a prob. with it but now fear it will be like all the others!! !!!
I WANT MY LIFE BACK!!!! I HAVE JOINED AN IOP GROUP 2/3 X'S WEEK; FIRST WAS FINE I LIKED IT, SECOND I WAS TOO SICK AND FELT TRAPPED BECAUSE OF THE LEXAPRO REACTION. i GO AGAIN TOMORROW. I WANT ONE ON ONE THERAPY TO GET TO THE BOTTOM OF WHAT STARTED THIS BUT I KNOW I NEED SOMETHING TO CHEMICALLY BALANCE MY BRAIN SO I CAN COPE AGAIN. PLEASE TELL ME YOU HAVE SEEN PATIENTS GO BACK TO PROZAC ETC. AND HAVE IT WORK! HAVE I BEEN OFF LONG ENOUGH 6/16 STOPPED.
Can Xanax, short term while getting back on Prozac over 4/6weeks, help me thru the transition and daily anxiety; then wean off. Will it trap me, is that too long to be on it? Or will I have to wean off Ativan too or before or what???? Would it mask the effectiveness of the Prozac? Please Help Me I am desperate. I just want to not feel anxious when I start my Prozac again. I know the mind is powerful and when I feel this way I feel helpless and think negatively.
I started having "DURING THE NIGHT ANXIERY ATTACKS" 14 MONTHS AGO; (WHICH WAS MANAGED, till now, BY 1 MG. LORAZ.in PM and on rate occas.I would take 1/4mg.in day) After learning my Husband has to have Valve Replacement surg. on his heart;Two weeks ago I started having severe DAILY ANX. 24/7 WHICH LANDED ME IN THE ER LAST WEEKEND; Next day, My Psyc. Med. Spclist. suggested Neurontin It was horrible; then they asked me to try Lexapro on Friday(.05mg.) and it was worse! I was a basket case and fell into a deep despair. My Husband took me to see the med specialist she and Psyc. told me to stop all of the above. I stopped prozac after 9 years 4 months ago and was functioning pretty well on 1 mg. loraz. at bedtime until two weeks ago. After I was told I had Prozac Poopout I have, over the Last 4 months, they tried Paxil, Traz.,Celexa, Serenity, and SAM-e all with the same side effects of the lexapro or worse. Now they prescribed Ambien as Loraz. won't get me thru the night like it always has. (I didn't want to increase the dose more and more).Ambien is giving me 4/5hrs sleep . The First nt. 1/2 tab.no loraz. then 1 mg. lorz. at 4am I was exhausted. I wok up a mess and was a mess all day depressed/crying awful! I took meclazine 25mg. for nausea and it made me feel worse/asthma etc. Desperate for sleep last night my husband sugg. I take 1 whole Amb. tab.w/1/4mg. loraz. got 6hrs - woke up took another Ambien 1/2mg. loraz. 5hrs. sleep. Woke up groggy, wobbly, Feel weak, hungover. I did force food down today; had not eaten since Thurs. I feel undelying anxiety don't know what to do for it I am so confused and just want my life back so I can function during the day. Can Ativan start causing depression even on this "low" dose over time. Is it working against me? Can I switch over to low dose Xanax without going off Ativan would it help me more and or longer. I want to go back to Prozac next weekend; want other meds out first. Will Prozac work again???? Please tell me it will I am desperate. I never had a prob. with it but now fear it will be like all the others!! !!!
I WANT MY LIFE BACK!!!! I HAVE JOINED AN IOP GROUP 2/3 X'S WEEK; FIRST WAS FINE I LIKED IT, SECOND I WAS TOO SICK AND FELT TRAPPED BECAUSE OF THE LEXAPRO REACTION. i GO AGAIN TOMORROW. I WANT ONE ON ONE THERAPY TO GET TO THE BOTTOM OF WHAT STARTED THIS BUT I KNOW I NEED SOMETHING TO CHEMICALLY BALANCE MY BRAIN SO I CAN COPE AGAIN. PLEASE TELL ME YOU HAVE SEEN PATIENTS GO BACK TO PROZAC ETC. AND HAVE IT WORK! HAVE I BEEN OFF LONG ENOUGH 6/16 STOPPED.
Can Xanax, short term while getting back on Prozac over 4/6weeks, help me thru the transition and daily anxiety; then wean off. Will it trap me, is that too long to be on it? Or will I have to wean off Ativan too or before or what???? Would it mask the effectiveness of the Prozac? Please Help Me I am desperate. I just want to not feel anxious when I start my Prozac again. I know the mind is powerful and when I feel this way I feel helpless and think negatively.
Doctor's Answer
by Roger Gould, M.D., Oct 20, 2003 12:00AM
, Oct 20, 2003 12:00AM
I think that is very likely the Prozac will start to work again for you, so finding something to help while it is building up is the issue. Xanax is a good, very effective, short term answer as long as you off of it carefully when it has served its purpose...and that means over a 3-4 week period. Substituting that for Ativan should be no problem.
You tried a small dose of Ativan/Ambien but ended up taking a larger dose of them. It might not be a good idea to cut down on your Ativan to 0mg or 0.5mg in the “First” and “Second” nights respectively in such unstable situations. Ativan is for both anxiety and sleep while Ambien is for sleep only. Since Ativan 1mg cannot compromise your stresses, it may not be the best time to cut it down by adding Ambien. It may be a good idea to try Ativan 1mg and Ambien 10mg for sleep. Keep this until Prozac takes effect. Worrying the effectiveness of Prozac in the future and the addictiveness of Ativan at present may only neutralize their efficacies and produce insomnia.
Don’t worry since you are in good hands.
Firstly, sleep hygiene and stimulus control change behaviors of sleep.
The following is sleep hygiene:
(1) Avoid caffeine, nicotine and other stimulants before sleep.
(2) Don’t eat and drink a lot before bedtime. Don’t eat spicy or fatty foods, which can cause heartburns before sleep. No alcohol. One can take small amount of warn milk, tuna or turkey that contain L-tryptophan or complex carbohydrate like bread or cereal.
(3) A program of regular physical exercise (but not before sleep) enhances sleep.
(4) Take a hot bath or shower that relax muscles helps bring on sleep.
(5) Make sure you have a bed and pillow that are comfortable and offer orthopedic comfort.
(6) Maintain a comfortable room and body temperature during sleep. The bedroom humidity should not be too dry or too moist.
(7) Keep the sleeping environment quiet. Silence is very important. So, no TV or radio. Use double-pane windows and heavy curtains to ward off outside noise. Use earplugs if necessary.
Use the bed for sleeping only. Go to bed when sleepy. Fix a constant wake-up time. Get out of bed whenever awake for more than 15 minutes and do something else before getting back to bed. Avoid reading, watching TV, eating, worrying and other sleep-incompatible behaviors in bed and bedroom. Refrain from daytime napping. In these way, only successful sleep is re-associated with the bed, bedroom and bedtime. To rephrase, stimulus control achieves such re-association by curtailing sleep-incompatible activities in bed/bedroom and by establishing a consistent sleep-wake schedule.
Secondly, proper timing of sleep-wake behaviors and light exposure maintain the natural circadian rhythm that governs sleep. Avoid daytime sleep. Try to develop a habit of going to bed and getting up at about the same time everyday including the weekends. Keep one’s window covering closed to avoid light from the street that may disturb one’s sleep.
Thirdly, through somatic and mental relaxation training, the arousal system is calmed. Deep-breathing exercises, progressive muscle relaxation, meditation and self-hypnosis reduce both anxiety and excessive tension at bedtime. Avoid arguments and emotional talks near bedtime. Refuse violent scenes in movies or TV near bedtime. Listen to some relaxing music before sleep.
Fourthly, in order to achieve regular and correct behaviors for sleep, one’s cognition has to be changed. Understanding the rationale behind the above concepts will perpetuate the above behaviors.
Don’t fight insomnia because the anxiety and stress levels will rise and one will never sleep.
Paradoxical intention is to stop one’s fear of insomnia, e.g. one simply prepares to stay awake since one can still function the next day without sleep.
Yes, your mind can be very powerful if it can think in the right direction. Don’t allow the withdrawal symptoms of Ativan to discourage you.
Looking forwards to seeing your good news in your next post.
I recently started University A big part of my course involves presentations. I knew this before I started but still i applied. It was the first day (everyone is usually nervous arent they?) I had normal nerves but I was generally ok ( I think so This anxiety makes one confused) but it all started when the lecturer asked us to introduce ourselves to the class. He simply wanted us to give our name and just say what we did last year (education) if anything.
Well thats when it started I began to feel really self concious my heart started to speed up I felt I was going very red ( did anyone notice?) I was feeling hot and both really awake and confused. the time for me to talk was drawing closer and closer i tried to smile block it out but no, it wasn't going away, it seemed impossible to overcome, really impossible, i was scared. I remained in this state thinking about how I was going to sound I thought I ws going to cry if I opened my mouth (really) How I was going to sound was unknown to me and I felt trapped obligued to talk as everyone else did it. We it came to my turn i spoke quickly My voice very weak and I was trembling it was over well so I thought. Then the lecturer asked where I studied I answered in a similar quick broken weak emotional voice. I felt really ashamed, very scared, very confused, very trapped, the list is endless.