Drugs...Yes! No! Maybe So!

[barfer]

We have touched on this subject already but it has come up again in another post so I decided to open it up for discussion again.

So many of us are meds phobic and don't want to try medication.  Others are willing to go down that road and have had great success, some others not.  The important question here is, Do you have panic/anxiety with agoraphobia first or was it depression that lead you to have this disorder?

This is a very important question because it make a huge difference how your doctor will want to treat  you with medication.  The medication you take if you initially have depression will generally be either an SSRI, SNRI, tricyclic, something that is really prescribe specifically for depression.  If you don't have any depression at all, most doctors today will be more inclined to prescribe the older types of medication that they have now come to realize are the best route for people who ONLY have an anxiety disorder (Panic disorder, anxiety disorder, GAD) those disorders that are typical of people with agoraphobia and they are the LONG ACTING benzos.  The short acting benzos should just be used on an as needed basis and if they are used more frequently than they should, it is better to switch to the long acting benzos like klonopin or valium to be taken on a daily basis to reach steady state. Another medication that is used with good results for some people with anxiety are beta blockers.

Now that may sound like a bold statement especially coming from a non medical person BUT there are exceptions to my little rule (as there usually are with rules).  If you present with depression first and then have anxiety or panic, the SSRIs and SNRIs or tricyclics are great meds.  Sometimes that requires the addition of a short acting benzo for those days when just the antidepressant won't cover the anxiety/panic that you feel.

Having made these statements, there are a lot of people who will disagree with me because they have been on an antidepressant for a long time and have had good results with it for their panic.  These statements I have made are my thoughts only and I look forward to hearing what other have to say strictly about medications they have taken or are taking that they feel have helped them with their panic and agoraphobia.  

It is important that we become educated in what is out there that can help us with our progress and any information or discussion about this topic helps us all make good decisions with our on going mental health.

[MrGreen]

Well I don't suffer from depression and take a 30mg anti-depressant called Zispin. Why? Because it is known to work well for anxiety. People who suffer from depression seem to hate the tablet. Makes them tired all day and gives them bad nightmares at night. Oddly I only get the nightmares. Which I don't mind. So it shows the effects certain forms of medication can have on people with various conditions. I once tried Exfexor and it blew me away. Made me much worse. That's another anti-depressant. Classic example of how anti-depressant can help and one can make you worse. Reason for this normally is that when you suffer from anxiety you are up too high. You need medication to bring you down and relax you. Anti-dpressants are designed to bring people up who are feeling down. So some bring anxiety sufferers up too far. Do more harm than good. Took them ages to get me to trust the Zispin. Had to make a deal with me. I had been through the Exfexor hell and expected the same thing. Other tablets bounce off each other. Making the side effects four to five time worse. Was there for a day once. Gave that tablet up after only one. So there are a few reasons why doctors like to try you on medication for a short period. See how it goes. They might alter the medication. Take you off one form and replace it. Depending on what you tell them. Feedback is always important. That is the only way they know if the medication is working as it was planned to do so.

[ducky8]

Here's another side of the coin.  I don't take any meds at all.  I tried to take Paxil, but that only lasted a month.  It made me feel anxious all the time, and I felt like I had no control over the anxiety.  There was nothing I could do (deep breathing, yoga, etc.) that would make the anxiety any better.  It made me feel out of control, and I hated it.  
That's when I decided that SSRI's weren't for me.  I'm not a depressed person, so I didn't see why I should take them.  I have some xanax tucked away in my room, but I've never taken one.  
I'm med phobic, and would rather do the desensitization without any meds.  
But, for some reason, it's good to know the xanax is there...........Just in case.......

[barfer]

MrGreen makes some very good points here from his wealth of personal experience.  Interestingly, the only antidepressant that I tried (and there were many) that actually worked for my anxiety disorder was Remeron (mirtazapine) also know as Zispin the medication that MrGreen is on.  I, on the other hand did not have any problem with nightmares while on that medication and slept like a baby at night.  Many of the other SSRIs I tried gave me horrible vivid dreams and I couldn't sleep or stay asleep without taking ativan.  Remeron (mirtazapine, Zispin) is one of the medications that many have had good luck with.  

[Dknd4v]

I have always suffered from depression- so i thought. now ive come to relize its actually my nxiety disorder that just make me so out of wack! Ive taken every anti-deprrssant you could think of. the only real med tht works for me is ativan cuz its not too strong but for sleep im prescribed 2mg xanax, but klonopin is good to keep your anxiety down all the time. I never got physically/mentally addicted to those meds so i have never had a problem tking them. but i have hd crazy side affects with depression meds over the years.

[MrGreen]

You say you never got addicted to the meds. Have you ever tried quitting them? I mean just stopping. That's when you know whether you are addicted or not. Especially to the xanax. If you take that at regular times you can't miss a tablet. You'll know all about it if you do. When I was on xanax I once had to skip two. That was 16 hours without. It was a living hell come to life. My whole room seemed so much bigger. Just to try and get from one side of the room to the other was a task. I remember my mother coming into the room. She seemed miles away. Her voice was a distant echo. Talk about whacked out of it. But the second I took an xanax it all just stopped. The room was the normal size again. My mother was next to me and I could hear her. An experience I will never forget.

[werewolf74]

I have quite "an experience" with psychotropic medications. I was firstly, mistakenly, diagnosed with OCD (the constant thoughts of being afraid that something might happen to me, that i needed to be close to the hospital - aren't they typical panic pattern thoughts? Anyway, another psychiatrist diagnosed me with PD with Agoraphobia) and got Anafranil (Clomipramine), Desipramine and Tegretol (Carbamazepine) to take together, so that my thoughts would go away. I was too tired/ sleepy after taking Anafranil, so my then doc put me on Paxil and the Hell broke loose...Actually, it was during the first week of Paxil when i had a full-blown panic attack, although i had panics before that. I was feeling so bad on Paxil, but also desperate to get better from what i thought was OCD, i asked my doctor for help. This is when he prescribed me Xanax to take "as needed"...The funny thing is "the as needed" quickly changed into "i need it all the time..." I would carry it in my purse/pocket/jacket/anywhere, and the moment i'd start feeling panicky, i'd take a pill. And it got out of hand.
Then i switched a psychiatrist, who put me on Luvox, and - almost miraculously - i managed to break free from the Xanax addiction. I stayed on Luvox for 2 years, was feeling more or less OK, but still agoraphobic...and decided to stop because i WAS STILL AGORAPHOBIC. Getting of Luvox was pure Hell. Honestly! I had severe headaches, so severe in fact doctors suspected a brain tumor and i went through all the CATs, MRIs,etc. (NOT a good thing for someone with agoraphobia). But they couldn't find anything. When i asked if it was possible to suffer from withdrawal symptoms of Luvox, they told me it was just my anxiety returning. Right. I'd never had such headaches before...
So i was once again put on Xanax (now i'm addicted to it :( ), and tried Celexa and later Lexapro. Side effects - you don't need a book or a leaflet of the possible side effects i had on either of them.

Yet, it IS said that SSRIs sort of need time to readjust your brain and body before they start showing their positive effects. Sometimes it can even take up to 3 months...But i'm not sure about the waiting (and headaches...now any psychiatric med i take, except xanax (sic!)).

Also, i'm not sure if any of you have ever watched a programme about benzodiazepine addiction. The addiction to VALIUM, LIBRIUM, CLONAZEPAM - the long-working benzos. If you ever get a chance to see it, DO!!!
I'm sorry for being blunt, but being in my shoes with xanax, and knowing about my Grandma's "strange behaviour after taking Valium" (she died before i was born, so no one really knew what was going on with the benzos), i think they should be taken in very small amounts. I would never wish anybody what i'm going through. And i know what MrGreen says about feeling all weird, not in this world really, until he took his xanax tablet. I know it very very well...

I don't know how many here are from the UK, but they're starting/ or maybe have already started/ a huge anti-benzos campaign. If anyone's interested, there's an interesting link:
www.benzo.org.uk

As i said earlier, in my other post, living in Poland means you basically get stuffed with meds. The place where i live is quite big for my country's small size :) - there are about 700,000 people living here. And there is only ONE CB therapist in the whole city!!! Thank G-d i managed to locate him...but via my friends in Warsaw !!!

But all in all, we have to give ourselves ever chance of getting better/ including better understanding of the disorder/, and when meds (just not benzos, please...SORRY!) help, we should take them.

I hope i haven't offended anyone by what i say in this post. I'm just trying to put my point across. Thanks.

[barfer]

Welcome to this discussion Werewolf and DKnd4v.  It is nice to see some more newbies to this new forum.

To start with, don't worry about offending anyone about medication because everyone is entitled to their opinion and this discussion was supposed to be open and honest so no one should get offended.

I hear what you are saying about the addiction to benzos which is way out of control in most countries because a lot of doctors simply prescribe them without really investigating if they are really needed or appropriate for the individual.  I am aware of the movement in the UK to ban benzos.  Frankly, if they decide that should actually happen, then they will have a HUGE problem on their hands not only from those who have depended on them for many years but also, from the backlash of those who have had problems with SSRIs.  

SSRIs are big business in all countries and they are far more expensive than the benzos that have been around for many years so therefore make the pharmaceutical companies extremely wealthy.  Propaganda is a dangerous business and without doubt, any medication that is abused will cause horrible side effects, benzos aren't the only ones that create that nightmare.  While there has been a movement in the UK to ban benzos, there has been a realization in North America, to some extent, that the old long acting benzos prescribed correctly, are more effective with many anxiety/panic patients who have not had success with SSRIs, tricyclics or SNRIs.  

Back when your grandmother was taking valium, it was common for women of that time to carry it in their purse and use as needed.  It was referred to as their "nerve pills".  I remember those times very well as my mother also carried valium with her and I swore I would not let that be the case for me.  Little did I know that it would be me but with a difference.  We are far more knowledgeable than our mothers or grandmothers were about medication.  Basically, they looked at doctors as being the closest thing to God and didn't even question what they were given.  If a doctor prescribed it, they took it, no questions asked.  We have the opportunity to be far more knowledgeable about the medication we are prescribed.  With knowledge there is power but with all the choices out there it can still be a tough decision as to which way to go.

The long acting benzos were definitely abused in the past and when the pharmaceutical companies came out with SSRIs the doctors started to prescribe these as alternatives to benzos for everyone from those who suffer from depression to absolutely anyone with a mental health problem.  Now I'm not saying there isn't a need for these types of medications and for many people they have been very helpful but the bottom line is, they aren't for everyone and alot of people who present with panic/anxiety (no depression) these medications simply did/do not work.  I know from personal experience that this is the case and there are numerous of us out there who feel the same.  

A doctor who prescribes a short acting benzo to a patient on an as needed basis should realise before it is too late if the patient is abusing the drug (taking it too often).  Those meds should only be given out 10 to 20 pills at a time.  Once they are gone, then the doctor should assess if the patient is taking them too frequently and if so, then a weaning process, followed by the addition of talk therapy, CBT, and possibly a long acting benzo (clonazepam or valium) or an SSRI, SNRI, or tricyclic.  Some people can have huge result with just watching their diet, exercising and CBT...others need medication.  

Typically, if someone has a bad experience on a medication, they are going to tell everyone not to take it.  Remember, everyone is different and what will work for one, won't necessarily work for another.  I can tell you right now, I'd never go back on either Paxil or Celexa and Paxil used to be the go to drug for people with panic/anxiety.  Of course, now everyone knows that going off Paxil is one of the hardest medications to get off of.  Having said that, I have friends that swear by both these drugs.  So who am I to judge?  Oh how things change as we gain more experience with medication and therefore, have more information.  We kind of are like guinea pigs for the medical community.  Once they find that one drug is causing more trouble than it's worth, they say OOOPs, sorry about that, here, try this other new drug, it works much better than that old **** we gave you before, then something else comes along and just confuses things even more.

In closing ladies and gentlemen, it is buyer beware and that is exactly why I started this discussion.  

No hard feelings, just hard facts.  Keep them coming...knowledge is power.  

[recrdpxi]

I know for me Zoloft helped me with the panic.  It is not a cure and none of these meds are.  I started on Effexor then Paxil and being med phobic was going to give up.  Then my Dr. let me dose myself on Zoloft.  He wanted me up to 100mg and over a course of months I got there and I am glad I did.
These drugs are not for everyone.  But I found that you have to keep trying if you really want to take them.
I remember for years my Dr. telling me...let me put you on something.  I said no it only masks the problem.  But I was wrong my problem is still with me, but the meds have helped me alot.

[catisme]

Awesome post and great information!!  Meds are a trial an error sort of thing, I have only ever been on 2 but I know many people who have been through the process. They vary from person to person. Who knows what the outcome is going to be like until you try it. The warnings here are greatly appreciated! Being that I have never been on benzo's, I cannot give any input.
  I would love to try something like xanax or klonopin. I'm stuck here in the house worrying " what if what if" " what if I need medical attention and have to go to the dr./ER. I want to know that I might be able to take something that would at least get me there.I don't have depression, but yet I'm taking an antidepressant. I've had surgery twice already in 4 years and suffer with intestinal/stomach problems, that need to looked into.

Very helpful info! I love reading the good, the bad and the ugly, you never know when you will be reading something that is or has happened to you, it's a comfort knowing that you are not alone.

[barfer]

Please don't confuse xanax with klonopin.  I know they are both benzos but one is just to be taken as needed (xanax) and the other (klonopin) is for long term.  There are some doctors who will prescribe klonopin on an as needed basis but it really should be taken twice a day every day to get the appropriate effect.  Xanax should only be taken on an as needed basis because after a time it often needs to be increase and increased until you can't increase it anymore and that is where you run into the problem of major addiction and it is difficult to get off.  Klonopin is used daily and once you reach your appropriate dose, it stays that way.  There are people who have been on klonopin for over 10 years with no change in dosage.  

Don't get me wrong xanax is a great drug as is lorazepam, but they were only meant to be used for short term or on an as needed basis.  Klonopin and valium are meant for long term and daily use
.
I just want to clarify that point

It does concern me that you are on an antidepressant and your doctor hasn't given you anything like xanax to help you get out of your house.  Sometimes that is all it takes, one xanax or lorazepam to get you out and then the CBT can kick in and with luck, you never have to take another benzo again.  Mind you if that isn't the case and you need a long acting benzo, then so what?  It sure beats the hell out of staying home when all you need to kick start your going out is a little pill and with CBT (constant practice) you may not need more than one pill (benzo).  It can happen.  

[werewolf74]

I have to agree with you as far as SSRIs are concerned...I've heard too that in the North America more and more doctors are realising that those drugs are not necessarily helpful for anxiety/panic disorders. First of all, as we know far too well, it takes a LONG time before they start acting POSITIVELY - gosh, when i was put on Paxil (see above), i started having panic attacks BIG TIME. And I mean BIG as HUGE, HORRENDOUS, etc. They (SSRIs) are supposed only to act on Serotonin, not Dopamine or Norepinephrine (other neurotransmitters), but it seems to me that they DO act on those other chemicals, thus causing the side effects. //I really need to brush up my knowledge on neurotransmitters LOL...we're all becoming REAL specialists in the field due to our problems//.
I remember the time when Prozac was first introduced in Poland at the beginning of the 90's - i wasn't diagnosed back then - and i remeber people, like SCIENTISTS, DOCTORS (including my mother's colleague) taking it not as antidepressant but as...a stimulant, to perform better. Mind you, her students (and her students are medical students) now suspect she's not only taking Prozac, but also Amphetamine. But that's another story.

And i understand what you're saying about the movement in the UK to ban the benzos. So no benzos, no SSRIs soon, no SNRIs...and maybe not tricyclics, fourcyclics,etc. too?...Still, i am absolutely terrified at the mass use of benzos in Poland. Both alprazolam (xanax) and lorazepam (here it is called lorafen) are given out almost as sweets. You have a problem, go to a doctor, and he gives you a precription for 3 boxes of xanax...This is what happened to me earlier this year, when i was trying to find a good psychiatrist. AND I TOLD HIM I AM A XANAX ADDICT!!!...

As far as Paxil (seroxat in Poland, as, i believe, in the UK), it helped my Mum immensely in the past, but then it threw her into manic state. Now she's been disgnosed with Bipolar Disorder. Well, i wouldn't be so sure of that - first Paxil, then Celexa, then Luvox...And SSRIs have the tendency of making people hyper (as above!...Mum's colleague).

I believe in good old CBT.

But, as everyone here says, we're different, and our doctors should look at us as individuals rather than a huge mass of people with anxiety disorders...

{I do hope i'm making some sense, i'm tired with watching over my 6-month-old puppy who had a stomach operation last week.}

[ducky8]

You wrote "our doctors should look at us as individuals rather than a huge mass people with anxiety disorders"..........Therein lies the problem.  Doctors RARELY look at us as individuals, and frankly, I think they'll give you whatever drug the company is giving them a kickback for.
I'm a little cynical and bitter about how doctors treat us.  I wish it weren't that way, but it is, at least in this country.  They don't seem to  care anymore.  That's why we have to know as much as we know.  Because if we don't care for us, who will?

Hope your pup gets better day by day.........Get some rest when you can...........

[barfer]

I'll make this very short....Excellent post!  You are so right, we are not all the same and doctors have got to realize that it can't be a one pill fits all situation.  We have to be treated as individuals.

[Katie35801]

I have only tried Prozac (20mg) and it helped me a ton (didn't cure it-but helped). And no side effects, well any worse than the anxiety without meds) I have taken it off and on over the last 10 yrs. Why I keep trying to do it without it, is beyond me!

[recrdpxi]

Ducky...
What you posted is so true.  These days with all of the HMO's...PPO's and whatever other O's there are...we are just a number.  I am fortunate enough to have Dr.'s who know me, remember me and understand me.  Like I have said again and again... WE have to advocate for ourselves.  We pay them....they don't pay us to be their patients.  NEVER let a Dr. give you 5 minutes and then you are out the door if you are not satisfied.