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First Time Posting - Adverse Reaction to Medication

Excuse the long post, first time posting anywhere about my anxiety. Hoping to connect with some individuals who've had similar experiences.

A little background: Female, late 20s. I've always been a pretty anxious person, but my anxiety peaked after the unexpected death of my Mother/my own divorce. I saw a psychologist for 1.5 years, but decided to discontinue treatment due to cost & we both thought I was improving. And honestly, life is better (I'm in a healthy relationship, have a great job, paid off a ton of debt, etc). Despite all of that though, the anxiety started creep back in over the last year and a half, so bad that it started manifesting physical symptoms & affecting my day-to-day life. I then realized that I wasn't entirely honest with my Drs or psychologist how bad the anxiety was, so I decided to start fresh with a new Dr, this time a psychiatrist, so I could get a more medical based opinion from someone who specializes in anxiety disorders.

I had my first appointment with the Dr 2.5 weeks ago. The appointment went very well - I was more honest with her than anyone else. She explained what she thought was going on, & we developed a plan of attack. In the past, Dr's have tried me on Laxapro & Wellbutrin, both with adverse side effects (basically felt like I was going bat **** crazy). This time, she decided to try two medications at low dosages (I'm very petite): Gabapentin 100mg 2x/day & Prozac 10mg 1x/day. The first week after taking it I felt GREAT! Tons of energy, focused, decreased anxiety. Placebo affect? By week 2 (this week) everything took a turn for the worse. Symptoms I've experienced:

-A very bad panic attack while driving on Monday
-Unsteady/dizziness, especially when looking at my computer screen/TV, talking to people, driving
-Dazed (catch myself staring into space)
-Very sensitive to my surroundings (bright lights, fast movements like driving on the highway, agitated by loud sounds)
-Tired (all I wanna do is sleep so I don't feel so ******)
-Muscles weak
-Hands sometimes clammy
-Very fidgety
-Thirsty

I completely understand that many antidepressants make some people feel worse before the positive effects take flight, but it's drastically interfering with my ability to function on a fairly basic level, i.e. driving & working. For example, I can't drive on the highway at high speeds when there's lot of traffic, too stimulating. I've had to take back roads home from work (2x the drive time). Even still, I'm a mess the entire hour drive home. I've also had to work from home 2 days, which I'm not supposed to do too often, so I'm at risk of hurting my career. I made it to work today, but it's taking every ounce of focus to do even the simplest of tasks. I feel so... unbalanced? My eyes & head are aching from the strain.

Luckily, my Dr has been very responsive answering my texts. First we tried ixnaying my second dose of Gabapentin & moving Prozac to evening, but despite no morning medication, I still felt very out-of-sorts. I took my meds as instructed last night, but spoke with my Dr again. She decided we're going to discontinue Prozac, but continue with Gabapentin. I'm praying since I've only been on Prozac two weeks that the effects will subside somewhat quickly. And perhaps since Gabapentin isn't an antidepressant, I'll have a better reaction? I know it's not typically used for anxiety, but there's strong supporting evidence it's helpful in that area. I sincerely hope this fixes how I feel now because I can't take much more of this.

I guess I'm not sure what my Q is.. I'm feeling discouraged & anxious. Honestly, the anxiety before this was "better" because at least I could get to & from work & do my job. Anyone out there ever had similar experiences with this type medication? Please don't tell me to ride out the meds. If I worked from home, I think I'd be much more willing. But in the meantime, I can't risk losing my job or hurting myself or others while driving.
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Avatar universal
Another update since Monday: Spoke with my psychiatrist. We decided to axe the morning dose of Gabapentin, so now I only take 100mg before bed. She said we'll continue that regime as long as my anxiety stays down - my obsessively anxious thoughts have in fact decreased the last 3 weeks. I seem to be sleeping well. The last three days I've slept SOLID (no waking up), but I'm still very, very tired. I do know however that I'm the type of person who needs 8.5-9 hours of sleep to feel good, & I haven't been getting that much. Hoping to establish a more solid routine starting tonight. And luckily I have a 4 day weekend coming up. I'm sure my body is also still adjusting to this new medication. For the most part though, I feel OK. I can drive & function at work. Will continue this medication, work on healthy habits (i.e. nutrition, getting enough sleep, yoga practice), & work closely with my Dr's. Thanks for the support!
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Avatar universal
I tried both of those for anxiety. The paxil with a small dose of ativan worked for a few months on the crazy anxiety, but then that stopped working. I only took the gabapentin  a few days because it made me feel so sick. I also felt very up and down those days. This is hard trying to find a good combo. I tried for 2 years and gave up. For the past nine months I took as needed Ativan but I still wasn't completely stable. I decided a month ago to try more medications. What s roller coaster!
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Avatar universal
Thank you for all of the responses! So here's where I stand since Friday: last dose of Prozac was 6pm Thursday evening. I've continued the Gaba medication as instructed (100 mg AM & PM). My sensitivity is lessening, AND I was able to drive to work this morning (yay!), but I'm still struggling to focus, especially looking at my computer. It seems to peak mid morning. However, at least I'm able to function on a basic level & my anxiety isn't through the roof. I will give it a week to see how my body adjusts to stopping the Prozac. If no improvement in concentration, I will reach out to my Dr regarding the Gaba medication. Side note: I do have an appointment with a new PCP this Thursday & my psychiatrist next Monday. I'll discuss my experiences with both.
Helpful - 0
Avatar universal
The taurine suggestion is a good one -- along with B6 it creates GABA in the body and does pass the blood/brain barrier.  I use capsules to protect it from oxidation, though.  But if you're on Neurontin (gabapentin) you probably have to very careful with this, as it might give you too much GABA effect.
Helpful - 0
1530171 tn?1448129593
Signs and symptoms of serotonin syndrome include anxiety, agitation, sweating, confusion, tremors, restlessness, lack of coordination and rapid heart rate. The symptoms do not have to be life-threatening.
In the last 3 weeks, I recommended to 2 friends who were both on 2 different SSRIs to check with their pharmacists ( hard to get doctors appointments soon enough here in the "free" public health system of Ontario) .
They both had most of the above symptoms and both were told to discontinue one of the two (after the pharmacist contacted their doctor) within 2-3 weeks of tapering down.
For you MidWestGal is not an issue to be concerned with anymore, since you changed meds.

Nothing is absolute when imbalance or impairment is mentioned.
One WILL have much lower substances  absorption and conversion rates in general when a candida infection, Klebsiella infection, leaky gut syndrome, gastritis etc are present.

SSRIs and antidepressants are not interchangeable, meaning you should
change meds till you hopefully find one that works for you with the least side-effects.

I personally take taurine powder instead of GABA, which keeps me calm, focused and it also helps with recovery from weight training and alleviate fatigue.

Cheers,
Niko
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Avatar universal
Oh, and don't worry about the serotonin syndrome suggestion.  It's also incredibly rare, and usually occurs when combining drugs that both target serotonin.  Right now that's not your problem, as gabapentin is basically pure GABA shot to the brain, as GABA taken as a supplement doesn't usually cross the blood/brain barrier.  Benzos target GABA, as do many plant remedies, but gabapentin is GABA.  Sometimes GABA has a paradoxical reaction and makes people nervous even though it's the nerve relaxer.  It was originally developed for chronic nerve pain, but has been used a lot for anxiety off label.  Again, good luck.
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Avatar universal
Well, lots of stuff here.  First, gabapentin is very sedating.  That's why you're tired.  Second, Prozac is a stimulating antidepressant for many, so that's probably why the increased agitation.  Now, some of what was said above is not probably accurate.  For one thing, Prozac is far from being the most stimulating antidepressant.  It is probably the most stimulating ssri, and maybe that what the above post meant, but most people have individual reactions to these meds, so one person's stimulation is another's sedation.  Wellbutrin is probably the most stimulating antidepressant, and the snri category is also more stimulating than any in the ssri category because they target norepinephrine, basically adrenaline, as well as serotonin.  So Prozac is far from being the most stimulating, but it could be for you as it does tend to be a more stimulating antidepressant.  As to the tryptophan discussion, there is no evidence whatsoever that serotonin is involved in causation with either depression or anxiety except in very exceptional cases.  Almost nobody has low levels of serotonin as a percentage of the population.  While it's true tryptophan as a supplement doesn't cross the blood/brain barrier very often, in food it almost always does.  Otherwise we'd all be dead.  It's an essential nutrient.  It is true that a die-off of beneficial microorganisms do cause mental illness, though it takes some time to do that and research is still trying to determine which organisms are the ones most responsible for this.  Die-offs are usually caused by antibiotics, which is also the main cause of yeast infections, so the cause and effect stated above might be problematic.  The reason we use serotonin targeting antidepressants isn't because serotonin problems caused the problem -- that was a lie spread by Eli Lilly to sell Prozac and has been thoroughly discredited -- but because serotonin can make you feel better even though you still have the problem.  It's just like taking aspirin for a broken leg -- it doesn't hurt as much, but the broken leg wasn't caused by a lack of aspirin.  At any rate, good luck -- finding an antidepressant that works is trial and error -- when I took Prozac and Zoloft I could have been drinking water, I felt no different -- no effects, no side effects.  It's all an individual thing in how well we metabolize medication.  And one other thing -- psychiatrists are actually more poorly trained in the science of mental illness than psychologists.  The thing they are better trained in is matching symptoms to medication, which unfortunately doesn't mean they understand the medications at all, but psychologists study a whole lot more psychology than a psychiatrist does.  They aren't more science based at all.
Helpful - 0
1530171 tn?1448129593
Back to normal, if such a place does indeed exist, lol!
So as I was saying:
Prozac is the most stimulating of the SSRIs, even at a lower dose.
It's a wait in see with Prozac
.Maybe if your serotonin levels are low, it;s likely because tryptophan (an aminoacid from food sources) does not covert to 5-HTP  in the small intestine-the first step in serotonin production
.In  step 2, 5-HTP converts to serotonin in the brain.
In the vast majority of cases of low serotonin, it is related to
problems in the first step, usually due to gut issues with yeast overgrowth (candida) or harmful bacteria like Klebsiella, which
inhibit the tyuptophan conversion to 5-HTP.
Stress also lowers serotonin.
The next few weeks will tell, how prozac works for you and
how well you tolerate it.
Best wishes,
Niko
Helpful - 0
1530171 tn?1448129593
OK your original 1st 2 meds were both SSRIs so there's a very good chance
you fell victim to serotonin syndrome. I'm surprised many doctors don't bother to check before prescribing!!!

The prozac elimination half-life is in the first few weeks/months  from 1-3 days,
so surely its effects carry over to the following morning!
From the drug interaction checker:
Using Prozac together with Gabapentin may increase side effects such as dizziness, drowsiness, and difficulty concentrating. Some people may also experience some impairment in thinking and judgment. You should avoid or limit the use of alcohol while being treated with these medications. Avoid driving or operating hazardous machinery until you know how the medications affect you. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Prozac is the most stimulating of the SSRIs

I have to continue later, something urgent came up!
Niko
Helpful - 0
370181 tn?1595629445
You need to discuss this with your p-doc in depth. It's possible you have a sensitivity to antidepressants. Many people do. I did. But..........you will find that there are p-docs out there who don't believe this and will urge you, as you said, to "push through the side effects." This, IMHO, is really lousy advice coming from a p-doc.

We all know that antidepressants often take weeks before they reach steady state, or the point at which they actually begin to help us feel better. We are also told that during that waiting period, we may have some side effects. For many of us, that is the understatement of the century!

I am NOT a doctor and I am in NO way advising you how to handle your medication issues. That must be between you and your doctor only.

What I finally decided..........FOR ME...........was that if the side effects did not show signs of abating by week 6 weeks, I was done. I know there are both patients and doctors out there who disagree with me completely, saying for some medication, that is not long enough.........that Brand X usually takes 8 weeks or 12 weeks before the side effects are gone. For those people who have 3 MONTHS to walk around feeling like a Zombie, more power to them. I don't and I won't.

I also hold a somewhat unpopular opinion that if I am fighting an anxiety disorder, I should be on an antianxiety medication, not an antidepressant since I am NOT depressed. And you will find a whole boat load of people who disagree with me about THAT.  

I finally left my p-doc and found a great therapist who practiced CBT. I was given a prescription for an antianxiety med to use on an AS NEEDED basis. Between the talking, the tools for coping my therapist taught me and the emergency use (access) to medication, I got my anxiety under control. Please note I did not say "CURED." I prefer to think of my anxiety as being in "remission." If.........and when.........(knock on wood) the anxiety returns, I know now exactly the path I will take and it does NOT include antidepressants.

You weren't sure what your question was and I'm sure as hell not sure I answered it............I gave you my OPINIONS, which are not based on anything medical, and I told you what I've done to relieve MY anxiety. I know what it's like to live with severe anxiety while raising a family and working a full time job........it's beyond difficult and nearly impossible. Trying to do all that while on the antidepressants was a living nightmare.
Please take what I've said as nothing more than food for thought. What worked for me may not work for you..........we all react to meds differently. But I do hope you find relief somewhere, somehow and get your life back.
RubyWitch  
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