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What is the best medication for panic with agoraphobia
I got really sick with the flu in January, and went several weeks with only 2 or 3 hours of sleep each night. Then one day at work I had a terrible panic attack, but I still thought it was related to my flu. I have had several since, and have been to the emergency room twice. I am now seeing a psychiatrist and have been taking zoloft for 7 weeks. I have been at 100 mg for 2 weeks, but am still having such anxiety, all I can do is pace the floor sometimes. Also I have loset 12 pounds, and really can't afford to lose anymore. He suggested switching to Paxil because he said it has more calming properties than Zoloft. Is this true? Also, while switching to Paxil, do I keep taking the Zoloft, or taper the zoloft down a little each day. He only has me at 12.5 mg of Paxil, which seems a very small amount, compared to the 100 mg of zoloft I was at. I am also taking 2 mg of xanax each night to sleep. I have tried not to take it, but I have had insomnia since mid-January when I got sick. I am experiencing such agoraphobia now it is just awful. I cannot go anywhere without my boyfriend, and even then I am in such a terrible state. And if he leaves to go play golf for the day, I feel like I am almost paralyzed till he returns, like something is going to happen to me. Please is there anything else I can do to get back to my old, outgoing self? I am very worried I am never going to get better.
You can't compare Paxil and Zoloft doses, and 12.5 mg for Paxil is a good starting dose. You should ask your doctor about the switch, but usually the best method is to diminish one while adding the other. Some doctors have you just switch cold, which also can work, but the tapering is a little smoother.
You should ask your doctor about ambien for sleep instead of xanax, or some added klonopin during the day. You should also seek psychotherapy in order to understand what is happening.
This happened to me. I was on the same amt of Paxil (Paxil CR 12.5mg), when the sleep stopped, the pacing bagan, i was irritable, always anxious, and cleaned all day just to do something. I couldn't sit still if u paid me a million dollars. Given the same speil about how Paxil is suppossed to be calmer than zoloft.
Turned out in my case the SSRI set off hypomania, and I had a form of Bipolar disorder called Bipolar 2.
Hypmomania is a mild form of mania - no delusions or psychotic feaures.
I had tried Zoloft (100 mgs)a year earlier with the same results, only I took too much xanax and drank alot of alchohol to calm myself down, so the hypomania was not caught. I was just a really hyper drunk or a passed out zombie. This is a bad combination - Trust me.
I'm not by any means saying this is what u have, I'm not a doctor and can't diagnose u, but ur situations sounds very similar - u may want to mention the possibility to ur doctor.
I'm currently on a mood stabalizer (Depakote ER) and take a low dose of an antipsychotic (Seraqeul) to sleep. (non addictive)
My panic attacks are gone. I don't know which drug stopped them, or if it's the combo, but all I care about is that they are gone!
My wife and 3 of 4 kids were all misdiagnosed with social anxiety disorder and depression. All had bad experiences with Prozak, Paxil, Celexa and Effexor. Decreased Libido, increased libido, amnesia, abnormally violent dreams, visual and audio hallucinations. My son was arrested after having a psychotic break and going to school with a rifle. He was eventually released on probation. We found with the help of a great psychologist/nutrionist that reactive hypoglycemia was more than likely the problem. Sure enough cutting back on the sugary stuff has helped them to get back to normal. I have learned since that hypoglycemia can cause phobias. A great website is www.alternativementalhealth.com and an article about hypoglycemia. If you have diabetes or alcoholism in your family then you are a good case for hypoglycemia. Allergies both food and mold can cause symptoms that mimic mental illness.
i tried paxil for my panic/ agoraphobia/ dissociation feelings which stem from stress and it was horrible im convinced antidepressants are bad the only that worked almost like a miracle for me was .5 mg of xanax twice a day it cleared my head and after the first day was back to feeling normal
Conquering Anxiety, Depression and Fatigue Without Drugs - the Role of Hypoglycemia
by Professor Joel H. Levitt
The Anxiety & Hypoglycemia Relief Institute
(For questions regarding anxiety & hypoglycemia and New York City
classes, contact Prof. Joel H. Levitt ***@****)
Stress is often blamed as the root cause for anxiety, depression and fatigue, but, although stress can make any problem worse, the source of such problems is often physical in nature. And hypoglycemia is one of the major physical causes.
This article covers the following:
What is Hypoglycemia? - the cause of hypoglycemia and its effects.
Typical Hypoglycemia Symptoms - the wide range of mental, emotional and physical symptoms.
Testing for Hypoglycemia - standard medical testing and why it is often unreliable.
The Solution to Hypoglycemia - a list of dietary and nutrient recommendations, with special notes and cautions.
Recommended Reading - books and other references that will give you a more complete understanding.
What is Hypoglycemia?
First of all, let's be clear on one major point - hypoglycemia is not a "disease" in that you either have it or don't, it is a condition, and, in most cases, it is fully reversible.
Some types of hypoglycemia are caused by a tumor or other physical damage to a gland. However, that is rare, and not the focus of this article. The more common type of hypoglycemia - called "functional," "reactive," or "fasting" - is your body's reaction to what you put in it.
Hypoglycemia is the body's inability to properly regulate blood sugar levels, causing the level of sugar in the blood to be too low or to fall too rapidly.
Blood sugar, in the form of glucose, is the basic fuel for all brain operation and physical activity, including muscular. If the available fuel is too inadequate, any marginal physical or mental system may start to shut down. In addition, the glandular imbalances that result, as the glands struggle to regulate the sugar level, cause their own symptoms - especially high adrenaline, which is usually perceived as anxiety or panic, but, in some cases, can lead to violence. (Am I saying this has something to do with domestic violence and street crime? YES! And there is expert congressional testimony to back this up.)
Here is a typical pattern:
1. You eat or drink excess sugar (the average American consumes well over 100 lbs/yr.).
2. The body releases insulin to put sugar into storage, but the insulin response is excessive (due to ADAPTATION and/or chromium deficiency).
3. About 2 hours later so much sugar has been put into storage that there is not enough left in the blood, and you get a low-blood-sugar emergency.
Symptoms such as weakness and mental fog begin.
4. The body responds to the emergency by dumping adrenaline into the system.
More symptoms follow from the high adrenaline, such as racing heart, anxiety, etc., etc., etc..
5. The roller coaster rises and falls in critical hormones, causing an unbalance in all the hormones and often resulting in ongoing symptoms.
Many Americans have hypoglycemia to a greater or less degree. The symptoms comprise a remarkably long list and range from mild discomfort to being completely incapacitated.
Typical Hypoglycemia Symptoms
Following is a list of symptoms I've drawn from multiple sources, plus my own observations. The list is long because symptoms result not only directly from low blood glucose but also from the glandular imbalances that result, especially high adrenaline. Only one or two symptoms may be present, but most often, you will find several.
Note that although I've listed mental and physical symptoms separately, they often overlap.
Anxiety - ranging from constant worry to panic attacks.
Phobias - claustrophobia, agoraphobia, acrophobia, and so on. This is anxiety tied to a particular issue.
Depression - especially with females
Violent outbursts - especially with males
Obsessive Compulsive Behavior
Forgetfulness - this may just be choline/inositol deficiency.
Inability to concentrate
Unsocial, Asocial, Anti-Social behavior
Nightmares & night terrors - terror can continue after you wake up. It is especially indicative of hypoglycemia if you wake in a cold sweat, if the terror continues, if there is pressure on the chest, or if you are unable to breathe.
Headaches - especially if a meal is missed.
Tachycardia - racing pulse due to high adrenaline.
Fatigue, weakness, "rubbery" legs.
Tremor or trembling of arm, leg, or whole body (outside or inside)
Twitching, jerking, or cramping of a leg muscle - cramping may be just calcium or magnesium deficiency or food allergy response.
Waking after 2-3 hrs sleep
Tinnitus - ringing in the ear, due to high insulin in about 70 % of tinnitus cases.
Abnormal weight - too high or too low.
Compulsive craving for sweets, colas, coffee, alcohol
Lack of appetite
A diagnosis of "mitral valve prolapse"
Crawling sensations on skin
Smothering spells - gasping for breath
Red blotches on skin or circular arcs of red skin
Lack of sexual drive
Chest pain - severe, but EKG normal.
Can't tolerate bright light or loud sounds
Another clue is that the symptoms are usually worse in the early morning after waking, and get better after being up and around a full day.
It's a remarkably long list and for very good reasons!
Many of the above symptoms can be found in the standard PDR
(Physician's Desk Reference) as the typical expected side effects
for a NORMAL HEALTHY person given an injection of adrenaline
(alternate name epinephrine).
Why should anyone not injected with adrenaline have such symptoms? To understand what is going on, we have to understand how humans have been designed to survive emergencies. Suppose you meet a tiger on the road. What happens? Immediately an emergency situation is detected and the adrenal gland dumps adrenaline. The adrenaline prepares you for vigorous
muscular activity. It brings sugar out of storage for muscular action. It raises the heart rate so your blood circulates faster and turns off digestion. You are now prepared for FIGHT or FLIGHT.
Some people will fight, their adrenaline response will be ANGER, most people will run, their adrenaline response is felt as FEAR.
In most cases, the simplest WORKING DEFINITION OF ANXIETY is the way you perceive HIGH ADRENALINE. If adrenaline is moderately high for too long a time, people feel anxious and wonder why. This is called "free-floating " anxiety.
If, on the other hand, adrenaline shoots up to a very high value rapidly, and
then decreases rapidly, the anxiety is brief but intense. This is called a "panic attack." If you regularly pick a particular thing to tie the anxiety to, such as high places, that's called a "phobia." What's the problem? What's wrong with the life-saving response to a tiger on the road?
The human body, because it's a wonderful self-adjusting system has a mechanism called ADAPTATION. If you repeatedly have emergencies the body learns to dump larger and larger amounts of adrenaline at the slightest hint of an emergency. The adrenal gland puts out about 60 different hormones- repeated requests for adrenaline dumps will affect all the others.
A hair-trigger adrenaline response is not what you want in modern life. What happens in modern life is that several times a day many people have low-blood-sugar emergencies. This leads to adrenaline dumping and ANXIETY, it also leads to hormonal imbalances.
NORMAL SUGAR PROCESSING: Eat food including sugar; pancreas
releases insulin; insulin puts excess sugar into storage for use later.
"REACTIVE HYPOGLYCEMIC" PROCESSING: Consume excessive sugar food
or beverage; pancreas dumps excess insulin (remember ADAPTION);
About two hours later blood sugar crashes to emergency level; adrenal
gland dumps excess adrenaline (remember ADAPTION); RESULT=ANXIETY
and HORMONAL IMBALANCE
The saving grace is that hypoglycemia, even early-stage diabetes when the pancreas starts to give up, is fully reversible with diet and nutritional supplements.
Testing for Hypoglycemia
Standard medical testing for hypoglycemia is the Glucose Tolerance Test (GTT). The person being tested is required to fast for 12 hours, then have a drink with a super-high sugar content - a disaster plan for someone with hypoglycemia. The blood is then tested every 30 minutes, for 6 hours. Unfortunately, the test is unreliable as it is frequently done in an inadequate way or is misinterpreted.
The most frequent problems with the GTT are:
The test is run for less than 6 hours - a 3 -hour test certainly can't catch a drop at the 5.5 hour point).
The test measures glucose level but fails to measure insulin and adrenaline - your blood sugar may be holding up because your adrenal gland is dumping huge amounts of adrenaline. Glucose alone can't tell the full story.
The symptoms are not carefully observed during the test - the classic story is of a man who went for his test, drank the sugar solution, became violent, and smashed the furniture in the waiting room. Upon leaving, he was given a bill for the furniture, and a test stamped "normal!" His glucose level didn't go below the level that lab used as an absolute criterion! If you become violent during the test, or faint, or break out in a cold sweat and start shaking you have FAILED the test REGARDLESS of the NUMBERS!
The rate of drop in blood sugar is ignored - the lowest glucose level is important, but the rate of drop is just as important. Falling too rapidly from high-normal to low-normal represents poor regulation and will give symptoms.
Because of the above testing problems, hypoglycemia is best diagnosed by its symptoms.
The Solution to Hypoglycemia
To reverse the condition, the glands must be allowed to recover. This is done by eliminating all foods and beverages that deliver sugar rapidly. Thus the cure for "low blood sugar" is to AVOID sugar and simple carbohydrates, like white wheat flour, that convert rapidly into sugar.
Stress, of course, makes all problems worse. And if you can eliminate all stress - fine. But, realistically, it is much easier to simply control what you consume.
My recommendations for handling hypoglycemia consist of diet, and nutritional supplements. There are also excellent full-length books available in the Recommended Books list at the end of this article. I especially recommend books 1 and 2.
Best foods to eat
raw mixed salad greens
seeds and nuts (not peanuts)
cooked greens (Collard greens, Mustard greens, Spinach etc.)
organic eggs (hardboiled for safety)
whole grains (one at a time)
carry seeds & nuts.
Freshly made vegetable juices. Most hypoglycemics should probably limit carrots in juice form to about 1/day or less, as a sweetener for other veggies.
Spring or filtered water.
Herbal tea - from one or two herbs, not "naturally flavored" blends.
Worst food ingredients
The packaging for some foods can be misleading. For example, many packages will say "Sugar Free." However, if you read the ingredients, you will find types of sweeteners just as harmful. Therefore, it is important to read all labels carefully.
Hypoglycemics should avoid the following:
Sugar - this includes sucrose, fructose, raw sugar (sugar + dirt), brown sugar (sugar, dyed brown), corn syrup, "dried cane juice", "raisin juice" etc., molasses, malt, malted barley, even maple syrup and honey.
Hydrogenated and partially hydrogenated oils - including vegetable shortening and margarine. These are hormone imbalancers.
White wheat flour and white rice - nutrients that prevent heart disease & cancer are removed from these products to give longer shelf life. Fiber is also removed, therefore the starch rapidly converts to sugar.
Peanuts & Corn - high mold sources which tax the immune system.
Special Notes and Cautions About Diet
The above list represents my personal current opinion, and is periodically modified. Consideration was given both to the influence on sugar metabolism, and on general health. Many foods not listed above as best or worst can be eaten in moderation, assuming of course that you are not allergic to them. Additionally, the following factors need to be observed
If you can't get "organic" foods, use non-organic foods less often.
If you are a vegetarian, of course eliminate animal foods. The vegetarian route requires more knowledge and more work; but I currently believe that, in the long run, it gives the best health in most cases - for hypoglycemics as well as "normals."
Food allergy and reactive hypoglycemia frequently go hand in hand. If you are allergic to one or more of the best foods, then they are not acceptable for you.
Individual food allergies must be carefully considered with any restrictive diet. For example, a grain-based diet can be a disaster for someone with grain allergies, even if the carbohydrate level can be tolerated. Another example is eggs, which are a common allergen.
To find out what you are allergic to is a gradual process of learning which involves primarily selective elimination, for at least 5 days, with careful observation of symptoms.
Likes and Dislikes
I also believe that you must be reasonably comfortable with your food choices to assimilate the food properly, i.e. foods you hate won't make a good diet for you.
Beware of Liquids Containing Sugar
Liquids containing sugar deliver sugar to the body too rapidly. In addition to obvious disasters such as sodas, colas, sweetened coffee (a double whammy if caffeine is present), and alcohol (behaves like liquid sugar), you should also AVOID FRUIT JUICES (an exception is grapefruit which can usually be tolerated in moderation, perhaps 4 oz./day)
AVOID SKIM MILK. Milk would be O.K. for hypoglycemics, but a harmful enzyme, Xanthine Oxidase, makes it a bad choice for all. Consider instead organic yogurt, from whole milk, NOT skim or low-fat. The harmful enzyme Xanthine Oxidase is de-activated when yogurt and cheeses are made.
Avoid Artificial Sweeteners
Artificial sweeteners have been a major American health disaster, especially aspartame, and should not even be considered as a substitute for sugar. They make recovery for hypoglycemics much more difficult and are a major health hazard.
The most important of the supplements are high level vitamin C - which is the primary support for the adrenal gland - and a good multiple formula containing chromium.
The best type of vitamin C, and the easiest to take in my opinion, is POWDERED Vitamin C (Ascorbic Acid).
I recommend Allergy Research (Willner stock # 10004), or Freeda (C PWD "Dull"- Willner stock # 14267, 4 oz & # 14268 16 oz).
Solgar Vitamin C Crystals do not dissolve as well but are still effective, and widely available.
The dosage depends on how serious your symptoms are. A general guideline for most people having uncomfortable symptoms would be 10 grams (10,000 milligrams) per day. A level teaspoon of powder or crystals gives about 4 grams, a heaping teaspoon 5 grams. Therefore two heaping teaspoons per day would give 10 grams. This should be split into two or more servings at different times during the day, preferably with meals. If you are not used to these levels, start with less and work up over a few days. An extra teaspoon can always be taken if you start to feel bad - indigestion, a headache, dizzy, a panic attack starting, etc.
The Multiple Formula
The multiple formula I recommend is Twinlab Maxilife Co-Q10 Formula, Multiple Vitamin/Mineral/Antioxidant capsules. This formula contains about 28 nutrients, including vitamins, minerals, anti-oxidants. The mineral content, and the Vitamin C content, is not significant but most vitamins and anti-oxidants are well supplied if the manufacturer-recommended dose of 4 capsules /day is taken (with meals).
The contents of 4 capsules are:
Coenzyme Q10 30 mg.
Dry Vitamin A Acetate 5000 IU
Dry Vitamin D-3 200 IU
Dry Beta Carotene 25000 IU
Dry Vitamin E (d-alpha tocopheryl succinate) 400 IU
Vitamin C 1 gram (1000 mg)
Ascorbyl Palmitate (fat soluble Vit C- 42 mg as Vit C) 100 mg
Citrus Bioflavonoid Complex 100 mg
Vitamin B-1 25 mg
Vitamin B-2 25 mg
Vitamin B-6 75 mg
Vitamin B-3 (niacinamide form) 125 mg
Pantothenic Acid 100 mg
Vitamin B-12 [note mcg=microgram] 100 mcg
Folic Acid 800 mcg
Biotin 300 mcg
PABA 10 mg
Choline Bitartrate 225 mg
Inositol 100 mg
Calcium (from calcium carbonate & citrate) 50 mg
Magnesium (from magnesium aspartate & oxide) 100 mg
Note that the above amounts of calcium and magnesium are negligible. Also, carbonate & oxide are poor sources.
Contains crystalline pure nutrients. No tablet binders, coatings,
or colorings. It is manufactured by Twin Laboratories Inc., Ronkonkoma NY 11779.
If you are currently taking a multiple, compare. Note especially the Co-Q10, chromium, selenium, and Vitamin E content. These are anti-oxidants. All anti-oxidants, including vitamin C, work together.
For vanadium, I currently recommend one Vanadyl Sulfate separate 7.5 mg tablet/day. This works with chromium to allow insulin to function properly, as it eliminates "insulin resistance." Adjust to taking chromium before starting the vanadium.
Other nutrients useful for reactive hypoglycemia and anxiety are:
magnesium (chelated not oxide) - If you can swallow large tablets, the magnesium I recommend is Nature's Plus "Dyno-Mins" Magnesium. Four tablets give 1 gram (1000 milligram) of elemental magnesium per day. This is a natural tranquilizer (which also insures against constipation.)
niacin (read about "flushing" before taking).
All nutrients, including Freeda, can be purchased by mail from Willner Chemists, 100 Park Ave (41st St.), New York City 10016. The phone numbers are 800-633-1106 or 212-682-2817, if not available locally. You can also contact them through their website at www.willner.com.
Freeda is at 36 E41 St. NYC. Phone numbers are 1-800-787-3737;212-685-
4980. Website address is www.imall.com/stores/freeda.
I don't receive any fees from Willner, Freeda or Twinlab (unfortunately).
I have separated the following list in categories for easy reference. However, the categories sometimes overlap. For example, books on mental health discuss sugar, nutrition and allergy.
On Sugar & Hypoglycemia
(1) Paavo Airola, Hypoglycemia, A Better Approach, Health Plus,
Portland OR (503-625-0589)
(2) Carlton Fredericks, Carlton Fredericks' New Low Blood Sugar and
You, Perigee Books (Putnam)
(3) William Dufty, Sugar Blues, Warner Books, N.Y.
(4) Saunders & Ross, Hypoglycemia: The Disease Your Doctor Won't
Treat, Pinnacle Books
(5) Martin L. Budd, Low Blood Sugar(Hypoglycaemia) The 20th Century
Epidemic?, Sterling Publishing, N.Y.
On Mental Health
(6) Carlton Fredericks, Psycho-Nutrition, Grosset & Dunlap
(7) Barbara Reed, Food Teens & Behavior, Natural Press
(P.O. Box 730, Manitowoc WI 54221, $9.95 +$2 s&h, 920-758-2500)
(8) Carl C. Pfeiffer, M.D. Mental & Elemental Nutrients, Keats
(9) Priscilla Slagle, M.D. The Way Up From Down (DEPRESSION), Random
On General Health
(10) Robert Atkins, M.D. Dr. Atkins Health Revolution, Bantam
(11) Carlton Fredericks, PhD Nutrition Guide For The Prevention &
Cure Of Common Ailments & Diseases Fireside (Simon & Schuster, N.Y.)
On General Nutrition
(12) Cass Igram, D.O. Self Test Nutrition Guide, Knowledge House
(13) Gary Null, PhD The Complete Guide to Health and Nutrition,
(14) Richard Passwater, Supernutrition, Pocket Books
(15) Ruth Adams, The Complete Home Guide to the Vitamins, Larchmont
Books. (very inexpensive 432 pg. paperback)
On Vitamin C
(16) Irwin Stone, The Healing Factor-Vitamin C Against Disease
(17) Ewan Cameron & Linus Pauling Cancer and Vitamin C, Warner Books
Encyclopedic References from Rodale Books (Emmaus Pa 18049)
(18) Staff of Prevention, The Complete Book of Vitamins
(19) J.I. Rodale, Complete Book of Minerals for Health
(20) Staff of Prevention, Encyclopedia of Common Diseases
(21) Mark Bricklin, Practical Encyclopedia of Natural Healing
History of Medical Progress (and Non-Progress)
(22) Wayne Martin, Medical Heroes and Heretics, Devon-Adair
(23) G. Edward Griffin, World Without Cancer, American Media
(24) Arthur F Coca, MD , The Pulse Test : The Secret of Building Your
Basic Health St. Martin's mass maket pbck ($3.99 Amazon.com)
(25) & (26) William H. Philpott, M.D. & Dwight K. Kalita, PHD.Brain
Allergies, and Victory Over Diabetes ,Keats Publishing
(27) Marshall Mandell, M.D. & L. Scanlon ,Dr. Mandell's 5-Day Allergy
Relief System, Harper & Row
I was fine, healthy And super outgoing until I caught mono when a band member from a concert spit water on the crowd hitting me and a few others in the face....
Anyway. I was social like crazy, i was alwas able to connect with people and could make anyone laugh.
After being sick for 3 weeks I was starting to get over it but I felt weird in a way. Not the 'same!' I wasn't happy. I wasn't social. Everything someone did or said caused me a great deal of anxiety, confusion and stress. I felt like (and still feel like) one foot is on the ground barely while the rest of me is teetering over the edge of a 1,000+ foot cliff.
I went to every cracked out doctor possible by the end I looked like a zombie pin cushion.. I couldn't go out of my room. I went from running, having a ton of friends to a 170 resting heart rate and crazy blood pressure that jumped up and down sometimes crashing to horrifying lows. It was a night mare. Ny doctor wouldn't touch me and would ask what the hospital said. I was so sick of being told I out-of-the-blue after being healthy 19 year old was suddenly sweating non atop sprawled out by m apartment door unable to breathe.
I worked my *** off (on my own) and got my heart rate down to 60-65 and now a perfect blood pressure. I found out I had adrenal burn out. It's been a bit over a year since I was that sick. And I can go out for short times to the store, I can actually go out of the bedroom for about 2 hours (such a ginormous leap from being in bed everyday). My symptoms were all angoraphobia, anxiety, paranoia, depression, social anxiety, noise sensitivity, racing heart, palpitations, muscle pain, tension, stress, fears of dying, sickness, easily sick (for extended periods). I know this isn't everyone's case..
Adrenal problems are often ignored in the doctor industry. If you went from being healthy and outgoing to bedridden this is possibly your culprit. 80% of people have adrenal insufficeny. Taking a ton of vitamins help me a lot.
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