which medicine works best

Hello,
I have a question if any of the doctors could answer.  Which med for panic/depression would be the least stimulating, causing the least anxiety producing effects.  I suffer more from anxiety than depression, but do have both.  Celexa to me was very stimulating, sleeplessness, heart palps.  My doctor has suggested zoloft or serzone.  What is the one you feel is the best choice for your patients, with maybe some sedative effects, because lack of sleep is a  big problem with me.  Also, if some readers could offer some suggestions, too?
thanks
jules

[Roger Gould, M.D.]

Paxil has a more pronounced effect on sleep and the least amount of stimulation. Sometimes there are paradoxical effects, but Paxil would be worth a try.

[Iris]

Jules:
My husband also suffers from depression and had problems with both zoloft and serzone.  Both meds left him so sleepy he could not function.  The doctor has placed him on Paxil, with a mild sedative for sleeping.

However, all meds react differently with each patient and each med should be tried under a doctor's supervision.  Each case and medical history varies therefore, meds and their effectiveness will vary.  

I suggest you discuss this in detail with your doctor, and make an informed decision together.  Good Luck to you.

[kevin]

Jules,I've tried all and zoloft seems to work well for me. I to
had trouble sleeping but with zoloft, I've had no trouble sleeping at all. I have been on it for just over a year. Hope this helps but every person acts differently to each SSRI good luck.

[Carol55]

Kevin, this is most helpful, your reply.  you mind my asking, did you have any weight gain, or other side effects?  i must admit,
i'm actually female, mid 40's and worry about weight and the sexual dysfunction problem.  my real issue is not so much depression, but anxiety.  that's is a real problem with me.  i tried celexa for 3 wks, but had such heart palps and then tachycardia that i had to quit.  it made me way too hyped up. .  
again, thank you and if you can add more, i'd appreciate it.
"jules"  thanks also to iris, hoping your husband continues to improve.

[Carol55]

Tthank you for your reply.  But, what in the world does it mean when you say Paxil may have paradoxical effects?  Does anyone understand this   term?

[kevin]

Jules, Yes I had some weight gain but most people who take zoloft
lose weight according to my doctor. As far as sexual side effect's ,I guess you have to make up your mind if you want to stop feeling like **** or have sex. It was a no brainer for me.
But I think after time your body gets ajusted to the meds and you start getting back to some what normal as far as sex is concerned.You might want to talk to your doctor about LORAZEPAM
it really helps me.Just hang in there you will find the right meds some times it takes tring a number of differnt drugs to find the right ones.
Beft of luck, Kevin

[kevin]

Jules, Yes I had some weight gain but most people who take zoloft
lose weight according to my doctor. As far as sexual side effect's ,I guess you have to make up your mind if you want to stop feeling like **** or have sex. It was a no brainer for me.
But I think after time your body gets ajusted to the meds and you start getting back to some what normal as far as sex is concerned.You might want to talk to your doctor about LORAZEPAM
it really helps me.Just hang in there you will find the right meds some times it takes trying a number of different drugs to find the right ones.
Best of luck, Kevin

[Carol55]

thanks for your post, kevin.  it helps to know others are out there who've been there, done that.  makes me feel less alone!

[Susan]

Isn't anxiety awful? People who have never experienced it cannot understand that with it, life is not worth living. It is so depressing to have it.
I have had luck with vitamin B6, 100mg twice daily for anxiety. But the most helpful thing has been to CUT OUT CAFFEINE. People think that they can get up in the morning, have some coffee and it won't account for their nervousness?? Wrong. Switching to decaf has been a lifesaver. Third, exercise. There is something about daily exercise that affects the brain. WE use a programmable treadmill. 15 minutes a day, that's it.
Remember: no side effects or "getting the right dosage"nightmares with B6 and decaf. No way I'd go through that mess running to the doctor's all the time.
I take St John's Wort also, once daily. There are scientific studies out there that show it is just as effective for mild to moderate depression as certain prescription medications and you can pick it up at any health food store. I am starting to experiment, cautiously, with Chinese herbs also. Success over thousands of years counts for something.
And for that headache from switching to decaf? Big deal: take 2 IBU's . It'll stop in a week. Good luck, susan

[khg]

Jules-

Like Kevin, I have had great luck with Zoloft, too.  I had only one full-blown panic attack 5 years ago but the apprehension of having another one was my problem (never ending dizziness, cold sweats, etc).  I have had weight gain but I really can't say if it is from Zoloft or not.  I just know that I seem to be in a different 10 lb. range every few months and that is NOT good!  Sexual dysfunction never seemed to be an issue on Zoloft--I was on Prozac for two years and it definitely was.  Zoloft has been a wonderful medication for me but I am actually trying to get off of it (trying to start a family and be "drug free").  I  may have to go with vitamins (I already exercise) to help with anxiety and if I do, fine.  However, I believe that Zoloft has brought me to the point where I am no longer afraid of the symptoms of panic attacks.  I know that the medicine has helped alleviate those symptoms, but I have done a lot of this myself.  I feel like I have outgrown this and it is time to move on and get a life!!!  I know that you can do this, too!!!  Good luck!!!

[Carol55]

hello khg,
do you mind if you could tell me a little more on how zoloft was effective for yoU?  here's my problem.  i cannot seem to be able to go out and enjoy life lately.  this has been about 2 yrs now, and i'm sick of it.   them most common symptoms i get are: racing heart, lightheadedness, and shaky. never knowing when it'll hit.  church , out shopping, just free floating anxiety, turns  to panic.  did you feel the zoloft leveled you off.  that's what i'm looking for .  just something to make me feel more balanced.  more in control .  wow, when my heart starts racing, that's it, it's like a downward spiral.  i've been checked out, and it's nothing but anxiety.  
thanks for any help
jules

[annieb]

Jules,

Let me first say that I completely know what you are talking about.  Church, weddings, the mall, you name it--it made me dizzy.  There was nothing wrong with me either except anxiety.  I was put on Prozac for two years following my panic attack.  It seemed to help but then I always felt like I was in a daze.  I also think that I wanted to rid myself of this feeling so badly so I believed Prozac was really helping.  I was off all meds for a year and then my feelings of anxiety came back.  I remember walking through the parking garage at work and got extremely dizzy.  I immediately made an appointment with my MD to discuss other medications for anxiety.  They thought that Zoloft would agree with me.  So, I started Zoloft (25mg/day for several days then increased to 50mg/day).  I remember being scared to death because my neighbor said that Zoloft made her manic and feel terrible.  As you know, for someone suffering from panic disorder, your mind starts thinking the worst and this is not something that we need to hear!  However, I tolerated Zoloft beautifully.  Had no problem with sleep--did not have insomnia or sleep too much.  I did have a little nausea when taking it in the morning so I switched to taking it before bed.  After that got straightened out, I began to feel like myself again--bascially symptom free.  It has been great.  

As I said in my earlier posting, Zoloft has brought me to a point where I am stronger mentally and have realized that my panic attacks are harmless.  I do not think that I could feel this way if I had not experienced my idea of normalcy while taking Zoloft.
Zoloft may be right for you or it may not.  This is totally my experience while taking it.  Discuss the concerns you have regarding side effects with your doctor.  This idea is repeated throughout the postings: "the same SSRI could work well for one person, but be so wrong for the other".  This is so true.  You may have to try a few before you get it right, but you can feel "normal" again.  Just be patient!  Good luck!

[Carol55]

hi,
i just wanted to thank you for your very encouraging post.   could you tell me, when you would get dizzy, did you also have a racing heart?  that is what i HATE so much.  it's like one feeds the other.  i start off with this lite headedness, and whamo, off
goes the racing heart. it's a downward spiral after that.  because i can't enjoy my self and just want to come home!
it really does get tiring.  and i know what you mean about worrying about starting a new med.  as you said it made your neighbor manic.  well, that's one of the things holding me back, too.  my neighbor also went on zoloft, and boy, she was so HYPER, that i thought there is no way i want to be that way.  because i am on the nervous side of things, i worry the zoloft will make me hyper too.  did you feel you had to adjust to any of this in the beginning of your medicine? it's ironic, because i just was talking to a nurse friend of mine today, and just casually mentioned maybe starting zoloft.  and she said he mom has been on this for yrs and has no intention of ever going off of it, it has been that helpful to her!  
again, thank you khg for your posting.  it was very helpful.
sincerely, jules

[annieb]

My heart would race--I was ALWAYS taking my pulse.  Sounds crazy doesn't it?  I just knew that I was going to die of a heart attack but had never been diagnosed with a heart problem.  My husband always joked that he was going to buy me a heart rate monitor so I could see my pulse all of the time.  Thank goodness he didn't!  In addition to the rapid pulse, I would break out in cold sweats and feel numb--I just knew that I was going to pass out any minute.  I was hyperventilating and did not know it. I bet I was a pleasure to be with!!!

Zoloft never made me hyper and I was like you--any little strange feeling would make my symptoms worse....downward spiral.  I don't recall having to adjust at all to Zoloft (other than the slight nausea which was easily taken care of).  I just know that after about two weeks it suddenly hit me that my symptoms had drastically diminished.  I began exercising again (would not before because of dizziness and heart rate) and just enjoying life.  Before Zoloft, I feared going places by myself because I was afriad that I would have an "episode".  Now, I honestly don't even think about it.  I go places by myself all of the time, got a new job, going back to school for another degree, etc.  Last  year, I even bought a heart rate monitor....to use when I exercise!  I do not freak out when I see it increasing--I simply see it as making my heart stronger.

If someone read this without having any history of panic disorder (themselves or family members) they would think that I was crazy. I thought that too about other people with panic problems before I had my first panic attack.  I have also never been one to take medicine for anything, but Zoloft has really made a difference for me.  I think that it is imperative that you have family and friends who understand what you are going through--I believe that has helped me as much as the medicine. Whatever you decide to do, just remember that you have ultimate control over your body and mind so do not let it get the best of you.  This is something that you can change.  Best of luck to you!

khg

[Carol55]

I cannot thank you again for such encouraging news.  You are a real inspiration.  The way you describe yourself, with the panic, heart out of control, dizzy, wanting to just get out of the situation, is my exact situation.  I  could've sworn I'd written it myself.  Isn't panic a real bummer?  Now I'm really more relaxed to try this med.  Actually think I'll start this weekend.  I'm  even more confident because you remarked about having such a racing heart.  Well, that's me, too.  About a month ago, I did try Celexa.  I don't know if it was coincidental, but after being on it for 2 days, noticed I'd have some skipped beats. I know I have mitral valve prolapse, so didn't think too much of it.  But then after a few weeks, had 2 different times of PSVT.  Heart rate about 160.  No fun!  So I tapered off the celexa.  I have to admit though, it's  better without, because it was really making me too hyper.  But, my doc says she's heard of no  one mentioning any earth shattering side effects with zoloft. So, think I'll give it a whirl!  I know everyone reacts differently, but, you never know til you try.  I hope I can be as lucky as you.  Because where you say you really have gotten on with and enjoying life, well, I sure want that too!
Thank you again,  you've really been helpful.  This internet, sure brings people together.  And you are right, when I was younger, say my early 20's, if I'd ever heard of panic and the havoc it can have, I'd probably laughed it off!  Funny how time changes things!
sincerely,
Jules

[annieb]

I am so glad that I could help!  Sometimes it helps just to have someone validate what you are feeling.  Keep me posted on your PROGRESS!!!

***@****

[Carol55]

I'll keep you posted!  May I email you personally sometime instead of thru the forum? Probably taking up other people's space!!!!  I noticed your addy!
again, thanx
jules  :-)

[annieb]

Of course! That is why I posted it! :-)

[Carol55]

THANK YOU!!!!

[tom]

i too have anxiety/depression anxiety worse im constantly tense and stressed even if nothing to be stressed about. ive been on and off of zoloft/prozac/paxil/remeron/xanax  you also say you want one to help you sleep, as i did as well being i usualy only slept for one to 3 hours a night, i would strongly recommend remeron... for me it helps anxiety alot and helps me sleep as well, currently im on a mix of paxil (for panic) and remeron and it has been the best yet! good luck

[Jo]

I suffer from panic attacks and depression, and have been on and off Sertraline (Zoloft) for 18 months now at 50mg per day.

It personally takes 3 weeks plus for it to kick in, and for a while I have problems with trembling, but this resolves pretty quickly.

I have found the drug to be fantastic as an anti-depressant, and I have never had a full-on panic attack during the time I have used it.

Good luck.

[Blk_Katz]

I have anxiety an bipolar disoder, and have been on moer medication then you could possibly imagine (about 21 different ones) right now what we are giving a try is lamactil and topamax. But have you asked your doctor about wellbutrin, it is said to have the least amount of sexual side effects.
  Well good luck.