Symptoms Difficult To Control

[hojo]

I have an severe anxiety disorder that I have been treating with 10mg Lexapro now for about 5 weeks with mixed results. The drug has reduced my baseline anxiety in half and completely prevented panic attacks (which is great). But I still have a significant amount of anxiety. The other half of my problem is that I have mild widespread neuropathic pain and muscle twitching associated with the anxiety, have you ever heard of this??  I am wondering if lack of serotonin isn’t my problem, but rather imbalance of other important neurotransmitters like norepinephrine, dopamine, or perhaps GABA. How should I proceed in finding the cause and getting the right treatment?

[Roger Gould, M.D.]

It all depends on how much anxiety you are having at what it is all about.  Anxiety is created in the mind in response to what is going  on in your life. If lexapro helps you with some of that, you should try to deal with the rest by figuring out what is going on and doing something about it rather than looking for another medication.  Therapy will be useful.  If the anxiety is incapacitating, then ask your doctor to add additional medications that are director toward the other receptors and keep trying until you find the right one.  There are no tests that can do that at this time.

[LongBallRebel22]

I think if you try something that calms you down and doesn't sedate you that would be good. Most anti-depressant, saratonin increasing meds can give you anxiety (it says so right on the bottle). I took Prozac from 12 years old to 16 and I had the shakes all the time, I was given wellbutrin to counteract it, but that gave me headaches. I stopped taking all those pills and I haven't had much of a problem since. All I can say is get off all the bougus meds and start learning how to deal. I'm not trying to be mean but I think most of the meds that are given to people for psychological problems probably do more harm than good. Scientists are still baffeled by the brain and it's abilities and really don't know much about it so how can they make effective medication to combat psychological symptoms. So do what you want, but I'm just trying to help.

[hojo]

I saw my neuro who validated the treatment that my GP started me on (Lexapro), and also gave me Buspar to help bring down any remaining anxiety. The combination so far seems to be working very well for me, I'm feeling a lot better and the twitching and pain have nearly ceased altogether. I still have good days and "not as good" days but doing well and practicing progressive relaxation techniques, breathing exercises, and self-hypnosis. The fact that I am actually feeling better tells me that this is anxiety, which I had a hard time believing for years. I never knew it could cause all kinds of neurological symptoms?

[spiderbaby]

Hi Hojo - I am wondering did the Buspar help with the nerve pain?  What kind of nerve pain is it?  

Also, isn't buspar the same thing as wellbutrin?  I have heard they are the same.

Thanks!

[rosetoes]

The best way to handle anxiety is to learn about it and its symptoms.  But until you can do that (surely you can't read about while you are experiencing it), you might need xanax.

Some people speak negatively about xanax, but it is a med that stops your anxiety and panic immediately.  You should only take them as needed and not 3 times a day for month.  If you do, you will become addicted and while you can get off of them, it will not be easy.....tremendous withdrawl.

I was on xanax for a period of time and learned the hard way about that little powerful pill.  I have no regrets about taking them, I just wished I had taken them differently and not as often as they were prescribed.

Good Luck

[espresso]

Re your comment that Xanax works right away, I was taking it ten years ago and it did work within 20 minutes. But I switched to the generic (alprazolam) in the past several years because it was free and I couldn't afford the brand name.  The alprazolam takes up to 4 hours to totally calm me, sometimes one hour but before that, it increases my anxiety or panic symptoms. It often fails to help at all, and it also leaves me feeling worse afterward. So I decided I must have become tolerant. I gave it up ten days ago. I wondered if the generic really is made differently and that is why it works so differently. I just wanted relief from attacks, but when the pill made me worse I had to give it up (I was taking it only occasionally, not every day).

The really strange aspect of this, which I realized, is that if a pill takes one to 4 hours to help, but the attacks would go away by themselves in less time than that without the pill, then it is sheer folly to take them.

Now I have withdrawal symptoms. They are different than they were before. I have 3 to 4 good days, then a bad day. I was going to taper with valium which I was given, but I have not touched it. My reason is fear that it would  complicate things. I was taking 0.25 xanax or alprazolam for off and on ten years, with as long as a year and a half off, and recently three months off. So I did not think I was addicted. However, taking one makes the body go into withdrawal when it wears off, so it led to taking it a few times a week. Now that I've been off it for ten days, I hope this is the worst of it, but I realize it could drag on a long time.

I just wondered if anyone knows why Xanax or its generic would work right away when a person first takes it, but then sometimes years later it would take hours to work, and make you worse at first, then leave you with a drugged feeling and rebound attacks that are worse than the original symptoms. Is this what is called tolerance, or is it probably a bad batch, or is alprazolam really inferior to Xanax? Anyway I cannot imagine touching it again, I think I'd rather endure the withdrawals as long as I know they are normal (legs and arms tingling and buzzing, face tightness, headaches, flu like symptoms, insomnia, unsteadiness, tiredness etc.)

[rosetoes]

I have taken alprazolam (generic) and xanax and they worked both the same for me.  I'm surprise to hear that it took 3 to 4 hours to work.  Maybe it is the dosage that you are taking... a smaller amount (.25mg) is very low and while it works, you can't really feel it as much, but the anxiety and anxiousness leave me.

Withdrawls are hell for sure and they do go away.  Since I've been of xanax I have taken a few and if I take a few in a week, then I have very mild withdrawl.  Nothing like what I experienced when I was withdrawling from 1.5mg per day for the few months I took them.

Everyone chemical make-up is different and xanax impacts us differently.

Best Wishes

[espresso]

Well since I posted I went into unbearable withdrawal symptoms. Though I toughed it out as long as I could stand it, I decided to take a pill. I felt better within 30 minutes.  I asked my dr. to prescribe real Xanax which he did, and decided I can't bear the cold turkey suffering so I will switch to the new Xanax tomorrow, take it every day for a while, then gradually substitute diazepam with a longer half life. I will follow the Ashton protocol and taper slowly. I hope this way I can taper successfully off them. I can stand a great deal of discomfort and pain. But this withdrawal was like climbing the walls and jumping out of my skin, and all I could do was pace, my head was like in a vice grip, whole body tingling, unable to eat or go anywhere, shaking like a leaf. This was just not going to work. I am lucky to have a sympathetic doctor who always answers my questions and will guide me during the tapering. There is just nothing as great in the world as feeling calm again. I won't jeopardize that, now that I know how powerful these pills really are, I will wean off them as slowly as I need to.

[rosetoes]

What dosage are you taking?  Please let me know if the real version of xanax (not the generic) works better for you.

Withdrawl is scary as hell, your body is talking to you loud and clear....not liking the change taking place.  As scary as it is, it does settle down.  I admit, a few times it got so rough, that I took a xanax .25mg.  But then I got right back on the program and stopped.  

Even when you wean slowly off of xanax, you are going to experience withdrawl...it is no way to avoid that.  Diezpram is the same.  Ashton manual recommends to taper due to the life of the benzo, but if you read threads there, withdrawl is sure to happen with valium as well.  I just had a problem stopping one benzo and starting another.  At least I knew and felt comfortable with xanax and I didn't know how my system would react to Valium.  Withdrawl is withdrawl and I just decided to withdrawl from xanax and not start anything else.

The thing to remember when you are weaning off...that you are not dying, you are alright, your body is adjusting to not having xanax to suppress your nervous system.  Things are a little haywire trying to build up your normal chemicals that xanax had taken away.  The adreneline is buck wild now and it will take a week to 10 days to settle down.  Your sleep is a problem because xanax sedates you and your body got accustommed to that...now your body has to find that natural rythum again.  
I experienced ringing in my ears, and I thought I'd go crazy, but thank God it only lasted a few days (on and off).  I had to leave the TV on at night, so it wouldn't be noticable.

Reading the Ashton Manual was absolutely the greatest thing that I could do from the standpoint I understood and knew what to expect from withdrawling from xanax.  The only thing that bother me, is the forum is very very anti benzo, anti asprin, anti medicine period....and I don't agree with that.
If I am having a rough time and feel overwhelmed, I will take a xanax.  I know now that taking them too frequently will cause addiction and I also know the issues with that.  If you have surgery, they give you xanax to settle you and sedate you before going into surgery.  Your not hooked then and if you don't have a dependence type personality you will be fine.

AS bad as you feel, you will be fine weaning off of xanax.  Take your time, and read up on the symptoms of withdrawl and I can't stress enough to learn about anxiety/panic and what you can do to overcome those feelings.  I did while I was taking xanax and that is the reason I was able to stop taking them on a regular basis.

I wish you the best and let me know how you are doing.

[espresso]

Thanks for your reply. I have gone to two alprazolam a day so I won't feel discomfort, until I can get the new Xanax. I felt it wear off after 9 hours, so took a second one last night. I broke a tooth and swallowed part of it without realizing it, and that increased my anxiety. Today i have to get it fixed so that is also hard for me (fear of the pain I am in for) and I took the alprazolam at noon. I am going back to the Xanax which I will pick up today at the pharmacy, because it did use to work better but I couldn't afford it anymore, the generic was free. Anyway I will just get it. I am going to taper so slowly, and take as long as I need. I have tapered and gone off it before, I took a year to gradually taper and was off it a year and a half, twice. I always took only 0.25. Very rarely for a funeral or other stressful time I took 2 or 3 pills in a day. Right now for some reason, maybe the stress of trying to get off it totally, my need has increased.  I've been reading about it and realize i have to stabilize on a comfortable dose, then start tapering. No more sudden withdrawal, though I used to do fine in between the doses for years. I assume my body got more tolerant to it. I've actually been in withdrawal in between my irregular doses for years, without realizing it. The last time I tapered off I did go up to a comfortable level first, until I was stable and then took a little less gradually. Thanks for your support, without the forums I'd be very alone in this as family don't understand or sympathize. My former psychatrist is sympathetic and said I could call to talk until I get to see the new psychiatrist in 2 months. I need an outlet and guidance to stay on track as I seem to get confused and forget how these drugs affect me.

[carmensinflux]

Espresso, I read your posts about the withdrawals from Xanax.  I take wellbutrin and prozac.  I have been extremely tense lately, either in a state of fear or sadness.  Since I have a few weeks off, and my husband was out of town, I decided to stop taking the ambien.  I had taken it every night for months when I used to take it about once or twice a week.  Anyway...... I went off it and got about 2 hours of sleep a night maybe... that might be pushing it..... had a severe headache... freaking out, couldn't get out of bed.... crying and feeling sorry for myself because the guy I want didn't want me.... I actually peeled skin off my face and now it looks awful (and I'm EXTREMELY vain)

so I went to my doc, and he gave me clonopin.  I have been amazed.  I'm sure it works differently for everyone, but I have felt calmer than I can remember feeling in a very long time.  I'm a little tired, but hopefully that will go away.  He has me taking 1mg in the morning and 1 mg around 6 p.m.  I went to 1/2 in the morning and 1 in the evening, and I feel so good!!  I know it's yet another tranquilizer like the ambien's a tranquilizer... I know it's just like xanax but it lasts longer...... i also know that i don't need sleeping pills and i've stopped crying at the drop of a hat...