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Mental Health  (Expert Forum)
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What medication is best?
Answered by
Roger Gould, M.D. - Mental Health, Wellness
Questions posted in the Mental Health forum are being answered by Dr. Roger L. Gould, author of the Mastering Stress and Depression program and affiliated with the UCLA. Department of Psychiatry. Topics covered include anger, attention deficit disorder (ADD) , bipolar disorder , dementia , electroconvulsive therapy (ECT) , learning disabilities, memory, obsessive compulsive disorder (OCD) , panic , personality disorders, phobias , post-traumatic stress disorder (PTSD) , schizophrenia , stress , transitions, and work problems.

What medication is best?

by wmtti86a, Nov 24, 2005 12:00AM
Hi all,

I was recently diagnosed with hyperthryoidism.  My bloodwork has never been way out of whack, but I've definitely been feeling many of the symptoms, with the worst being extreme anxiety (last month, I even had full-in panic attacks).

My blood work is now in normal range, but I still feel anxious most of the time (not as bad as I was last month).  My doctor put me on 12.5 mg of Paxil CR and .25 mg of Xanax (to take as needed).

My questions are:
(1) Are there certain anxiety medications that are less addictive, easier to withdraw from, etc.?
(2) Can Xanax truly be used "as needed".  Some days I take 3, some days I only take 1.  I noticed that I feel very shaky lately.  Is this due to the inconsistent use of the Xanax?

Thanks,
Dani

by Roger Gould, M.D., Nov 30, 2005 12:00AM
Xanax can be a very, very addictive drug.  Yes it can be used as needed for panic attacks, but for generalized anxiety I would ask your doctor about klonopin,; not addictive, longer lasting, and easy to stop.
Member Comments (8)

by wmtti86a, Nov 28, 2005 12:00AM
To: Forum MD
Just so I understand how this set-up works, does a doctor post a reply for the $5.00 fee?

I have an appointment tomorrow with my psychiatrist, so I will validate/confirm all opinions with her before switching medication.

by rosetoes, Jan 16, 2006 12:00AM
I have been taking xanax for the last 10 weeks for anxiety and panic attack due to a rapid heart rate on Nov 1st that had me in emergency room.  I had to take something to help me get through the constant panic I was have 24 hours a day.  

I must say that xanax (I thought) was a miracle drug.  My panic instantly gone and I had never felt so relaxed.  
I was prescribed a total of 1.5 per day (.5 three times a day).  Well after reading all the negative things about xanax, I started wean myself off of them gradually.  I am now down to 1mg per day and this week I'm attempting to take .25 three times a day which is half of what I initially started.

I must say that some days are awfully dificult with headaches, nervousness, tension and sleepless nights, but I have never been on drugs, never smoke and drink socially every now and then.  I am determined to do this and get off soon.

What medication is best, I don't know, however, please look at all the medication as a temporary fix.  I would never say don't take medication, because even though it is tough now, medication did get me through the panic attacks when I was at my weakest.

By the way, I did start meeting with a therapist that specializes in anxiety and panic and I have learned to deep breath (which is tremendously helpful if you can remember to start the process before a full blown panic/anxiety attack)

All benzos are addictive and easy to get on and more difficult to get off of and the sad thing is that it suppresses the anxiety but those feelings come back once you stop taking them.  I guess you have to look at it as a means to get help while you are on them, so you can strengthen your knowledge of your disorder and learn to deal with it once and for all.

Good luck

Rosetoes

by SmallVoice, Jan 16, 2006 12:00AM
Rosetoes, roughly speaking:  if a med has 'cured' a disorder then it won't come back for several months.

BUT that med's withdrawal can cause the symptoms and if they come back on finishing the drug or in the first few weeks or so, then its the drug's withdrawal effect rather than the disorder it was treating.

Thats very roughly speaking because I'm in a hurry :-)

If you go to benzo.org.uk there's lots of help there, tapering advice etc and probably a better explanation that I just gave of that point.


Oh and a metal nail file can be useful when needing to reduce a bit of a pill more gradually (when its got too small to cut with a razor or other tool).  I don't know if you'll find that on benzo org but its the experience of people on other meds in other web sites.

Best wishes, I hope you find that you've made it off them safely and that its the end of it for you.

by rosetoes, Jan 17, 2006 12:00AM
To: SmallVoice
Thanks for your input.  I appreciate your suggestions.  I have been on the benzo website and what concerns me is that they encourage using valium while weaning off of xanax.  They are both benzos and have addictive results.

I just want off of xanax without starting up another drug.  One doctor suggested Zoloft while weaning off of xanax and I took the pill one time and prayed that if I survived that one dose that I would never take it again.

It has been difficult weaning off of xanax and everyday I work hard at adding an extra hour or two without the .25mg pill that I'm now take 3 times a day ( I was taking at the most 1.5 mg per day for 10 weeks)

When I started taking xanax, I also started to see a therapist that specialize in anxiety/panic disorders and have learned deep breathing techniques that I have used over a two month period. It has really come in handy since I began to wean off of xanax, because it does mask anxiety and doesn't cure it.

Also since I have been seen by a cardiologist, internal medicine doctor, I do know that I am in pretty good shape.  
I have never been addicted to any drug, smoking, alchol and when I first experience xanax and it relieved my symptoms I felt great, now I dread that I have to take the pill at all because of the long term effect.  Once I complete the weaning period, I will never keep a few for backup or just in case.

Good luck to you and again I appreciate your thoughts and comments.  It is great to know that there is support out there.


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