tegratol and zoloft

[dlcottage]

yes i have been on zolfot for 10 years for panik disorder i had just weaned off  i did it gradually with tappering . that was in aug sept 2007  as the panick attacks were at bay only taking zoloft 25 mil every other day then i had extensive dental work done and 1 mon later diagnosd with trigiminal neuralgia neuro put me on 200mg 3x a day for neuralgia of course i started at 200mg reaching 600 mg by jan 5th , The problem im having is my panik attacks are back just like they were 10yrs ago .. i know i was told that if u take tegretol that some medicinces u take might have to be adjusted as i have now been on tegretol 3mons now , i did notice little panik attacks when i was on tegretol for 3 lweeks thought it would get better but they only seemed to get worse could this be the tegretol..i
hate to have the dr change the tegretol as it does help my TN
Any one  have any suggestions ..

thanks rpse

[ggreg]

Dear DLCottage,
Tegretol and similar drugs can cause agitation and nervousness.  I'm not sure if that's the source of the return of your panic.  Plus I think you have to take that kind of drug on account of your type of neuralgia.  But I think you should indeed ask your doctor if there is something else around, though, that is a totally different class of medication.

I have panic disorder also, and so I am familiar with Zoloft, and I am proud of you for getting off it.  I think you might want to look into behavior modification for your panic attacks.  Also, the drug Klonopin is useful in treating it.  It's totally different than Zoloft and rather safer to use, particularly on an as-needed basis.  The musician John Mayer has panic disorder, and just having his medication with him, he says helps him.

A good psychologist at a mental health clinic who is familiar with panic disorder should be able to help you control it with breathing techniques, among other things, as well as "exposure therapy."  I went through it, and it helps keep me from having an attack, or if I have one, to control it.  I have a severe form of it, so I do take medication as well.  But it is the behavior modification that helps me the best.

Just to make you more familiar with what it is, you have to expose yourself repeatedly to your triggers for panic, and also physical things you can do to cope with it.  Once your mind realizes nothing will happen to you, the fear no longer presents itself, or at least in my case isn't as powerful.  The breathing deal is whenever you're in the midst of an attack, you slow your heart rate by counting to ten, taking a deep breath and letting it out slowly on each count.  The physical self doesn't ramp itself up so much this way, and so the fear is not as great.  There are other techniques, too, which a psychologist can help you with.

One of my triggers was heights.  Through behavior modification, I finally got to where I drove up the highest mountain on the East Coast and felt no fear.  I also was eventually able to go up the highest building in my town, stood at the window of the top floor, looked straight down and felt no fear.  This took some time, as you can imagine.  My panic comes from a car wreck, it left the road and went into a ravine, and since I still suffer physical problems from it, my disorder is very bad, because the discomfort constantly reminds me of it.  

I hope you will try getting some therapy for panic, it helps immensely, and will keep you from having to fool with anymore drugs for it.  But I personally think very strongly that you should stay off that Zoloft, for sure, which I imagine you know exactly what I'm talking about, as it's so hard to get off.  If behavior modification doesn't help enough, then the mental health clinic might give you the Klonopin, commonly used for panic.  But as for your kind of neuralgia, I don't think there is an option for a totally different kind of medication.  Still, since I'm not an expert in that diagnosis, you should surely ask the doctor who is treating you for that, if there's another drug out there that won't agitate you so much, in case that's intensifying what would normally be just mild panic.
GG