Best long-term anxiety management meds?

[clarice82]

Hello,

Thank you all for posting all of your comments. I've been reading them and feel a little bit better about the issues I've been dealing with. I just wanted to get feedback on the best long-term SSRI-type drugs (Zoloft, Paxil, Celexa, etc.) you all might have tried.  Do they ever work at all?

I suffer from stress-related generalized anxiety and occasional panic attacks. This has also, I believe, helped to increase my typical blood pressure readings to above normal (very healthy 28-year-old, otherwise. I work out, am at healthy weight, etc.).  I'm on meds for blood pressure and have been taking Klonopin as-needed for panic attacks and other severe anxiety bouts.  

But recently, after an extended period of high anxiety I visited a psychiatrist who told me to try Zoloft and take Klonopin every day for a month, then taper down and go back to using as needed.  How does this strategy sound to you guys? Has Zoloft been effective for anyone? Has anyone gotten addicted to Klonopin or suffered withdrawal after a month of continuous use?

Thanks so much, again, for everyone sharing their experiences. Anxiety is such a difficult thing to conquer and I'm sure it manifests itself a little differently for everyone. It's so interesting reading these posts! I love the men who show up at the hospital with panic attacks and no idea what's happening to them! I've read that women are more likely to suffer from anxiety problems and panic attacks, but perhaps that's only because women pay more attention to their own bodies and recognize the symptoms for what they are.

Since I've experienced all sorts of anxiety and panic issues, I'll try to give a quick explanation of what they mean for me, in case it's helpful for anyone for diagnostic purposes.

1. At low levels of anxiety, I feel symptoms like a quickening heartbeat and maybe a little stiffness in my back.
2. At more moderate levels, the stiffness in my muscles turns to outright cramps, and I can feel my pulse pounding in strange places, like my temples or my fingertips. Sometimes I get headaches and cramping in muscles in my chest, which is a symptom that might scare someone into thinking they're having a heart attack.
3. When I have a full-blown panic attack, my heart-rate is sky-high (165 while lying down, the last time I was in the emergency room) and I feel like it's pumping hot acid through my veins. I'm numb or tingly all over, possibly nauseous, and totally disoriented.

Most of the time when I get to a 2, I can talk myself out of reaching the 3 level. But it ***** when it happens. Klonopin (0.5 mg dosage) has been helpful in knocking a 3 down to a 2 or a 1, or knocking a 2 down to a 0.

[nursegirl6572]

Hi there!  Welcome to the forum...and thanks for sharing details about your anxiety, it really helps people!  

There is no right or wrong answer to your question, and like you said....some things work great for some, and don't work at all for others.  Finding the "right" med for YOU will involve some time, and patience on your part, and many times, a degree of trial and error with different doses and regimens.  Just remember that relief doesn't come overnight (as much as we wish it did), and meds like Zoloft, Paxil, Prozac, etc (SSRI's) and SNRI's (Pristiq, Effexor, etc) can take 4-6 weeks or more to really start making a difference...hence where the "patience" part comes in....a trait NONE of us are very familiar with, lol.

For me, I have had great success with a few SSRI's...Zoloft, Lexapro and Prozac...all at different times in my life.  All were successful for me, although I'd also have to rank Zoloft up there as one of the best for me...both for the effectiveness factor, and also it was the most easily tolerated for me...I had few side effects.  Lexapro also was great, although it had a few more side effects in the beginning.  Nothing awful but definitely more noticeable for me.  The Prozac was Rx'd for a short period of time during my last pregnancy, as my p-doc and OB both concurred it was "safer" than the Lexapro.  I have the least experience with Prozac, but again, was helpful to me.  In the case of Lexapro and Zoloft, over the few year period I was on them, I required a few dosage increases...I believe, for example, that my ending dose of Zoloft was 200mg daily, when I started out at 25-50mg daily.  All the increases were tolerated well, with improvements being noticeable fairly quickly.  

While on these meds, I used a short acting anxiety med, mostly Ativan, on an "as needed" basis (for rescue relief vs a steady action) until the AD's started stabilizing my anxiety for me.  My usage of the benzos widely varied depending on my symptoms, but I never relied on them long term as I was fortunate to have a lot of anxiety symptom management with the SSRI's.  It was always nice to know they were there if I needed them....many times just that fact was enough to ease the anticipatory anxiety for me.

Allow yourself to have your own experience, and again, be patient with yourself....it isn't always an easy process at first.  It sounds like you've already got a great handle on it and a great attitude to go with it!  Those things alone will give you great advantages as you go down the road to ridding yourself of anxiety.

Best of luck...please keep us updated, and let us know if we can help you in any way...we're here for you and know what you're going through!

[Alisonj29]

Zoloft is effective for many people. I have always been on an SSRI and then taken Klonopin or prior ativan when needed. I find the Benzo's are best taken only when needed to help avoid both dependency as well as a tolerance. If you dont need the Klonopin everyday I likely wouldnt use it daily. I was on ativan for 3+ years and was very dependent on it but managed to wean off it slowly and without any issues.
You anxiety and panic sounds very familiar. It is good that you are able to knock it down to a lower level.

[jlroesner]

I take Zoloft and Pristiq and Risperdal for my Panic Disorder and MDD.  I think Zoloft is awesome.  For me, it really helps.  If I'm ever "in a slump" or having a cumulative time of greater than normal anxiety issues, my psychiatrist may up my doseage a little for a specified time and it seems to knock it right out.  Then after some therapy and time, we bring it back down.  Works like a charm.  My favorite day is about day 2 or 3 when suddenly I just feel that Zoloft kick in.  LOVE THAT sudden release from constant anxiety.