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Getting Meds - Need help and information
Hi, all - I'm new to the boards, and have lots of questions. I have had a swallowing difficulty for about 2 months now, deemed to be the result of anxiety. I have been taking 1/4 an ativan daily, about 1/2 an hour before eating, and that has helped, although so far, I'm limited to very soft foods, and have a long way to go. I have been referred to a psychiatrist to obtain meds, and SSRI's and something called TCA's have been discussed with me by my primary care doctor. Has anyone else taken meds for this problem or similar issues? If so, how did they affect you? (I do not ask for specifc 'advice' about what meds to take, more interested in getting input as to how the meds work, how they affect others, and so on as I am very new to the whole 'med' thing.) I just read a post on one of these boards by someone who said SSRI's can make one's throat feel 'tight' or closed up and that is why I am seeking help in the first place - because I have had a lot of difficulty eating. Any input would be greatly appreciated. Thanks.
Good for you on the grilled cheese. Just focus on that and not on tonight. I have problems like that too, I LOVE sweet potatoes and some nights I will gag on them and cant swallow them. Strange. Just focus on the prize and that is you being better!
Glad you have come to update!
Glad you have come to update!
Thank you, so much, all, for your warm and cogent responses. Nursegirl, your lengthy and full response was particularly helpful (am assuming you're an RN? You seem very knowledgeable.) Mammo and Alison, your feedback is also encouraging, as folks who 'know.' I am very unsure right now - by the way, I do have a therapist of many years, who rocks - but what with the OCD and occasional panic attacks and 'depressive days,' it is an ongoing challenge, particularly lately. It is a frustrating process, as my psychiatrist appointment was pushed back until early next month, so I'm still struggling along on the Ativan alone. I had been doing fairly well, introducing 'new foods,' e.g. I ate a grilled cheese sandwich this past weekend and thought that was a big deal. Tonight, however, I had trouble with potatoes and stuffing, my old standbys, to the point my husband slapped me twice on the back, thinking I was choking. (I'm like dude... don't you know the Heimlich manuever?) Anyway, it is 2 steps ahead, 3 back right now and your input and support is very welcomed.
Welcome to the forum! First, I'm sorry you are having trouble with anxiety, but rest assured that you are headed in the right direction by seeking help from a psychiatrist. The very best advice I could give you as you start addressing the anxiety with a professional is to keep an open mind about treatment options, be patient with yourself during the process, as relief doesn't happen overnight, and celebrate your accomplishments along the way, no matter how small you perceive them to be! There are NO insignificant "wins" with anxiety...every one is important in the road to recovery.
As for the meds, it is VERY important to not get too many preconceived notions about any one of them...especially for someone with anxiety...it will often lead to excess worry that is unnecessary. You could gather thousands of stories from people who have experiences with a med you've been Rx'ed, and 1/2 of them will give you hope, and 1/2 will scare you to death and make you want to flush them. EVERY person has different experiences, allow yourself to have your own...try to be unbiased and let your doctor recommend what he feels is the right choice for you...then go from there.
Some basic info about AD's:
SSRI's are the newer antidepressants, with "SSRI" standing for "Selective Serotonin Reuptake Inhibitors". ....like Prozac, Paxil, Zoloft, to name a few, etc. They work by affecting one of the chemicals (Serotonin) in the brain responsible for our feeling of "well being". Basically, there are receptors in the brain that regularly "grab onto" these chemicals (the "reuptake"), allowing for a certain amount to remain circulating. It is believed that in depression and anxiety, SSRI meds help by blocking the reuptake, allowing more of the chemicals to circulate, hence improving the sense of well being, and decreasing depression and anxiety. Even newer still (everyone has seen the commercials...lol) are SNRI's, which are meds that function in a similar capacity as the SSRI's, only the targeted chemical for reuptake blocking is "Norepinephrine", another chemical in the brain that affects mood and well being. Examples of SNRI's are Cymbalta, Effexor, Pristiq.
There are some things to remember when starting these kinds of meds. Again....your experience will be your own, so don't automatically assume that you will fit into a predetermined course based on these common characteristics of SSRI/SNRI therapy....
First, these meds take some time to really alter the chemistry and allow for the patient to see noticeable changes. Standard time frame is about 4-6 weeks, with many people noticing subtle improvements before that and some taking a little longer to really be able to assess how the med is working. That is where the patience comes into play. It's easy to want to write off a med b/c it doesn't seem to be working, although in order to be fair, enough time has be to given to come to any determination. Sometimes the initial dosage (which is usually started at the low end range to minimize any side effects) will need to be increased to get a person to the therapuetic level. Secondly, these meds CAN have some initial side effects that lead people to either give up on the med, again, before giving things a chance. Some side effects that are common are feeling "jittery", an increase in anxiety, trouble sleeping, drowsiness, etc. Feeling of one's throat being tight/closing is NOT a common side effect. It is more a symptom of anxiety. PLEASE discuss this concern with your doc...he/she will explain the side effects in more detail and help you to address these worries. If these side effects occur, MOST times, they start to subside within the first 2 weeks of treatment, and go away completely shortly thereafter. This has always been MY personal experience with the several SSRI's I have taken thru the years. There are options to deal with the side effects if they become bothersome....talk to your doc. Sometimes a med like Ativan/Xanax will be added (or in your case, increased) temporarily until the symptoms improve. Basically...discuss any concerns about this with your doc...don't automatically write a med off for this reason. I admittedly had a few rough days in the beginning of a few of these meds...but sticking it out was WAY worth it, and the addition of a benzo was verrrry helpful! Lastly, for now...once you are started on these types of meds, do not make any changes or discontinue the med without 1st discussing it with your doc and if you do decide to d/c a med, do it under doctor supervision for an appropriate taper as these meds DO frequently have a discontinuation syndrome, like a withdrawal, if stopped abruptly. I tapered off the SSRI's slowly with my doc and never had issue one. Sure, some people have a harder time, but again...don't let that color your opinions about these kinds of meds.
TCA's, or "tricyclic antidepressants" (ie "Elavil" and "Pamelor") are the older AD's, still very commonly Rx'ed. The SSRI's largely replaced the TCA's in popularity due to the thought process that the side effects and concurrent drug interactions (with other Rx meds) was much less of a concern with the SSRI's. TCA's are still widely used, sometimes alone, many times WITH an SSRI with great success for many. TCA's are not typically used as a "front line" med...most times an SSRI is tried first. It all depends on the individual person, their diagnosis, any other pertinent medical history, allergies, etc. Again, discuss this with your doc...do your homework about these meds, but don't get caught up in the info/warnings to the point where you become more anxious. Of course starting something new like this is going to cause some worry and anxiety...that's only normal, but try not to ruminate about it,
Therapy is a key component of anxiety treatment, please discuss this with the doc as well. Most p-docs have therapists on staff, or ones they refer patients to, as part of a holistic treatment plan...and I feel it is vital. While the meds often help with the symptoms...therapy will help you to explore any issues/triggers that need to be dealt with, while also teaching you valuable coping skills that you will retain for a lifetime...helping you deal with anxiety when it comes up.
Please be sure to let us know how your appt goes, and remember that we are here for you and know what you're going through....it's rough to deal with, but there is help out there...again, just go into this with a positive attitude, and be kind to yourself, you will have good days and bad. Hang in there!
As for the meds, it is VERY important to not get too many preconceived notions about any one of them...especially for someone with anxiety...it will often lead to excess worry that is unnecessary. You could gather thousands of stories from people who have experiences with a med you've been Rx'ed, and 1/2 of them will give you hope, and 1/2 will scare you to death and make you want to flush them. EVERY person has different experiences, allow yourself to have your own...try to be unbiased and let your doctor recommend what he feels is the right choice for you...then go from there.
Some basic info about AD's:
SSRI's are the newer antidepressants, with "SSRI" standing for "Selective Serotonin Reuptake Inhibitors". ....like Prozac, Paxil, Zoloft, to name a few, etc. They work by affecting one of the chemicals (Serotonin) in the brain responsible for our feeling of "well being". Basically, there are receptors in the brain that regularly "grab onto" these chemicals (the "reuptake"), allowing for a certain amount to remain circulating. It is believed that in depression and anxiety, SSRI meds help by blocking the reuptake, allowing more of the chemicals to circulate, hence improving the sense of well being, and decreasing depression and anxiety. Even newer still (everyone has seen the commercials...lol) are SNRI's, which are meds that function in a similar capacity as the SSRI's, only the targeted chemical for reuptake blocking is "Norepinephrine", another chemical in the brain that affects mood and well being. Examples of SNRI's are Cymbalta, Effexor, Pristiq.
There are some things to remember when starting these kinds of meds. Again....your experience will be your own, so don't automatically assume that you will fit into a predetermined course based on these common characteristics of SSRI/SNRI therapy....
First, these meds take some time to really alter the chemistry and allow for the patient to see noticeable changes. Standard time frame is about 4-6 weeks, with many people noticing subtle improvements before that and some taking a little longer to really be able to assess how the med is working. That is where the patience comes into play. It's easy to want to write off a med b/c it doesn't seem to be working, although in order to be fair, enough time has be to given to come to any determination. Sometimes the initial dosage (which is usually started at the low end range to minimize any side effects) will need to be increased to get a person to the therapuetic level. Secondly, these meds CAN have some initial side effects that lead people to either give up on the med, again, before giving things a chance. Some side effects that are common are feeling "jittery", an increase in anxiety, trouble sleeping, drowsiness, etc. Feeling of one's throat being tight/closing is NOT a common side effect. It is more a symptom of anxiety. PLEASE discuss this concern with your doc...he/she will explain the side effects in more detail and help you to address these worries. If these side effects occur, MOST times, they start to subside within the first 2 weeks of treatment, and go away completely shortly thereafter. This has always been MY personal experience with the several SSRI's I have taken thru the years. There are options to deal with the side effects if they become bothersome....talk to your doc. Sometimes a med like Ativan/Xanax will be added (or in your case, increased) temporarily until the symptoms improve. Basically...discuss any concerns about this with your doc...don't automatically write a med off for this reason. I admittedly had a few rough days in the beginning of a few of these meds...but sticking it out was WAY worth it, and the addition of a benzo was verrrry helpful! Lastly, for now...once you are started on these types of meds, do not make any changes or discontinue the med without 1st discussing it with your doc and if you do decide to d/c a med, do it under doctor supervision for an appropriate taper as these meds DO frequently have a discontinuation syndrome, like a withdrawal, if stopped abruptly. I tapered off the SSRI's slowly with my doc and never had issue one. Sure, some people have a harder time, but again...don't let that color your opinions about these kinds of meds.
TCA's, or "tricyclic antidepressants" (ie "Elavil" and "Pamelor") are the older AD's, still very commonly Rx'ed. The SSRI's largely replaced the TCA's in popularity due to the thought process that the side effects and concurrent drug interactions (with other Rx meds) was much less of a concern with the SSRI's. TCA's are still widely used, sometimes alone, many times WITH an SSRI with great success for many. TCA's are not typically used as a "front line" med...most times an SSRI is tried first. It all depends on the individual person, their diagnosis, any other pertinent medical history, allergies, etc. Again, discuss this with your doc...do your homework about these meds, but don't get caught up in the info/warnings to the point where you become more anxious. Of course starting something new like this is going to cause some worry and anxiety...that's only normal, but try not to ruminate about it,
Therapy is a key component of anxiety treatment, please discuss this with the doc as well. Most p-docs have therapists on staff, or ones they refer patients to, as part of a holistic treatment plan...and I feel it is vital. While the meds often help with the symptoms...therapy will help you to explore any issues/triggers that need to be dealt with, while also teaching you valuable coping skills that you will retain for a lifetime...helping you deal with anxiety when it comes up.
Please be sure to let us know how your appt goes, and remember that we are here for you and know what you're going through....it's rough to deal with, but there is help out there...again, just go into this with a positive attitude, and be kind to yourself, you will have good days and bad. Hang in there!
Welcome!
I havent heard of SSRI's making the throat feel tight but that doesnt mean it doesnt exist. That is good that the ativan is helping so far and hopefully it will help even more. I have heard of anxieties with people feeling like their throat was closing lots of times before but I dont know alot about it. I had one panic attack that I actually thought I forgot how to swallow. It was very strange and scary. Thankfully it wasnt long lived.
Keep working with your doc and whomever else is helping you through this so you will soon be able to eat normal again
I havent heard of SSRI's making the throat feel tight but that doesnt mean it doesnt exist. That is good that the ativan is helping so far and hopefully it will help even more. I have heard of anxieties with people feeling like their throat was closing lots of times before but I dont know alot about it. I had one panic attack that I actually thought I forgot how to swallow. It was very strange and scary. Thankfully it wasnt long lived.
Keep working with your doc and whomever else is helping you through this so you will soon be able to eat normal again
Hi and welcome! It's good that you are being referred to a psychiatrist as they are most knowlegable with these types of medications, and what will work best for you. An SSRI will help with the anxiety, and most of us anxiety sufferers take an anxiety medication (like Ativan) along with an SSRI or TCA which are both antidepressants, and the combination seems to work well. I've never heard of an SSRI causing one's throat to feel tight or close up, nor has it ever happened to me. Along with the medication you should ask your psychiatrist to refer you to a therapist who can help you overcome your swallowing problem. Trust in your psychiatrist and always work closely with him on your medications. I hope this helps and wish you all the best.
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