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Panic disorder with CONSTANT anxiety? PLEASE HELP!!

I have panic disorder with agoraphobia.  I have been prescribed Paxil, Prozac, & Ativan at different times over the past 8 years.  I was in cognitive-behavior therapy for over a year, which helped my understanding, but of course, doesn't change my biology, or physical sensations associated with anxiety. Today, my doctor decided I should try effexor since the latest attempt (PaxilCR) doesn't seem to be working properly. (OK, fine, but....)
My question is this; Everything I read about panic disorder, or panic attacks, anxiety, etc says that a panic attack comes on, peaks, and wanes.  If that were true for me, I think I would be able to handle it.  My panic attacks last for days, or even weeks, coming in powerful waves, but when the waves recede, I am left with this CONSTANT heightened PHYSICAL (I can't stress enough, I am a very laid back person with few worries, my issues are ALL PHYSICAL/ ADRENALINE-type sensations) anxiety characterized by derealization, jitteriness, dizzy/lightheadedness, excess nervous energy, and such.  Nothing I read about describes this....the closest thing is generalized anxiety, but this is always described as constant worry/stress (mental).
I have been examined by an endocrinologist, who said that although I match exactly the profile for hyperthyroidism, and have elevated blood metanepherine levels, he couldn't definitively diagnose a thyroid or adrenal condition (my TSH and T4 always come back either normal or borderline), and thus couldn't treat me.
I am desperate to know if there is some sort of hormonal (cortisol levels came back ok), or chemical (aside from the seratonin, obviously) BIOLOGICAL root that is TREATABLE.  I realize that the agoraphobia means that I am still bound to be pre-disposed to working myself into a panic attack when faced with triggers, but those things I can understand, so I can deal with them.  PLEASE HELP ME!!!!!
20 Responses
242532 tn?1269553979
Ask your doctor about a strong dose of beta blockers when the attacks first start.  That should prevent the secondary exhaustion you describe after the attack.  There are probably people doing research on this who might be able to follow more hormone levels more accurately as they happen, so keep digging for those kind of research projects that focus on cortisol levels.
Avatar universal
did the other meds help you, how come you went off them.   there is definitely something out there that will work for you.
Avatar universal
I started with Paxil, that worked well, but was EXTREMELY tired, so after about 3 or 4 years switched to Prozac, which also worked for about 3 years.  About 3 weeks after I delivered my 3rd baby, I had SEVERE and bizarre symptoms, felt like the prozac was NOT working at all, in addition to some insane OCD symptoms that I had NEVER had before---best described as "intrusive thoughts".  I was not diagnosed, but am fairly convinced that if I didn't have postpartum psychosis, I was close (had my tubes ties afterward, it was THAT bad).
The doc decided to transition me back to paxil, citing "Prozac Poopout" which evidently just means that the meds just stop working for no apparent reason.  Instead of totally weaning, however, it seemed that a combo of prozac 20/day, & paxil 20/day was working.  So I was fine with that for about 9 months.  Then, my doc (Psychiatrist) was unavailable for an appointment, and I saw her colleague.  Well, that doc FLIPPED out about me being on both, and wanted me to stop the paxil & go back on the prozac, even though I explained that I would rather be narcoleptic on Paxil, than panic ridden on Prozac.  She wouldn't listen, so I went to my GP who wanted to try me on Paxil CR since the only bad side effect I was having from the Paxil was sleepiness, and the CR is supposed to have milder side effects.  whew....short story long, here I am still on CR, sleeping 16 hours + a day,(not an easy thing to accomplish with two toddlers!) and still having anxiety, so today, my GP said she'd call in Effexor. Haven't picked it up yet.  The Ativan I have taken sporadically when things get really bad, but I try hard not to take it--have only had to twice this year--both times in anticipation of medical procedures (I'm a very anxious patient).  I should probablyjust suck it up and take it, but I'm afraid of addiction
Avatar universal
I am just about ready for the xanax however am also avoiding it hoping the meds will start kicking in.  but I know they give them to you because it takes time for the meds to kick in and keep you calm in the meantime.  my heart is pounding like crazy and I am trying to function somewhat at work but sick and nervous and can't concentrate.  however I know most people do take this while they are waiting for the meds to kick in just not sure how long to wait and just keep telling myself one more day and I will feel better but when I don't I panic worse which is probably why they prescribe the xanax, I have okay moments though just keep going up and down.  just want to level... ugh... I know how you feel so frustrating. Good luck with those babies, they are what keep you going though it doesn't seem that way now.
Avatar universal
hey scaredy, I just responded to your post.....I need to practice what I preach!  LOL
If you are anxious, TAKE IT.  That's what it's there for.  I know I don't follow my own advice, but I also create panic attacks for myself by taking meds, since I'm afraid of having a reaction....LOL....do you ever feel like a complete nut?  I sure do!
Avatar universal
take the xanax! you are a lot stronger than me....i'm waiting for the prozac to kick in and taking ativan as needed. i dont even care about addiction at this point...well i do but i just hate feeling like i cant breathe all the time. my anxietycomes out in choking episodes...its just great. i just want to feel good again...good luck everyone. have a wonderful friday.
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