comparable meds for panic disorder?

[azrael770]

I have a anxiety/panic disorder for about 7 years with no known trigger except nausea.  I have been to a psychotherapist and was placed on paxil 40 mg for a maintenance drug and Klonopin 1/2 mg in case of attacks.  when I lost my insurance due to job loss I had to stop seeing my psychotherapist (who by the way claimed that I was basically fine and really couldnt do much more than medicate and hope it went away).  so as I found a new general physician he as most doctors seem to took me off my meds and re prescribed them as is per his (moral?,ethical?,religious?) belief system.  in doing this he took me off the klonopin and refused to even discuss prescribing that or anything else in its place.... so my question is this:  is there a medicine that is less addictive or more easily prescribable that I could change to? (one that might fit my present docs unknown criteria?)  if not should I change type of doctors if so in what field of medicine (psychiatry in my area is over 200 dollars per visit.....something I cannot afford.      thank you

[Roger Gould, M.D.]

there's no question in my mind that the very best medication for occasional panic disorder is either Xanax or Klonopin. most general physicians will prescribe those medications as long as are given in limited amounts so you should find a doctor to do that.  If you cannot afford psychotherapy you might try working at my low-cost online self-help therapy ***@****.

[Jaquta]

It's hard when health professionals put limits in place especially when a patient feels unheard.  Being able to discuss health concerns for many people means being able to feel comfortable and able to speak freely.
Doctors will often prescribe based on their own experience and hopefully a patient's presentation and history.
Your doctor doesn't seem all that bad although his inflexibility does seem concerning.

BuSpar is said to lack the additive qualities that many other anti-anxiety meds have.  I was told that this was an expensive med though.  ??
If the klonopin was only being used short-term to manage the panic it probably shouldn't have been a problem.

A psychiatrist should have a better grasp of your situation.  That would probably be a better option.  Seeing a specialist and then being referred back to your general doctor with a management plan might also be an option.  ??

That's a cop out for a therapist.  I personally wouldn't recommend seeing that one again.

I was also just wondering whether the nausea was a symptom of the anxiety versus a trigger.  Just a thought.  You will have more insight into your own situation.

I think meds are OK as a tool but I think therapy is the most important aspect to help resolve anxiety and panic.
You could check out the doctor's website  (myvirtualshrink.com) and see if that is useful.

[Paxiled]

First, I'm not the doctor.  Second, sorry, but general docs don't know anything about these meds.  Most psychiatrists don't either, but you have a better shot with them.  As for cost, the $200 is probably just for the first visit, after you get on a med for maintenance purposes you'll only have to see the psychiatrist for fifteen minute sessions which shouldn't cost more than $100.  That's still a huge amount for very little work, but they didn't go to school all that time so they wouldn't get rich, did they?  Most places do have community health clinics for people without means, though they're not the best, and soon you'll be able to get subsidized health insurance thanks to the new health care legislation, but to be honest, the shrinks who work for insurance companies aren't the best.  As for now, go to your new doc and threaten to sue him for malpractice for abruptly discontinuing an addictive medication that can cause seizures -- thankfully, this didn't happen to you, but if you want to get back on the klonopin that ought to shake the guy up.  It is completely against medical practice to discontinue any of these meds abruptly, but especially benzodiazapenes.  As for your therapist, you need a different one.  Anyone who's on meds for panic disorder needs therapy, and if this one couldn't help you, another might.  To say you don't need therapy is just ridiculous, but you're now involved in a profession without any supervision, regulation, or professional standards.  Each practitioner is a God unto themselves.  You might want to try a cognitive therapist -- no guarantee therapy will help, but it's the best we got right now.  Hope this helps.