Tell me about anxiety medications

In My Humble Opinion
1

So, I have OCD and depression. My therapist has told me she thinks the latter is largely a product of the former, since not being able to set aside worries and constantly running catastrophe scenarios is exhausting and, well, depressing. Unfortunately every SSRI I have tried has had intolerable side effects, so I can’t go that route.

I do OK if I limit my stress, exercise, and use my CBT techniques. Meditation helps too, but I’m still working on fitting that into my schedule.

However, I occasionally have a day where I can’t cope. Case in point: this weekend we discovered an infestation of beetle larvae all over the house. Suddenly I started finding these things crawling all over the furniture, walls, and floors. I completely freaked out and got to the point where I couldn’t stop crying, and I was sobbing constantly as I compulsively examined every square inch of everything for bugs. While I never felt like I was having a heart attack or couldn’t breathe, I’m pretty sure it qualified as an anxiety attack.

So, I’m going to talk to my therapist and doctor about possibly getting something to tranquilize myself when such crap comes up. We’re going on vacation soon, and that always stresses me out (yeah, I know, irony), so I would feel better having something I can take, not on a daily basis, but when I start to flip out.

TL;DR questions: What anxiety meds are available for acute use (as opposed to daily stuff like SSRIs)? What have you had success with? Is it possible to take the edge off the crazy without simply making myself sleepy/zonked? What is least likely to be habit forming, and how much do you need to take of habit-forming drugs for dependence to be an issue?

Thank you!

2

I do well with Ativan on an as needed basis. I recognize when my anxiety is higher than I can handle on my own and take one. Usually works within half an hour and I am back to feeling normal (or what passes as normal for me). It does not make me feel sleepy or zombie like.

3

Benzos are still the most effective for acute anxiety, but there also addictive, some more than other. My neurologist prescribes benzos off-label for tinnitus, he’s found lots of his patients have gotten addicted to Xanax, not a single one from Klonopin. YMMV.

Buspar is non-adictive, but from what I’ve heard, also pretty ineffective.

My psych nurse suggested for acute anxiety I try low doses of fast acting Seroquel. (50 mg, usually XR is what’s available but she told me to break the tablet to get immediate release.) It didn’t do anything but it might be something to try as it’s completely non-adictive (although expensive as it’s still brand-name only in the US).

4

Without benzos I’d still be using alcohol habitually to do simple things like run to the post office, or whatever. I think the ones I’ve tried are remarkable tools – anecdotally, I’ve gotten to the point where I only use them occasionally to help get to sleep, and use, admittedly way too much, alcohol once in a while when I get bored, but neve when mixing with alprazolam.

Of course I’ve used other techniques concurrently – that’s why I think these sorts of medications are a tool, not a cure.

5

My life has finally worked out that I don’t have much anxiety. I only really get anxious when I’m on the manic side of things. More specifically, I mean, as long as I’m anxious about the future and “doing things” I’m anxious but if I take it day by day and don’t make any exaggerated plans, that helps, a lot. In fact, I don’t even take anxiety medication any more. All I take now is lithium. I’m not saying that you shouldn’t pursue better meds, I just hope that your life is as calm as possible and that you do well.

6

This. Atavan is the magic beans. Sometimes I take it at night when I can’t sleep.

Meds could definitely help you, but have you tried exposure therapy? It’s pretty much the evidence-based treatment for OCD, and in the psychological community, OCD is often considered one of the most treatable mental health conditions. You really do not have to live like this. If you have Netflix instant, check out the documentary TV show ‘‘Obsessed’’ which has the most accurate depiction of a therapeutic intervention I’ve ever seen on television. In addition to learning what to expect from exposure, the show would also probably help you not feel so alone.

7

When I was first diagnosed with anxiety disorder, I was taking zoloft and klonopin daily, with a handy bottle of xanax for “just in case.” After a year or so, I slowly weaned myself off of the klonopin. I still have the bottle of xanax for just in case. (In four years, I have taken it maybe a dozen times).

I find that xanax stops the rising panic in its tracks. I have not had any issues with dependence… but a big part of that was only using it when it was truly necessary.

I went to the emergency room about five days after I gave birth to my son by c-section. I fainted because I was so anemic. I could feel the tide of anxiety start up, and I told the ER doc that I was afraid the fainting bout would trigger an anxiety cycle for me. (I had been having increased anxiety during pregnancy - long story). Anyway, he gave me a whack of ativan in my IV drip. Wow… just wow. It was awesome! I had to pump and dump for a day. But it was worth it.

For me, anxiety is always a physical manifestation of the stress I don’t even know is cooking. I’ll be doing fine, and then “wham”… I can’t breath and my heart is all pitter-patter. Deep breathing exercises and mantras take care of it 9 times out of 10. But when that just won’t work… half a xanax and a thirty minute breather really seems to do the trick.

Good luck!!!

8

I used clonazapam (Klonopin) regularly for many months, but at a very low does – and got horribly addicted. They say that benzos can be harder to quit than heroin.
See http://www.benzo.org.uk/ (which I just noticed has been totally thoroughly re-designed since last time I looked). ETA: In particular, read the Ashton Manual there.

When I realized I was addicted, I quit, and had nasty withdrawal troubles for almost a year-and-a-half. They say that 10-15 % of users will have that kind of prolonged withdrawal trouble.

Benzos appear to be safe and effective for occasional or short-term usage ONLY. Even just a few weeks of regular use can be addictive. (I found the clonazapam to be highly effective and helpful, until it wasn’t.) The earliest symptom of addiction you might notice is simply that you find yourself needing larger doses, or more frequent doses, just to get the relief you want. If you’re going to use it on an as-needed basis, you really really need to exercise some self-discipline to avoid using it more and more.

Yes, I’ve heard that Xanax is even more addictive than Klonopin. In general, the shorter the half-life of the benzo, the more strongly addictive it is.

9

Well, about two hours after I posted that, I shit you not, the preschool called to say my kid had lice. When I was dealing with the beetle larvae over the weekend, I had literally said to my husband “If the kids get lice, you’ll have to put me in a mental hospital.”

Well, I’m still here, so I suppose that’s a point for me. I had another, worse attack, and went to the doctor. This isn’t my normal doc, just another one at the practice. She offered me tricyclic antidepressants, Effexor, or Cymbalta. I told her I don’t want to deal with constant side effects to cope with a problem that really only bothers me significantly a couple times a year. So she tried to convince me to go on a vegan diet and lose weight. She was kind of a douche about it. When I asked if I could use Valium or something, she said for a chronic condition it wouldn’t be appropriate.

So at the moment I’m using some bourbon. Not planning on it being a long-term fix, but I need to force my system to just chill the fuck out a little.

I also called on my husband and MIL to vacuum and launder everything in the house while I shampooed and nit-combed the children. I usually hesitate to ask for such help, but I knew I needed it today.

I’m going to talk to my therapist and see what she thinks. I’m pretty mad at the doctor. I realize she offered me some pharmaceutical help, but she refused to give me anything that would help me today (or even this week). My normal blood pressure is about 118/78, and today it was 155/90. I asked the nurse about that as I left and she said sure, it’s because of the anxiety, and “hopefully it’ll get better.”

I do have Ambien so I know I’ll be able to sleep at least.

Senegoid, that’s really useful information. I’m looking for something that I’d use for a day or two a few times a year, so hopefully it wouldn’t be a problem.

10

ACH! It makes me ill to think a doctor would suggest weight loss for anxiety attacks!

I’ve been on Zoloft for a year but I think I would benefit from something like Klonipin. Unfortunately my insurance doesn’t cover anything like that or Xanax.

11

I have been on Effexor for depression. Alcohol is a no-no with it. I felt drunk (as in dysfunctional and almost falling down) after 1 drink. Also it takes awhile to get the correct dosage–they tend to ramp you up until you feel numb and then decrease the daily dosage until you are balanced between numb and not-depressed. For me, even when balanced correctly I was just flat-lined emotionally, nothing could make me happy, but then again nothing made me sad–just flat-lined and unemotional. I went off of it because I did not want to go through life as a zombie.

For me Trazadone was the miracle drug for anxiety. GREAT drug. Good sleep aid. Only side effect was cotton mouth in the morning, but a glass of water every a.m. fixed that. I was on 100 mg daily, at 6’4" and 250 lbs. My mother-in-law was on 250 mg and she was 4’10" and 95 lbs.

My SO was on Cymbalta and loved it. Said it made her feel normal. But it was for depression not anxiety. She liked it better than Zoloft.

PS: I have MS, and I am very sensitive to any psychotropics…so YMMV.

ETA: Trazadone takes about 1 week to work. Effexor took two weeks.

12

FWIW, bug larvae all over the house would freak me the fuck out, too. And my anxiety has been fairly under control lately. That’s one thing I kinda had to learn when treating my anxiety - what situations would generally cause someone anxiety - it made me feel more normal, and somehow prevented me from getting stuck in that cycle of anxiety self-fulfilling prophecy. I understand you are miserable like this. I used to have severe anxiety. I think you should see a psychiatrist. I’m kind of very against GPs prescribing psych meds - too often they are completely clueless about what they are doing.

Also, I take a tiny dose of Risperdal before bed, and it has a pretty significant impact on my anxiety without making me feel drowsy. The first dose I started with was too much - sometimes you have to experiment before you find the right dose.

13

This confuses me; you would “use” alcohol to run to the post office? What do you mean? You would need to get drunk/buzzed in order to have the motivation to operate your car?

I wonder if that was a part of what I experienced after I stopped using Xanax a while back. I had been prescribed a small amount of a low-dose of Xanax by my doc when I was really having insomnia problems. While it worked great for the 5 or 6 days I was on it; once I stopped the medication, I didn’t sleep for shit for about 3 months afterwards (much worse than the insomnia which prompted the prescription in the first place). I thought I was going insane.

14

Effexor is notoriously difficult to go off so do a bunch of research if you’re thinking of going along with your idiot doctor’s recommendation.

I find Lorazapam good for periodic anxiety and insomnia and haven’t had any problems with addiction. Both it and the generic version of klonopin are cheap, for those without good prescription coverage.

15

Klonopin is available as a generic, called clonazapam. If I’m not mistaken, I think it’s dirt cheap. (Anyone else know better?)

16

With all due respect, that is very correct. Benzos can be fine, I suppose, for occasional short-term usage for acute situations. (Although, with my past experience, I won’t go near the shit.) But fer sure, for longer-term regular use, benzos WILL end up doing you more harm than good.

When used regularly, you can and WILL become dependent on benzos. You’ll need more and more just to control your anxiety, and you’ll feel worse and worse (that is, more anxious all the time) when you aren’t getting your daily fix, and those daily fixes will need to be bigger and bigger. That’s what happens when you get addicted. Benzos, used regularly, WILL do this to nearly everyone who uses them that way.

17

I don’t quite know about that, but I don’t quite doubt it either. Xanax is one of the MOST addictive of the benzos – it has one of the shortest half-life, which is the most addictive. Still, having that long of insomnia after 6 days on it does sound X-treme. That sounds like real badd shitt.

Valium has quite a long half-life and is much less addictive, from all I hear. Klonopin is somewhere in between.

18

I take Effexor for depression and love it. However, it doesn’t do much for anxiety. I, too, have occasional anxiety that I treat with .25mg of Xanax. It is the cat’s meow for removing yourself from that panic situation. What I have to be mindful of is to not take it in anticipation of anxiety. To me, that is the difference between being therapeutic and being addictive.

19

Google “rebound anxiety” .

Basically, your brain stores up all the anxiety you avoided while taking Xanax, then releases it when you go off the meds. Lotsa help, huh?

Quoted for truth. I would rather have panic attacks.

20

The docs say I have moderate OCD and severe panic disorder. I tried a shit load of meds and finally stumbled onto my cocktail.

Lexapro, Effexor, Xanax, and Ambien(demon drug I just posted about!). Don’t ask me dosage, I just know meds don’t kick me like they should, so its a bit high. Damn Xanax never did anything. Haven’t refilled that script in years.

Honestly I had a little relief in the beginning from Rescue Remedy. Why not try that? Its toted as all natural so not FDA enforced. I can’t cite any studies but it might help.

Hang in there. That goes for everyone in the thread too :slight_smile: