Thinking about Meds. Please help/advice

[viremarthius]

Hi there,
I have very bad Health Anxiety. It consumes me on a daily basis. ONe bad bowel movement=colon cancer. One headache=brain tumour. It is ruining my quality of life. I am thinking about going back on medication. About six months ago I came off of paxil, but I was only ever taking 10Mg. My doctor told me it really wasn't doing much for me at that dose.

I have some worries/questions.
1) Any idea what would be the best med out there right now? Anything new?
2) I do like to have a beer once in a while, so are there any that do not react with alcohol, or least reacst the least?
3) What med has the least side effects? My anxiety comes from physical symptoms. Therefore, when I get a symptom, it makes me worse.

Thank you for your help.
:)

[Emphyrio]

Hello,

There are a lot of medications out there which help with anxiety, though, typically, your GP would look at prescribing you with an SSRI medication first before looking at other options (which may include SNRIs or atypical antidepressants like pregabalin).

As to your questions - I guess that there is no 'best med' out there - we all react differently to medication. In terms of SSRIs for anxiety - I think all of them work to some extent, but I would try something like escitalopram (cipralex) or sertaline (zoloft) which seem to be fairly well tolerated and effective for anxiety issues.

SSRIs may also be activating or sedating - prozac, for instance, is fairly activating, and may cause some people to feel agitated or have insomnia. On the other hand, paxil and fluvoxamine are supposed to be sedating - which can be an issue for some people. The other SSRIs are between these two. Again, its not the same for all people though. Some people find prozac to be sedating, for instance - it all depends on the individual.

I wouldn't worry too much about alcohol - I would say the majority of people taking antidepressants drink at the same time. Just make sure its in moderation though, and preferably at a different time of day when you take the medication.

As for side effects - again it depends on the individual. For instance, I had few side effects on prozac when I took it the first two times - I then experienced really bad side effects the third time I went on it which ultimately caused me to come off it. Something like escitalopram (cipralex) seems to be one of the better tolerated SSRIs though.

PS: If you do go down the medication route, try to get some talking therapy as well. While the meds can help, if they happen to stop working, or you decide to come off them, then the anxiety will return. Medications are a bit like a mask (albeit a very effective one) - but not a long term solution.