Anxiety Medications what now?

[A Nervous Nigel]

History
Citalopram
Sertraline
Fluxotine
Pregabalin
Propranolol
Effexor

Absoltuely sick of trying new medications and starting to lose paitenence with the antidepressant merry go round. So I have had anxiety al of my life.. I didnt always realise when I was younger that it was anxiety but these past couple of yearsit has gotten worse. In the past 3 months I have lost 2 jobs because of it and I think it is the cause of my suicidal thoughts and depression (im not always depressed but always anxious). Im still on my Propranolol daily which helps phsyical symptoms but not mental ones. I had some success with Pregabalin but it caused me some memory and concentration problems which didnt really go well with my studies. Then I got moved on to Effexor which I HATE with a passion, makes me feel awful anxiety , vommiting, bed belly, no sleep.

Im getting referred to a Psychiatrist in next week or two, which is great but if they offer me another antidepressant I am going to SCREAM lol. I will be saying no because of my previous experiences with them, but what else can I expect or even ask about? I know Benzo's arent prescribed any more because of withdrawals/addictions/tolerance issues and i've tried Pregabalin which did help to a degree and I like Propranolol but it only helps slightly..

My main problems are being on edge and irritated all of the time, social anxiety (why ive had problems with work and studies), sleep problems (would love a good nights sleep!!), suicidal thoughts (but these usually happen when im very anxious and not because of feel depressed), hairpulling, excessive worrying about nothing!, no motivation in life anymore even with relationships.. im just getting sick of it all now, I was very optimistic and open minded with medication but now I just dont know :(

Does anybody here get prescribed something for anxiety that perhaps I havent tried yet? Would love some comments or ideas!

I'm hoping to get some therapy too but my last therapist was terrible I was lucky if I got 25 minutes with him and all he kept trying was self help exposure therapy, he gave me no coping strategies or anything! :(

[yenool]

I could have written your post as many of my symptoms are the same. I also have an appointment with a psychiatrist coming soon.

If I were you I would take the list of medications you have tried with you to the appointment and try to stress to them everything you have written here: the big impact this is having on your life, how the medications haven't worked and so on. Specialists can prescribe a wider variety of drugs and have more experience managing these type of symptoms.

I don't really have any advice but I can really sympathize. I've tried most of the drugs in your list (and some not on there too) and not one of them helped my anxiety, in fact several of them made it considerably worse. I'm not convinced antidepressants work for anxiety.

As a last resort my GP prescribed my Lorazepam (a benzo) about a year ago and it is great for taking the edge off the social anxiety, the irritation and stopping the excessive worrying and over thinking about everything. I've not become tolerant or addicted to it but I have been quite sparing with my use, taking below what I have been prescribed.

I have no idea if a benzo would be right for you and most doctors are highly "benzo phobic" because of the risks..... but if nothing else has worked maybe it is an option worth discussing.

Looking at your list I notice you haven't tried any of the older antidepressants (Tricyclics), the doctor might suggest one of those as they can be quite sedating which helps with sleep. Mirtazapine is another option for sleep. I found neither useful for day time anxiety.

[SarahH]

If pregabalin helped a bit why not try it again...just a thought

Sarah

[MrAndy]

I tried a lot of meds as well,olanzapine gave me almost instant relief and great sleep

[A Nervous Nigel]

Thanks for your replies

Yenool, your right about anti-depressants they seem to do nothing for anxiety and in most cases make mine worse! Do you know if these Tricyclics are known for their bad start up side effects? I just dont think I can do that again lol. Its even harder when you have something like studying or work to do because they seem to put me in bed ill for at least first few days!

Sarah that is actually a good shout, I had a full box of my pregabalin left and I took it yesterday as I was prescribed and it stopped all my repetitive thoughts (even suicidal ones) dead in their tracks. Maybe I should never have stopped it? Maybe I need that and perhaps need something else? I have seen that quite a lot of pregabalin users have it as part of a combo?

Do you think I should ring doctor and tell him im taking Pregabain again? Or should I just keep taking it and just let my psychiatrist know when I go to my appointment?

Mr Andy, i've never heard of olanzapine? Is it an antidepressant?

[yenool]

Thanks for your replies

Do you know if these Tricyclics are known for their bad start up side effects? I just dont think I can do that again lol. Its even harder when you have something like studying or work to do because they seem to put me in bed ill for at least first few days!

It depends which one as they are all slightly different. Generally speaking they can be sedating and make you feel groggy. People try to get around that by taking them in the evening, but sometimes they can still hang over to the next day. Other common side effects are dry eyes, dry mouth and constipation.

I found the start up effects easier than with SSRIs, because the SSRIs (especially sertraline) made me feel quite jittery where as the tricyclics didn't.

Olanzapine is classed as an antipsychotic medication, developed for schizophrenia. However it is quite often used at lower doses for other conditions like general anxiety. I think most GPs would not start you on it, you would probably need to see a psychiatrist if you wanted to try that. I have no personal experience with it.

How long were you on the pregabalin for? Side effects often get better with time. I wonder if you could talk to your doctor about restarting that at a lower dose maybe?

[SarahH]

Hi,
Personally I would call the Dr and say you are trying Pregabalin again. Go up the doses (you can takes up to 600mgs a day). Then if you still feel the depression is getting to you you could try adding an SSRI, which will be easier as the pregabalin stops the jitters. Now I have terrible start up SE's with SSRI's but you can start on a tiny dose by cutting the tablets. I started on 2.5mgs of citalopram and very slowly upped my dose over 6/7 months. I am now on 20mgs with 300 pregabalin and that combo suits me well.
I understand that Mirtazapine is a great AD for start up SE's and is also great for sleep. You could look into that one or search on this board.

Sarah

[MrAndy]

Thanks for your replies
Andy, i've never heard of olanzapine? Is it an antidepressant?

its an anti pyshcotic but used in small doses to smash anxiety ,its very broad spectrum and for me gives no side effects except for some initial weight gain that hasnt increased any further.It also works great for insomnia with no morning hangover
http://www.crazymeds.us/pmwiki/pmwiki.php/Meds/Zyprexa