Re: Recommended medication for catastrophic thinking?
Originally Posted by
matrix123
Thank you for the message. I got out of Escitalopram again since it wasn't working anymore. I'm considering Zoloft and using Xanax as needed.
Sertraline (Zoloft) might be a good choice. It has fewer interactions with other meds than is the case with other SSRIs and if it falls a little short on effectiveness can be more easily supplemented with a noradrenaline/norepinephrine (NA) reuptake inhibiting AD such as nortriptyline, or desipramine to create a bespoke SNRI turned to your biology (it is already a more potent NA inhibitor than venlafaxine, albeit still only a weak one). The sertraline+nortriptyline combo was popular before SNRIs became available and is arguably still a better option than venlafaxine, desvenlafaxine and duloxetine. The problem is many GPs and even psychiatrists lack the confidence and/or experience to prescribe outside the box, or are hampered by government guidelines.
Dependence tends to build sooner with alprazolam (Xanax) than with lorazepam (Ativan) so all other factors such as effectiveness being equal, lorazepam is the better option, imho. In both cases definitely take it when needed - whiteknuckling through anxiety is counterproductive - but limit taking it 'just in case' as BZDs inhibit AD effectiveness.
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The opinions expressed above are based on my observations and, where applicable, interpretation of cited data and are general in nature. Consult your physician before acting on anything stated.