Originally Posted by
bluewalls
I would get in such a desperate panic, I would go to my mom for help. She didn’t know what to do, so she would get me to go to the doctor. The doctor would give me antidepressants. This is basically why I used them. They probably helped a little. But never enough to give me a life.
So did you take the antidepressants (ADs) daily, or just when anxiety got bad?
Actually, I discovered the best way to reduce the panic is by alternating days of taking Effexor.
Which pretty much ensures venlafaxine won't work. Whatever benefits you're getting from it probably owe more to the placebo effect than the med.
Antidepressants have no direct effect on anxiety, or depression in the way say aspirin has on a headache. They work by stimulating the growth of new brain cells (neurogenesis) to replace cells killed, or prevented from growing by high brain stress hormone levels. The therapeutic response is produced by these new cells and the stronger interconnections they forge, not the meds directly. For more detailed explanations see: Depression and the Birth and Death of Brain Cells (PDF) and How antidepressant drugs act.
Venlafaxine has a very short half-life, around 15 hours for the XL extended release version. By taking it ever second day you are probably continually switching neurogenesis on and off and essentially training the brain to stop responding to the med. ADs need to be taken daily.
if I start taking an antidepressant regularly again, the anxiety starts to get stronger after several days. I hate being anxious as hell all day and getting in a state of desperate panic.
Unfortunately, that is a common initial reaction to ADs, especially the SSRIs and SNRIs. They can make anxiety/panic worse at the beginning because they initially increase serotonin activity. Despite the common myth, serotonin isn't a 'feel good' neurotransmitter. Just the opposite as you've discovered. However, after a week or two the brain and body respond by down-regulating serotonin synthesis and expression and the anxiety and other side-effects usually begin to diminish, although they may return for a while after dose increases.
Ask your doctor to prescribe a small dose of one of the benzodiazepines (BZDs) to help you get past that initial anxiety/panic surge. If s/he's reluctant to prescribe it then ask for *hydroxyzine instead. It is a prescription antihistamine with pretty good anti anxiety properties. Not quite as potent as the BZDs, but often potent enough. Also, BZDs block the neurogenesis mechanism by which ADs work so take them only when anxious, not routinely just in case. That doesn't mean you should white-knuckle your way through a panic attack as that reinforces the disorder, just don't treat them as M&Ms.
*Hydroxyzine comes in two forms, hydroxyzine pamoate (Vistaril) and hydroxyzine hydrochloride (Atarax). Anecdotally, the pamoate form is claimed to be the more effective anxiolytic, but just how true this is remains a matter of debate in forums.