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What do you take for anxiety if antidepressants don't help?

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Posted

I have a prescription for Ativan, but I don't use it too often as I don't like relying on benzos. I don't know, I'm weird that way.

I have pretty much a generalized anxiety. Just a lot of tension and worrying. My new pdoc is being quite cautious with me, far moreso than my old one. I had mood swings like crazy from the antidepressants that my old doctor prescribed that I'm just beginning to see now. Prozac made me off-the-wall manic. If the antidepressants weren't making me manic, they weren't doing anything at all (this was mostly the case).

What do you take for anxiety if antidepressants don't help? I think I've been on mostly SSRI's. I also tried Buspar and had racing thoughts/the worst irritability of my life, so I can't try that. I use Ativan but I'd prefer something that felt like less of a band-aid on the anxiety.

I'm curious as to what other kinds of medications people are on for anxiety.

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Posted

Have you considered a longer acting benzo like clonazepam? You can take those regularly rather than needing to wait for a PRN. There are also the atypicals, though since you are already on one atypical, doctors likely won't be falling all over themselves to give you another.

You could consider one of the non-SSRIs that are sometimes more tolerable for the quasi-BP crowd. Remeron comes to mind.

There are also the mood stabilizers such as valproate, but in terms of medication change upheaval, they might not be your best friend.

I have been on all of those things at one time or another and they all helped my anxiety. Honestly if it were me, I'd lean to clonazepam. Since you have had decent results with lorazepam and since it doesn't need a long time to take effect and tends to be fairly benign in terms of side effects. Personally I had unbearable side effects with it, but that is not really a common reaction.

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Posted

I know most people say it isn't strong enough, but I honestly can't function without Vistaril. I take it morning and night every day with a third dose PRN for breakthrough anxiety as needed. It's a very old antihistamine that keeps my GAD symptoms in check as well as cuts the nausea from the Topamax and the Luvox. It helps me to feel calmer and more relaxed (though at first I felt a little sleepy, that went away though).

Vistaril is the favorite at the psych hospital in town here, because they don't like to give out a lot of benzos. They dole it out like bright green little candies. It helps me avoid using my Xanax.

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Posted

Some non benzo options I have tried include buspar and gabapentin. Neither has been particularly effective for me, but you may have a different experience.

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Posted

I take Valium now, but I have been prescribed Vistaril and gabapentin for anxiety before as well. They work for some people, just not me.

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Posted

the only thing that made a significant difference in my anxiety is an aap, and most of them didnt help---the only one that made a meaningful dent was risperdal. whether youd want to mess with your abilify or add to it is something between you and your pdoc, and i dont know if youd be able to find something that could make a difference for you. ive never achieved functionality/quasi-normalcy through medications or therapy, so...i cant be very helpful.

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Posted

I've found working with a tdoc is just as important as drugs. Someone said you can't have "zero anxiety" because small amounts are normal. I think my doc said something to the effect that Benzos are not for dealing with everyday problems.

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Posted

Lots of people like beta blockers, but in my experience, they mainly treat the physical symptoms of anxiety rather than the mental thoughts.

I wanted to have the less potent benzo available to take PRN. My pdoc prescribed Librium, the oldest benzo, one that is mainly used in detox patients. I only take it every now and then, but it takes the edge off my anxiety so that it's not the sole focus of my attention, and it has zero physical effects for me.

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Posted

I'm on xanax.

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Posted

Lots of people like beta blockers, but in my experience, they mainly treat the physical symptoms of anxiety rather than the mental thoughts.

I wanted to have the less potent benzo available to take PRN. My pdoc prescribed Librium, the oldest benzo, one that is mainly used in detox patients. I only take it every now and then, but it takes the edge off my anxiety so that it's not the sole focus of my attention, and it has zero physical effects for me.

I take Beta Blockers for a totally unrelated issue (Heart problems) And for the first time the weirdness of how I feel is more understandable. My heart really has a hard time spazzing out with the Beta Blockers I take so I get dry mouth and start to get "unsteady" etc. I was having problems "believing" I was really have anxiety problems. Or - that they were the "correct" anxiety problems.

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Posted

I'm new to beta blockers which are making a big difference in the physical side of things. I take it as needed, which has forced me to pay attention to my thoughts and worries. Once I take it, the physical side of things stops which helps me have the anxious thoughts less often (I think). Also starting with Sertraline, but haven't been on it long enough to notice a difference.

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Posted

I take valium. For the most part it works.

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Posted

I also only take my Ativan for emergencies. When I need it I want it to work, so I don't want to develop a tolerance. Plus I don't really like the way it makes me feel, anyway.

I've found working with a tdoc is just as important as drugs.

This is also my perspective. When I add therapy and other coping strategies to my med regimen, it makes my meds more effective. I work to include meditation, yoga, exercise, good food, and sometimes even sleep :) into my life as much as possible. I also use stuff like fish oil pills and make sure I keep up w the vitamins the gdoc told me to take, like my B and D stuff. I go to talk therapy and have worked on things like biofeedback. I think it helps take some of the load of the work off of the meds, so they work better.

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Posted (edited)

Hi, I think I might be able to help with some advice! I have been a victim of Generalized Anxiety Disorder for about the last 15 years and I finally forced myself into treatment over the past 2 years.

I have a prescription for Ativan, but I don't use it too often as I don't like relying on benzos. I don't know, I'm weird that way.

Firstly, not wanting to rely on benzos does not make you weird in any way. Most people don't like the idea of relying on any sort of medication. The mere thought of having to take a pill a day for the rest of my life just to function normally absolutely terrifies me. That fear kept me from seeking treatment for years and years because I simply did not want to take anything for my anxiety. Once I got over it and finally started seeing doctors, it has made a huge improvement in my life. There are a lot of horror stories out there surrounding benzos, but each person reacts different to each type of benzo....so maybe Ativan (Lorazepam) is not for you.

What do you take for anxiety if antidepressants don't help? I think I've been on mostly SSRI's. I also tried Buspar and had racing thoughts/the worst irritability of my life, so I can't try that. I use Ativan but I'd prefer something that felt like less of a band-aid on the anxiety.

I'm curious as to what other kinds of medications people are on for anxiety.

From my personal experience, I absolutely despise SSRI's. I had serious side-effects from each major SSRI that I was prescribed. Zoloft gave me never-ending hiccups....I was never suicidal until I had experienced hiccups for 2 weeks straight lol. I quit Celexa after 2 days because it made me yawn probably 300 times the first day and my tongue felt like it kept wanting to creep into the back of my throat....After a few other attempts with different SSRI's my Dr. decided lets try Wellbutrin. After a few weeks of it, I knew we found a keeper. No side-effects and it helped me quit smoking cigarettes in just a few months...total bonus! But during this entire time, I have been taking Klonopin daily, and really, that is what kills my anxiety. It killed my anxiety the first day I took it, and its done a pretty damn good job ever since.

Honestly, I don't even want to take the anti-depressant, but I do just to maintain my prescription of the Klonopin because I haven't found a doctor that will prescribe a benzo without also prescribing an anti-depressant. I actually quit taking the Wellbutrin completely and haven't noticed a single difference, but if I don't take my Klonopin and have a stressful day at work...I will be driving home that day with no fingernails and a good amount of hair missing from my head lol.

The Dr. has you taking Lorazepam which is a high-potency, fast acting, short term treatment for anxiety. Which is nice if you suffer from panic attacks, but if you have generalized anxiety all day long, then maybe its not right for you. It kicks in fast, but drops off just as fast with a short half life. Klonopin on the other hand is great for generalized anxiety because you can take it first thing in the morning, it has a gradual amp time, you don't really notice it..but you do notice that your anxiety seems to not be hovering over your head and can last all day depending on the severity of your anxiety or your tolerance to the medication. I also noticed it gave me a huge boost in self esteem which started disappearing years ago for reasons I cannot explain. I found myself being able to communicate much better with people and just generally feel much better about myself. I felt so good that I started exercising regularly again (it has been years) and that has made a huge impact on my anxiety/panic issues as well. More and more these days I find myself not even taking any medication. I don't even think about it in the morning....that must mean it is working right?

Anywho, I just joined this forum today and your post was the first that grabbed my attention. I hope the information helps. If you're not comfortable with the medication your doctor prescribes, tell him, try the next, and rinse/repeat until you find the match. Once you do, its all downhill from there :)

Edited by Panic Ensues

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Posted

I take klonopin but I don't need something on a regular basis.

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Posted

I'm another for Risperdal (risperidone). My pdoc put me on a low dose (0.5mg) to start in the evenings, and during a period where my anxiety became much, much worse he added an additional 0.5mg. As my anxiety levels improved and my level of distress reduced, we slowly reduced the dose again until I was off of it completely. I refuse to be on any anti-psychotic for extended periods, so we save it for when shit's really hit the fan. Mine was for anxiety related to people and leaving the house, and it brought me to a point where I could do those things again. I still required help from my mum, couldn't leave the house alone or every single day even with the meds, but my anxiety levels.when I did have to do it went from being a constant 8-10 down to a 2-6 depending on the scenario I was placed in. My night time over-thinking was completely nixed (which actually eventually drove me up the wall, so if you like having umpteen thoughts whizzing through your head, you might not like Risperdal).

Combined with therapy, Risperdal even on a short-term period could help you to reduce the anxiety and confront it head-on. The key, however, is that it does need to be both, so that you are eventually able to manage your anxiety without, or at least with lower doses of, meds. So if you're not already in some form of therapy, consider looking into it. :)

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Posted

I take Xanax, 0.5mg, twice a day, and sometimes 0.25mg PRN (usually sublingual) Xanax if I really need it.

I've never not been anxious. I was an anxious toddler, child, etc. I've thought about switching to klonopin, but decided if it works, stay with it.

Generally, benzos are used if SSRI's are not.

I've heard of beta blockers, some antihistamines, AAP's. Some TCA's can be pretty helpful.

CBT or DBT (therapy) is also useful. Anxiety is a bitch, but can be tamed.

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Posted

I take Xanax, 1mg am/pm, and 1mg prn. Sandorfalot, I was also an anxious child. My parents teased me about it constantly (which did wonders to cure it, as you can imagine). I managed for a long time.

But when I hit my 40s, my anxiety shot through the roof. My first experience of Status with my DH may have triggered it, but it just never calmed down again. Buspar is like sugar pills for me. I can't take gabapentin because it makes me gain weight. And to be honest, as the benzos seem to be working, I'd rather save the AAPs for my next mixed episode.

CBT helps, but isn't enough on its own for me. My pdoc just read my MSW's notes about my CBT class to me for shits and giggles a few appts. ago, and he had said that I "enthusiastically threw herself into the course." So I feel like I really did give it a fair shake (and I use it, don't get me wrong).

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Posted

I am in CBT, and I do find it helps, but definitely not completely. I was just put on a beta blocker, so we'll see how things go. I don't think my pdoc wanted me on two AAPs, haha.

Thank you for all of your advice/help, everyone.

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Posted

I don't know if someone said this already but I was on Prazosin, an alphablocker. It did wonders for my social anxiety/GAD/PTSD. The VA has done studies/trials using Prazosin with vets who suffer from PTSD. Might want to check it out as alternative. Lamictal at maintenance does also has anxiolytic effect if you can stand the memory loss.

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I don't know if someone said this already but I was on Prazosin, an alphablocker. It did wonders for my social anxiety/GAD/PTSD. The VA has done studies/trials using Prazosin with vets who suffer from PTSD. Might want to check it out as alternative. Lamictal at maintenance does also has anxiolytic effect if you can stand the memory loss.

What is a maintenance dose, if I may ask? My doctor is aiming to get me up to 200mg of Lamictal.

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Posted

Maintenance doses can range anywhere from 100-400mg typically, and there are outliers that take more or less. I think 150mg is considered the official "therapeutic dose."

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Maintenance doses can range anywhere from 100-400mg typically, and there are outliers that take more or less. I think 150mg is considered the official "therapeutic dose."

Thanks, crtclms!

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Posted

Maintenance dose for Lamictal with me is 600 mg/day. It is a little on the high side but it doesn't help at lower levels.

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Posted

Melissaw72, you are why I mentioned that some are on the higher side. There may very well be others on the board that are on the amount you are for BP, but it is a pretty notable dose. Not more dangerous, my husband takes that for seizures, just unusual.

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