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So my bipolar is bad on its own but when you add the panic/anxiety things get really rough. Right now it's really rough. I've tried pretty much everything. All four of the common benzos at reasonably high doses, gabapentin, typical antipsychotics, seroquel, latuda. Zyprexa, SSRIs, remeron, trazodone, inderal and various combos of the above. my doc doesn't want to prescribe lyrica and I can't think of much else to try because it all interferes with the bipolar....ex. I can't try stelazine cuz I need my two current aps for mood stability and SNRIs are a no go cuz ads make me manic. Idk what else is left...the panic is driving me insane. Idk what else to try...I'm currently using Xanax 1 mg and it only helps a little but I don't wanna get hooked by adding more and more. So any bright ideas? 

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Have you tried buspar? It's hit or miss, but if you haven't tried it, you might as well.

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I struggle with the same issue myself, although I have OCD with panic attacks.  High dose antidepresssants trigger mania so I had to find alternatives.  I have found a couple medications that have calmed things down.  Topomax, which can be used as a mood stabilizer has some anxyolitic properties.  Prazosin  is an α1-blocker which acts as an inverse agonist at alpha-1 adrenergic receptors.  It can be used to treat anxiety and is often used in the treatment of PTSD.

Benzodiazapines should be your best option.  1 mg of Xanax is not a lot and you shouldn't be afraid of them.  I've always found a dose that works for coverage and rarely have to raise the dose.  For instance 2 mg of Klonopin is just right for me. Push your benzos to the limit, I promise you're not going to become addicted.

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And how could you possibly promise that? First of all, you just shouldn't do that. I've never had a doctor promise me a med would work. We don't play doctor here, and you've been walking the line. If benzos have worked for you, why don't you just discuss your own successful experience, instead of telling others what you think they should take? We're here to discuss our experiences with MI and different medications, not to give medical advice.

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@phidippus I have tried klonipin 4mgs a day before and it didn't help...I've also tried 6mg Ativan a day. Its not like I'm only doing skimpy doses. But being stoned doesn't always equate to anxiety relief. And yeah I PROBABLY won't get addicted. But I'm worried about long term dependance and never being able to wean off of them...it's not like the typical situation when someone's waiting for an AD to kick in...I have very few good long term options, @crtclms- my doc thinks that BuSpar is a lot more miss than hit so we haven't tried yet. But I see him Wednesday and we will probably bring it up .

We've also talked about flexaril to help me chill (I'm grinding my teeth all day) and possibly mini doses of trazodone once or twice a day. I need help but I also don't wanna be a zombie

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4 hours ago, Iceberg said:

my doc thinks that BuSpar is a lot more miss than hit so we haven't tried yet. But I see him Wednesday and we will probably bring it up .

What is it? A 5ht1a agonist?  I took it and it did nothing for me.

I notice in your profile you mention ADHD as a possible diagnosis.  When I treat my ADHD with  a stimulant, my anxiety decreases noticeably.

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Update: so we decided to do 2 mg Xanax Xr am and possibly 1 pm...and then .5 to 1 mg ir for breakthrough up to 4 mgs a day total. We both agreed to stay away from antidepressants. Doc didn't want me over four mgs a day mainly because the rebound anxiety from the it might make it too hard to get off of. I'm back to check in with him in 2 weeks to see what's what 

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I hope you start to feel better. I am going through a lot of panic and anxiety and my valium is not doing much. I've been given the go-ahead to take 1 extra if I need it, but i get only 30 (1 a day) in the bottle so then I run out quicker and you can't just get them filled whenever you want. So then I go a couple days without ANY and the anxiety is even worse. So I feel ya!! Right there with you. Feel better.

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