Transitioning Meds. Bring on the PANIC!

[PseudoLucky_Peach]

Aint life grand when changing meds for anxiety causes anxiety? FML

 

I have been taking Pristiq for approx 3mo's. Went directly from Celexa one morning to Pristiq the next night. Transitioning from an SSRI to an SSNRI was physically brutal, but I worked through the initial side effects (some not so negative), and found that Pristiq REALLY helped my GAD. I mean, insanely effective.

But I would still have moments when I would have to fight off a panic attack--the

 

Oh my god, I can't breathe, I CAN'T BREATHE!!!/ Oh my god, I'm having a stroke/heart attck/aneurysm while driving with my kid in the car!!!/Oh my god, the sky is falling, THE SKY. IS! EFFIN. FALLING! Don't you get it?!?!

 

varieties. So, I would take an Ativan when I knew I would be in one of these helpless positions where the people around me would not understand/be able to help beyond taking me to the ER. As time passes, I've relied less and less on the Ativan. I like to have it with me, but I only take it as a last resort.

 

Trouble is, between the Celexa (taken for 1yr) and Pristiq, I gained a ton of weight, and w/Pristiq, lethargy and fatigue have taken over my life. Not helpful. Not worth it for me to become diabetic to mitigate anxiety. I asked my pdoc about an SNRI, and we settled on WellbutrinSR, 50mgs to start while I ween off of Pristiq--a process I wouldn't even wish on someone I really didn't like.

 

My energy is up, my appetite a bit lowered, but I am still well doused with Pristiq. Just found out that my pdoc wants to discontinue my Ativan rx. I am becoming nervously concerned that when the Pristiq wears off and the Ativan is gone, my anxiety might come roaring back. Such is the mind of someone so wound up about everything, everywhere, all the time.

Edited March 10, 2014 by PseudoLucky_Peach

[DreamTheater81]

Switching meds is always a scary prospect. I've been there. Hell, I'm going to be increasing my Zoloft dose by 50mg and I'm freaked out about that, even.

 

I was on Paxil for 10 years, and it stopped working, so I switched to Celexa. The cross tapering process caused me a lot of stress. I had somewhat of a breakdown six months later and was switched to Prozac, which helped my depression but made me have violent intrusive thoughts all the time. Then they changed me to Zoloft, which is where I'm at now (150mg, going up to 200mg after a recent OCD diagnosis. Yay!).

 

But every time I made a change, I got freaked out. Will this new med be as effective as the old one? Will it be worse? Will it turn me into a zombie? I'm not trying to put these fears into your head, rather I'm just telling you that I've been there. As long as you work closely with your pdoc you should be OK. 

[HAL9000]

I get that (Changes = panic)   I get uptight just refilling my MI meds.   

 

You might want to have a discussion about the ativan.    Maybe he is worried about addiction or dependence issues?   Maybe he would be willing to switch you to a different benzo?    Maybe you could figure out some reasonable compliance plan and or sign one of those agreement letters *Which are more for opiates but...   I'm not a huge zealot about benzos but I think they have a place.   If your having Anxiety attacks like this I would really want to have this as an emergency plan.

[Phoenix_Rising]

I agree with Hal that you should ask your pdoc why he feels its necessary to stop ativan.

 

In the meantime it sounds like it would be helpful to brush up on your coping skills to deal with anxiety.  CBT has some really good techniques.

[PseudoLucky_Peach]

Thanks for the feedback, all.

 

A quick talk with my pdoc, and he refilled my rx. He was under the impression that since the anxiety was becoming better managed with long-term meds, a benzo wouldn't be necessary. And he wasn't all wrong. But my main dx is panic disorder, and as much  as I want to say it is under control, fear of an attack is enough for me to want a benzo on hand-- for everyone's safety.

(I have had attacks when: driving, in crowds, middle of the night, school, work, etc. . .)

 

Truth be told, I have had the benzo 'script, on and off, for about 5yrs. I know that will sound like trouble, to some. But, I take it when I physiologically/psychologically need it. Not more than the rec'd amount (outside of a few times--like when getting on a plane, long car rides, mandatory public speaking *still never goes that well), and not daily.

 

Phoenix, I have done so much reading on CBT. I am nearing finished with my degree, and so I might finally *feel like* I have the time to explore it to develop some coping skills. I may also look into anxiety/panic group therapy sessions. I am still not ready to initiate long term counseling, which is ultimately what I need to address all of the issues underlying my negative thought patterns and MI in general. I know I can't rely on the benzos forever, and maybe there will come a day when I can be off of meds completely.

 

#OnTheBrightside:

 

The pristiq withdrawal is lightening up. I realized I had also came down with a nasty cold which greatly intensified and added to the symptoms. (No wonder I felt like I was detoxing from narcotics/dying).

 

The wellbutrin sr, now at 200 mgs, is helping some. It's only been two weeks, so I know that's no real time to measure. But, my appetite is down, and my energy levels are already better. I'm back to being insomniaic, which counters a bit of the energy boost. But, I'm working in some melatonin and hopefully that will get more effective over time. Still quite nauseous, which is its own brand of torture but *fingers crossed* it's worth it.

My anxiety is still a background grumble, and I am certainly riding the bummer-wave to shitsville most of the time. But, I am present for my family, mildly functional, and I get little glimmers of lighter moods every now and then. That's enough for right now.