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Non benzo anxiety relief in bipolar


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Hello med-knowing ones

I've got a psych app in a week or so.  I'm coming off diazepam and am nearly there but have crippling anxiety still so I'll need something else to cope. I can't increase my sertraline (currently 75mg) as last time made me high. And the increase I had in aripiprazole to 15mg 6 weeks ago hasn't cut it. It has made me seem calm on the outside whilst dying on the inside if that makes sense?? I'm hardly working/doing anything (no motivation and sleeping all day......am I just depressed too) due to this and finances are crap so I need some suggestions to go into my next app with. My gp suggested I ask about buspirone so if anyone has experience with it I'd be really grateful. Or any other non benzo solutions? I built tolerance and addiction really quickly to the diazepam unfortunately.  

Thanks for your help all 

 

Eilatan x 

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Gabapentin helps some so does lyrica and vistaril. I've heard some really mixed reviews abt buspar. You can also use some super dose aps -25 of seroquel, 2.5 of zyprexa, as a last resort. Stelazine too but I wouldn't expect that to be an option. 

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23 minutes ago, Iceberg said:

Gabapentin helps some so does lyrica and vistaril. I've heard some really mixed reviews abt buspar. You can also use some super dose aps -25 of seroquel, 2.5 of zyprexa, as a last resort. Stelazine too but I wouldn't expect that to be an option. 

Thanks I have a friend on gabapentin actually.  I'd forgot about that.  Yeah I was worried buspar didn't have good reviews. 

They would LOVE me to go on seroquel or zyprexa but I'm refusing on weight gains issues.  I have a job where weight gain wouldn't be good snd I am being stubborn!!! 

No idea what stelazine is even if it were an option lol...... 

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49 minutes ago, looking for answers said:

for me buspar and vistaril did very little..........is it physical manifestations of anxiety perhaps something like propanalol? just kinda slows u down........

 

there are other types of benzos

It's the mentail more than physical manifestations sadly 

Shame busbar and visteril didn't cut it for you. Seems like that's the case for way too many people 

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On 8/6/2017 at 1:01 AM, looking for answers said:

i'm ok taking benzo it's what i need to be ok

Yeah I would be too but my team are not. To be fair I build tolerance v quickly and they make things worse in the end....

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On 8/5/2017 at 5:20 PM, Eilatan said:

They would LOVE me to go on seroquel or zyprexa but I'm refusing on weight gains issues.  I have a job where weight gain wouldn't be good snd I am being stubborn!!! 

 

For anxiety I take 25 mgs of Seroquel as needed. You will not gain weight from that dose.

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Buspar brings me from anxiety that keeps me up until 2 in the morning to a more manageable level of anxiety. It doesn't remotely get rid of it. My dad has had great success with Vistiril, but I did not. It really varies from person-to-person. If you were looking for the physical manifestations, Benadryl is, so far, the only thing that's helped me. It doesn't make me drowsy unless I'm already tired and take two. But I know that's not what you're looking for.

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I'm guessing you're using aripiprazole as your main mood stabilizer, so this may be of limited help, but raising my lamotrigine dose seemed to really cut my anxiety. Mood-wise I was pretty good at 200 mg, but had some lingering anxiety after we dropped my sertraline down to 75 mg, because with more than that I was cycling hypo. Bumping the lamotrigine to 250 mg made a good dent in the anxiety - actually more so I think that the sertraline was doing in the first place. This is likely not useful if you don't already have lamotrigine on board as a mood stabilizer, since I can't imagine it would be worth adding for that, but if you do already take it, raising it might be worth considering. 

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On 8/7/2017 at 5:40 PM, looking for answers said:

that really helps with the physical

part, not mental

part

y r they not ok

They just don't want anyone on long term diazepam cos of addiction. It seems to be a policy 

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On 8/8/2017 at 6:36 AM, thunder said:

I'm guessing you're using aripiprazole as your main mood stabilizer, so this may be of limited help, but raising my lamotrigine dose seemed to really cut my anxiety. Mood-wise I was pretty good at 200 mg, but had some lingering anxiety after we dropped my sertraline down to 75 mg, because with more than that I was cycling hypo. Bumping the lamotrigine to 250 mg made a good dent in the anxiety - actually more so I think that the sertraline was doing in the first place. This is likely not useful if you don't already have lamotrigine on board as a mood stabilizer, since I can't imagine it would be worth adding for that, but if you do already take it, raising it might be worth considering. 

Yeah I'm not on lamotrigine and yes you're right the 15mg of aripiprazole is my mood stabilizer.  Ha ha you're on 75mg sertraline too? I'm considering asking for that to be raised now as the anxiety has turned to depression too. Grrr 

Still my appointment is tomorrow so fingers crossed they csn do something for me

Ta all for your input. Really appreciated.  I've got my appointment tomorrow so I'll see what thry can suggest 

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Well just had my appointment and he's increasing my aripiprazole to 20mg because he says mood stabilisers have antidepressant properties. 

No other options were given sadly and I feel a bit reluctant to take so much aripiprazole.  Is anyone here on 20mg of it? How is it?? 

 

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1 hour ago, Eilatan said:

Well just had my appointment and he's increasing my aripiprazole to 20mg because he says mood stabilisers have antidepressant properties. 

No other options were given sadly and I feel a bit reluctant to take so much aripiprazole.  Is anyone here on 20mg of it? How is it?? 

 

I take 30 mg of aripiprazole. It's wonderful. There is not a giant difference between 15 mg and 20 mg. 

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I have to amend my answer given the title of the thread. I have not found that aripiprazole has done much for my anxiety. Just my depression. And notloki is right, it works to augment an antidepressant so keep in mind that when I said it is wonderful, it is wonderful in conjunction with an antidepressant to relieve depression. I don't think that it is the best mood stabilizer because some people have gone manic or hypomanic on it.

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1 hour ago, jt07 said:

I have to amend my answer given the title of the thread. I have not found that aripiprazole has done much for my anxiety. Just my depression. And notloki is right, it works to augment an antidepressant so keep in mind that when I said it is wonderful, it is wonderful in conjunction with an antidepressant to relieve depression. I don't think that it is the best mood stabilizer because some people have gone manic or hypomanic on it.

Yeah this is what i thought. I am depressed as well though so perhaps they think my anxiety will clear up if the depression goes.... and I'm also on 75mg of sertraline so maybe that will be augmented. I asked for the sertraline to be increased but he refused lol.

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I've read about Topamax being used for anxiety before, but that's just hearsay for all anyone is concerned since I can't find the link that said it.

I've also heard about gabapentin, Lyrica, Depakote/Depakene, low dose Seroquel (25-50 mg), an adjunctive low dose tricyclic (e.g., nortriptyline), and adjunctive Remeron (if you don't mind gaining weight like crazy) being used for anxiety.

Also, the OTC antihistamine chlorpheniramine purportedly has anxiolytic properties and acts as an SNRI itself.

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34 minutes ago, mikl_pls said:

I've read about Topamax being used for anxiety before, but that's just hearsay for all anyone is concerned since I can't find the link that said it.

I've also heard about gabapentin, Lyrica, Depakote/Depakene, low dose Seroquel (25-50 mg), an adjunctive low dose tricyclic (e.g., nortriptyline), and adjunctive Remeron (if you don't mind gaining weight like crazy) being used for anxiety.

Also, the OTC antihistamine chlorpheniramine purportedly has anxiolytic properties and acts as an SNRI itself.

Thanks for all the info. They don't seem interested in giving anything else for the anxiety and have just increased my aripiprazole to 20mg instead. I'm not sure im going to go with that tbh. I have to tomorrow afternoon before I need to decide. 

 

Interestingly just 7.5mg mirtazapine was amazing for anxiety but I quit it because of the weight gain. 

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  • 2 weeks later...

Just thought I'd update as I've been on the increase to 20mg of aripiprazole as they wanted me to. 

My anxiety was about 30% better for the first few days but right now this minute I'm hiding in bed having cancelled all work. I'm shaking nauseous and dizzy with a stinking headache.  I'm not sure if this is just a bug but I am in bits with anxiety. But physically very very tired and lethargic.  

Next appointment on 18th Sept and I'm gonna beg him to increase sertraline (or any of you guys' suggestions) as now I'm on such a big dose of aripiprazole I'd never get manic......  still I'm in the uk and the NHS doesn't give me huge medication choice it has to be said.....

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  • 2 weeks later...
On 8/5/2017 at 6:20 PM, Eilatan said:

They would LOVE me to go on seroquel or zyprexa but I'm refusing on weight gains issues.  I have a job where weight gain wouldn't be good snd I am being stubborn!!! 

FWIW, I was prescribed Seroquel (manic psychosis) on 2 separate occasions, was on it for 16 months, swapped to try an alternative, went back to Seroquel, didn't work at all the second time.. developed heart and blood pressure complications, was concurrently on Lamictal and Lithium.. more intolerable side effects there.. 

Of all the side effects, I never gained an ounce on any of the prescriptions. Yes, even the dreaded Seroquel. Staying hydrated and active is essential to assist metabolism when taking medication that sucks the life out of you.

I suspect having a physically demanding occupation and unquenchable coffee addiction certainly helped me to avoid weight gain. But, I'm sure that also contributed to my heart problems when medicated.

About 12 years ago, I decided to take an alternative way out and completely sacrifice my social life rather than my sanity. Solitude is not an option for a lot of people, but.. it seems to work for me.

Here's the list of my adventure. Not in any particular order. Of everything on the list, I still occasionally use the Ativan a few times a month. The rest got flushed. If the psychosis ever returns, I will instantly hop back on the Medicoaster. 

  • Seroquel.
  • Geodon.
  • Risperdal.
  • Abilify.
  • Symbyax.
  • Zyprexa.
  • Lamictal.
  • Lithium.
  • Xanax
  • Ativan.
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Aside from the obvious physical side effects, mentally, I had a very difficult time with distinguishing what was 'manifestation of illness' vs. 'affect of medication'. 

After 3 solid years of riding different colored cars on the Medicoaster, that became the deal breaker for me. I didn't know who I was underneath the mask of pharmaceutical influence and had completely lost my true identity. 

In hindsight, going off medication was probably very selfish of me. I was easier to be around.. but it was all so incredibly fake. As long as I showed any outward signs of life - and kept paying my share of everybody's salary - nobody seemed to care that the meds were killing me. Paranoia reigned. Since when is having a heart attack at the age of 25 considered a healthier alternative to psychosis? They blamed anxiety? (Convenient for them). I blamed the meds. (Convenient for me).

In my twisted mind, the local small town professionals became as much of a liability as the illness. That was unacceptable.

I had to find my own path. It has been a very muddy, uphill climb.

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On 9/1/2017 at 7:48 AM, Lms-Kaz said:

FWIW, I was prescribed Seroquel (manic psychosis) on 2 separate occasions, was on it for 16 months, swapped to try an alternative, went back to Seroquel, didn't work at all the second time.. developed heart and blood pressure complications, was concurrently on Lamictal and Lithium.. more intolerable side effects there.. 

Of all the side effects, I never gained an ounce on any of the prescriptions. Yes, even the dreaded Seroquel. Staying hydrated and active is essential to assist metabolism when taking medication that sucks the life out of you.

I suspect having a physically demanding occupation and unquenchable coffee addiction certainly helped me to avoid weight gain. But, I'm sure that also contributed to my heart problems when medicated.

About 12 years ago, I decided to take an alternative way out and completely sacrifice my social life rather than my sanity. Solitude is not an option for a lot of people, but.. it seems to work for me.

Here's the list of my adventure. Not in any particular order. Of everything on the list, I still occasionally use the Ativan a few times a month. The rest got flushed. If the psychosis ever returns, I will instantly hop back on the Medicoaster. 

  • Seroquel.
  • Geodon.
  • Risperdal.
  • Abilify.
  • Symbyax.
  • Zyprexa.
  • Lamictal.
  • Lithium.
  • Xanax
  • Ativan.

Wow thanks for your response. You gave indeed been on a few meds. Glad you can manage without nowadays...... it's tempting to try...

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Living for 12 years without meds is its own seperate madness.

Since it is not possible to know how my life would have been different if I mustered up the patience to try new Medicoaster tracks, instead of the alternative approach, it is all a mystery.

In hindsight, I probably should have stayed on meds and sacrificed my physical health. My mental health issues have caused a LOT of issues and heartache for everybody who tried to care about me.

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On 9/3/2017 at 1:44 PM, Lms-Kaz said:

Living for 12 years without meds is its own seperate madness.

Since it is not possible to know how my life would have been different if I mustered up the patience to try new Medicoaster tracks, instead of the alternative approach, it is all a mystery.

In hindsight, I probably should have stayed on meds and sacrificed my physical health. My mental health issues have caused a LOT of issues and heartache for everybody who tried to care about me.

Sorry to hear about the heartache. I always feel so bad for those close to me 

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