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Return of anxiety after 10 years without...need insight!!


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In January of this year I woke up with a panic attack completely out of the blue.  Despite several episodes of anxiety and depression in my 20s, my last episode was back in 2008!  At that time I went through a year or so of therapy, committed to staying on 30mg of Paxil, and I never looked back.  I honestly would have said I was cured!  The panic attack led to a period of anxiety that lasted right through February.  I upped the Paxil to 40mg and worked with a psychiatrist who suggested adding Lamictal.  We started at 25mg for 2 weeks, 50mg for 2 weeks, and then 75mg.  I started noticing a positive difference at about a week on 75mg.  A few days later, the anxiety and depression just lifted!  It was like I had my life back.  For nearly a month I felt great, and believed the Lamictal must have made the difference.  Unfortunately, it didn't last.  

About a week ago something minor triggered anxiety in me, and again it has lasted!  My psychiatrist recommended going up to 100mg of Lamictal, so I started that two days ago.  My question is, does lamictal work and then wear off if it's not at the right level?  Has anyone had success with an SSRI and lamictal for anxiety and depression, not related to bipolar disorder?  Can anyone offer advice on how to keep the faith with these medication changes, or how to overcome anxiety?  Looking for others who get it, and want to help!

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I also say raise the Lamictal. Most people do not get benefit until 100-200mg. I try to stick as low as possible, but if I were to get stuck really deep down (or anxious) I would try to raise it to 100mg and then if that doesn't work, try up to 200mg at least. If it's worked for you for 8 years - that is great!! Some people also experience "poop out" with antidepressants. A/Ds dont work for me as well as SNRI's (like Cymbalta or Effexor) I have less problems with anxiety, but I know that Effexor also helps in that area.

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  • 2 weeks later...

I have been in the same boat as you - no anxiety for years and then boom!  And mine, like yours, lasts days; I don't have "panic attacks" per se but severe anxiety that doesn't relent unless the meds I am on are changed up somehow.

I'm wondering if the temporary relief you felt at the 75mg level of Lamictal could actually have been your body getting used to the extra 10 mg of Paxil?  I know that when I started on Paxil years ago at 20 mg for anxiety, it initially sent my anxiety THROUGH THE ROOF, and then the Paxil started working and the anxiety subsided.  Just a thought.  I know my pdoc says that if you're anxious already you have to start Paxil very gradually; I'm not sure if this is true for an increase in the dosage or if it only applies to when you actually start the drug.

I have found, knock on wood (ok, so it doesn't work so well for the slight OCD I have), that Trintellix (10mg) plus .5mg of Klonopin per day has worked wonderfully for my anxiety.  I know Trintellix is usually prescribed for depression, but my pdoc has found in his practice that it actually has worked for anxiety for many of his patients.  He is brilliant and I really trust him.  Occasionally I will have the *start* of break-through anxiety but I've found if i use  breathing techniques (look up belly breathing) it goes away quickly.  Also, since my main fear is the "fear of the fear" or the fear of the anxiety coming back, I've found if I can distract myself that works too.  I often distract myself by thinking about what's happening in a book I'm reading or in a tv show I've watched.  It's weird, but it helps me a lot (especially since this anxiety for me usually comes at night while lying in bed).

Just wanted to post this since it sounds like our anxiety looks similar.  And I'm hoping the post about the Trintellix can help someone else.  The big problem with Trintellix is the cost - it's not affordable if you don't have insurance or deep pockets.  There are good coupons out there, however, and perhaps you could get in touch with the company to see if they could work with you - ???

Really hope this helps you, Courty, or anyone else who reads this and is suffering with anxiety.  It is really a terrible affliction.

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