Taking anxiety medication?

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I'm on 80mg of Lovan (Fluoxetine Hydrochloride) a day for OCD and depression. It's the same as Prozac.

I've been on it for ages and I find it does help a fair bit.

I have been suffering from acute anxiety and clinical depression during the two last years. I have clearly overcome most of the depression, though some things are still here sometimes, and anxiety is still extremely present even though I am gradually getting better at managing it. I have used various prescription drugs and other things in the last years, and some helped, so I think I should share my experience. I also have a training and a keen interest in neuroscience (although I am in no way a doctor or a qualified clinician) so I have a bit on insight on how and why those drugs work or don't.

As a whole I would say drugs can be a welcome help. They are not perfect, there are side effects, addictions, they do change the way you think and make you "not be yourself" and I don't think it is a good idea to rely on them for daily life in the long run if you can avoid it. But they make your brain work in a different way, which includes in ways that can help you find out how to do better without drugs.

1) Antidepressants
a- Prescription
I tried a few when I was diagnosed with acute depression. The first I got was escitalopram (Cipralex), which did little good and if anything seemed to make meltdowns more frequent. Then I got algomaltin (Valdoxan) which did absolutely nothing at all (and was insanely expensive). Then I got paroxetin, which was the best and really helped me manage my emotional state for a few months (and eventually get better and stop medication). The efficient dose was 40mg (two 20mg tablets) for me.
SSRIs are a mixed blessing. They did help me, once you are on it the physical side effects are minimal (I only experienced a moderate loss of libido), they are not physically addictive for most persons (unlike anxiolytics and despite some crap you can read on the Internet), and stopping them gradually is usually not problematic. On the other hand you have to know that :
- They are not instant anxiety-relief drugs (that's anxiolytics)
- They will not help you immediately, the 3-6 weeks delay before experimenting any benefits is a real thing with physiological basis. I know first hand that waiting that long can be extremely frustrating and depressing in itself when you are really depressed and desperate to find ways to get better now. The only advice I can give in this situation is hang on, find other ways to help yourself and don't give up (unless of course you experiment unusually severe side effects)
- When you start taking them you can have some really unpleasant physical side effects (nausea, dizziness and balance problems, diarrhea). They recess (usually completely) after 2-3 weeks of use once your peripheral nervous system has adapted. In my experience they peak about 1-2 hours after taking the tablet and get better later in the day, so manage your time appropriately if needed.
- They do alter your behaviour and emotional processing, in a way that is much more subtle than anxiolytics. What I mean is that they don't just turn you into "yourself, minus some anxiety attacks, brooding and horrible emotional crisis", they turn you into someone who really thinks and behave in a different way. It can be subtle did not notice it when I was under medication, but NT people who know me well picked it at the time, and I understood it after stopping medication.

b- Other
- I tried St John's Wort (Hypericum perforatum). It did not work for me, but there increasingly strong scientific evidence that it is statistically as efficient as an antidepressant as synthetic SSRIs, and it causes much less trouble and adverse effects. I would recommend using either standardized extracts or the plant itself (most non-standardized pills sold in "natural health" shops are junk). It disrupts hormonal contraception so female on the pill (or using rings/implants) should not take it or use another contraception. Also do not use it concurrently with prescription SSRIs (they work on the same system in a different way and the interaction can be bad)

Globally, different antidepressants work very differently depending on persons. The most honest psychiatrist I saw once told me bluntly that as a doctor prescribing AD, there is really not much more you can do than trying different molecules at different doses until you find the one which works, and relying on your experience and intuition (and on the patient's feedback) to be as quick and efficient as possible.


[b]2) Anxiety relief[b]
a- Prescription
Benzodiazepins are the most common. (I am lucky in that my brain is extremely sensitive to that stuff, I only very small doses to achieve an efficient therapeutic effect.) I tried three.
- Bromazepam (aka Lexopam, Lexotan, Lex* more generally) : I was given half a tablet of that thing once, it just took all of my anxiety off, along with most of my other thought processes, and turned me into a happy idiot for one evening and night. I don't ever want to touch it again. I think it can be insanely addictive and has a huge potential for abuse.
- Diazepam (valium) : Diazepam has a very long half-life compared to other benzos, as well as active metabolites, which means it is active for a very long time (up to a few days, depending on the dosage). It is therefore more widely used for "background" treatment than for on-the-spot anxiety relief. I took a 2mg tablet every other day (with is a very low dosage) for a few weeks. I hated it. It turned me into a robot, I didn't feel any emotions, didn't want to do anything, and didn't care about it. From an anxiety relief point of view it was efficient but the cost was to high for me.
- Alprazolam (xanax): It is by far the best anxiety drug for me. I keep some on me and only take it if I really need it. The effect comes very quickly (a few minutes), the duration of effect is appropriate (a few hours), and it very efficiently calm me down and breaks anxiety attacks. I use 0.25mg tablets and use a half or a full one depending on the amount of anxiety I have to find. It does disrupt my thinking (especially if I take a full tablet) and if I take one in the evening I will have trouble waking up in the morning but it remains manageable.

Benzos all act in the same way and mostly differ by their half-life, which determines the time they remain active. If the half-life is short it is mostly an "on-the-spot" anxiety relief, if it is long it is more a background treatment. All half-lives are on wikipedia and some other medical information websites. Be careful about addiction. I would recommend finding something that help you manage high anxiety and that's all, and stick to it. Avoid taking that kind of medication just to feel more "comfortable".

b- Other drugs
- I don't know if I am allowed to discuss illegal drugs here, so I won't. Anyway I only tried rather common stuff and it didn't help much.
- Valerian, chamomile and most herbal remedies are nice but just help me sleep
- I tend to use alcohol as an anxiety relief but I really don't think it is a good idea; I think I am mildly addicted, like too many people in Europe. Alcohol is a really "bad" drug from a neuropharmacology point of view. It is primarily a GABAergic (roughly like benzos) but it also messes with plenty of other biochemical processes, which accounts for the wild variety of reactions it can cause. Its effects are unpredictable, it is addictive and it is bad for health. I love beer (I am a craft brewer) but I watch myself tightly here and I am much more concerned about alcohol addiction than benzos addiction.
- A few months ago I discovered a plant name kava (also known as kava-kava or Awa) and I like it a lot. You use it by infusing ground roots into cold water and drinking it (you also have capsules and instant drinks now). It has a traditional use in the pacific islands, where it is very much part of the culture (you have kava bars, and people go for a kava together after work, etc.) I love this plant, it both relieves anxiety and slightly lower social inhibitions. The effect is strong but very "gentle", you never have the feeling of loosing control. There is an impairment of reasoning and thought processes but nothing as bad as benzos or even alcohol, and it seems to be completely innocuous for health (pacific islanders have been using it habitually for 2000 years and they don't have any medical condition that could be associated to it). I use it occasionally for good success to relieve moderate anxiety.

c- Other things
- Steam room and sauna sessions help me a lot relaxing and lowering my anxiety. The heat automatically makes your body and muscles relax, and it seems my mind can't have highly stressful or anxious thoughts when in the sauna. Depending on my energy and state of mind I can do some insightful introspection or just let my mind wander, but it is always a good time away from the external world.

I currently take Valium(diazapam) for anxiety, and 2.5-5 mg once a day....though I might talk to the psychiatrist about taking it twice a day if needed because on some days my anxiety gets out of control more than once and some days I wouldn't even need to take it at all. While in the psych ward they had me taking it 3 times a day as needed. Anyways the valium works a lot better for me than klonopin(clonazapine), that crap was terrible for me.

^^^^
I wouldn't feel right taking v that's probably thanks to the nutters like Tom Cruise, who could probably do well with some medication it may not be rational for what ever reasons I take greater comfort taking an ssri for anxiety

yeah I for got to add that I do recall thank god the only side effect to Paxil is weight gain, though from my experience thoughts of suicide isn't limited to the young, thank god that's past to.

ps try an air conditioner this helps as much or perhaps more so than the meds

pps it made mine worse to , so much so my mom said it was criminal of my doc to put me on them when I got to the full dose things started to improve, perhaps try sticking it out ?

[b]yes with out a doubt humidity /heat is a bad one for most of us ?[/b] didn't know this prior to being dx/ medicated as is rapid changes in temperatures now I've got it I notice the nervous system goes in to overdrive as I leave my bedroom in to the living room and vice versa , I'm to cheap to get whole of house air con And it's not money it's cheapness even if I was a millionaire I'd do the same .

stay in my room from now on , until I find a job , my gp even noted it in my medical certificate that employment must be in a low stimuli environment .

i too enjoy hearing temple grandin speak, i can relate to her so well. im on a mild anxiety medication thats usually used as an anti-depressent

I found buspirone took the edge off many situations. I'm just talking about the pharmacological way of doing things here. (I think we all need to think about coaching, mindfulness, exercise, diet and a whole bunch of other stuff too...)

New prescription in two more weeks... I've always had generalized anxiety, but financial/vehicle/job/personal issues always seem to weigh in a little louder lately.

Every anti-depressant(effexor, mirtazapine, prozac, wellbutrin) I have tried makes me more anxious and doesn't help the depression, well a lot of them do seem to have stimulant properties maybe that has something to do with it. I also tried zyprexa for anxiety/depression and that made me completely apathetic and uninterested in everything I decided to stop taking it when I came to the conclusion it made me feel like someone who survived a lobotomy might feel based on what I learned that does in psychology class. Then I've had seroquel(however you spell it) which I hate just makes me irritable and frusterated. I have also been prescribed anti-histimines which just make me feel weird. I tried klonopin but had problems with that mostly it was too addictive so I ended up abusing it and crap.

As of now I am prescribed valium, which works ok....but I end up supplementing that by herbal teas or tinctures with herbs such as valarian, lavander, chamomille, hops, passionflower and there's probably other relaxing herbs. I more use the valium for intense anxiety or panic attacks not on a daily basis.

I have very very severe Generalized Anxiety Disorder which I've had since I was a toddler, though I was diagnosed when I was 6. I have been on meds since then. I've been on I don't know how many different meds and combinations of meds over the years. The doctor that I went to from when I was 6 to almost 17 years old missed a couple of pretty key things about my anxiety, not to mention miss diagnosing me with other disorders and completely missing my AS. When I was nine or ten I started throwing up a lot and sometimes it was so bad that I couldn't eat for almost a week. I was misdiagnosed with a stomach condition, but I found out when I was 17 that it was simply that my anxiety was under treated. Then when I was 16 I got really sick, I was tired all the time and would lay in bed, on the couch, or in the nurses office at school in a half awake half asleep state most of the time. It lasted a month and that month is almost completely blank in my memory. Several different doctors could not figure out what was wrong. Finally I went to a psychopharmacologist who figured out with in 10 or 15 minutes that all it was was my medications interacting with each other. We started afresh with new meds but it took almost 4 months before my anxiety was controlled again. Now I take 4 different meds for anxiety through out the day.

If my anxiety is not effectively treated I am completely unable to function at all. I can't eat because I am either sick to my stomach or have no appetite. During the 4 months that it took to find the right meds for me, I had no appetite to the point that almost nothing was palatable and I lost almost 20 pounds in 2 months. I could not sleep and when I did fall asleep I would sleep for over 12 hours at times.

So basically without my meds I would be have almost constant panic attacks and would be unable to be with other people, do any sort of school work or house work, do basic activities of daily living, eat, sleep, or do almost anything besides being on the couch.

Even with my anxiety well treated with meds and therapy, panic attacks and just being anxious in general is a part of everyday life, and I still struggle doing a lot of things because of my anxiety.

I have xanax. I don't take it regularly and only take some when needed, which is when I need to fight anxiety attacks (and meltdowns, when I am lucky enough to see it coming early enough). Xanax is quick enough to act that you can actually use it that way and avoid taking it as a background treatment, which I would not want. I am quite lucky because that stuff is insanely efficient on me ; I have 0.25mg tablets and for moderate anxiety I only need half a tablet. A full tablet will defuse all but the most severe anxiety attack, and also send me to bed early and give me a difficult wake up the next day if taken on the evening.

During my best months I only had to take some once or twice a months. When I am really feeling bad I can take it as often as twice or three times a week. The average for the last year or so would be twice to three times a month.

Anxiolytic medication are useful, but they are only a crutch. My position is that I only use them to avoid events (anxiety attacks, meltdowns) which are highly detrimental to both myself and the people around me and provide no benefit or insight, and to be functional enough so I can work on improving my life and ultimately using less anxiolytics. It is like antidepressants; they won't solve your depression problems themselves but they are useful to "bootstrap" yourself out of depression (well, if you find the right one, antidepressants are much more hit and miss than anxiolytics).

I already gave a comprehensive report about my experience with anxiolytics and other drugs here a long time ago, you can have a look if you are interested.

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