Ideas on new meds for treatment-resistant Panic Disorder?

Post Reply New Topic

I have treatment-resistant Panic Disorder as part of AS. For about 6 years Paxil (Paroxetine) was helping along with Clonazepam, but for some reason I still don't fully understand, a new psychiatrist (a Johns Hopkins one) took me off of Clonazepam and then a month after I had my first ever visit to the Psych Ward. The psychiatrist was worried about the long-term use and abuse of Clonazepam, but I cannot have a life without it -- I cannot hold down a job without it, I cannot have a social life without it, I can't even go outside my house.

But I know Clonazepam isn't as effective as it was 5, 4 years ago, and Paroxetine isn't as effective either. The problem with anti-depressants is that they can make me suicidal where no thoughts of suicide occur off of anti-depressants. They can also make me depressed, despite being anti-depressants, and also make my anxiety worse. This has been recently (in the last 2 years) the case with Cymbalta (Duloxetine) and Abilify (Aripiprazole), and partially the case with Clomiprimine. I've even tried Trazodone, which helps me sleep, but doesn't seem to do anything to reduce panic attacks. Over the last 20 years or so I've tried a huge amount of different drugs as prescribed by psychiatrists, as well as a huge bunch of therapy and different kinds of therapy.

Right now I'm back on Prozac (Fluoxetine), where I last used it without success as a teenager (has some decent effect now), but who knows if that's going to get better or worse as I increase dosages. I'm going to try to convince my psychiatrist to try some experimental methods like combining drugs you don't normally combine (can you combine a TCA with a low dose of a SSRI?)

I'm also interested in marijuana/medical marijuana as I've read research (mostly European research as American is very hard to come by) as well as testimonials by Aspies that it has helped them in cases of very high anxiety, with the feeling of paranoia being a low risk factor (mostly attributed to being illegal). It also has the benefit of being non-addictive (physically), unlike drugs like Paxil/Paroxetine and Clonazepam. But unfortunately I'm in one of the American states where it can't even be used for medicinal purposes.

Panic Disorder is different than Social Anxiety in important ways. Often people have panic attacks in social situations with Panic Disorder, but that's more about the general stress level of the area increasing the risk of a panic attack. I also get them daily at home while relaxing. I can't even play video games much anymore due to the crippling effects of this anxiety.

Anyone else have some ideas that could augment Clonazepam (a benzo) or replace it for crippling anxiety? Probably something I'll get addicted to and have to try something new in a few years? Or maybe some effective alternative treatment to try in addition?

Right now I think I'm making progress with targeted therapy and meditation (not spiritual), but I think it may be yet a few years before I see real effect from therapy. One of the therapies I want to look into is hypnotherapy.

Thanks,
Thrae from IRC

canada also has good research...on medical mj
and US is beginning to have some research

strawberry cough is supposed to be designed for anxiety....i have yet to try it though I have pretty much given up on the substance- don't like the side effects from it.

some other viable alternatives:
Clonidine (anti-hypertension)
Mertazepine (anti-depressant....though unique in its nature)
Propranolol (anti-hypertension)
Guanfacine (anti-hypertension)
Gabapentin (GABA related drug)
Any similar type of drugs might work

Thanks for the reply! I haven't tried most of those drugs. I did try Gabapentin (Neurontin over here) and it wasn't very effective.

I haven't heard of the use of hypertension drugs for extreme anxiety?

well i've heard great things in relation to panics,

i've tried clonidine myself with success

my brother has tried propanolol with success.

As for the rest I have not tried them.

mirtazepine is supposedly like smoking legal pot......but for many it only works for couple months and then poops out.

they also make a newer gaba related drug called pregabalin
supposed to be like souped up gabapentin.....but i've heard mixed things about it.

as for you severity level....I do not know if they would work...just like anything could be a hit or a miss- basically all of them try and calm you in a way.

some other types of drugs to try....
Carisoprodol
Cyclobenzaprine

i have tried cyclobenxaprine, it's very powerful at slowing you down....but i've never heard of it being use for anxiety so these last to are just possibilities....as they are the same type of drug.

the problem with using anti-anxiety medications as you are using is that they increase your anxiety in the long run.

I have found ssri's do little in the way of helping sever anxiety with panic attacks...IMO any of my suggestions will do much more than any ssri, as you will actually be able to feel the effects.