Posted by Alan on October 18, 2002, at 23:16:48
In reply to Re: Is Lexapro helping anyone with anxiety, posted by cody on October 18, 2002, at 18:23:44
> Alan,
> Thank you for the helpful information. No, I have not been offered bzd as monotherapy. In addition to the Remeron, I have also been asked to try Paxil and Celexa, but was unable to tolerate either. My doctor has always seemed willing to prescibe the ativan and has told me to increase the dosage while adjusting to the Lexapro. As hard as I try, I just don't seem to be able to tolerate any AD except Remeron. I don't know why, but I have always tried to avoid taking any bzd. After reading the info on the subject, I now have a better understanding of my illness and ways to treat it. Thank you so much for your help.
============================================You're welcome.
There is a distinctive trend amongst anxiety sufferers - those that respond best to bzds and those to AD's (the AD' as I mentioned before are in the distinct minority).
Both drugs have tolerance ("poop-out" is the euhpemism used by the pharmecticals for AD's) and withdrawal ("discontinuation syndrome" used by AD co's.) so it's a wash.
So, if you've run a sufficient amount of clinical trials with the new AD's sounds like it's time to try the bzds in monotherapy. Remember that each of them will give you a different response so your doctor should give you the latitude to try any one of them either as a single type or combining a long acting (klonopin or Valium) with a shorter one PRN (xanax or ativan) for breakthrough panic or anxiety attack. Either way, it sounds like you are a good candidate.
Remember that there are sedating side effects at first but that will wear off over the course of the first week or so. DO NOT confuse the decrease of the sedating side effect with the med losing any of it's anti anxiety effect. Keep upping the dose (under the docs supervision of course) until either the med has enough benefit without too much side effect to enable you to stick with it.
If one type doesn't work, go to the next one....that's the beauty of it, the med works right away so you can go from one to the other until you find the one that YOU feel best on. DON'T feel bound to some arbitrary starting dose that's on some chart or is preconceived that is not individual to you. Only YOU will know by listening to your body what med at what dose works for you and in what situation. The dose may fluxuate too to trace the waxing and waning of the underlying anxiety disorder.
Leave the commercial interests standing between you and a good doc that understand these meds behind. YOU are the boss and the doc is YOUR employee. As long as you remember that, you'll be in control of your health and the hopelessness of things being out of control will lessen.
Second and third opinions are sought after on a daily basis in medicine. Why should psychiatry be immune to these standard practices? Find someone that is not benzophobic and beyond that understands and has experience treating with these very safest of drugs for anxiety disorders!
Best,
Alan
poster:Alan
thread:109458
URL: http://www.dr-bob.org/babble/20021012/msgs/124215.html