[mugwort2]

My psychiatrist wants to put me on an antipsychotic forgeneral anxiety. He prescribed previously generic Effexor for depression He just increased it from 75 mg per day to 150 mg. IOW twice what I was taking.
Now he wants to put me on Loxitane. sp? I never experienced any audio or visual hallucination. I don't suffer delusions. No other shrink or any other doctor ever diagnosed me with schizophrenia. IMHO I think he should of prescribed an antianxiety med. I'm thinking he is prescribing a much too strong med for simple anxiety. I know you don't know me except through this forum but I am able to function. I go to my drs. appts. I write a blog. I do my artwork. IMO its like using a sledgehammer to burst a balloon.
I'm seeking a 2nd professional opinion. If this is not enough info please let me know. Thank you.

I'm not familiar with that medication. Sometimes an antipsychotic is prescribed with an antidepressant when the antidepressant alone isn't quite doing it. For me, my pdoc occasionally prescribed an antipsychotic because my anxiety showed up in the form of ruminating thoughts that in turn complicated the depression. The antipsychotic helped slow down the ruminations. You don't necessarily have to be psychotic to benefit from an antipsychotic medication.

That said, you are still on a fairly low dose of effexor (I usually was on 300mg), so there is still a lot of room to adjust the effexor. Can you just ask your pdoc to hold off on the antipsychotic while you see if the effexor increase does the trick?

[TicTacGo]

Okay so what happens is that antipsychotics can be used for the off-label use for sedative properties; for sleep and for anxiety.

I used to be on an antipsychotic for anxiety until I got better enough to be off of it. Yes, an antidepressant and antipsychotic may be better, but that wasn't an option so I had the antipsychotic alone.

The increased Effexor may help, so perhaps consider trying that out first, but what he is essentially trying to do is not prescribe an "anti-anxiety" med because those are actually more habit-forming and tolerance does build up after a few weeks to a month of regular use, perhaps sooner.

[*Laurie*]

Hi mugwort, It is not at all unusual to use an antipsychotic to treat anxiety, especially anxiety that tends to be severe. It is safer to take an antipsychotic than it is to use benzos, which would likely be the other anxiety medication.

[still_crazy]

hi. "Antipsychotics" are really just tranquilizers. The old term is neuroleptic--to seize the neurons--because of the effect high(ish) doses of the older drugs have on people. Not fun.

Low doses of loxapine would be cheaper than a low dose of a newer, "atypical" drug. That's one plus, I guess. The other thing is that tranquilizers/neuroleptics in low doses can be sedating, help anxiety, reduce agitation, etc. Sometimes, doctors will use a low dose neuroleptic with an antidepressant until you're adjusted to the antidepressant, or the new dose of antidepressant.

I dunno. If you have the $$$ and inclination, I'd personally see about a different psychiatrist. Thing is, the standard anti-anxiety drugs are the benzodiazepines. They're sedatives, controlled substances (Schedule IV--you can get refills). The problem is that now there's more pressure on doctors to avoid the benzodiazepines, which is both good and bad. It might be good because being dependent on benzodiazepines is rough and tapering can be hell on earth. It might be bad because many doctors resort to neuroleptics, antihistamines, etc. instead of benzodiazepines, and those drugs can also cause problems.

Did you look up the dose your doctor prescribed? I don't want to sound crazy, but some doctors pretty much just shut their patients up, if you don't watch them. I don't know what that's about, honestly. Low doses of loxapine have been used for anxiety now and then, probably more in the 70s, before all the lawsuits about using neuroleptics for non-psychotic problems.

Sorry about all this. I don't think this sounds like the craziest medication maneuver ever, but I wouldn't go for it, personally.

[CobolCapsule]

Like what some of the others have stated. It is quite common to prescribe a antipsychotic for anxiety. Many people take them for non psychotic problems. They are some of the most prescribed medications out there, just behind statins. You might want to be aware of some of the side effects though. All medications have side effects, and the chances of getting them are slim, so i wouldn't be afraid of taking an AP. I take a low dose of one with no problems.

[BeyondtheRainbow]

Loxitane has a weird property that it partially metabolizes into an antidepressant (amoxapine) on the way out. So it should help anxiety/depression a little more than other APs by that action.

I was on it for several months about 2 years ago. It helped my depression somewhat but I had some dangerous side effects and had to come off it before we got the dosage high enough. (Don't worry about it, it was rare and I'm very sensitive to meds. It is extremely unlikely you'll have problems like I did). I actually liked it. I lost some weight and it had few side effects until the problematic one kicked in. It wasn't even that sedating but helped with sleep which is a major problem for me.

[mugwort2]

[QUOTE=lolagrace;5511632]I'm not familiar with that medication. Sometimes an antipsychotic is prescribed with an antidepressant when the antidepressant alone isn't quite doing it. For me, my pdoc occasionally prescribed an antipsychotic because my anxiety showed up in the form of ruminating thoughts that in turn complicated the depression. The antipsychotic helped slow down the ruminations. You don't necessarily have to be psychotic to benefit from an antipsychotic medication.

That said, you are still on a fairly low dose of effexor (I usually was on 300mg), so there is still a lot of room to adjust the effexor. Can you just ask your pdoc to hold off on the antipsychotic while you see if the effexor increase does the trick?[/QUOT
TY for replying. I sure hope he reconsiders the Loxitane. Your remark on a you don't need to be psychotic to benefit made me feel better. Still concerned about getting TD. I too get ruminating thoughts I think due to my PTSD I know how it feels.

[mugwort2]

Originally Posted by TicTacGo

Okay so what happens is that antipsychotics can be used for the off-label use for sedative properties; for sleep and for anxiety.

I used to be on an antipsychotic for anxiety until I got better enough to be off of it. Yes, an antidepressant and antipsychotic may be better, but that wasn't an option so I had the antipsychotic alone.

The increased Effexor may help, so perhaps consider trying that out first, but what he is essentially trying to do is not prescribe an "anti-anxiety" med because those are actually more habit-forming and tolerance does build up after a few weeks to a month of regular use, perhaps sooner.

So that explains why he didn't Rx the anti-anxiety drug. Thanks for the info.

[mugwort2]

Originally Posted by *Laurie*

Hi mugwort, It is not at all unusual to use an antipsychotic to treat anxiety, especially anxiety that tends to be severe. It is safer to take an antipsychotic than it is to use benzos, which would likely be the other anxiety medication.

I somewhat agree. TBH I'm thinking too many psychotropics come with far too many serious side effects. Realize its a rather complicated issue. Side effects vs wanted effects. IOW I get the impression its extremely difficult to make an MI drug that's effective without terrible adverse reactions.

[mugwort2]

Originally Posted by still_crazy

hi. "Antipsychotics" are really just tranquilizers. The old term is neuroleptic--to seize the neurons--because of the effect high(ish) doses of the older drugs have on people. Not fun.

Low doses of loxapine would be cheaper than a low dose of a newer, "atypical" drug. That's one plus, I guess. The other thing is that tranquilizers/neuroleptics in low doses can be sedating, help anxiety, reduce agitation, etc. Sometimes, doctors will use a low dose neuroleptic with an antidepressant until you're adjusted to the antidepressant, or the new dose of antidepressant.

I dunno. If you have the $$$ and inclination, I'd personally see about a different psychiatrist. Thing is, the standard anti-anxiety drugs are the benzodiazepines. They're sedatives, controlled substances (Schedule IV--you can get refills). The problem is that now there's more pressure on doctors to avoid the benzodiazepines, which is both good and bad. It might be good because being dependent on benzodiazepines is rough and tapering can be hell on earth. It might be bad because many doctors resort to neuroleptics, antihistamines, etc. instead of benzodiazepines, and those drugs can also cause problems.

Did you look up the dose your doctor prescribed? I don't want to sound crazy, but some doctors pretty much just shut their patients up, if you don't watch them. I don't know what that's about, honestly. Low doses of loxapine have been used for anxiety now and then, probably more in the 70s, before all the lawsuits about using neuroleptics for non-psychotic problems.

Sorry about all this. I don't think this sounds like the craziest medication maneuver ever, but I wouldn't go for it, personally.

Pdoc told me 70 mgs. No idea how low that is since I know hardly anything about the meds dosage.

[BeyondtheRainbow]

That's a moderate dose. I was taking it as a 2nd AP (partly why I ran into trouble) but my goal dose was 40-50 mg. It's got a huge dose range though, something like 30-250 mg.

[*Laurie*]

mugwort, you can google loxitane dosage to find out the low, average, and high dosage infor.

[VanGore28]

Anti psychotics do had intense side effects for most people. One is the weight gain when they affect metabolism, some ive learned seriously damage the kidneys, i will inevitably get diabetes.....
sorry bleak bleak picture
A low dose should be nothing to worry about though
I have succumbed to the fact i will need meds for the rest of my days. But if i had depression or anxiety and not a psychotic condition , i would want to know i had tried all the safest avenues first,

[Lorimums]

My doctor put me on Abilify for my anxiety. I have not started it but like your doctor, thinks anti-psychotic meds are what I need ??

[-jimi-]

Antipsychotic medication is pretty hardcore and I think doctors prescribe them off label too easily. They are not safer than anti anxiety meds, they are actually less safe. What they mean when they say antipsychotics are safe is that you can't get high on them and that they are much less addictive.

[CobolCapsule]

Just keep your dose as low as possible. Always use the lowest effective dose for whats being treated.

Take care of your physical health while taking an AP. Do some research at drug websites. https://www.drugs.com/sfx/loxapine-side-effects.html
You will discover that the side effects are really not much worse than ssri's. Most of the side effects are rare.
I just got an annual checkup, and my health is great.