anxiety/mild panic attacks

I need some help, I have tried benzos for the treatment of anxiety and they make me too drowsy. What are other options that are available?
Has anyone found a particular med to be more reliable in these situations? It would be something I would need maybe once a week, but might take more often as a precautionary measure.

Thanks in advance

I have a friend who had major panic attacks & she takes Zoloft (it has been for years now) & she is doing very well.--Suzy

sillygirl - There are several antidepressants used for anxiety and panic attacks. The most common of the SSRIs for these indications are Paxil™ (paroxetine) and Zoloft™ (sertraline). The dose for panic disorder is usually higher than is used for depression, but your doctor will help you decide what dose will be appropriate for you. You will need to take the SSRI every day for it to work properly and to prevent panic attacks.

Your doctor will probably start you at a low dose and increase it slowly to minimize what I call "start-up" side effects. These can be things like nausea (take the SSRI with food to minimize this), drowsiness, headache (more like a pressure in the head that is noticeable, but usually not that uncomfortable), and dry mouth (just suck a candy or chew gum).

One start-up side effect is a bit more bothersome when treating panic disorder with SSRIs. When you start the SSRI you may experience an initial increase in the number of panic attacks. This and the above start-up side effects are just your body adjustung to the medication and will begin to lessen within the first couple of weeks. Normally, after 3 to 4 weeks one experiences far fewer panic attacks than they did before taking the medication. Some say that the difference is like night and day, and is well worth the initial increase in attacks seen at the start of therapy. For those first few weeks many doctors will give a sublingual benzodiazepine like Ativan SL™ to be used if you feel a panic attack coming on. The sublingual form of benzodiazepine dissolves under the tongue and absorbs quickly to take the edge off of the ensuing attack. After the first couple of weeks, as the number of panic attacks subside, you probably will not need to use the benzodiazepine anymore.

Talk to your doctor about this and let us know what you decide. I hope that this is of some help - Cam

Neurontin (generic is gabapentin)

It works. No risk of addiction. Minimal (none for me) side effects.

Okie

I am on Buspar (Buspirone) and so far so good. It has a similar effect as the benzos but you have to let it build in your system, so you can't take it on a per-needed basis. The odd thing about is that it feels (to me) alot like effexor did in the beginning but without the stomach-aches and initial jitteryness. But, it does have the same odd feeling of being wrapped in cotton batting (not an unpleasant feeling just a little odd)

Tried Paxil and hated the effect (became true to my S-name, nasty nasty agression and combativeness on Paxil!!!) So, I've avoided Zoloft and cousins of Paxil. I guess it is a little different for everyone!

I also used buspar for anxiety attacks and got better results with less side effects with that med then any.
Best of luck.
Laverene

Lexapro has been a huge help for me with regard to panic and anxiety. It's an SSRI like zoloft, paxil, prozac, etc, but the side effect profile tends to be much milder. The only side effect I've had on it is night sweats, which is annoying, but definitely tolerable.

Since it is an SSRI, though, you can't really use it on an as needed basis like you can benzos. As far as I know, you have to take it every day for it to work.

Thanks to everyone for the info. I didn't realize ssri's were used for anxiety, thats too bad since I can't take them . I tried 3 of them for Dep. and had terrible reactions.

But, Buspar and gabapentin sound like possible options. I am not familar with either of them. It was mentioned that the side effects were low, is weight gain something anyone has noticed?
Are these older drugs?

Im feeling so desperate right now. My anxiety seems to be getting progressively worse and Im so afraid it will take over!

I'm on the neurontin for anxiety and panic attacks and it works great and I have no side effects.

I love my CELEXA (20 - 40 mg daily) and I often included a natural herb when a little some thing extra is needed - VALERIAN ROOT... this herb can be purchased at your local store, in the Vitamin section.

I hope YOU find some PeAcE with in your mind and soon.

LoVe,
Rhapsody - ((( )))

I went to my pdoc and discussed my options, in particular neurontin and buspar. My pdoc is not a fan of either medications . I was more interested in buspar after researching it more but he said he didn't want to give it to me. He did not prescribe either of them, instead suggested I try out the klonopin again at a lower dose so I don't get too drowsy. I was hoping for something I haven't tried before. Ill give it the week. Life is so very very frustrating and disapointing.

I was wondering something else about anxiety and medication. I'd prefer to not have to take a drug daily for it. And I think that I might have an anxiety provoking situation that causes me intense panic or anxiety only a few times a week. Does taking sometthing daily seem right? I fear that I will get addicted to a drug. But at the same time my life is in pieces because of it . And it's possible that I only have that number of situations arise because I only allow that number by keeping myself from highly anxious settings

Xanax?

Edit: Oh whoops, Xanax is a benzodiazepine, sorry

Well, can you describe for us what you're facing? We all get anxiety now and then. I'm not trying to diminish what you're experiencing, just trying to understand it more.

In the meantime, maybe it's a long shot but you could try Valerian? You can buy it, it's cheap, and people take it for anxiety. It might make you sleepy, but there's only one way to know for sure

Take care,
Sean

talk to us.....one of us might have a "lightbulb"moment and come up with some more help.......

i guess that i favor psychological interventions over chemical interventions for a number of reasons:

- side effects of medical interventions (for anxiety) include drowsyness, increased anxiety etc etc etc. there are also a number of other side effects (and possible side effects) that imho make medication a 'last resort' kind of strategy.
- withdrawal effects of medical interventions (for anxiety) include increased anxiety. sometimes even more anxiety than one experienced before taking the medication!

here are some psychological interventions.

- therapy. it might be that there is a particular trigger for your anxiety. it might be an increase in stress or a particular stimulus. if you can identify this then you might well have an 'advance warning' on your anxiety.
- systematic desensitisation / flooding can be very effective for treating anxiety that results from a specific stimulus.
- mindfulness meditation, progressive muscle relaxation, visualisation exercises can be very effective for treating anxiety that is more generalised (in response to more distributed or general stressors)
- such things as adequate exercise and eating properly can help one sleep better, reduce general levels of stress, and help so that it is easier not to respond to particular triggers
- ability to 'lift the judgement / evaluations' can also help lessen anxiety.

none of the above psychological interventions have possible (likely?) side-effects of increased drowsyness and / or increased anxiety.

i'd really reccomend trying psychological interventions first because of the above.

an additional complication with chemical interventions for anxiety is the potention for tolerance and withdrawal (aka addiction). if your anxiety has been around for a while then it is likely that medication will mask it for a time and as soon as you stop taking the medication your symptoms will resume. possibly worse than they were before given the potential for tolerance and withdrawal.

Well, First off, my ideal way to approach this dilemma would be a non-medical route. I agree with you Alexandra 100% but I am feeling desperate and I have no coverage for therapy. I can justify spending money on clothes and wine and most tangible objects but for whatever reason I can't get my head around the idea of spending ALOT of money of therapy. It is something that I might have to just get over! I would love to hear any other options there are for therapists? Is there a cheaper alternative, truth is I haven't looked into that possiblity.

About my anxiety. I am afraid to let peoploe down, I have a fear of saying something wrong or stupid (recent), I think my entire anxiety actually revolves around a fear of people finding out Im not what they think I am. They expect something and I am not able to perform. When I am is a situation where this becomes an issue, my face goes red, which in turn causes me to feel worse, I start sweating, my heart races, I get light headed, I feel like Im going to pass out sometimes. Oh and my hands have actually started to tremble as a response! How embarrassing. That's an idea of how I feel when its really bad, but as daily issue, I get more of that racing heart and sweating when Im stressed, but that incluses mind blanking. It is hampering my development and growth in everything!

I also have a paralizing fear of relationships. Im an anxious idiot around men, Far beyond what I would consider "normal nervousness"

I really hate myself

Does sounds like I need some therapy ontop of drugs! Doesn't it? Or not?

sounds like it's worth a try, is it at all dangerous?

Hey. given what you have said it sounds like therapy would be a better approach. it might need to be supplimented with medications or it might not need to be supplimented with medications.

is there any way you could get coverage for therapy? how much do you think you could reasonably afford for therapy? many therapists are willing to see people at reduced rates if the person simply can't afford to pay full rates at present. there can be considerable variation in the rates that different therapists charge and in the expected time frame for therapy.

a cheaper alternative would be for you to try and self-help your way through learning how to do mindfulness meditation / progressive muscle relaxation etc. to try and self-motivate your way through exercising and eating appropriately etc. that can be pretty hard though. most people find they need / do better with a therapist who can help motivate them. it can also help a lot to have a relatively objective point of view. and... someone who you can talk to about your fears.

> I am afraid to let peoploe down, I have a fear of saying something wrong or stupid (recent), I think my entire anxiety actually revolves around a fear of people finding out Im not what they think I am. They expect something and I am not able to perform. When I am is a situation where this becomes an issue, my face goes red, which in turn causes me to feel worse, I start sweating, my heart races, I get light headed, I feel like Im going to pass out sometimes. Oh and my hands have actually started to tremble as a response! How embarrassing. That's an idea of how I feel when its really bad, but as daily issue, I get more of that racing heart and sweating when Im stressed, but that incluses mind blanking. It is hampering my development and growth in everything!

sounds like you are a perfect candidate for therapy :-)

> I also have a paralizing fear of relationships. Im an anxious idiot around men, Far beyond what I would consider "normal nervousness"

and that sounds like something that medication won't really be able to help you with (aside from sedating you into a drugged haze so you no longer care what people think about you).

whereish do you live?

e.g., do you live in a big city like NY or chicago or something (just thinking of treatment options)

I will look further in to therapy, I could afford to go twice a month possibly. Or as you mentioned look into other options, like sliding scales/social workers. I tend to agree with you that therapy would be most helpful, it is such a commitment though. I do live near a lot of resources so I should be able to find something. I really do not enjoy living in a haze. Thanks

Yes there are sliding scales.
Sometimes there is provision for people to work with people who are training for significantly reduced costs as well.
Some people are a little worried about the competence of therapists in training. In support of the notion I'll say that the best psychologist I've ever seen was in training. I found her to be more willing to view me as an individual than people who have been practicing for longer (with more of a 'stereotype' in effect). I also found her to be really motivated toward helping me.
It might be worth contacting universities in your area to find whether this is an option.
Another option is psychoanalytic training institutes.
The advantage of the latter is that the time it takes them to train means that you are likely to get more continuity.

Hi Sillygirl,

I think you know yourself well and your thinking that medications may not be the answer sounds right. You want relief, but not to be drowsy and numb. You want to conquer this, work toward lasting relief.

There are ways to find inexpensive therapy. But I'm wondering...you have a pdoc, so does that mean you have medical coverage? If you do, then you probably do have coverage for therapy.

Your pdoc is a place to start; ask him about psychologists he might know about, clinics, etc. And if you do have insurance coverage, you may need to use one of 'their' psychologists, so you may want to check there too.

Another resource is good old Google: Here is a site that I like that is about therapy and was written by the therapist: http://www.kellerphd.com/psy.html. Here is a site that has a good question/answer section about therapy: www.aboutpsychotherapy.com.

You can also search for training institutes in your area that may have clinics that offer inexpensive therapy or can refer you to therapists in your community: http://www.div39outreach.org/ is one site where you can search by location (state). http://www.apsa.org/HOME/tabid/288/Default.aspx is another site that might be helpful.

This site has a guided meditation called Secret Garden that is very relaxing; it is 20 minutes, but feels like 5 minutes: www.meditainment.com. If you like that and might want to do more, this site has tapes and CD's you can order. I borrowed my therapist's tapes to try and liked them, then I ordered from them: http://www.wholeperson.com/index.html

You are worth any costs involved. It is an investment in you and your future. You'll learn things about yourself that will benefit you the rest of your life and will make life so much better for you.

I wish you great success!

ECHOES

Thank you for all that information!

the psychoanalytic training institutes sounds like a good idea. I like the idea of continuity.