Best drugs for Anxiety + Depression

[pally pete]

Im sure this questio has been asked a thousand times or more but im at the point where my life and others are now at risk.

Ive been prescribed Citalopram, Sertraline and Venlafaxine at varying doses since last june, none have worked at all in fact i probably feel worse today than i did before i started any of these medications.

My G.P/Psychiatrist (Who discharged me after one 1 hour session/appointment) Both my G.P and that excuse for a shrink have washed there hands of me and said thre is NOTHING they can do to help me.

I have a G.P appointment on wednesday.

What are/is the most effective drug/drugs for treating General Anxiety/Social Anxiety/Depression? I have suffered for 15 years yet only had the courage to speak to my G.P 9-10 months ago!

Ive researched and researced!

All suggestions welcome so that i can present them to my G.P on wednesday.

She always mentions she can not do anything for me due to my Benzo use approximately 100-200mg per week.

Any imput appreciated my brothers and sisters.

 

[ErgicMergic]

Your benzo use (100-200mg per week, I'm guessing of diazepam) is making you more anxious and depressed, seriously. Benzos are great for short-term anxiety, but they end up causing anxiety in the long run due to interdose withdrawals. You need to start a slow diazepam taper if you ever want to be free of those handcuffs.

If doses of benzos like that (20-30mg diaz) can't help your anxiety, then you're tolerant and/or dependent to them, and she's right, she can't help you. It might sound stupid, but you have to help yourself get better. Everyone I know who's dependent on benzos has anxiety through the roof now, they seriously cause anxiety problems in those who never had it getting in to it.

At this point, you have two choices: chase the benzos, constantly raising your dose for short-term relief and fucking yourself over (tolerance will catch up to you and you'll be in the same place you are now), or maintain/taper over time.

 

[Allein]

I have been though 7 ADs in less than 2 years, I find Venlafaxine has helped quite allot although I still have unwanted side effects from it and really aim to be off this year if possible.

The problem is everyone seems to react differently to different drugs and the differences are beyond placebo IMO, the problem I've had is being able to tolerate the drug long enough to see if it has any effect on the depression.

I made a list a while back as I was getting asked so often by various doctors etc:-

Citolpram - made me suicidal and caused hallucinations, really not a pretty , the physical nausea paled into insignificance compared to the rest of the side effects.

Lofepramine – really bad dreams and I'm not normally bothered by such things, that and circulation problems, very cold feet and hands as well as making me really apathetic,
Chlorpromazine - Added whilst on Lofepramine -= made me non functional zombie

Prozac - Just made me throw up violently on first use

Sertraline - Seemed OK for a few weeks albeit made me feel very emotionally compressed then I had some internal bleeding which required a hospital visit so it was ceased.
-
Mirtazapine - Made my derealisation much worse, ended up having a car accident.

 

[SPC123]

In my experience the SNRIs are the best course for comorbid anxiety and depression. Venlafaxine or Cymbalta (duloxetine) are your options. I found one as good as the other.

Your problem is most definitely with your benzo intake. ErgicMergic is absolutely correct. You will get no relief from your symptoms as long as you continue your course with benzodiazapines. They are great for panic attacks and other breakthrough anxiety, but if you are using them every day you are going to run into problems. I was taking venlafaxine for almost 2 years, and found it virtually eliminated my anxiety and curbed depression. I also had a clonazepam scrip (still do) and I would take 0.5mg as needed, which I limited to a few times a week at most. Now I have discontinued SNRIs and rely on other coping mechanisms, using the clonazepam strictly as necessary. Again, 2-3 times a week at most.

 

[Alex000]

One of the best drugs for anxiety and depression are, of course, opiates. I am not suggesting this outright, but I am letting you know that when used in a controlled fashion, which is a huge challenge in itself, can be great for anxiety and depression. I would be concerned, though, because of obvious addiction risk and what I have read to be, from previous posts, enormous benzo consumption. In any event, no doctor will rx you opiates for anxiety or depression. I do not know the ins and outs of all your symptoms or your conditions, but there are a number of drugs, which psychiatrist will rx, for anxiety and depression. As much as I tout the dangers of neuroleptics, they can be helpful, used in the very short-term or as a PRN, for anxiety and depression. Clonidine is a good anxiety drug too, IMO. It is quite calming in effect. Lyrica or Neurontin would be quite good for anxiety. Perhaps simply hydroxyzine (Atarax/Vistaril) could help take the edge off in a med-cocktail or as a PRN. For depression, there are a number of different AD's which can be helpful. Remeron (mirtazapine), Deseryl (trazodone), TCA's, Wellbutrin (bupropion), Strattera (atomoxetine) are all other anti-depressant options, and there are many more, I just gave you some of the non SSRI's, because you didn't respond to 2 of SSRI's as you mentioned. With some of these drugs though, I would be worried about your intake of benzos. I know you have a substantial tolerance, but still, a bit concerning. Hope this helped in some way or another.

 

[SPC123]

Keep in mind, drugs that increase dopaminergic activity can aggravate anxiety, even as they help with depression.

 

[Alex000]

Keep in mind, drugs that increase dopaminergic activity can aggravate anxiety, even as they help with depression.

As they can help it, as well. If you take an amphetamine before a social occassion, having social anxiety, I highly doubt you will become more socially anxious, for example. Increased dopaminergic activity, yes can aggravate anxiety, but can also help with it.

 

[ErgicMergic]

As they can help it, as well. If you take an amphetamine before a social occassion, having social anxiety, I highly doubt you will become more socially anxious, for example. Increased dopaminergic activity, yes can aggravate anxiety, but can also help with it.

Social "anxiety" is more of a situational phobia, which is why stimulating antidepressants like Segeline, L-Deprenyl, Parnate, Effexor, and Wellbutrin are sometimes used for it. This is also why exposure therapy and CBT is so effective for social phobia, and not as effective for GAD or PD.

People with generalized anxiety or panic disorder will usually not benefit off of non-serotonergic antidepressants, IMO, SNRI's and MAOI's usually make them more anxious due to the stimulating nature of NE and DA.

 

[onlyone3232]

I can tell u the REAL best drugs for depression/anxiety. the ones that have worked for me.
bupe is suppose t work great. im only trying it today for the second time. & i feel pretty happy. & i had meth & oxy last night ffs so im also coming down.
http://en.wikipedia.org/wiki/Bupe#Antidepressant_potential
read that its different to the other opiates ive tried. I dont feel "high" on it i just feel well
next.....
tramadol i took for 4.5 months it's a weak opioid but the only decent SNRI ive tried.

the to above im sure of but the next i dont have experience with. well atleast not the use of it every day.
dexamphetamine. small dose every morning. than take small dose antipsychotic and/or temazepam each night

 

[pally pete]

Thanks for the replies.

But although my Benzo use/Tolerance is high im not and never have been a daily user.

Even now when i take my 100mg dose it's usually only 1-2 times per week and only then do i take it out of desperation due to my Anxiety/withdrawal symptoms going through the roof!

My drug Councillor will not start a taper because she said the highest medically prescribed daily dose for a taper begins at a maximum of 30/40mg per day which in her own words "wouldnt even touch my sides!"

Although yesterday i went through 300mg Diazepam + 7mg Alprazolam which only just took the edge of things.

As another poster mentioned im Dependant and pretty much completely tolerant to Benzos.

My Drug Councillor who i see once every 2 weeks has been talking about tapers/sending me to Detox etc but never following through, should i push her harder on this? Is a Detox clinic right for a patient like me who uses Benzos sporadicaly? Is a daily taper (even from 100mg) the most sensible + sucessful route to take? Because if it is then i will begin this taper on my own without the help of the professionals as i have done a massive amont of homework on the subject of Benzos to the point that whenever i go to see my G.P/Drug Councillor/Psychiatrist my knowledge embarrasses them.

 

[pally pete]

I can tell u the REAL best drugs for depression/anxiety. the ones that have worked for me.
bupe is suppose t work great. im only trying it today for the second time. & i feel pretty happy. & i had meth & oxy last night ffs so im also coming down.
http://en.wikipedia.org/wiki/Bupe#Antidepressant_potential
read that its different to the other opiates ive tried. I dont feel "high" on it i just feel well
next.....
tramadol i took for 4.5 months it's a weak opioid but the only decent SNRI ive tried.

the to above im sure of but the next i dont have experience with. well atleast not the use of it every day.
dexamphetamine. small dose every morning. than take small dose antipsychotic and/or temazepam each night

Its funny should say that i have a friend who swears Buprenorphine in small 0.2 doses upto 10 times a day if needed is the best/Most successful medication he has ever used for his Anxiety/Depression.

Coincidentally enough i may be meeting him tonight but thats to pick up some Oxy which im in 2 minds about because when i use it i feel great, but i usually binge on it so my 7x80's, 5x40's and my 3x20's all (OC) will be gone in a few days - a week and then im not sure if this is a symptom (almost how i describe as a rebound depression) but for the next week or so my Depression worsens, but bearing that in mind i always use Benzos with my Oxy so that just complicates things even more, even though i keep the Benzo use to a minimum (as i always do) or try to!

So the question is go for the Oxy for a few days - a week of depression relief or stear well clear? Btw i somehow dont get addicted to Oxy/Opiates... I can use and the not even bother about them or think about them for months.

 

[Anon54]

I can tell u the REAL best drugs for depression/anxiety. the ones that have worked for me.
bupe is suppose t work great. im only trying it today for the second time. & i feel pretty happy. & i had meth & oxy last night ffs so im also coming down.
http://en.wikipedia.org/wiki/Bupe#Antidepressant_potential
read that its different to the other opiates ive tried. I dont feel "high" on it i just feel well
next.....

tramadol i took for 4.5 months it's a weak opioid but the only decent SNRI ive tried. Cool thing is it works straight away. ya dont have to wait 6 weeks & ya can control ya dose every day. I found 150mg to be the best dose but sometimes took 200mg. I tried up to 400mg (the dose u shouldnt exceed due to seizure risk) & it was a little to over stimulating & restless

the to above im sure of but the next i dont have experience with. well atleast not the use of it every day.
dexamphetamine. small dose every morning. than take small dose antipsychotic like 50mg Seroquel and/or temazepam each night. Temazepam doesnt mess with REM sleep like other benzos.
dont be scared to antipsychotics. I like them Seroquel comes in 400mg pills so taking 2 25mg pills wont hurt ya. they're great for getting to sleep & ya dont build a tolerance to em

mirtazepine. according to wikipedia is superior to ssris & this one u'll actually have a chance of getting prescribed
its also also alot safer with drug interactions. its an antihistamine so it will help u sleep too

Wellbutrin. I dont know about this one but its a DRI & ive heard good things about it. Never heard good things about SSRIs/SNRIs except for tramadol.

another thing u can do to treat anxiety & depression is to quit smoking iif u smoke. even using NRT will help. im using to gum & im feeling good on it. its not the nicotine so much that makes ya lazy & lethargic. it's the other 1000 chemicals in tobacco. Nicotine itself is DRI so in a way u could call it an antidepressant.

Benzos work great for anxiety but u cant take them every day in most cases. I actually know someone who has taken 12mg daily of valium for years. i dont know how that's possible. in most cases u should only take them when something have triggered u off to be times of ya worst anxiety.
dont bother with these if ya just trying to get high though cuz u will have re-bound anxiety. u can sorta play around with valium though cuz of its long half life. it tapers itself out of ya body.
I think valium should come in high potenxy 40mg pills. & not the short acting 2mg high potency xanax pills. u basically get less re-bound anxiety from valium.

Now if binge drink u need to break that habit too. if u know when to stop its ok but theres alot of ppl out there who wipe themselves out like I used to & wake up feeling sick for the next few days thinking about all the stupid things u dont or said.

know which drugs work for u. if ya a pot smoker & u know that smoking more than one hit may make u a tired or feel weird than dont smoke more than one hit. if ya get majorly depressed after taking mdma than dont take it.
i know my drug limits. I occasionally only take codeine, oxy, & valium or temazepam. im liken this subutex though. i had like 32mg of it lol a bit over kill. umm yeah but my point. know ya limits with ya drugs. i can occasionally take the substances i just said without it effecting me life style to much. I had meth last night which is out of my character & the jaw clenching if really bothering me so im simply not gunna take it any more. I hadnt had it it in ages.

next...
take a multivitamin (I found Swiss to be the best one here in australia, ya have to do ya researh on which one to buy), fish oil (lowers stress, can help with inflammation if ya got it), milk thistle (strong antioxidant that repairs ya liver from stuff like to much alcohol) & maybe extra B group vitamins (lowers stress). also drink plenty of water & if ya dehydrated from drugs or alcohol. go to the medical section in ya super market or go to the pharmacy & get a hydrate drink pack. or electrolyte drink. whatever ya wanna call em. they're great for dehydration. 20 effervescent tablets come in the ones I get called hydrlyte. make it strong mix about 5 in some water & sip that.

i hope I've been of some help.
Im going to have a cup of tea now. oh that reminds me. dont drink more than 300mg of caffeine a day. that's 3 coffees, or 6 cups of tea. caffeine stays in ya system for 12 hrs & can cause insomnia. buy some decaf for when ya want a coffee but its to late or uve already had 3. green tea i suppose to be good. but u dont have to go overboard. it doesnt have much taste.

 

[pally pete]

Your benzo use (100-200mg per week, I'm guessing of diazepam) is making you more anxious and depressed, seriously. Benzos are great for short-term anxiety, but they end up causing anxiety in the long run due to interdose withdrawals. You need to start a slow diazepam taper if you ever want to be free of those handcuffs.

If doses of benzos like that (20-30mg diaz) can't help your anxiety, then you're tolerant and/or dependent to them, and she's right, she can't help you. It might sound stupid, but you have to help yourself get better. Everyone I know who's dependent on benzos has anxiety through the roof now, they seriously cause anxiety problems in those who never had it getting in to it.

At this point, you have two choices: chase the benzos, constantly raising your dose for short-term relief and fucking yourself over (tolerance will catch up to you and you'll be in the same place you are now), or maintain/taper over time.

Your probably correct.

But please remember ive had these symptoms 15 years + yet only ever took my first Benzo 3 years ago and in that time my Tolerance/Abuse reached a high as 300mg Alprazolam a weekend!

So in a sense i have brought my useage down somewhat!

 

[ErgicMergic]

Yikes, I was hoping that was for diazepam. 100-200mg of Xanax a week is definitely making your problems a lot worse, man. That's equivalent to 2000-8000mg of diazepam weekly, although some people would say 1000-4000mg diazepam, still a lot though.

You have made great progress, congrats! Hopefully you'll continue bringing down that usage. Just remember with benzos, slow and steady wins the race. Don't rush the taper!

 

[SPC123]

Doesn't matter. Saying you take 100-200mg of benzo's (I'm going to assume it's Xanax, since you as much said it) would be like saying you drink 100-200 beers every week. It doesn't matter how you break it down, you're doing an insane amount of benzo's and you have a serious habit that would likely kill you were you to stop cold turkey (just as alcohol withdrawal would). If you don't reduce your benzo dose, there isn't much anyone is going to be able to do for you. Frankly, any doctor that prescribes you ANYTHING when you are on that much Xanax should have their license revoked and be thrown in jail.

300mg of diazepam + 7mg of alprazolam is the same as taking 440mg of Valium in a shot. That's an impressive kind of stupid. I'm sorry if this sounds harsh but you seem like you need a wake up call. Please believe me when I tell you that you are probably taking more benzos in a go than anyone else on earth. If they accepted such dangerous records you'd get your face in the Guinness book. I'm sure others have done more, but I am also pretty sure in their case it was a suicide attempt.

At the levels you claim, you should get into detox. It would be dangerous, and even life threatening, to attempt to quit that large an amount on your own. That said, there isn't any pharmaceutical help for your anxiety while you continue to take such high levels of drug. And anyone here even SUGGESTING this guy add opiates to his routine should get a stern moderator warning. This site is about harm reduction; not how to kill yourself with benzos and opiates.

 

[onlyone3232]

just go to the ER. thats what i did. i only was on 40mg (sometimes more) a day diaz or equivalent in temazepam or xanax. Not a massive amount but was taken every day few a few months. Would have been very uncomfortable to do it cold turkey as I had been cought dr shopping.
anyways. I was sent to a drug Councillor who switched all benzos I used just to valium & tapered me off over 2 months. I had to go to the pharmacy every day so they made sure I didnt take to much but i got to choose a close one. I wasnt judged to badly. they new i suffered from GAD.
The amount ya taking u cant do on ya own. u need a expert to put u on a tapering schedule. just go to the ER & they'll set everything up for ya. they wont ring the pollice or anything. so dont worry about that.... just get the help

 

[pally pete]

Yikes, I was hoping that was for diazepam. 100-200mg of Xanax a week is definitely making your problems a lot worse, man. That's equivalent to 2000-8000mg of diazepam weekly, although some people would say 1000-4000mg diazepam, still a lot though.

You have made great progress, congrats! Hopefully you'll continue bringing down that usage. Just remember with benzos, slow and steady wins the race. Don't rush the taper!

Thanks, the 300mg Xanax was done over the course of 48 hours, not a week (And i repeat im not impressed by this, im ashamed and embarrased) I havent used these levels for over 18 months now.

Doesn't matter. Saying you take 100-200mg of benzo's (I'm going to assume it's Xanax, since you as much said it) would be like saying you drink 100-200 beers every week. It doesn't matter how you break it down, you're doing an insane amount of benzo's and you have a serious habit that would likely kill you were you to stop cold turkey (just as alcohol withdrawal would). If you don't reduce your benzo dose, there isn't much anyone is going to be able to do for you. Frankly, any doctor that prescribes you ANYTHING when you are on that much Xanax should have their license revoked and be thrown in jail.

300mg of diazepam + 7mg of alprazolam is the same as taking 440mg of Valium in a shot. That's an impressive kind of stupid. I'm sorry if this sounds harsh but you seem like you need a wake up call. Please believe me when I tell you that you are probably taking more benzos in a go than anyone else on earth. If they accepted such dangerous records you'd get your face in the Guinness book. I'm sure others have done more, but I am also pretty sure in their case it was a suicide attempt.

At the levels you claim, you should get into detox. It would be dangerous, and even life threatening, to attempt to quit that large an amount on your own. That said, there isn't any pharmaceutical help for your anxiety while you continue to take such high levels of drug. And anyone here even SUGGESTING this guy add opiates to his routine should get a stern moderator warning. This site is about harm reduction; not how to kill yourself with benzos and opiates.

I dont use Xanax at anywhere near them levels anymore, if at all, i generally try to just use Diazepam, and im not stupid, just very silly!

just go to the ER. thats what i did. i only was on 40mg (sometimes more) a day diaz or equivalent in temazepam or xanax. Not a massive amount but was taken every day few a few months. Would have been very uncomfortable to do it cold turkey as I had been cought dr shopping.
anyways. I was sent to a drug Councillor who switched all benzos I used just to valium & tapered me off over 2 months. I had to go to the pharmacy every day so they made sure I didnt take to much but i got to choose a close one. I wasnt judged to badly. they new i suffered from GAD.
The amount ya taking u cant do on ya own. u need a expert to put u on a tapering schedule. just go to the ER & they'll set everything up for ya. they wont ring the pollice or anything. so dont worry about that.... just get the help

What country are you from?

Because if i went into my local ER id be sent straight home without any help.

 

[SPC123]

Just FYI pete, I wasn't calling YOU stupid, I was calling the act of taking hundreds of milligrams of Xanax stupid. We ALL do stupid things from time to time, and on a harm reduction site I feel it's very important to point out to people when they are ACTING stupid. I don't know you bro, but I do care about you. If I didn't I wouldn't waste my time trying to give you what I believe is the best advice possible: Go to detox and get help before you kill yourself!

 

[Supeudol]

Just FYI pete, I wasn't calling YOU stupid, I was calling the act of taking hundreds of milligrams of Xanax stupid. We ALL do stupid things from time to time, and on a harm reduction site I feel it's very important to point out to people when they are ACTING stupid. I don't know you bro, but I do care about you. If I didn't I wouldn't waste my time trying to give you what I believe is the best advice possible: Go to detox and get help before you kill yourself!

^ Why the fuck do you keep talking about Xanax? pally pete was talking about Diazepam. Xanax sucks and is way overrated, way too short of half life.
I suffer from depression which is caused by long-term benzo and opioid use combined, but more so the benzo's than the opiates. BTW - you don't get interdose withdrawals from taking diazepam every day, because diazepam has a long half life + many active metabolites, so i don't know who said that, but whoever did is incorrect. I am a long term benzo user who used to take huge amounts of benzos daily for years, but now I am just prescribed 4mg/day of Clonazepam and I only get 6 2mg tablets every 3 days. But the dosage is not high enough in the Clonazepam, because my tolerance is huge from so much past benzo use.. I have been through benzo withdrawal, and really bad interpose withdrawal symptoms I honestly think those big doses of benzos fucked my brain permanently, because I get these sensory sensations that feels like my skin is crawling, its really gross.. I'm not sure if long term opioid use has to do with it or not but I know its probably just the benzo abuse and going to take a long time to heal, which is why I reinstated diazepam, which worked well, and i don't think i should have switched to clonazepam but and the bugs crawling on your skin feeling "goosebumps" and as if someone took their nails down a chalkboard.

I've been on Paxil, Cipralex (Escitalopram), and now Venlafaxine, and none have done shit for me.. except paxil really helped my anxiety when i first went on it, other than that. none of them do shit but emotionally flat-line me.

 

[SPC123]

^ Why the fuck do you keep talking about Xanax? pally pete was talking about Diazepam. Xanax sucks and is way overrated, way too short of half life.

I agree with you about Xanax sucking. That said, quoted from pally pete: But please remember ive had these symptoms 15 years + yet only ever took my first Benzo 3 years ago and in that time my Tolerance/Abuse reached a high as 300mg Alprazolam a weekend!

Note that alprazolam is the active drug in Xanax.