Misc Desperate for your advice on meds for debilitating anxiety

[MrsMorphine]

Dear fellow sufferer/friend:

I have not noticed that my tolerance has gone up dramatically over, say, the past decade. When I was working in a high-pressure environment similar to yours (in my Valium days), I could take 5mg and feel only relief from extreme anxiety or panic--not drowsiness, and no loss of mental acuity, which is so important in your profession. Yes, if you needed to, you probably could take 2mg or 5mg Valium/.5mg or 1mg Xanax more than once a day p.r.n.; knowing that I COULD take it sometimes did me nearly as much good as actually doing so. Of course, your mileage may vary, as they say: your weight, intake of caffeine and other stimulants, etc.

At present, I take 6mg of Xanax a day as needed, which has been a pretty consistent dose for at least six years. My highest prescription was for 8mg/day, which my psychiatrist tapered to 6mg just to see how that went. Except for a couple of emergency months, the dose has stayed at 6mg, where it is today.

Probably you've heard this, but it bears repeating that alcohol is very dangerous with benzos, so you'll have to cut it out completely. Carbonated beverages, in my experience, such as seltzer or Diet Coke, dissolve the tablet(s) more quickly than plain water, but since the bioavailability of benzos is 90%+, you should begin to feel those little squiggles of relief within ten minutes. At your desk, you'll take a deep breath and say to yourself, "Aahh, now I can cope!"

My husband is a lawyer; I worked in legal-related professional jobs, so I can attest that your anxiety is more common than you'd imagine! Unlike SSRI antidepressants, which are known for a syndrome called "Prozac poop-out," in which they simply stop being effective and another SSRI is substituted, I have never heard or read of a similar loss of efficacy with Xanax or Valium. A number of people have had to stop taking them because they upped their dosages seeking a buzz, not just relief, or have made benzodiazepines part of a drug "cocktail" comprising components that create a dangerous synergistic effect. But that doesn't sound like you. From what you've written, you seem to be a highly sensitive person whose response to stimuli, emotions, and day-to-day activity churn up a maelstrom of unpleasant, unwanted physical/psychological feelings underneath your button-down shirt and tie. I hope that Xanax or Valium will help you as much as they have for me... and very few people know, or ever knew, about the discreet little vial in my handbag.

Please keep us posted, or PM me. I'll be sending good thoughts your way. xxMrsM

 

[cbtodacb]

Haha thank you for your kind message MrsMorphine, it brought a smile to my face. You sound like a lovely person.
I too have my little stash hidden under the stationary cabinet
I am very encouraged by your reports on xanax. I feel this could be a route that I seriously consider and take action on.
I currently take Valium but I need at least 40 mg to get me through the entire 8 to 9 hour working day.
Are you still taking some form of anti-depressant with your xanax regime? I have heard some very encouraging feedback on drugs like Pristiq or Paxil. Do you know much about any of these that I could use in conjunction with my xanax/valium regime?
Do you live in Australia. I am currently looking for a shrink with a strong clinical, scientific focus so I would be open to suggestions.

Thanks again for your message

 

[lolwhatzdrugs]

Hey rollinstoner. So true about the ssri's. They hand them out and if they don't help they simply keep bumping them up. I can't believe my shrink got me up to 60mg daily! I have been seeing my shrink for 5 years and all we have done is lexapro, a little valium (very rarely) and a tiny bit of serequel for bit. This is despite me being driven to social isolation, dysfunctional social relationships, inability to function at work in my professional capacity and at times coming close to thoughts of suicide (not there now thank goodness). This was and is all due to extreme unrelenting anxiety which is beyond my mind but purely chemical. Thanks for the reply rollinstoner.
I must admit that lyrica that my GP gave me (not my shrink, go figure lol) and valium do seem to be dulling the anixety. Anyone know of more effective medications?

You need a new doctor/psychiatrist who is more open to trying different things, from CBT to other no n drug therapies in addition to trying different antianxiety meds. Not all are even dependence forming. Is the lyrica off label for anxiety? Might wanna try gabapentin first. I hear pregablin withdrawals are something else.

How about instead of diazepam (a long duration one) you take shorter ones (ativan/alprazolam) as needed.

Shorter acting ones for me always had more profound and rapid effects. I think taking a short acting one right before the anxiety provoking situation.

 

[cbtodacb]

Yeh I am in the process of arranging a new shrink. After 5 years there have been no real gains with the anxiety condition. Yeh, the Lyrica is off label. Mate I am finding it quite effective but it has only been 2 days. I would usually have had about 15 panic attacks today (im serious too) but on the Lyrica they were mini panic attacks which subsided quickly rather than snow balling into a full out, life destroying mental maelstrom.

In regards to the short acting benzos, they arn't for me. Unfortunately with my condition there is no 'one' anxiety inducing event. Because of my chronic social anxiety and underlying severe GAD the anxiety inducing event begins when I get out of bed and doesn't finish until I'm back in bed later than evening. Social contact simply intensifies that underlying GAD to an unbearable level so that I am crippled and can't function. Unfortunately these social contacts occur every 10 to 20 minutes over an 8 hr working day. I need something which will last all day and zonk me out for the whole working day so I can function in my role. I need to consult with colleagues constantly, make phone calls on serious matters constantly and oftentimes appear in court. I need something long acting.

Lyrica seems to be going alright after 2 days. I still take lexapro but it is useless. I posted the thread just to see if anyone knew of a miracle pill, or some medication which could zonk me or relax me for a long period, and I need it everyday, probably or the rest of my life.

Thanks heaps for the suggestions and help. I am truly appreciative. Any comments/thoughts/suggestions on this post?

 

[Morphling]

Is duloxetine available in Aus? It could possibly be more effective than the lexapro you're taking right now. At least I found that to be the case.

It should be noted that lyrica should potentate(a ton!) the anxiolytic effect you get from your current dose of diazepam. The lyrica takes 4 hours to peak, however, so keep that in mind. You may need to take it when you first get out of bed, in order for it to be effective for your workday.

Consider adding atarax to your regimen. It's a sedating antihistamine, and could do you a bit of good.

Think that's as much advice as I have right at the moment, betwixt and between your multiple threads.

 

[cbtodacb]

haha thanks mate. I really appreciate it. Sorry for my ignorance, but by potentate did you mean intensify? If so that would be cool.

How is your anxiety going man?

 

[MrsMorphine]

Dear cbtodacb/TwinSeparatedAtBirth:

Thank YOU for your kind words! In regards to antidepressants, I currently take Lexapro, Remeron, and recently was introduced to Seroquel, as Abilify did not help me as it has helped others. My psychiatrist is still fiddling with the Seroquel dosage; I'm not sure how quetiapine (the generic form of Seroquel) has actually raised my mood, but I sleep much better with 25mg to 50mg per night. Previously, I spent at least a couple of nights a week with no sleep at all, despite also using a boatload of opioids (Fentanyl patches plus morphine IR for breakthrough) for chronic pain management. At least I can laugh--bitterly, but it's still laughter, yes?--when writing on various forms that my "primary-care physicians" are the pain-management group and a psychiatrist. The latter is the one who prescribes the antidepressants and the Xanax. But all of the doctors and physicians' assistants I see get a complete list of what I take and who prescribes it.

About the psychiatrist I've been seeing the past few years, I just lucked out: I was handed over to him when his predecessor retired, and we just clicked. This being America (not Australia, sorry), I have to feel really fortunate to get proper medical care at all; when I was much younger and uninsured, I had access to almost none. If your GP can't recommend a psychiatrist with the qualities you seek, you'll have to ask/shop around. Is there a teaching university near you? All of the best physicians I've seen since moving to the East Coast have been affiliated, one way or another, with my city's two major medical schools.

You have just reminded me to make an appointment with my new internist, who replaces one who recently retired. Sometimes it appears that I spend most of my time scurrying between the specialists mentioned above! Best to you, and I'm feeling for you and your anxiety across the miles... ;-)

 

[Morphling]

Potentate, intensify, yes. Lyrica and benzos have different mechanisms of action but they work on the GABA system. Your current dose of lyrica may not be adequate, however, if you haven't noticed any difference.

Anxiety is doing very well, thank you Got it sorted, thank God!

 

[cbtodacb]

Thanks for clarifying, lets hope these meds stack eachother up and knock this SAD out of the water.
Could you give me a run down on your med regime. If you already have, forgive me, it's been a big day or work and absorbing information from this forum simultaneously.
Could you also describe your symptoms and condition with your med regime just so i know where you were coming from.
I would be so appreciated!

 

[Morphling]

Heyo mate,

My current med regime wouldn't do you any good, to be honest. I suffer from chronic pain as well, and am on vast amounts of muscle relaxers and pain meds, which also take very good care of my anxiety.

Several years ago, when I was younger, it took me years to get my anxiety, depression, and pain under control. I was young, and so the doctors didn't take me seriously. It was at that point that I got most of my experience with benzos and and anti D's.

I was on 120mgs of propanalol and 3mgs alprazolam daily, along with every antidepressant they could throw at me. The alprazolam(xanex) was great for my panic attacks, but in my experience it's more addicting than other benzos. Since you have chronic anxiety and social phobia, you'd want something more long-acting, and also, possibly, a rescue med such as alprazolam or lorazepam which work in short order and have a shorter duration than such things as clonazepam and valium.

My 2pp. Good luck!

 

[DexyDevil]

Thanks a lot for your post, very informative. Mate I would say that our use of pills is justified by our conditions. I too was suicidal at one stage due to the life crippling and crushing effects of anxiety. What else are we to do? We cannot simply rot away allowing the anxiety to consume every healthy fibre of our God given human existence. I think the fact that we pursue and fight to preserve our quality of life is a credit to us. It is quality to be admired. This is especially so with you my friend, your knowledge and understanding of such pills and things shows that you have drawn your sword in the fight against this tormenting foe we call ANXIETY which seeks to consume us. This is all said under the caveat that such pills and medications are being used for legitimate therapeutic use. If such medications are simply being use to brighten one's day or cause some sought of recreational buzz then that is a different story.

My friend, what we endure with these anxiety conditions is an experience that very few of the population go through. Yes, it is true that statistics say that something like 1 in 2 people suffer anxiety but this is hogwash. They are not referring to serious, life crippling anxiety. They are simply referring to people who get a bit stressed out about external circumstances. My condition is unrelated to external circumstances; my condition is a hellish, invasive battle against an internal chemical foe which destroys my quality of life regardless of outside circumstances.

Chin up mate, we are to be admired in the way we fight for our existence and the pursuit of personal freedom. Whether it be by pills (as in our case), or by the sword or gun (as in the case of people whose lives are crushed by dictators), such an engagement in the fight for personal liberty (in our case chemical liberty) is a trait to be greatly admired!

Follow up questions:
-Why are you thinking of adding Pristiq to your regime?
-What's your opinion of Lexapro, or what have you heard?

I agree that the statistics about anxiety are bullshit. Everyone gets nervous. Everyone gets depressed. But I put myself in a coma twice last year by attempting suicide and have had six total suicide attempts in the last year. My mental health issues could be fatal without treatment. My suicide attempts are not "cries for help." I attempt suicide because I genuinely want to die when the depression and anxiety get so bad. 1 out of 2 people DO NOT experience this. That's a load of crap.

Lexepro didn't do much for me. I'm adding the Pristiq in hopes that my depression will not return as I just gave up on Paxil because it was making my anxiety FAR worse.

 

[DexyDevil]

Potentate, intensify, yes. Lyrica and benzos have different mechanisms of action but they work on the GABA system. Your current dose of lyrica may not be adequate, however, if you haven't noticed any difference.

Anxiety is doing very well, thank you Got it sorted, thank God!

Actually, it is a common misconception that Lyrica and Neurontin are GABAergic. They actually bind to voltage gated calcium ion channels and in so doing inhibit the production of excitatory neurotransmitters including Glutamate, Norepinephrine and Substance P. GABA inhibits these neurotransmitters as well, thus the similarity in effect. However, excitatory transmitters also typically inhibit GABA, so it seems reasonable to me that Lyrica, by inhibiting excitatory neurotransmitters, also increases the amount of available GABA. Can anyone offer any insight on this theory?

It is like this...

GABA > Excitatory Transmitters > GABA


Does that make sense? It is kind of circular. GABA is always inhibiting excitatory neurotransmitters which are always inhibiting GABA, which is always inhibiting excitatory neurotransmitters... and on and on...

The thing is EVRERY chemical in the brain effects every other chemical in the brain. When you take an SSRI you aren't just effecting Serotonin, you are effecting every neurotransmitter which Serotonin effects and which are effected by Serotonin. The nice, simple ways people explain how drugs work are just that... SIMPLE! The brain is FAR from simple. I once read a marvelous quote; "If the human brain were simple enough for us to understand it, we would be too simple to understand it."

Lyrica is also the most recreational prescription drug I have EVER taken. If you have no tolerance, 600-900mg will produce the most euphoric, trippy, tipsy, colorful, stimulating yet relaxing high! It truly is similar to a GHB and MDMA combination as many have compared it.

I wouldn't give up my access to Lyrica for $10,000! It is the best kept secret in psychopharmacology!

 

[R(x)AGE]

xanax/ativan brah

 

[MrsMorphine]

"Lyrica is also the most recreational prescription drug I have EVER taken. If you have no tolerance, 600-900mg will produce the most euphoric, trippy, tipsy, colorful, stimulating yet relaxing high! It truly is similar to a GHB and MDMA combination as many have compared it.

I wouldn't give up my access to Lyrica for $10,000! It is the best kept secret in psychopharmacology![/QUOTE]

Whoa, DexyDevil, you're giving me... ideas. It's been so long since I've gotten "euphoric, trippy, tipsy, colorful," etc., off any drugs, I can't remember when it last happened! I suspect it occurred a couple of years ago when a sane and caring ER doctor gave me the amount of IV Dilaudid that actually will kill acute pain for someone with my opioid tolerance, instead of "how much I think you should have."

I hope the Pristiq works well for you. Paxil just kind of sputtered out on me... "Prozac poop-out," without the Prozac.

 

[Salvinorin A]

I have very bad anxiety caused by my obsessive compulsive disorder. SSRIs work for some and others not so much, i happen to be the later. What youre about to hear you will not like but its the truth. Benzos are a quick way out of anxiety but the addiction creeps up on you fast, its a cycle. Benzos will take away youre anxiety but what these medications give you, you owe them in return. Benzos are detremental to anxiety they will set you back futher than you will ever be able to imagine. They will turn youre live upside down and the cycle continues. Benzos cause anxiety in the long run. Have you tried a healthier diet? Limit your amount of sugar intake and try not to consume caffene. Incorporate some vitamins into your diet like B and C. Also look into GABA, kava, and st johns wort. I know it may sound corny or whatever but it may help you. Melatonin is also good. Bring this up with your pyschatrist

 

[DexyDevil]

"Lyrica is also the most recreational prescription drug I have EVER taken. If you have no tolerance, 600-900mg will produce the most euphoric, trippy, tipsy, colorful, stimulating yet relaxing high! It truly is similar to a GHB and MDMA combination as many have compared it.

I wouldn't give up my access to Lyrica for $10,000! It is the best kept secret in psychopharmacology!

Whoa, DexyDevil, you're giving me... ideas. It's been so long since I've gotten "euphoric, trippy, tipsy, colorful," etc., off any drugs, I can't remember when it last happened! I suspect it occurred a couple of years ago when a sane and caring ER doctor gave me the amount of IV Dilaudid that actually will kill acute pain for someone with my opioid tolerance, instead of "how much I think you should have."

I hope the Pristiq works well for you. Paxil just kind of sputtered out on me... "Prozac poop-out," without the Prozac.

If you have a script it is well worth trying out and one trip won't mess your tolerance up your tolerance to the therapeutic effects too much, if at all. You have to take a decent amount though or you'll just get a weird, dissociated feeling. 750mg is probably a perfect first time dose for a trip depending on how much you take each day.

 

[thebigbenzobob]

Ignore the rest and try a single attempt at 600mg Lyrica. (Pregabalin). See what happens, you will probably be a bit high, but once you tolerate this dose it does wonders from anxiety. If it becomes to intense take a few valiums.

Source: Personal Experience.

 

[cbtodacb]

Thanks for the info guys.
First of all, as a serious sufferer of anxiety it concerns me to hear people talking about abusing drugs like lyrica to get 'high'. If word get out that this is so then they will stop prescribing them as much and people like me get screwed because we can't get our hands on them for our genuine needs. If you are going to hit it up hard for recreational use, keep it on the down low so word doesn't get out and doctors stop prescribing it to people who need it to survive, people like me.

To the bigbenzo, 600mg sounds like a good dose. I am currently on 300mg. Definitely helps but there is still a disconcerting residual level of anxiety. Still several mini panic attacks throughout the day. Have you found that at 600mg your anxiety eased? Did you build a tolerance to it whereby your anxiety returned? I have heard mixed reports about tolerance with Lyrica, some say its has the same effects for years, some say otherwise. Your thoughts?

 

[psytaco]

Thank you for your kind and informative message MrsMorphine. I have a few questions about your med regime because I am new to all this (except for useless stuff like lexapro). Have you found that you gain a tolerance to xanax i.e. does it lose its effects over time? I have found Valium has been working moderately well, not as well as people say xanax does, but I am concerned Valium will lose its effects as time goes by.

Do you have any information/experience you could provide regarding xanax losing it effects? What doseage do you take and how often?

And also, just to clarify, I work as a lawyer in a highly social environment so it is horrible and excruciating dealing with people all day when having a social phobia, not to mention the compounding negative effects of an overlying generalized anxiety disorder. Would xanax be suitable for such a lifestyle i.e. what I mean is would I need to take it 3 or 4 times a day and would the positive effects of the xanax last throughout the entire day? I ask this because I need something that will give me freedom and escape from the horror of the anxiety for the period of my working day (8am to 6pm)

Many thanks my fellow sufferer.

Hey mate,

I also suffer from depression and anxiety. I have also used valium, xanax and a few other benzos. I will tell you this, if you use valium or another benzo everyday for more than a few weeks, you will become addicted. That might not seem too bad to you but believe me benzo withdrawal is excruciating. Whatever anxiety you are feeling now is nothing compared to what you feel once you try to stop taking benzos. Add to that nausea, constant headaches, shaking, sweating, insomnia etc.

Sadly, you can not take a benzo every day without become addicted. Look into mindfulness or some other alternative and just use the valium or xanax to have a break once or twice a week.

Someone mention mirtazapine, which I also take. It is an antidepressant but it is not an SSRI. It has a different action. It is also highly sedating, so if you suffer from insomnia it can be great. I have found it very effective for depression but not so much for anxiety (somewhat effective). It does have a side effect of weight gain though. I put on about 7kg in 2 months

 

[cbtodacb]

Yeh I hear weight can be a killer with some of these drugs. Howcome you hose mirtazapine over other SSRI's? Did SSRI's not work?
I have heard of people being on xanax for like 6 or 7 years daily, howcome they can do it? It is so tempting because of the positive effects and relief from the horror of SAD and GAD.