Misc Desperate for your advice on meds for debilitating anxiety

[boltfan909]

This may sound odd, and some people may (or may not) frown upon it...

I got out of rehab for a heroin habit about 2 weeks ago. While I was there, they detoxed me using suboxone. I started at a really high dose then went down to 2mg and off. I did NOT like the high doses, but what I realized was at ~2mg I felt human for the first time in YEARS. Not the least bit high, no change in my mood, EXCEPT it completely knocked out my debilitating anxiety. When I got home from rehab my anxiety was at an all time high. I couldn't even function. I know that is part of the PAWS and what-not, but I felt like this prior to using, and it's what drove me to opiates/alcohol. I wound up going to a sub doc for maintenance or I was going to relapse. I have been using suboxone for 9 days now, at 2mg and let me tell you; it's a god send.

I, too have been on lexapro, cymbalta, paxil, effexor, and celexa; along with ativan, kpin, and xanax. NONE of these did shit for me. Since going on the low dose suboxone I have discontinued my lexapro, only take my klonopin when I am on the verge of a panic attack, and I feel AMAZING. I can focus on life, I can operate like a normal human being.

I talked this over with my therapist (who is/was anti sub maint.). I basically asked what the harm was in low, daily doses of subs for treatment of anxiety. He was intrigued. He's in the middle of researching this, but he's coming around on the thought. People would be crazy to think they will not get any type of WD whens stopping a SSRI or benzo. Benzo's can fucking kill you. I am not telling you to go on suboxone for anxiety, because 99% of docs would look at you like you are crazy. Not to mention, if you do not have an opiate tolerance 2mg would be WAY too much for you. There are 2mg strips, so you could quarter one and see what it does for you. SOME people say Subs actually give them anxiety, but I can only speak for myself and it has been an absolute life saver.

I know this is way outta the realm of your normal anxiety treatment, but it truly has saved my life. I plan on trickling down slowly and seeing how low I can get while still getting the anti-anxiety benefits.

Best of luck to you.

 

[Cyanoide]

@Cyanoide
So would I be alright to drink coffee on Propranolol.

Yeah, coffee is OK. Even an energy drink is OK, as it's not much stronger than a cup of coffee. Stronger stimulants are dangerous with propranolol though.

One thing propranolol makes very hard is working out. Any kind of exercise on high doses of beta blockers feels quite horrible to be honest, as you just gasp for air and your pulse won't rise much at all even if you try some more intense exercise. You just don't get enough oxygen, as your heart rate won't rise, even if you try any kind of exercise there is. Also you may feel very light-headed when standing up from a chair or bed, as your blood pressure is low. Also check your sleep, some find propranolol interferes with their sleep to a considerable degree. In that case you may have to switch to another beta blocker. But for anxiety, propranolol is usually the best choice, as it is a non-selective beta blocker.

 

[pyrovfuel11]

Chlouracetam

yes. a nootropic.

 

[bunge]

Stimulants like ephedrine shouldnt be taken when your on propanolol as it causes seizures.
Amphetamine can be prescribed with caution but i would avoid it to be safe.

 

[cbtodacb]

This may sound odd, and some people may (or may not) frown upon it...

I got out of rehab for a heroin habit about 2 weeks ago. While I was there, they detoxed me using suboxone. I started at a really high dose then went down to 2mg and off. I did NOT like the high doses, but what I realized was at ~2mg I felt human for the first time in YEARS. Not the least bit high, no change in my mood, EXCEPT it completely knocked out my debilitating anxiety. When I got home from rehab my anxiety was at an all time high. I couldn't even function. I know that is part of the PAWS and what-not, but I felt like this prior to using, and it's what drove me to opiates/alcohol. I wound up going to a sub doc for maintenance or I was going to relapse. I have been using suboxone for 9 days now, at 2mg and let me tell you; it's a god send.

I, too have been on lexapro, cymbalta, paxil, effexor, and celexa; along with ativan, kpin, and xanax. NONE of these did shit for me. Since going on the low dose suboxone I have discontinued my lexapro, only take my klonopin when I am on the verge of a panic attack, and I feel AMAZING. I can focus on life, I can operate like a normal human being.

I talked this over with my therapist (who is/was anti sub maint.). I basically asked what the harm was in low, daily doses of subs for treatment of anxiety. He was intrigued. He's in the middle of researching this, but he's coming around on the thought. People would be crazy to think they will not get any type of WD whens stopping a SSRI or benzo. Benzo's can fucking kill you. I am not telling you to go on suboxone for anxiety, because 99% of docs would look at you like you are crazy. Not to mention, if you do not have an opiate tolerance 2mg would be WAY too much for you. There are 2mg strips, so you could quarter one and see what it does for you. SOME people say Subs actually give them anxiety, but I can only speak for myself and it has been an absolute life saver.

I know this is way outta the realm of your normal anxiety treatment, but it truly has saved my life. I plan on trickling down slowly and seeing how low I can get while still getting the anti-anxiety benefits.

Best of luck to you.

thanks guys.
This suboxone sounds VERY interesting.

 

[dingophone]

Might be too late, but I'd recommend a longer-lasting benzo rather than alprazolam. I like clonazepam when I was on it, it was very effective for my anxiety but too sedating for me. I'm on lorazepam now and it's pretty effective too.

EDIT: Also, MAOIs are supposed to be effective in treating anxiety. Suboxone does sound promising, but good luck finding a psych who'll prescribe it :/

 

[cbtodacb]

How long did clonazepam last (i.e. long acting) in comparison to something like diazepam? I would ideally like the benzo relief from my anxiety to last 8-9 hours (to cover my working, socially intense office work hours). Even if I had to pop something twice or 3 times I would be happy but I would not like to have something whereby you pop it and it only lasts for 1 hour. I think this on-off would increase my anxiety and possibly cause panic attacks from the fear of anxiety re-emerging from under the benzo cloud.

 

[Cyanoide]

How long did clonazepam last (i.e. long acting) in comparison to something like diazepam? I would ideally like the benzo relief from my anxiety to last 8-9 hours (to cover my working, socially intense office work hours). Even if I had to pop something twice or 3 times I would be happy but I would not like to have something whereby you pop it and it only lasts for 1 hour. I think this on-off would increase my anxiety and possibly cause panic attacks from the fear of anxiety re-emerging from under the benzo cloud.

I don't found the difference in duration effect-wise that different at all. It's just that diazepam has an insanely long half life with active metabolites. But Clonazepam has a long half life too (18-50 h). Depending on your dose, the actual effects of diazepam are maybe 1-2 hours longer. Still, I managed perfectly by taking my clonazepam only twice a day (so the duration of effects is 6-7 hours).

In your case, if benzos are your choice, it's pretty much between diazepam and clonazepam (long duration, continuous anxiety/GAD), and they are the most easy to taper down from when that time comes.

Hoever both diazepam and clonazepam has a somewhat slow onset of action, it can take up to 60 minutes before you start feeling the effects. So it's not like alprazolam that's suitable for more "surprising" panic that you need to calm down fast and hard, and it has a quite rapid onset of action (but of course the downside of lasting only a few hours).

 

[cbtodacb]

Yeh I must say I do find valium effective but I am having some dosage problems with it i.e. need a higher dose for therapeutic efficacy. Do you know how long you can remain on Valium for when taking it daily, or do you know of people who have taken it for years?

 

[Lightning-Nl]

My dear and precious fellow sufferers of anxiety. We share a horrible ailment but we can share and help one another in places such as this. My anxiety is chronic, extreme and unrelenting. I work as a lawyer in an office with over 200 people so you can imagine the pain that causes.

I NEED ADVICE ON MEDICATIONS THAT ACTUALLY WORK FOR SEVERE ANXIETY!

I have been on Lexapro for years. I have been up to 60mg per day but am currently on 30mg. This stuff is useless for my anxiety and chronic, unrelenting fear of social interaction. CBT and all that other crap is useless too,

I need to find meds which ACTUALLY WORK in cases of extreme anxiety like mine.

My current medication regime:

-Lexapro 30mg daily
-Valium 30mg daily
-Started Lyrica today 2 x 75mg

DOES ANYONE HAVE ANY SUGGESTIONS OR EXPERIENCES WITH MEDICATIONS THEY CAN RECOMMENED WHICH ACTUALLY WORK BETTER THAN LYRICA ETC?

Please help a fellow sufferer by providing advice

Valium is one of the strongest antianxiety agents in existence. It's a very powerful drug and should work amazingly for anxiety. It's actually used as a recreational drug due to the fact of how powerful it is. It, therefore, also has an incredibly high addiction potential. I'm extremely surprised Valium isn't working for you.

Lyrica works in a similar way to Valium (sort of). It is an analogue of the natural "calming" neurotransmitter in the body called GABA. While it doesn't actually bind to GABA receptors - it augments it in a way that's very different from Benzodiazepines (like Valium). This increased GABAergic activity SHOULD really help with anxiety.......obviously it isn't.

If you're already prescribed Valium, I'm sure that your doctor shouldn't have a problem with giving you a different Benzodiazepine. I would tell your doctor everything. These meds are not working, therefore, you have every right to request a medication from your doctor. I would ask your doctor about Xanax, Ativan, or Klonopin. These are (debatably) more powerful than Valium and might help you more. However, keep in mind that, just like Valium, these are extremely addictive drugs. Don't get me wrong, they are THE BEST anxiolytics in existence - but that power comes with the price of addiction potential.

If another Benzo doesn't work - you're gonna have to try something else. Zolpidem works in a very similar way to a Benzodiazepine. However, there are things about Zolpidem that we don't quite understand, because of these unknown factors, it has been shown to be a god-send for certain people with anxiety. You could also ask your doctor about this.

If that doesn't work, I don't know what to tell you. You could try an MAOI. Those have been shown to be very effective for some people. They, however, also have a lot of side-effects. Antipsychotics might also work for you. You could ask your doctor about Seroquel, Risperdal, Geodon, or Abilify. Those work great for some people.

OTC meds you could try are Diphenhydramine (Benadryl), Melatonin, Valerian Root, Kava, St. John's Wort. Those can help some people. But if Benzo's aren't working for you...I don't know what tell you, med wise at least.

You also really need to be in therapy. Therapy works wonders. Medications can only take you half-way, the rest HAS to be done by you.

 

[Cyanoide]

Yeh I must say I do find valium effective but I am having some dosage problems with it i.e. need a higher dose for therapeutic efficacy. Do you know how long you can remain on Valium for when taking it daily, or do you know of people who have taken it for years?

I was addicted to benzos including diazepam for 15 years. The problem you describe is quite common; you need a higher dose for the anxiolytic effects. I have however noticed that if you follow your doses strict (and don't take humongous doses a few days and then return to your normal dose) the tolerenace buildup to the anxiolytic effects are not as strong as many say. I definitely felt the anxiolytic effects after years of use. Hoever I must note that I did build up a quick and strong tolerance to the hypnotic properties of all benzos, and had to take antipsychotics to sleep. No matter what dose of benzos got me to sleep at one point.

I'm not sure what you mean by how long you can be on it. Do you mean before developing a physical addiction (and then you're hooked, bad time, worse than alcohol or heroin). Most sources seem to agree that no more than 4 weeks should benzos be taken on a daily basis. I don't find it impossible you could get WD symptoms after 2-3 weeks too, but they should be quite minor.

I used it for many years myself. You can stay on it all your life. The nasty thing about benzos is that you can eat them 10's of years without yourself or anyone else noticing that your cognitive functions really can have suffered. I must say though that even 15 years of daily use did not impair my memory to any noticeable degree; I graduated from university with good grades and got a job I manage well. There may be some cognitive impairment, but it depends on quite many factors; the benzo you use is probably the biggest factor in memory impairment (hynpotics being worse than anxiolytics), the dose, the time, how you eat, exercise, read etc. I'm going to play a little devil's advocate here and state that I believe it's possible to use benzos long-term (tens of years) without any drastic changes in cognitive function.

Oh, and here on BL, most people have taken benzos for quite many years

 

[cbtodacb]

yeh I'de be keen to take them for years too hey, wisely obviously, but part of an ongoing regime. For SwampFox, it's not that they don't work, its just they dont work at the very low doses my doc tells me to use.

 

[Cyanoide]

yeh I'de be keen to take them for years too hey, wisely obviously, but part of an ongoing regime. For SwampFox, it's not that they don't work, its just they dont work at the very low doses my doc tells me to use.

Sometimes being on benzos continuously (=addicted) is the least worst choice. At least in my case it felt so. I could live a normal life with them. Then doctors started talking about tapering and detox while I though I was just fine. So eventually they almost pushed me into detox. And frankly, I regret it. Just about every damn thing in my life has fallen apart since detox. I drink far too much, I use far too much drugs, I can't handle my economy, can't keep my flat clean anymore, my relationship with my parents is almost broken, I've lost friends. I was continuously told that after about 2 months after detox everything will start to get better, but even after 6 months I just feel worse. My life quality is better with benzos, and if it means addiction, I'm willing to take that risk. Taking a few pills a day compared to live in misery is a quite easy choice for me.

Only one doctor of over 10 told me (I had alprazolam back then) I don't have to quit them if I feel well with them...If my life quality is better with them, why risk so much going into detox? If there anyway isn't any other class of drugs that work, why take them away?

I'm sorry if I offended some (ex)addicts here (I wouldn't write like this on the dark side), but I'm an addict too and feel that being addicted to benzos is better than the miserable, vile, anxious and panic-ridden life I otherwise have. Why fix something that isn't broken? Just now like back then, on benzos I'm less tempted to do stupid things, less stupid irrational impulses, and the stuff keeps me away from booze effectively. Benzos have been vilified and burned on the stake again and again, and I don't deny the (serious) problems they can have, but they really are a life-saver for some people.

 

[cbtodacb]

You hit it spot on Cyanoide. Most people have NO IDEA of what life is like what our disorder (if yours is like mine, mine is severe GAD/SAD and they tell me OCD). For me I am willing and happy to take a shorter life span (if they do that), screw my liver (if they do that), and be an addict to a therapeutic medicine like valium and the like, if they improve my condition and deliver me from the daily hellish cage of my disorder. Only people with severe disorders such as ours understand that. To even says things like this shows the horror of what life is like without these therapeutic aids.

Also Cyanoide, if you are taking your meds for therapeutic use, I wouldn't call you an addict per se. It is more you are simply taking the medicine you require. It isn't like smokes (I smoke) or recreational drugs whereby (no offence to those who use them) it is an addiction which is 'on top' of everyday life. Without the therapeutic effect of meds like valium (still trying to find a dose which really frees me) etc I do not have a life - it is a broken, confusing, terrifying rubik's cube or emotions and horrible experiences.

If someone is a diabetic and they take insulin for the rest of their life, do we label them an addict to insulin. Or, if someone has an iron deficiency and is required to take iron supplements for the rest of their life, do we call them an addict to their supplement? The answer is a given.


I took a day of my meds today (except my SSRI) and my quality of life has gone to shit again progessively as the day has worn on. The panic returned and sweet honey of life was robbed of it sweetness.

 

[DexyDevil]

All this talk of Buprenorphine is quite interesting. I was on Suboxone a few years back and found that it had antidepressant and anxyolitic effects far stronger, for me, than the characteristic opiate effects. After the first couple days on Suboxone the warm, itchy opiate glow vanished entirely. I also found Bupe to be the most energizing opiod I have taken.

Lyrica still works better for me as an anxyolitic however. It is simply the best. This is especially true because I have paradoxical reactions to all the benzos except Diazepam and Chlordiazepoxide. Clonazepam, Lorazepam, Alprazolam, and the others, if administered daily, make me very irritable, aggressive and ultimately more nervous. Alcohol usually makes me sleepy and grouchy. Conventional GABAergics are just bad news for me. I don't believe in "wonder drugs" for obvious reasons but Lyrica is the closest thing to a panacea I have found.

I'm three days into Pristiq and am very pleased with it. I was taking Paxil for two weeks before it so it seems to have taken effect from the first dose.

 

[cbtodacb]

I've been on Lyrica for 1 week, and only a trial pack from my doc. I had such a horrible week with the anxiety that when I started this thread I hadn't started Lyrica yet, had only just got the trial pack from the doc. I just to wanted to find out the best shit to get rid of anxiety in case Lyrica failed on me. I was desperate, and still am. I'm still not sold on Lyrica, it's only been a little while BUT at a dose of 375mg a day it has been very promising. The efficacy of it for my SAD/GAD is far supperior to that of SSRIs like Lexapro, Zoloft (ones I have tried).

 

[cbtodacb]

All this talk of Buprenorphine is quite interesting. I was on Suboxone a few years back and found that it had antidepressant and anxyolitic effects far stronger, for me, than the characteristic opiate effects. After the first couple days on Suboxone the warm, itchy opiate glow vanished entirely. I also found Bupe to be the most energizing opiod I have taken.

Lyrica still works better for me as an anxyolitic however. It is simply the best. This is especially true because I have paradoxical reactions to all the benzos except Diazepam and Chlordiazepoxide. Clonazepam, Lorazepam, Alprazolam, and the others, if administered daily, make me very irritable, aggressive and ultimately more nervous. Alcohol usually makes me sleepy and grouchy. Conventional GABAergics are just bad news for me. I don't believe in "wonder drugs" for obvious reasons but Lyrica is the closest thing to a panacea I have found.

I'm three days into Pristiq and am very pleased with it. I was taking Paxil for two weeks before it so it seems to have taken effect from the first dose.

Any chance you could keep us updated on how pristiq goes for you?

 

[DexyDevil]

Feel the same. For me it lacks the rush/warmth/comfort of heroin and allows you more access to your emotions. Bupe is way more energizing for me..

If lyrica was so helpful why are you no longer taking it? Or are you taking both the pristiq and lyrica?

Im hopeful I can try this out cause my anxiety seems to be getting worse with age.

Oh, I'm still very much taking Lyrica. You can pry my Lyrica script from my cold dead fingers. I take 150mg 3x daily. The Pristiq and Remeron are more for depression. I also take Adderall and Seroquel.

 

[DexyDevil]

Any chance you could keep us updated on how pristiq goes for you?

I would be very pleased to keep you posted. SSRIs have always failed me. Remeron is fantastic stuff and I think the Pristiq is going to be the perfect adjunct.

 

[gr33n3y3z]

I was on Xanax for about three year for major anxiety then it just stopped working for me.

Now I'm on Klonopin and it takes a while to kick in id say about 30-60 mins but it has a long half life.

It works wonder on me but everyone is different.

good luck.