Mental Health My psych. said no SSRI is better for anxiety than any other.Please tell me he's wrong

[Mycophile]

I do not like my current psychiatrist.


I had to switch to him recently after I was forcibly taken off of my Klonopin (which I wish I could have back).


So since I got off the Klonopin my social anxiety has returned and the Prozac I've been on for years is no longer sufficient to take care of the problem.


My therapist, who is pretty nice, suggested I try Luvox because he heard that it's better for Social Anxiety than some other SSRIs and I looked it up on WebMd and it said this was true and as I looked at other SSRIs descriptions it said that some were geared more towards helping with anxiety and others depression etc.


However, today I saw my psychiatrist and told him that I might want to start taking Luvox because I'd heard that it was more geared towards helping with Social Anxiety than the others and here was his response:


"Who told you that? No, all SSRIs are pretty much the same, none of them help any more with anxiety than any others".


I said that my therapist had heard this and that another therapist in my family said the same of Lexapro, that it can help more with anxiety than some other SSRIs that might be better for depression or whatever and he just goes:


"Nope, that's not true"


I said, "well, why take any SSRI instead of any other at all?"


He just shrugged his shoulders and said "there's really no reason, they all work equally".


Then I asked why he would even suggest I switch SSRIs from Prozac to Luvox if it's not going to make a difference"


Then he just kind of shrugged and said "well, it might..." but didn't give any reason.


I said "well, could the Prozac maybe have started to lose some effect over the years?"


He said "maybe".


This guy just fucking sits there and clearly doesn't give TWO SHITS about whether or not my anxiety will go away with any med he gives me.


He asks me "what I want to do" in terms of medication and I keep telling him that I don't know much about meds cause I'm no doctor but what does HE think might help?"


He suggests Buspar but I said it didn't work for me when I tried it years ago.


That's ALL he fucking suggests and just shrugs his shoulders.


He was going to put me on the Lexapro WITHOUT taking me off Prozac till I told him I was worried of Serotonin Syndrome and then he decided to take me off Prozac....just basically as a fucking afterthought. He said he'd "monitor me while on two SSRIs so I didn't get SS" but then I said "well how will it help that you are "monitoring me" if I suddenly get really sick with SS?" He says "well it would happen gradually not at once like a heart attack" but never mind that I recently read of a case of Serotonin Syndrome that came on suddenly and was very crippling.


I wanted Klonopin but he refuses to prescribe any benozodiazapene because the hospital he works at is against that.


However, he'll only tell me what he WON'T give me but offers next to ZERO advice on why I should take any medication over any other medication.


I ask about Beta Blockers and he says "no that won't work for your kind of anxiety".


I tell him Klonopin worked for me and he says "no, Klonopin doesn't work on that kind of anxiety, only drugs that effect Serotonin work for your kind of problems"...


I wanted to fucking yell at him like "so I was just IMAGINING the VAST relief I got from Klonopin for ELEVEN fucking years?!?!"




Long story short, any time I ask him what medications he suggest he shrugs his shoulders, might throw a name or two out there and I ask if any are better for my kind of anxiety and he just keeps saying "No, they are all the same".


Then I'm getting really frustrated because I want him to MAKE ME BELIEVE that there's some hope that putting me on a new med might help me...


But no...he is pretty much unable to make me feel hopeful because it's CLEAR he doesn't give TWO SHITS about helping me.


He has NO opinion on whether or not switching to Luvox or Lexapro would be a better choice because he says they are just the same.




Then he gets slightly annoyed and tells me "your time is up so have you decided what you want?"


THE FUCKING NERVE of this guy!!!


So he writes me a prescription for Luvox and I walk out.






Please tell me this guy is WRONG and that some SSRIs work better for anxiety and social anxiety than others!




I want to believe that there was SOME reason I just switched SSRIs and doesn't anyone else hate how little some of these docs care?!?!


Shouldn't a psychiatrist really WANT to help his/her patients and consider their unique problems and really put some thought into which meds might work better than others rather than just shrug their shoulders and ask me what I WANT as a patient without giving me any real info on what might help me??!!

 

[sirfoxey]

Sounds to me like you need to find a new doctor. I have recently had near on debilitating anxiety which has been overcome with CBT therapy, but to have the therapy work I needed to get my medications in line and working to reduce my anxiety enough to find a long term solution which did not require taking medication for.

I can't really advise you on what medications to take, but a combination of Effexor, clonazepam, a beta blocker and olanzapine was able to reduce my depression and anxiety to a level that I could function well enough to have the CBT therapy work for a long term solution and thus I have been able to wind back the dosages of the drugs above and even remove the clonazepam completely.

I really think that if you feel this way about your psychiatrist then you need to find a new one that you gel with. As from my experience that if you can't tell your psychiatrist your deepest darkest secrets and have a completely open relationship with them you will never get the help required.
I regularly discuss my combinations of medications from the on going research I do and discuss all the what if's when it comes to changing doses and medications completely and any side effects I might be experiencing. This has resulted in a number of changes and now I feel that I have the best possible combination and dosage.

 

[Mycophile]

^^^^

What kind of a medication is Olanzapine and exactly how does it work and what do you take it for?

Also what kind of Beta Blocker do you take?

Also, what kind of psychiatric issues do you have?

I have anxiety and depression.

 

[sirfoxey]

I have the same, anxiety and depression. The beta blocker is pindolol and olanzapine is a antipsychotic. My understanding it that is more often used for people with bi polar, but I use it for the mood stabilising affects. I will be discontinuing it soon, it was only for when we were balancing my meds etc to even out the highs and lows and side affects. Now we have nailed the combination and dosage I have discussed the need to continue taking it and it was agreed that since I have only recently returned to full time work and got back into the regular lifestyle it would be wise to not change anything in the short term.

 

[aq.]

Definitely find a new doctor. He sounds like a total quack.

Have you considered SNRI's?

 

[paranoid android]

If your shrink refuses to give you Benzodiazepines solely based upon how the hospital he works at feels about it then that is a sign you should look for another Psychiatrist. Also different SSRI's work better for different people just like with any medication or SSRI's just might not work for your anxiety depending on your luck. I don't know how well SSRI's work for anxiety but i know that they don't work very good in treating depression with most people. Also Fluvoxamine (brand name Luvox) does seem to be used more for things like OCD and anxiety so it would be worth a shot anyway. It seems to also work on he Sigma receptor and what the Sigma receptor actually does i don't know nor does anyone else but that might explain why it works better at treating some things then other SSRI's. Certain Tricyclic anti-depressants such as Doxepin, Trimipramine and Clomipramine are also used a fair bit in treating anxiety.

Also Olanzapine is a Atypical anti-psychotic which means that it acts as a Serotonin and Dopamine Antagonist. Usually atypical and typical anti-psychotics also act as H1 antagonists, Anti-cholinergics and anti-adrenics. Those are side effects of the anti-psychotic though i think they do play some part in many of the therapeutic effects as well. When doctors prescribe low doses of Quetiapine as in 100mg's or under for insomnia or anxiety they are essentially trading on Quetiapine's strong anti-histamine effect to cause sedation. Olanzapine is a Serotonin and Dopamine antagonist along with being a anti-cholinergic, a H1 antagonist and somewhat of a anti-adrenic as well i think. It is only prescribed on label for treating Schizophrenia, Schizoaffective disorder and Bipolar disorder. It is used off label however just like Quetiapine in treating both insomnia and anxiety as it is one of the more sedating atypicals for most people. Although it really only brings me back to "normal" during a Manic, Mixed state or Major depressive episode without causing any major sedation even at 20mg's a day.

I am prescribed 6mg's of Clonazepam a day to treat my anxiety along with the Lamotrigine and Quetiapine i take to treat my bipolar disorder. I also just started back on the Bupropion to treat the depression i have been having lately. Before the Clonazepam my anxiety was through the roof plus it does help my Mania as well.

 

[Flowing]

It just seems like another case of where the psychiatrist doesn't know what to do. Anytime that happens, you need to find a new psychiatrist. Each one of the different SSRIs (and psych meds in general) will affect everyone differently. One SSRI might be the key to solving your anxiety while another might cause you to have a manic episode and then you'll be left with a bipolar diagnosis. You have to be very careful. Do the necessary research on your own but expect the medications to not work even close as how they are marketed to the public as to how they work.

 

[SixBuckets]

Find a new doctor.

Different SSRIs work differently for different people - Zoloft was like popping tic tacs for me, but I know some people who take it and swear it's a wonder drug.

Personally, SNRIs work far better for me, but there's no way to predict if that would be the same for you. My pshrink let me try a few different medications until I found the right one.

 

[Rybee]

In his defence, I've not found much difference between SSRIs in the efficacy of treating Anxiety. However, I think most would agree that each have their little traits, different side effects and different characteristics.

As aq. suggested - have you thought of SNRIs? I tried Citalopram/Celexa, Prozac/Fluoxetine, and Zoloft/Lustral/Sertraline for a combination of 'Major Depressive Disorder' and 'Generalised Anxiety Disorder' - and honestly, none of them helped with either. On the other hand, I then moved over to an Effexor/Venlafaxine which is probably the most common SNRI to prescribe after SSRI's do not work. I found it worked VERY well for my anxiety.

You also have other options such as Pregabalin which has been touted as one of the best long-term medications for anxiety. The only problem with me is that it made me a little fuzzy in the head and I wasn't as sharp in my job, though it absolutely melted my anxiety away.

I don't know how often you use Clonazepam/Klonopin for your anxiety but I'm not an advocate of long term Benzodiazepine use, so I can understand why he may feel like that too. That said, I still use trusty old Diazepam/Valium for when my anxiety just gets the better of me, it's a really useful tool to use as a last resort.

I don't particularly believe in the whole Serotonin depletion theory and I don't think he can state that certain medications 'don't work for X type of anxiety' - sure as a general rule of thumb, some medications have a higher efficacy for certain types of anxiety, but to rule it out complete is a little stupid IMO. He sounds very inexperienced with what he's doing and almost like his entire opinion is based on the reading of an inaccurate Wikipedia article on Anxiety.

Beta-blockers are a weird one. Whereas Clonazepam/Klonopin can be used as an acute tool for the psychological side of anxiety by relaxing your mind and melting away that anxiety, Beta-Blockers such as Propranolol can be very good very good at treating the physiological side of anxiety. I've had a lot of job interviews lately and I always take 40mg 90 minutes before hand. It is VERY effective at stopping the rapid heartbeat, the sweaty palms, the jittery movements, and the stumbling speech. It basically just hides all the physical signs. Though unlike Benzodiazepines, it doesn't help with that mental element.

I don't usually advocate this, but to eho what aq. has said once again, move doctor - he sounds like a total quack.

Psychiatrist may be a branch of Science, but in no way does it have much scientific methodology. Unfortunately, we don't know much about it, and it is quite hit and miss. I found Tricyclics to be quite relaxing, perhaps a little bit too much - but you really do have other options than ineffective SSRIs. You really need that mutual trust and confidence between you and your Psychiatrist to ensure that treatment is effective, without it, you're not going to progress.

I'd be looking elsewhere. Any queries, just give us a PM.

 

[Mycophile]

^^^^^

Well, I've been on Lexapro for a week now which isn't enough time to see if it will work so I'm going to have to give it a few more weeks.

If it still doesn't work I'll probably raise the dosage and wait a few more weeks before I'd try something else.

I'm going to hope that it works because I don't want to have to try a million things but I DO want to switch doctors it's just that it doesn't really make sense to switch right now while I'm in the middle of trying a new med because IF it works then I only need him for scripts.

I REALLY don't like this guy though and I wish doctors wouldn't be so averse to trying benzos and other meds that might have slightly more dangerous profiles or thinking outside the box and not just writing out prescriptions for the same SSRIs all the time.

 

[Pretty_Diamonds]

What's the harm in trying something new? It may work for you; everyone's different. Even just you, believing it'll work will improve your chances. Advice? Stop being so angry.. move forward. Don't like your medication? Change it. Don't like your doctors? Get new ones? Don't like your previous medical decisions? Get over it.