Mental Health Needing some advice for anxiety

[Miguel330]

Hello all,

This is my first time posting on this forum, however i have used this forum for my reference several times over the years.

I am 28 yr old male. I have been taking RX medication since I was roughly 14yrs old and have been through several doctors/therapists over the years. My main issue has always been anxiety, common occurrences of panic attacks. The most common "feeling" is extreme tightness in the chest and shortness of breath. Secondly, I have struggled with depression over the years, but after completing college, getting married, and securing employment the symptoms of depression have improved greatly.

My main problem is the anxiety. I am in pretty good physical health. I exercise 3-4 days per week with heavy cardio, abs, and just a little lifting to tone, quit smoking cigarettes, even gave up coffee and switched to yerba mate. I do enjoy a beer and a shot or a nice mixed drink but I am far from a heavy drinker.

Ill skip all the boring stuff.

-2008 I started Effexor and Xanax. By 2011, I was at 375mg effexor and 2mg of Xanax 3x daily.
I honestly felt it was not working anymore, even the Xanax.

-2011 my PCP switched me to Paxil and Valium - eventually up to 80mg Paxil and 10mg Valium 2x daily.

-Jan 2016 - didnt feel it was working for me. I was very tired throughout the day, Paxil made me put on some weight. PCP switched me to Wellbutrin 100mg 2x daily and kept me on Valium 10 2x daily.

My PCP moved out of state and I decided to go to a very well regarded hospital for outpatient treatment as the psychiatrists in my area suck and are all tied in to community mental health organizations. I am currently driving a little over an hour to this hospital and I Just started going In APril of this year.

I told the doctor this is my last effort with meds (yes I've had countless therapists in the past and know every coping skill in the book).

The doctor kept me on Wellbutrin and Valium and added Vistral 50mg PRN or 3x a day and that did nothing. She then added Seroquel 25mg 2x daily and after reading the side effects and reports of weight gain I did not fill the RX.

I go back to see her the end of this month.

What are my options? I honestly am not depressed, I just struggle with panic and anxiety mostly at work and in public places. Sometimes so severe that I actually vomit. I dont want to look like a med seeker saying "all i want is benzos"

What do you folks suggest I should do?

Your help is greatly appreciated.

Thanks

 

[AlphaMethylPhenyl]

That sounds like some serious anxiety, if it makes you vomit.

Researching the drugs one takes can be good, but it can also sabotage the recovery process. Every medication has side effects. Weight gain is a pretty common side effect, as far as most psychiatric meds go. We're talking most antidepressants, benzos and other anxiety meds, and antipsychotics, at least. The only medications that don't produce weight gain are stimulants and directly stimulating antidepressants.

I'd give the seroquel a shot, is what I'm saying. Some people take 800mg a day of it. 50mg is likely just a drop in the bucket. There's a low chance of it significantly increasing your weight.

I am a bit surprised though. Respectfully, if your anxiety is so bad that it causes you to vomit, wouldn't potential weight gain be a small price to pay? You don't have to stay on it forever, just please see what happens.

If you try it for a few weeks, then find it intolerable, at least you can say that you did what the doctor ordered.

 

[Miguel330]

Thank you for your reply.

The vomiting is rare, but still occurs 1-2 times per month where the panic attacks are occurring 4-6 days out of the week.

I worked hard to get back in shape after gaining weight on the paxil and just the thought of gaining more on Seroquel makes me anxious.

Any recommendations of med combos I can try? Or inquire to Dr about?

Thanks again

 

[AlphaMethylPhenyl]

Again, giving the seroquel a solid four weeks would be the first thing I'd do. It's not a high dose. Sedation should pass.

Okay because the impression I got was that vomiting from anxiety was a bit more common.

Antipsychotics tend to be good at dealing with anxiety that SSRIs and benodiazepines do not help significantly.

I'd recommend not being in the mindset that medications will feel perfect, or will even feel good, unless each change is given four weeks. You mention, for instance, that you switched to Wellbutrin due to sedation, but Wellbutrin probably adds to your anxiety. It's a give and take thing.

Benzos have questionable efficacy after the first four weeks, unlike most other meds, which require several weeks, or even months, to work fully.

I'd also practice mindfulness meditation on a daily basis, get a good therapist who specializes in CBT.

Also, not using drugs or alcohol while you find the right meds is essential.

Good Luck