Mental Health Benzos vs SSRIs and mood stabilizers

[Dcole461]

Hi all,

I'm bipolar and have GAD but these past few months my anxiety has been unbearable. I stopped taking meds for my bipolar and have been managing for years that way (although cannabis helped a lot). Now I can't even smoke without getting paralyzing anxiety.

My doctor prescribed me clonazepam, but he wanted to put me on an antidepressant. I know benzos can cause physical dependence, but what's the difference between having to take a benzo everyday and having to take antidepressants and mood stabilizers everyday?

I want to solve this long term but I don't know which route to take. Any advice?

Thanks!

 

[Jabberwocky]

Bipolar people need to be careful of SSRI’s. They are notorious for triggering mania. I learned that the hard way.

I ended up on anti-psychotics instead which had a lot of side effects but were generally excellent for controlling mania and anxiety.

My anxiety was caused by intrusive thoughts and rumination so a combination of CBT therapy and Abilify worked wonders.

 

[Flynnal]

My anxiety was caused by intrusive thoughts and rumination so a combination of CBT therapy and Abilify worked wonders.

Strangely enough, I have those same exact problems. I tried Abilify (5mg or 10mg) and while it was effective in some ways, a dose would cause akathisia and I would get restless because I could not really sit still. It was not at all pleasant.

I was on it for 2 weeks. I wonder if those effects would have gone away had I stayed on it for longer, but the fear of ending up with some permanent form of tardive diskinesia is what ultimately scared me away from these otherwise useful drugs. If only they didn't have these terrible side effects!

 

[Jabberwocky]

Luckily I had so side effects. Although it was hellish when I tried to quit. I think many of these drugs have side effects when you first start but they dissipate after a month.

I was on Abilify for 4 years and when I quit I was really shocked by how much of my emotional depth and range it had covered up. It helped me at the time but I would not take it again if I can avoid it.

 

[dopamimetic]

To my experience, antipsychotics should be used only in people with psychosis and even there not everybody responds. The side effects overweigh their benefits by far when it comes to anxiety. Mood stabilizers can be effective, have mixed experiences with sodium valproate (made anxiety disappear but developed physical problems, weakness and hair falling out etc at above 600mg. Apparently you need to supplement biotin with it but docs don't know.), pregabalin is easily tolerated usually but was too weak for me in the long term. Heard good things about lamotrigine. Lithium works but is toxic and needs careful monitoring.

The SSRIs can and do cause at least hypomania, depends on whether you are susceptible to full blown mania, then they shouldn't used unless you get severe depression too. Also getting hypomania off them might be a warning sign about too much serotonin, thus causing downregulation and dependence. I had and have problems getting off venlafaxine, intense dysphoria and brain zaps. DXM, as weird as it seems, can be an alternative - it is a SNRI too but an atypical one which has different pros and cons.

I love that K is now approved in some parts of the world and could be used off-label almost everywhere. You dose once or twice a week and if you react to it, it protects you against depressive feelings / thoughts at least like a SSRI. Can trigger mania too, but differently so than the SSRIs and probably much more briefly so.