Question about psychiatrist appt for Anxiety

[Tokey]

Hello, I'm new to this board. This is my first post, so if I'm commiting any major faux-pas here, please forgive me.

I have an upcoming psychiatrist appointment on Tuesday for an anxiety disorder that recently went from years-latent to full blown and downright scary. I have been missing work and classes, and haven't slept a full night in weeks.

Anyway, I have been on SSRIs including Prozac and Cymbalta in the past, both of which were temporarily helpful, but ended up having horrible side effects to the point of being nearly life destroying. My primary care physician suggested I might go on one of these temporarily and try to ride out the anxiety, but I have no interest in going down this route again. Years later and I still have some of the side effects. I'm pretty sure I've been perma-fucked by SSRIs in some way. I told him no way and he referred me to psychiatry.

** Please note that my goal here is not to score some sweet drugs and get fucked up. I want to get my life back on track. **

I know that benzos can be sometimes prescribed for anxiety / panic attacks, although I'm not sure if this is a good route for me. All I know is that there's no way in hell I'm going back on SSRIs. I'm also betting that the psychiatrist is going to want to put me back on them. I don't know what to do! Arg, okay this is making no sense

Two questions:
1) Are benzos a good choice for generalized anxiety / panic attack / insomnia / some OCD?
2) Is there something better for these symptoms
3) How do I convince my doc to not put me on SSRIs?!!

Thanks in advance for the help.

[wafflehead77]

Benzo's do work well for many of these conditions, but they dont help the underlying problem in the way SSRI's can. The only downside of the benzo's are the addiction/dependence. They work great while you are on them, but trying to kick benzo's after months/years is not a pleasant experience.

Have you ever tried some of the older tricyclic ant-depressants, like Elavil (amitryptyline). Could be beneficial, as well as Buspar for a non-benzodiazepine anxiolytic.

The only things that have worked for me have been benzo's, the buspirone wasnt worth a fuck.

If the doc wants you to take an SSRI while he/she rx's benzo's, you could always just tell them you take the SSRI's, and just dont.

In my experience, just knowing I had a valium to "save" me seemed to help with my anxiety. So just getting 10-20 doses/month may be enough if you can reserve them for the really stressful situations.

Good luck. Hopefully you will find a compassionate doctor.

[Hiram]

It took several years for my brain to correct itself enough to relieve my anxiety after I quit a lithium/paxil combo cold turkey. Benzos are designed to be a temporary measure, like maybe a month or two at the most. WH hit the nail on the head, they may be best to use to "save" you during those extreme anxiety times, as opposed to daily usage. The SSRI WD's are no joke, but neither are the benzos. If you do opt to go the benzo route, maybe try to find one that has a short half-life. Xanax being one of the shorter ones, and Valium being about the longest for typical benzos. Xanax always kicked depression in for me, but that's different for everybody. Ativan was always my favorite for anxiety relief.

[Tokey]

Thanks for the feedback. If I'm prescribed anything short acting, my goal is to not take it every day if possible, so hopefully I wouldn't become dependant. Two SSRI and recent opiate WD's are enough to strike the fear of addiction into me. Actually, the opiate withdrawal was what kicked this whole latent anxiety thing off. Yay repeat injuries and staph infections!

I know benzos are bad news. I know SSRI's just don't cut it. Maybe one of those older drugs wafflehead mentioned will be worth looking into. I'm just such a mess right now, strung out on ambien which isn't working anymore, and desperate for anything that will make me normal again.

Before anyone suggests, therapy = bullshit. Does. Not. Work.

[LorTabitha]

I have had great luck with Ativan for anxiety and panic attacks. I used to take one tablet almost every day, but now, like was posted earlier, just knowing I have them works in most cases.

I would definitely look into the other kinds of antidepressants because they're not all alike, and one might actually help you long-term. :-)

[SurfRat]

There's another one called Desipramine (sp?) might be worth a try, it is older type.

I would opt for Valium or Ativan over Xanax, I think Xanax tends to be a little more addictive, but it usually amounts to personal preference.

As far as SSRI's if you are really done with them then tell the doc you have tried all of them and they don't work.

Remember especially when talking to a Psychiatrist that you are there to get your needs met and he is there to prescribe drugs. Nothing else. Like if you need to fix a dripping faucet, you call a plumber. Doctors are no different.

[Maggie38]

I see a psych doc once every 8 weeks, have been for the past 6 years. I have Dysthymia which is a very long lasting depression. I've had it most of my life but didn't know that I had it.

My grandma raised me and she died about 7 years ago. She and I were very close. That was when my dysthymia came to a head. I sank into one of the deepest, darkest depressions one can imagine. I literally stayed in bed, didn't clean my house or cook food (thank God for my husband) for 3 years after she died. I got to the point that I wanted to commit suicide but was scared of not being able to carry it through, or how much pain I would put myself through, even my children and my husband.

I have insane panic attacks as well. I was with my grandma the day that she died. I was in the bedroom with her and she was talking to me and everything. Then the next minute, she was moaning very loud over and over with each breath and then she was gone. I've seen dead people before, but never seen someone actually die in front of my eyes, especially someone that I love and care about. So since then, I became horrified to go out to stores, scared for my children to walk out the door and catch the school bus, even fear for my husband leaving of a morning to go to work. I make him call me as soon as he gets there, and call before he leaves to come home. I am so scared of death. I've seen it and I don't care to see it again. I feel like I'm being tortured sometimes.

I take Lexepro 20 mgs...It seems to have brought a little balance to my mind.

Xanax 1 mg 3 times a day. Switched to Ativan same milligram 3 times a day. It did nothing for my panic attacks. Switched to Klonopin 3 times a day. Baby asprin would have done more for me. Then, Serax same deal, nothing. Went back to Xanax .5 2 times a day or as needed, and it seems to be helping, or I'm just making myself balance out. The key with benzos are to take them AS NEEDED. And it's really hard to do that because they make a person feel pretty darn good. But take as needed, and things will be better.

Finally, from all the other shit going on in my life, I don't sleep. I take Ambien 10 mgs at night for bed along with some Melatonin. Take those every other night and it doesn't seem to mess with my tolerance. 6 years with them and they still work for me.

Just be honest with your Dr. and most importantly, honest with yourself. Hopefully you will have a compassionate Dr. that will be able to help you. I know I could not live with out mine.

Best wishes!

[limitless_euphoria]

Two questions:
1) Are benzos a good choice for generalized anxiety / panic attack / insomnia / some OCD?
2) Is there something better for these symptoms
3) How do I convince my doc to not put me on SSRIs?!!

Thanks in advance for the help.

Hey Tokey. I've been a seasoned veteran when it comes to going for psychiatric care.

Benzos are good as an adjunct medication in your type of situation but not for monotherapy as they call it. If you decline SSRIs, which you have EVERY right to do... don't let anyone push you around about taking them... they might try you on other types of "mood stabilizing" medications. Which one(s) will depend on your doctor and his/her beliefs, experiences and opinions.

As far as what benzos are good ones, klonopin and valium seem to be very effective. Many people like xanax more for recreational purposes but according to my psychiatrist it has the most addiction potential.

Just make sure you let the doc feel empowered (they DO NOT care for the patients telling them what they THINK they should be on). Mind you, it's a different story if you've had adverse reactions to a certain class of drugs e.g. SSRIs. That's one of the first things you should mention when the topic of medication comes up: tell the psychiatrist you've tried more than one SSRI and you had an adverse reaction and you are not at all interested in trying them again. Establish that from the get-go.

Feel free to let us know how it goes.

[Dr. Oxy]

Thanks for the feedback. If I'm prescribed anything short acting, my goal is to not take it every day if possible, so hopefully I wouldn't become dependant. Two SSRI and recent opiate WD's are enough to strike the fear of addiction into me. Actually, the opiate withdrawal was what kicked this whole latent anxiety thing off. Yay repeat injuries and staph infections!

I know benzos are bad news. I know SSRI's just don't cut it. Maybe one of those older drugs wafflehead mentioned will be worth looking into. I'm just such a mess right now, strung out on ambien which isn't working anymore, and desperate for anything that will make me normal again.

Before anyone suggests, therapy = bullshit. Does. Not. Work.

I had two bad experiences with pyschologists and have vowed never to see them again too. Benzos will work well for your anxiety, unforunately, doctors have grown afraid to prescribe them, they used to be handed out like candy. many vietnam veterans used to get like 300 valiums a month. I never got addicted, but did have my tolerance jump very quickly, they stopped working for me after 3-4 days unless the dose was increased. If you rule out anti-depressants, they'll pretty much be limited as to what they can do for you, and your chances of getting benzos will be better.

[Tokey]

well i had my appointment last week. i told the doc i didn't want to do the SSRIs again. he said its the only thing that will address the root of the issue but said we could try other stuff, mentioned ativan and xanax. before he went that route he wanted to do some tests on me so i did blood and urine tests last week (i'm probably in a minority on this site--don't have anything to hide) i think he wants to rule out me being a seeker, and wants to see my prior medical records before he considers prescribing benzos. i have to go back for a follow up appointment and we'll figure out where to go from there.

i'm really just in the research phase right now, quite honestly, it scares me to see how addicted some of you guys seem to these drugs. i really just want something to fall back on in a crisis like in the middle of an attack but i do have kind of addictive personality so i worry about the possibility of becoming strung out yet again on yet another drug. i worry about a lot of stuff though. it's my job.

i really don't know what to do. this anxiety bullshit is impacting my performance at work. one of my co-workers is bipolar and he takes a xanax whenever he has a crisis and he magically feels better. that's what got me thinking about this benzo stuff.

part of me wants to swallow a few caffeine pills before i go to my follow up appointment, get a huge and measurable panic attack from the tweak and walk out with some benzos. then i would be sure to cut out the bullshit and get something that actually works for a change. i keep having these panic attacks and it's making me crazy and can't sleep but i don't know if that would be a good idea either.

[pharmboy]

If your problem is intermitent panic attacks then I think benzos are
for you. Personally I prefer Valium to any benzo they just make you
feel better with out all that amnesia like Xanax gives you.

But if your problem is a more long acting depression then I would
say opiates are the ticket. Opiates raise the dopamine level in your
brain that is the cause of alot of the cronic depression out there.
Ssri's don't work on this kind of depression because it is dopamine
based but the medical community isn't about to tell you that.

It's really hard to get doctors to prescibe Valium. They just have
some stupid and probably totally illogical aversion to it.

Well Good Luck though and keep in touch. .:jumping-s

[Maggie38]

Ya know, I wish they would give me opiates. I bet that would help with my depression more than anything on the planet. I used to order Tramadol online but sadly, the state I live in just passed that dreaded law that I can order them, but can't get them shipped to the state I live in. Weeeeee karma.

[zenpunk]

I suffered from pretty severe PTSD attacks which can be similar to an anxiety attack. Before SWIM found another route that now makes those attacks non-existent, she found that Valium seemed to work the best overs like Xanax, Ativan, Klonipin, etc, even though some of those drugs may be categorized as "stronger".

[Chicago]

Dr. these days like to rx xanax xr instead of regular xanax, one dose will last you all day, plus they do not worry of you abusing it like regular xanax, but xanax xr is expensive if you have no insurance, ask your dr. about it.

[Tokey]

rx xanax xrwow! that tripped me out at first. a palendrome :D

um, oh yeah. i have kind of crappy insurance, so out of pocket costs for pills are a factor, but really i'll go with what my dr. recommends and worry about the $$ later i guess

[MaryJane34]

Whoa! Reading this is like y'all are in my head. A few years back my dr. told me I was having panic attacks, but offered no rx because I told him that I could eventually make them go away. I thought it was exercised induced asthma. My pride would not allow me to believe that it was actually a panic attack. That is until one thing right after the other started crapping out on me in my life. I would start getting short of breath and my chest would get tight. My head would start spinning. If I had any caffeine it would kick it into high gear. Finally, I found myself being angry all the time... yelling at the family, being very cynical generally. Finally, after contemplating ending it all, I went to another dr. explained my situation and she prescribed lexapro. I did feel some relief but it gave me a wicked headache the next day and I found my jaw developing a propensity to lock up on me. That scared me and I stopped taking it and never went back. Lately, I have found myself sinking back into hopelessness. I got so angry last night that I literally felt like I was going to tear up the house and come out of my skin. Thank God I have reddragon as my SO. SWIM took 1/2 of one of his xanax - too afraid to take a whole o.25 mg (can you say wuss?). 15minutes later took the other 1/2 and went to sleep. Obviously, it did enough to allow for sleep or maybe it was the placebo effect. I felt nothing significant at all. I just found myself calming down and finally getting sleepy. So, I don't know. I have been contemplating going back to the dr. and telling him that even though I may be able to "control" the panic attacks that I feel I need help. Why put the family through my emotional roller coaster in the meantime? I don't want to have to take something everyday. I want to be able to take something only as needed. So, even though what I am going through is not as advanced as you, Tokey, I do understand where you're coming from.

[pixiegirl]

I actually took Elavil for quite while for depression and it worked absolute wonders for me! I was skeptical at first...cause you know-in my mind nothing will ever help unless it's an opiate. However, I was pleasantly surprised with the Elavil. It took away my depression and insomnia. Slept like a baby...and woke up smiling every damn day. The one drawback, for me anyhow, was the massive weight gain. I literally gained about 30 pounds in less than 3 months once I started the Elavil. And my appetite was out of control... inhaling everything edible in sight. Unfortunately, after about a year I had to make a decision because I could not lose any of the weight no matter what I did. I could be fat and happy or live with the depression/anxiety and get my girlish figure back. Vanity won that war...lost all poundage and still losing sleep.
anyhow, now that I've rambled on... Elavil is defintely a winner for the symptoms you have listed....and maybe you can find a way to curb the appetite. good luck!!

[MaryJane34]

I actually took Elavil for quite while for depression and it worked absolute wonders for me! I was skeptical at first...cause you know-in my mind nothing will ever help unless it's an opiate. However, I was pleasantly surprised with the Elavil. It took away my depression and insomnia. Slept like a baby...and woke up smiling every damn day. The one drawback, for me anyhow, was the massive weight gain. I literally gained about 30 pounds in less than 3 months once I started the Elavil. And my appetite was out of control... inhaling everything edible in sight. Unfortunately, after about a year I had to make a decision because I could not lose any of the weight no matter what I did. I could be fat and happy or live with the depression/anxiety and get my girlish figure back. Vanity won that war...lost all poundage and still losing sleep.
anyhow, now that I've rambled on... Elavil is defintely a winner for the symptoms you have listed....and maybe you can find a way to curb the appetite. good luck!!

O god! You had me until the massive weight gain. I've been trying to find a girlish figure in me. After 4 kids, I think the girl has permanently left this body.

[pixiegirl]

O god! You had me until the massive weight gain. I've been trying to find a girlish figure in me. After 4 kids, I think the girl has permanently left this body.

haha. yeah, it was quite a tease for me as well MJ. don't sweat it...with 4 kids, you deserve all the pharms you can get. I am also a mum so I know the obstacles with re-claiming the 'bod'. but I only have 1 child...so no excuses for me.
kudos to you though. anyone with 4 kids has my respect.

[MaryJane34]

haha. yeah, it was quite a tease for me as well MJ. don't sweat it...with 4 kids, you deserve all the pharms you can get. I am also a mum so I know the obstacles with re-claiming the 'bod'. but I only have 1 child...so no excuses for me.
kudos to you though. anyone with 4 kids has my respect.

haha! Well, I need all the pharms I can get. Thanks!:)