Posted by tendency on April 15, 2005, at 12:46:51
In reply to Re: pdoc bullsh!tting me about SSRI helping anxiet, posted by sukarno on April 15, 2005, at 4:49:31
> SSRIs tend to be a crap shoot in the treatment of panic disorder. Not sure about regular anxiety or GAD, but in panic disorder the success rate is 30 to 50 percent according to a psychiatrist I know.
..interesting. don't have panic disorder so that one does not concern me.
> Usually SSRIs make anxiety worse in the beginning of treatment which many patients simply cannot deal with, so a benzodiazepine is often added to get them through this period.this was the case with me. pdoc gave me 3 weeks worth of klonopin and until celexa kicks in. at this point im not sure i want to go off klonopin; it works great with (so far) no side effects.
> In conclusion, SSRIs are best for anxiety *secondary* to depression. If anxiety is the primary problem and there is no associated depression, or depression is clearly secondary to anxiety, a sedating TCA (tricyclic antidepressant) such as imipramine, nortriptyline or amitriptyline may be useful as would be BuSpar or benzodiazepines.
..this is good food for thought. im BPII tending towards depression but lately im thinking that anxiety may be the primary symptom. so..im not sure what to do. pdoc wants me on celexa for depression and anxiety and if mood gets wacky to put me on topamax. Maybe the TCAa would be worth investigating for me after a trial run of celexa.
<snip>
> SSRIs also have sexual side effects such as anorgasmia, and lowered or non-existant libido.
> Also, the dependence which forms and results in "zaps", visual lag, tolerance ("poop-out"), nausea and vertigo upon discontinuation is something to consider...im definitely concerned with this as i have some hormonal issues which are affecting my sexual functioning as well. how common is the 'poop-out' effect? other withdrawal symptoms seem tolerable if they're not that long drawn out.
<snip>
> Imipramine was once considered the "gold standard" in treating anxiety and depression. It remains an underutilised medication today since the SSRIs came about. However, it seems to have far fewer side effects (less sexual side effects and few to no withdrawal reactions upon discontinuation)...is imipramine a TCA?
<snip>
> Why go through torture when you can take something like TCAs which will work more quickly and are more sedating? I truly feel sorry for people who have pdocs who are forcing SSRIs down people's throats...especially when those people have had several negative reactions in the past to this class of drugs.
>
<snip>thanks for the great advice. more food for thought.
poster:tendency
thread:484205
URL: http://www.dr-bob.org/babble/20050413/msgs/484680.html