I need information/experiences of medications for anxiety

SuZir

Well-Known Member
I have noticed many have knowledge and experience about anxiety medications either for their difficult children or themselves around here. I'm especially interested about medications used off label to reduce anxiety. But of course also information and experiences about actual anxiety medications. What medications are used, for what type of problems and how are side effects.

difficult child's team's doctor wants to consult with difficult child's psychiatrist to talk about putting him on to anxiety medication. difficult child is very against medications, but is afraid he will be forced to take them. I'm afraid he is not able to advocate himself, is forced to take a prescription to medications he doesn't want and he will not take them but lie he is taking them. That could end up to quite a mess. I hope that talking with him and giving him information about different options before appointment would help him to advocate himself and be more open to different possibilities.

He has had hard time lately. He has been diagnosed with PTSD, is in therapy but has not been on any medication. He has been very against medications, especially SSRIs. He has been very wound up lately and also struggling with his sport performance and been under great pressure. Recently he had a good game and while very relieved, he ended up with full-blown panic attack right after it and couldn't calm down before he was given diazepam. It calmed him down, made him extremely sleepy and he hated how he felt next day. His team doctor has since added faster/shorter acting benzo to team's medicine assortment if need arises again. Apparently also his blood work and other physical symptoms suggest high anxiety levels, so does his behaviour and he is not denying it himself. That is why the doctor thinks medication should be considered.

difficult child is truly afraid of SSRIs. He had a classmate, who gained lots of weight after starting SSRI and, according to school yard rumours, had also bad sexual side effects. So difficult child is sure he will turn fat and impotent if he has to start SSRIs. Persuading him to even try them can be very challenging. And I have to say that I'm worried about especially some SSRIs too. My dad (while not truly bipolar) has had drug induced mania and I also have bipolarity in my family tree also elsewhere. difficult child has not ever been the most stable person when it comes to his moods. And he needs onset of bipolar like another head.

I check local guidelines to medication of anxiety and SSRIs are the first choice. Either paroxetine or fluvoxamine seem to be recommended so are venlafaxine and buspirone from non-SSRIs. In reality (after reading some local anxiety message boards) Lexapro, Zoloft and Celexa seem to be popular too. Then again buspirone doesn't seem to be commonly used. However in here i have noticed many seem to be using also other medications to help with anxiety and I would be interested to have more information about those.

I do hope that having information about different possibilities would help difficult child to be more involved in the meeting and voice his concerns and listen and be more open to try medications. Right now he feels violated and is catastrophizing and is sure he will be bullied to something he doesn't want to and he will not be heard on this. And if he goes to the meeting in this mood, he will not be heard. After all it is difficult for doctors to listen the patient, if all they are saying is "what ever" and "I don't care"... Luckily difficult child's team's doctor likely knows difficult child well enough that he knows that if it goes like that, it will only mean that difficult child may 'agree' to take medications, he may get them from pharmacy, but he will certainly not be taking them. And will be lying about it.
 

DDD

Well-Known Member
None of the children/grandcildren have been on anxiety medications. Following difficult child#1's Traumatic Brain Injury (TBI) I finally decided I needed some help in coping with all the stress. I take a generic Ativan most nights before going to bed. It is Rx's for up to four times a day. on the other hand, I am afraid of being dependent or any medication so it is only on rare...very rare...occasions that I take 1/2 or one pill during the day. I'm sure others will be of more help. DDD
 

Jody

Active Member
I take Ativan-It helps wonderfully. I take a low dose as needed. I have had a little extra stress and I have taken it the two times a day recently but there were months at a time that I didn't need it. I have anxiety so bad sometimes that I cannot feel my arms and legs, so I tend to watch my anxiety level very closely so I don't get to that point.
 

BusynMember

Well-Known Member
I have VERY high anxiety. My panic attacks were so bad I couldn't leave the house. This is my layman's opinion. All the SSRIs put weight on you...or I should say they make you hungry. They are also in my opinion not good for anxiety alone. They are actually anti-depressants. I think your son can avoid them and still have some sort of calming medication. I take clonazapan. It is a slow acting benzo and does not overly dope me up or I would never take it. It lasts all day so you can take it at night. Everyone is different, but I am very sensitive to all medications and I really have no bad side effects on clonazapan and it has kept my panic attacks away for twenty years. (Not saying your son needs to take them for twenty years...he is not as severe as I was if he can play a sport in front of an audience...lol).

Sportsfan also takes Clonazapan and thinks it is "amazing" for his own deep anxiety. If you take it at night, it does not tire you out during the day, but it still works. It does not cause hunger either.

I have tried many anxiety medications and don't like a lot of them because they zombie me out, which I won't tolerate. The medications that work for me are Paroxatene (for depression...and it DOES make me hungry) and clonazapan for anxiety.

Something else that could help, which is not a medication, is Dialectal Behavioral THerapy. It is unique from all other therapy and teaches you how to calm yourself in any situation at any time. There are a lot of books out of DBT now. It is gaining tons and tons of popularity here in the States because it is beneficial to so many patients. It was originally used for borderline personality disorder, but now it is being used for everything. If you use your search engine to bring it up, you can get a pretty good idea of what it is. To focus on anxiety issue, don't even put DBT in the search engine. Put in "Wise Mind." This is sort of a form of meditation. I find it very useful and have cut my Clonazapan use in half.

I wish your son lots of luck. There is a lot you can do without medication to learn how to control anxiety, but it does take practice. Let us know what he decides to do.
 

flutterby

Fly away!
Benzos (clonazepam, ativan) work well for anxiety, but they can become habit forming. If you have a difficult child with an addictive personality, it would make me nervous. The newer SSRI's (Lexapro, Celexa) are more weight neutral. However, with a history of bipolar disorder in the family I would definitely keep a close eye on things.
 

SuZir

Well-Known Member
I don't think difficult child would be prescribed benzos. They are the most abused drugs around here and doctors really don't like to prescribe them for more than short term before everyone else is tried first. Especially for young people or people with addiction issues (and difficult child certainly fits a bill.) There are also some studies that claim that in long term use benzos create anxiety and don't help and those are referenced a lot around here. If i have understood correctly, around here doctors usually prescribe benzos only from two week to month for anxiety to help until SSRIs kick in.

I also don't believe difficult child would be willing to take benzos regularly. He really hated how diazepam made him feel. Especially how it made him feel slow and sloppy and out of sync (relating to his sport performance) even next day.

But thanks for your replies and I'm of course interested to hear also your experiences with benzos even though they are not likely a regular medication option for difficult child. If he gets new panic attacks that he can not get over, then yes, he may be given a benzo, but not for daily use.

difficult child is taught also to use other methods to deal with things like that. To my understanding his therapist is currently having further education on DBT (it is getting very popular also around here among CBT therapists) and is probably already using some techniques. And his mental coach uses mindfulness and related methods a lot. But his doctor seems to think, that he could also benefit from medication.

I don't really know. I have seen him only few times after summer and talked with him on phone twice or thrice a week. Last I saw him a week ago, he was really wound up and anxious, so if that has been normal to him lately, I can easily understand why the doctor feels it could be a time for medications.
 

SuZir

Well-Known Member
Oh, I forgot. In reality the weight is not an issue. It is just something difficult child has prejudice with.

It is almost impossible to get fat while doing what difficult child is doing. He uses so much energy he really has a hard time to keep up with it at dinner table. And his anxiety is influencing his appetite and he is in fact loosing weight quickly. His target weight in this point would be little less than 200 pounds and at best he was somewhere around 195 pounds during summer. Now I don't think he is at least much over 180. And the target weight for him as an adult is more like 210-220 pounds or even little more so he has quite a lot weight to be gained yet. Also his body fat percentage is under the target range and his trainers would like that to go slightly up too.
 

buddy

New Member
http://en.m.wikipedia.org/wiki/Audio%E2%80%93visual_entrainment#section_4

This is a link to one of the alternatives we use and it is for home use so can easily fit into the day. Because it actually stimulates and alters brain waves it doesn't require a lot of study or training. Quin also does Neurofeedback and that is at a center that uses the passive kind where in order for a movie to work Quin has to get his brain waves into a relaxed pattern. No instructions are given. It's kind of amazing. They are giving free therapy to vets with ptsd right now too.
He did take prozac specifically for anxiety but it didn't work. His seizure medication was chosen for its anti anxiety benefit in addition to the seizure control.
Lexapro worked really well for me and I didn't gain weight. Just my experience though. Haven't been on anything for many years. I hated Xanax by the way, made me too sleepy.
 

DammitJanet

Well-Known Member
I take something no one else seems to be taking...long acting xanax. I take it at night and I certainly do not feel it the next day. In fact, I dont think I feel it at all...lol but then I am on a lot of medication. When taking an extended release medication the release of the dose is so slow into the blood stream so that it works all day long. It doesnt hit at once like the diazapam they gave him. I have taken just about every benzo out there I think at one point or another for various reasons and I like this one the best. It just works for what it is supposed to do and I dont feel anything.

My doctors have no worry about addiction with me with my psychiatric medications because I am probably going to be on psychiatric medications the rest of my life.

You might want to look into this even if its just something for a short while. It does come in a 1 mg dose which is very small. I take 3 mgs which is low.
 

Andy

Active Member
My difficult child is on Citalopram. If he misses a few days in a row, we can notice his anxiety rising. He also received intensive therapy to gain tools and learn about anxiety.

I am glad that along with the medications, your difficult child is getting therapy to recognize the onset of anxiety and tools to combat it such as breathing exercises, journaling, talking to a friend, preparing for upcoming events where anxiety might kick in, etc. therapy will also help him understand how anxiety affects his body and mind thus giving him more control of the situation.

i understand his fear of medications. They really are scary because each person reacts differently. I would assure him that he would be started on a minimum dose to determine how his body accepts it and then increased to the dose best for him. I don't think the doctor would start anyone out full dose on a strong medication (you can verify with the doctor).

Then, assure him that the medication is not a set in stone forever thing unless it is working. If he does not like how he feels on it, the doctor will look for another medication. Docs know patients are not likely to take medications they don't trust or feel good on.

Help your son to make a list of his fears (and you can add yours) and discuss each one with the doctor who can answer your concerns and choose a medication based on these issues.

He will most likely be given two medications. One for every day to keep anxiety in control and a PRN for when he does have a panic attack. If the PRN proves to be too strong, ask for a lower dose.

You might like to open the conversation up as "difficult child, I want to put together a list of concerns you have about taking medications. I know one is that you don't know how they will make you feel. What are some others? I do understand these concerns an am interested in how the doctor would address them. Are you willing to hear what he says? We can't be the only ones with these fears. You don't have to make a decision at the meeting if you need time to think about what was said. It is a meeting to ask questions and get information. I am making a list of questions I want information on. How about you, can I help you make a list so we don't forget to ask something?" (I am assuming you can give him a day or two to process what he heard at the meeting and perhaps ask more questions before the medications are ordered? He might feel less pushed into it if given a little more time?
 

Nancy

Well-Known Member
My easy child takes paxil for anxiety. She has not gained weight or had any other negative side effects. However she did try to wean off it twice and was not able to. Anxiety came back and withdrawal effects were bad.

Nancy
 

flutterby

Fly away!
Paxil is notoriously hard to come off of. I have always refused to try that medication because of that reason. Prozac worked very well on my daughter's massive anxiety with-panic, but made her intensely depressed and suicidal. It took me a while to figure out it was the medication because she also had new, situational things going on. After another similar bad experience on Luvox, and again with amitriptyline, we have discovered that all AD's are not a good fit for her. We were trying to wean her off amitriptyline (tricyclic AD) for that reason, but it went from bad to worse, so she is in a holding pattern on a dose that doesn't make her suicidal, but certainly makes her depressed while we figure out what to do next.

She takes Seroquel for psychosis, but it was the AP chosen because it also helps with anxiety and mood especially in her age group. It has helped a lot, but I certainly wouldn't go that route for straight anxiety. Way too many side effect risks with that class of medication and a whole lot of sedation.

Buspar might be an option - it's in a class all of its own and I think it's less habit forming than other anxiolytics. It's not a benzo or an AD.

Andy is right - most likely he's going to need a maintenance medication and a PRN, along with therapy he is already receiving.
 

Andy

Active Member
Add "how habit forming is this?" to questions to be asked for every single medication suggested. Ask for the bottom line recommendation after the meeting along with time to consider so you can do more research before committing.
 

BusynMember

Well-Known Member
SSRIs are habit forming and very hard to get off of. It is the dirty little secret that none of us are ever told. Frankly, I would have taken them anyway and plan to stay on my medications until I die. I can't function without them so there is no option...it is insulin to a diabetic for me. However, don't think any drug is innocuous. Paroxatene, which I have taken for over twenty years, is EXTREMELY hard to wean off of. Every SSRI is difficult to wean off of just like benzos (I'm not planning on every quitting Clonazapan either though so for me it doesn't matter).

Anxiety, of all disorders, in my opinion is the easiest to control with just good therapy. If there had been DBT when I was younger, I may not be on clonazapan...but DBT wasn't around and I am and that's ok. I wouldn't want a young person of mine on either an SSRI or a benzo unless there was absolutely no option...it was life or death, like with me. I believe that Tenex (don't know generic name) can help with anxiety and it is pretty harmless. There are natural herbs you can try as well. They never worked for me, but your son is not me.

Keep us updated! We do care :)
 

DammitJanet

Well-Known Member
LOL MWM...yeah...Im not planning on leaving the benzo's either. WTH, I had enough done to me as a kid to get the Generalized Anxiety Disorder (GAD) and PTSD labels, I will just keep taking that nice little triangle shaped pill the rest of my life.
 

flutterby

Fly away!
MWM's comment about Tenex reminded me. They do prescribe the beta blocker propranolol - and possibly some others - for anxiety.
 

SuZir

Well-Known Member
Andy, thanks for reminding that he should write down his questions and concerns, that could help him also voice them and advocate himself. He is quite nervous and feeling bad about it and is convincing himself that they will bully him to do as they want and will not listen to him.

I did give him list of my concerns and questions and he was in fact happy about that. He is still young enough to think that mom's concerns are considered more valid than his own by professionals. So he is likely to use those questions at least.

I have noticed in this board that many kids seem to be on Tenex. It is a medication that is not in our market but how much does it differ from for example clonidine? Around here antihypertensives other than beta blockers don't seem to be used to other things than blood pressure though. Beta blockers can be little iffy with him. They are used on social phobias also here, but difficult child doesn't really have any certain situations he would be anxious with. It is more like he is just all the time being very afraid of being total screw up, not living up to the expectations and feeling bad about himself most of the time overall. beta blockers can also interfere with sports quite badly (both in making physical ability to lower and on the other hand it is forbidden by anti-doping rules in some sports.)

At least difficult child haven't had other panic attacks now right after the first one and he doesn't seem to be too worried about them. And even during the attack he wasn't for example worried something would be physically wrong with him even though the doctor treating him took his EKG and was thinking of hospitalizing him to make sure it was nothing heart related (there has been some very tragic cases in Europe there players have gotten heart attacks during the games lately.) difficult child said he mostly felt like when he was younger and having a meltdown. Just that he wasn't screaming and raging but shaking and not able to stop crying. But he said that the feeling of not being able to control himself was the same.
 

SuZir

Well-Known Member
Does anyone have experiences about BuSpar or Atarax? And just how addictive Xanax is, if not used regularly?

I made a new topic to Parent Emeritus about this because it is more parenting thing (I started this thread here because this was more for information about options and because many who are not regulars in PE probably have lots of knowledge about the topic) but I would appreciate reading about your experiences about these drugs.
 

flutterby

Fly away!
Buspar is in a class of it's own - all by itself. It can be somewhat sedating at first, but it goes away. I *think* it is less habit forming than the benzos. difficult child's former PCA takes it and loves it. It made difficult child despondent. My understanding is that it is used as a maintenance medication. I don't know if it's used PRN.

Atarax is an antihistamine. It will cause drowsiness - in my case it knocks me out. I can't stay awake no matter how hard I try.

Tenex is in a class called centrally acting alpha[SUB]2A[/SUB]-adrenergic receptor agonists and Clonidine is in a class called centrally acting alpha-agonist hypotensive agents. I don't know how they differ.
 
Top