medication question: which AD's work best for anxiety?

Discussion in 'General Parenting' started by flutterbee, Dec 4, 2007.

  1. flutterbee

    flutterbee Guest

    difficult child has finally seen the need to go back on her AD (lexapro 10 mg) all by herself with no world war III. Big relief. So, I go to refill the prescription and now the insurance is wanting prior approval from the doctor and may make her try something else. This just really annoys me because she is currently taking lexapro and it works. I hate the idea of switching to something else just because the insurance company says so.

    Anyway, lexapro was chosen by the psychiatrist because of how it works with anxiety. Which of the other SSRI's (they will be picking one that has a generic) work well with anxiety? I want to be knowledgeable about what they tell me what they want her to take.

  2. nvts

    nvts Active Member

    Heather! We went through that insurance garbage with difficult child 1's concerta. We just had the psychiatrist write a letter telling them that these medications are not interchangable and the insurance company backed right down.

    Hope this helps!

  3. Josie

    Josie Active Member

    Yikes! I don't know the answer to your question because the only medication we've been on for long is Lexapro. I just wanted to tell you how sorry I am that you have to switch just when difficult child agreed to take it and its working. I would have been crushed if they told me I had to stop taking it to switch to a generic.

    Any hope the psychiatrist will say she must take Lexapro and insurance will pay?
  4. flutterbee

    flutterbee Guest

    Her psychiatrist left the practice she was in and it was a 6 month wait to get into the new one, so her pediatrician doctor wrote the script we currently have going off psychiatrist's recommendations.

    I think they will fight for it, but since she hasn't trialled other AD's, I don't know how well it will go over.

    I wouldn't be adverse to trying celexa (or the generic) because I know that lexapro is basically just a refined version of it. I'm not sure, though, how effective celexa is on anxiety. And anxiety is the biggest issue to be addressed with medications.

    difficult child was just saying tonight that she doesn't see a difference since she's been taking the medications. (I paid for them out of my pocket while we wait for this to get ironed out.) Sigh. That's the beginning of "I don't need it." I'm afraid if they change it, she will flat out refuse again.
  5. DammitJanet

    DammitJanet Well-Known Member

    Heather...prior approval isnt usually a huge deal with insurance companies. I am becoming quite adept with insurance issues since having to deal with Medicare Part D and many of my medications have to be prior approved. Or they decide they have to be the month after I have been taking

    What happens is they have the docs nurse call in and state its what works, the insurance company is happy, they call the pharmacy, you get the medications. Its all a big run around.

    Step therapy is a bit harder to go through. Thats when you have to prove you have tried other medications and/or therapies and that they didnt work so you need this new medication that is more expensive or not on their formulary.

    I have to do this fighting constantly. And once a year I get to check the plans to see who is changing the medication formulary to carry my medications...ugh!
  6. flutterbee

    flutterbee Guest

    That's the thing...she hasn't tried anything else so I have a feeling they're going to make her. I stressed to the doctor how important I feel it is that she stay on this. We'll see.

    As for me, they're not taking away my lexapro. I already told my doctor that. I've tried most (if not all) of the other SSRI's - listed them all off today just to make sure they had them all down and could let the insurance co know.
  7. gcvmom

    gcvmom Here we go again!

    My difficult child 1 has been taking Lexapro for about a year now and it's served him very well for controlling his anxiety. He has a severe needle phobia, and before Lexapro, I had to sedate him for blood draws or medical procedures with two Ativan tablets, and he would still get hysterical. After starting Lexapro, he only takes one Ativan, and there is absolutely NO drama with blood draws. In fact, this last time, he told me to wait in the lobby while he went in by himself! He said he thinks he could do with just 1/2 an Ativan now because he doesn't like how loopy he feels from it. I see this all as proof of the Lexapro's benefit.

    For myself, I've been on Norpramin (desipramine) for Generalized Anxiety Disorder (GAD) for a number of years. It's also helping my depression.
  8. Josie

    Josie Active Member

    You've probably already done this but I would tell difficult child's doctor about all of the a/d's you've tried and what happened with each of them. Both of our psychiatrists were very interested in family history when choosing which one to prescribe.

    I know my difficult child was put on Lexapro just because I was on it and it worked well. I really think my doctor (family practice MD) put me on it because the drug rep had just been there and she had some samples.

    My difficult child did fine on Lexapro, but easy child/difficult child has had side effects from 5 SSRI's including Lexapro. So there is hope that your difficult child will do fine on something that didn't work for you.

    It is very upsetting to me that they make people switch medications when they are doing well.
  9. SRL

    SRL Active Member

    There is no "works best" when it comes to medications for anxiety. It's very much a matter of what works best for the specific individual being medicated. For instance, Zoloft works extremely well for anxiety with some people. Anxiety combined with 2 weeks on Zoloft sent my son into a downward spiral that took months to undo. My other children have begged me never to medicate him again--it was that bad.
  10. SomewhereOutThere

    SomewhereOutThere Well-Known Member

    I can give you my first hand experience as one who has had extreme anxiety and panic problems since toddlerhood (my mom traces it back to infancy). The short answer is: It's individual. Paxil works like a charm for me. Some people are more activated and nervous on Paxil. Zoloft made me nuts. Some are calmed by Zoloft, but I ended up in the hospital. Prozac made me manicky and gave me bizarre nightmares. It even made me SLEEPY, but NOT calm. Some people are calmed by Prozac. Celexa made my daughter so on edge that she quit taking it on her own. Some people think Celexa is "it" for calming them down. There is no one answer. If it works for you then it's 100% successful but SSRIs affect people in very different ways. Sadly, lots of it is trial and error. I hope that the first medication you try for your child is THE medication :wink: Good luck.
  11. bby31288

    bby31288 Active Member

    My difficult child was on Lexapro for about 2 years. Did so so on the anxiety. Major weight gain. New P-doctor switched her to Wellbutrin SR, and it was a miracle. She has lost about 30 lbs. Her her anxiety has really diminshed. It also helps with her ADHD symptons. We are currently taking her off the concerta which she has been on since about the third grade. We can't just stop the concerta because then she has anxiety over not taking the concerta. So we have gone from 54 Mg to 36 and then to 18 and then hopefully off. Knock on wood, she seems to be doing well.
  12. flutterbee

    flutterbee Guest

    The insurance approved the lexapro. The doctor argued 'continuity of care' and that's all it took.

  13. ML

    ML Guest

    Prozac activated mine and I stopped after a coupla weeks. Celexa seems to have reduced his anxiety about 50 percent. Good luck!!
  14. Kjs

    Kjs Guest

    Lexapro was awful for my difficult child. Took many weeks to get back to where we were before Lexapro. He has tried Paxil at one time, he has tried Ativan. Tried prozac, tried zoloft. None of these were given much time to work. We had noticable issues right away.

    Now, we use nothing.