Advice please? Zoloft....propanolol....klonopin...oh my!

[klewis]

I have had a heck of a time with medication for my anxiety and panic attacks lately! My doctor had me on 40 mg of Prozac and 1 mg of klonopin as needed per day for like….three months. Then she wanted to up it to 60 mg of the Prozac. Upped the dose to 60 mg and that day my vision went so blurry I couldn’t see and felt really really dizzy. She told me to just go back down to the 40 again but I kept having panic attacks, nearly every other day.

So I went back in and she told me to stop taking the Prozac and just start taking 50 mg of Zoloft a day. She also doesn’t want me taking klonopin anymore, I still have a little left because I would only take it as needed but she is worried because of its addictive qualities. So she prescribed me 40 mg of propranolol twice a day.
Can I just say…this is the second day taking the Zoloft. It is messing with me! I feel like I am detached and floating above my body, everything sounds far away, dizzy, lightheaded, extremely drowsy and nauseous. I know these symptoms are common but they are really starting to get to me! Yesterday I took the Zoloft and the propranolol at the same time and it was horrible! I called the pharmacist in a panic and he said the Zoloft and propranolol together can have more of a sedative effect but there is no interaction or anything that I need to be worried about. I was simply miserable though. So today, I took the Zoloft, and waited. I started to feel anxious so I took a half of a klonopin. I still feel weird and anxious.

This is starting to get to me. I work on the phones doing customer service for a utility billing company and so I have to be engaged, talking, thinking, etc, all day long. I feel like my cheese is sliding right off my cracker!

Is this normal? How long will it last? Any suggestions? Is there anything that I can do to help this process? Or make it not so bad? Is propranolol a good medicine in general? Anyone got any insight into why it made me feel so crummy? (I don’t have high blood pressure at all. She just prescribed it for anxiety and panic attacks).

Any feedback or advice would be most welcome. Thank you!

[bajablue]

Is your Doctor a Psychiatrist? If not get to one instead of a GP. She should not just cut you off of Klonopin first of all. You were on a small dose. I have had a Benzo of one kind or another for 20 years within hands reach 24/7/365. I go months without a single pill and then I may go a few weeks or more taking one or two a day. Been at this long enough I know very well how to ween myself off it so you do not get withdrawals.

[klewis]

Is your Doctor a Psychiatrist? If not get to one instead of a GP. She should not just cut you off of Klonopin first of all. You were on a small dose. I have had a Benzo of one kind or another for 20 years within hands reach 24/7/365. I go months without a single pill and then I may go a few weeks or more taking one or two a day. Been at this long enough I know very well how to ween myself off it so you do not get withdrawals.

No, she is not a psychiatrist. She referred me to see the mental health dr, but I am not sure if he is a psychiatrist or a psychologist. She did say she was concerned about me developing a dependence on the klonopin, that is why she wanted me to stop taking it. I sure don't like that propanolol stuff she wants me to use in place of it though. It makes me feel funny. Although the Zoloft seems to do that a little bit too. That might just be me being paranoid, I am not sure. I just don't know. Definitely gonna try to give the zoloft more of a chance. I hope the mental health dr can help me.

[temperancebrennan]

I am on both Zoloft (100mg) & propranolol (80mg).
I take the Zoloft in a morning & the propranolol at night. I think it works well this way.
I've only been on them for about 2 months or so, but I'm feeling a whole lot better!
There were some side effects at the start. I lost my appetite & my anxiety was increased for a couple of weeks, but it seems to have settled down now.
Hope you get on well with your meds :)

[alankay]

The best doc to judge dependance, etc, would be a pdoc in general. At times a benzo is needed for longer than expected or even long term(I've had an rx for a benzo since 1982 for occassional use as many do). The thing to know is that the beta blocker is for bodily symptoms(shaking, tremor, rapid heart beat) and not for psychological fear. That's where to benzos work so well. Treatment needs to be customized to the specfic patient. Alankay.

[klewis]

I am on both Zoloft (100mg) & propranolol (80mg).
I take the Zoloft in a morning & the propranolol at night. I think it works well this way.
I've only been on them for about 2 months or so, but I'm feeling a whole lot better!
There were some side effects at the start. I lost my appetite & my anxiety was increased for a couple of weeks, but it seems to have settled down now.
Hope you get on well with your meds :)

I am still hanging in there. Still have some weird symptoms or side effects with these medications but all in all I am starting to feel better, at least I think so. Does the propanolol seem to make you more tired or dizzy when you take it at night?

And Alankay, I have an appointment with the psychiatrist, so hopefully he will be able to help me. I think my doctor is just afraid to have me on the klonopin for much longer. And yeah I see what you mean now about the propanolol only helping physical symptoms after taking it for a bit. I have started trying to journal when I feel the frantic or racing thoughts, I feel like it helps a little I just write whatever is on my mind although I swear half of the time it comes out as nonsense! :)

Thanks to all for the replies though! Much appreciated!

[alankay]

Well I understand about the klonopin concern to a point but if your anxiety is severe and it not responding to AD's, a benzo may/will be needed longer. Just keep taking the AD as the doc recommends as they take time to work. Propranolol is most often used for social anxiety(SA)/performance anxiety. If you don''t have SA, slowly stop the beta blocker(unless it really helps) and use both the AD/ssri as prescribed and the klonopin or other benzo only when really needed. If you have no history or substance abuse you should have a rx for a benzo to use it wisely and sparringly until your anxiety is not severe and/or debilitating.
The propranolol effect should peak 1- 2 hours after taking it and not just at night. It may indeed lower you BP a bit. Alankay

[klewis]

Yeah...my anxiety has been severe for the last six months, and I have been on the klonopin trying different AD's throughout that time (switched me from ativan to klonopin like...three months ago? maybe a little more. Now on the zoloft and the propanolol seems to sort of help with the physical but does nothing for my mind. My dr does not want to give me anymore klonopin so I am trying to use other methods and make it through until my appt with the psychiatrist later in the month. Im just irritated with my dr, gives me something that helps (klonopin) then takes it away...blahhh....and I was not taking it all of the time either. And no, I dont have SA or performance anxiety. I also have vistaril that I can take if i am having a bad attack but...i havent taken one yet I am wary of new meds and I am on so many of them now! Thanks for all the advice and input though makes me feel better.

[alankay]

I have little doubt in your case the pdoc will rx a benzo for you. A good GP will try to show some restraint for rxing a benzo longer term. If a patient doesn't get relief via the ssri/AD, a pdoc should over see his care in most cases. Your GP is doing the right thing by referring you to the pdoc. Vistaril should help for now. I've used it too in the past.
It's also important to try and see if a source for your anxiety can be found via pyschotherapy which the pdoc is trained in. He may also recommend CBT, etc, as well. PM me any time. Alankay

[klewis]

Thanks Alankay! I may take you up on that! :) The vistaril seemed to help a little bit last night, but nothing like the klonopin does. I just gotta tough it out.

[alankay]

Yeah the klonopin seems to work well for you so just let the pdoc know it works very well with few/no side effects, you have no need or desire to take it liberally, understand you should use just when needed and also know it's best to try other things(CBT, psychotherapy, adding an SSRI, etc) as a comprehensive plan to treat and manage your anxiety. That you fully understand the need to respect the meds and the need for them to be monitored by your doctor. Let him know that your anxiety is severe and has been for some time and that klonopin works very well for you and you have been using a steady dose when you do need it. PM me any time. Alankay