Confused which meds to take

[toblerone36]

Hi,

This is my first post, I've sufferred from anxiety on and off for over 15 years. Since having a few medical problems last year my anxiety has been worse than ever. I have a mixture of GAD and panic disorder and I've been managing my condition successfully with Lorazapm. I take 0.5 in the morning and the same at night I'm usually fine unless I drink alcholol in which case my anxiety is 10 x worse the next day and to be honest I drink most days inspite of this. I've been on Lorazapm for about a year.

When I abstain from drinking I feel a lot better and have been able to cut down to 1 x 0.5 of lorazapam however my GP has recently prescribed me Citalopram with a view to comming off the lorazapm when the new drug kicks in. I took my first dose yesterday and like a lot of people I've been very nervous about the pospect of side effects. So far I've been fine but I'm not sure whether that's the lorazapam still keeping me calm.

This morning I've been constantly worrying before i'm due to take my second citalopram pill about whether I should simply continue to stop drinking and gently phase out the lorazapam rather than introducing another med into my life.

So basically I'm confused whether to continue with citalapram and phase out lorazapam when if it starts to work for me or whether to phase out my lorazapam on it's own and in both cases abstain from alchohol.

Any replies will be greatly appreciated.

Toby

[northstar]

hi toblerone, i'm afraid i don't have any advice on these medicines, i don't know very much about anxiety meds since i haven't been on any myself. the best person to advise you on this kind of thing is your doctor :)

i can however tell you that whichever drug you choose it's best to stay completely away from alcohol, especially since you've already noticed that it ups your anxiety levels. this kind of reaction to alcohol is very common, and lots of people seem to think it's just their anxiety at work rather than realising that it's actually a reaction to the alcohol. i'm going to copy and paste here a section i wrote on another thread about alcohol and why it makes you anxious:


1) dehydration, which is pretty easily fixed by sipping from a bottle of water throughout the morning

2) when you drink you burn through your body's supply of vitamins, especially the B vitamins. B vitamins are responsible for keeping your nervous system happy and helping you to stay stress free - so naturally if you've depleted them with alcohol you're gonna feel bad and anxiety & panic will ensue if you're prone to it. the best way to solve this is to take a B vitamin complex the morning after, something like Berocca or lots of hangover cures contain B vitamins, ask your pharmacist about it

3) alcohol acts like liquid sugar within your body and will play havoc with your blood sugars. the blood sugar crash you get after a night out in the pub can give you all kinds of symptoms like sweats, shaking, ringing in your ears, anxiety, panic attacks, heart palpitations to name but a few. again there's an easy way to combat this: make sure you eat before you drink or even while you're having a couple of glasses or when you arrive home. and i don't mean typical after-the-pub-fare like kebabs and chips lol, but things like wholegrain bread or toast or nuts & fruit. if you eat pretty healthily the next morning too it will help with the hangover, complex carbohydrates will keep your blood sugars stable for longer so try to get some in smile

so basically i'm not telling you not to drink at all, but just to remember that it can cause anxiety and panic problems that are easily fixed by just simply taking care of yourself. i find that the knowledge of what physically happens when we drink and how exactly it causes anxiety really takes the power away from the panic feelings - i know that if i drink i may feel anxious, but i also know that i can solve this pretty easily and that i'm not going crazy it's just my body giving out to me, so i don't freak out if i feel bad the next morning, i just start doing the things i know will help me to feel better.

hope you find this a bit helpful :) if you like take a look at this thread, it is a list of all the kinds of things i did that helped me through my own anxiety problems and you may find some help in it: http://www.anxietyforum.net/forum/viewtopic.php?t=4087

feel better soon :)

[worldpar]

Hello,
I don't want to give you any advice on which meds to take or not to take. That would be dangerous and should be your decision and your doctors. But I can share with you the drugs I take and what I know about them.
I also take Lorazeapm which is the generic form of Ativan. And Citalopram which is the generic form of Celexa. When I was given my prescription for Ativan I was given the choice of Kalonapen, Xanax, or Ativan. So the Ativan is in the benzo (benzodiazepine) family. They work on calming you down on a physical level the nervousness, pounding heart etc.
The Citalopram however is what is known as a Selective Sertionan re-uptake inhibitor (S.S.R.I.) These work on the chemicals in your brain to, as the name implies, prevent your brain from taking all the free Sertionan from you blood stream.
I have been battling anxiety since I was a child and I'm 48 now. I was only diagnosed a few years ago and have been trying new meds all the time. It takes time to get the right ones sometimes so hang in there. If they are helping at all it is better than it was. The problem with the S.S.R.I.'s is that it can take up to a month for them to kick in and do what they are supposed to do. So it's quite a battle sometimes. I had no luck with the Celexa, and was put on Paxil which is another S.S.R.I. but again had no luck.
As far as taking the meds I would stay on them just like they tell you and just hold on until you see the desired effects. If in a reasonable amount of time you feel it's not working tell your doctor and move on to the next one.
The thing that has worked for me the very best is a drug called Neurontin (Gabapentin). It was originally for seizures but has had quite a lot of success in the field of mental health. And was a God send for me.
As far as side effects I had none with either the Celexa, or Paxil, so just keep your eyes open and try not to worry too much about the side effects, but every one is different.
I hope something I've said helps you at least a little. If I can do anything for you at all please just contact me or post here. All I have is my experience strength and hope to share and you are welcome to it all. We are all in this thing together. Anyone that doesn't suffer from anxiety hasn't a clue what we go through so we have to stick together.
Thanks, and sorry for rambling.

[toblerone36]

Thanks for the replies guys,

I've dicussed this a lot with my Doctor and she's pretty much left the desicion to me, one thing we both agree on is that I should start to think about reducing my Lorazapam intake.

My gut feeling is that I'm going to continue staying off the booze, gradually reduce the lorazapam and use some CBT and relaxation to reduce my baseline anxiety levels. I have some experience of antidepressants as I was on Effexor about 10 years ago and it basically wiped me out, It reduced my anxiety by turning me into a zombie!! I don't want to continue with the citalapram just yet as I'm extremely sensitive to any changes in my mood and health, if this strategy dosn't work then I'll give the new med a go.

For me Lorazapam has been absolutely fantastic, whilst I'm fully aware how adictive it can be, simply taking 0.5 at the start of the day has totally saved me.

[Robbed]

For me Lorazapam has been absolutely fantastic, whilst I'm fully aware how adictive it can be, simply taking 0.5 at the start of the day has totally saved me.

Then again, SNRIs/SSRIs like Effexor and Celexa can be at least as addictive for some (if not more addictive) than Lorazepam. Remember that the manufacturers of these drugs simply changed the definition of 'addictive' and 'habit forming' so that they could promote these drugs as 'nonaddictive' and 'non habit forming'.

[danstelter]

Definitely stop the drinking. You may want to look into Alcoholics Anonymous. Do not be ashamed, addiction is pretty normal for anxiety-sufferers (I have an addiction). I am not saying that you are an alcoholic, but judging by your statements it sounds like it may be something you at least want to check in to.

I don't know much about the various medications out there. What I do know is that doctors are reactionary and try to treat symptoms, not the disorder itslef. I think you are wise in being very cautious about all these different medications!

I would try staying on the Lorazapam and stop drinking for a couple months to see how things go. I fully believe that you can manage your anxiety to the point where medication becomes unnecessary, but medication can be very helpful in the short-term (I take 10 mg of Lexapro and it is helpful). One thing I would try is adding exercise as a way of helping you manage your anxiety. It sounds like you are self-medicating with alcohol, which worsens the anxiety. Exercise is a great stress and anxiety reliever (all you need to do is 20 mins 3x per week to see benefits).

Try this route for 2-3 monts and hang in there if things seem hard. Keep a journal and record how you are feeling.

If this route does not make you happy, try the other route that includes phasing out lorazapam and going on citalapram.

In either route, stop the drinking because it's only worsening your condition. Good luck and keep us updated on your progress!

[toblerone36]

Thanks again for the replies.

I'm sticking to my plan to stay off the booze ( 4 days now) and continue with the lorazapam. I ended up taking just 2 citalapram 20 mgs the last one on Sunday, the problem is that since taking them my anxiety has rocketed with worries about the effects this may have had on me especially as i've been feeling really depressed since taking them.

I'm sure that only 2 citalapram pills can't have done that much to me so it must be the increased anxiety from the whole episode. This is very frustrating as I was doing pretty well prior to this experience.

The other problem I have is lack of sleep which I've had from for a long while, I normally take 0.5 to 1 mg of lorazapam and end up waking up about 3-4 hours later and wake up every hour or so from then on.

Anxiety really is a rollercoaster ride, just when you think you're getting on top of it it comes back to bite you hard again.

[Topcat]

How about not taking any medication 8)

I am totally amazed by the amount of posts I keep reading about all the different medication people are taking, all medication has side effects of one type or another some of which can actually contribute to anxiety.

Yes it may make people think they are feeling better, but is it? It isnt making the fears and anxieties go away its hiding them, one day you will want to stop taking them and I keep reading about people too scared to come off their medication.

I would suggest to anyone thinking of taking meds and to those on them, try and face your fears head on, try to get plenty of sleep, stay hydrated, dont let your blood sugar fall (this can cause anxiety related symptoms) practice deep breathing exercises try a herbal remedy such as Bach Rescue Remedy and keep telling yourself that this is just thoughts causing these horrible feelings and it will go away as soon as you have calmed down.

I know you may say its easy for me to say but I took medication for years (many years ago) and I can honestly say, I still had anxiety, I still had panic attacks together with a very dry mouth and a constant tremor. I actually felt better in myself knowing that I had no drugs in my system when I came off them.

Anyway thats just my thoughts :)

[Robbed]

How about not taking any medication 8)

..........................try a herbal remedy such as Bach Rescue Remedy

Remember that herbal remedies are simply medications of a different color. Just because something is 'natural', this does NOT mean that it is automatically good, safe, or free from side effects. In fact, MANY work in much the same way as synthetic pharmaceuticals. St John's Wort, for instance, is basically a natural SSRI/SNRI. So in the end, taking these herbal remedies amounts no less to 'putting a band-aid on the problem' than taking Ativan or Lexapro.

[Topcat]

You can give Rescue Remedy to children and animals, it doesnt have side effects and it is not addictive to suggest that it is the same as taking a prescribed drug is absolutely laughable!!

Both the drugs you suggest change the chemicals in the brain
Compare this I know what i would rather have in my body;

Rescue Remedy - Bach Flower Remedies: : The Bach Flower Remedies are a safe and natural method of healing. They gently restore the balance between mind and body by casting out negative emotions, such as, fear, worry, hatred and indecision which interfere with the equilibrium of the being as a whole. The Bach Flower Remedies allow peace and happiness to return to the sufferer so that the body is free to heal itself. They do not smell, they can never do any harm to anyone at any time, they are made by infusion of wild plants & flowers from a certain area in England. They can be taken whilst pregnant and to help during labor, It is impossible to overdose with the Bach Flower Remedies, they are 100% natural and safe. You can drink a whole bottle of Remedies and not "overdose." They have no side effects.



Avitan - It is important to know that Avitan is a medication that will cause some people to be addicted to the medication. As this is a habit forming medication, you should be aware that you should not just stop taking the medication, but you should wean yourself from the medication for the best overall results. Avoid and do not drink any forms of alcohol when taking Ativan. Ativan is not a medication for women who are pregnant, for those who are nursing or for women who are thinking about becoming pregnant in the next few weeks. The effects on the baby and unborn children are not known, as testing is not completed or done in this area.


Lexapro - Important information about Lexapro
Do not take Lexapro together with a monoamine oxidase inhibitor (MAOI) such as isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam), or tranylcypromine (Parnate). You must wait at least 14 days after stopping an MAOI before you can take Lexapro. After you stop taking Lexapro, you must wait at least 14 days before you start taking an MAOI.
You may have thoughts about suicide when you first start taking an antidepressant, especially if you are younger than 24 years old. Your doctor will need to check you at regular visits for at least the first 12 weeks of treatment with Lexapro.

Call your doctor at once if you have any new or worsening symptoms such as: mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), more depressed, or have thoughts about suicide or hurting yourself. SSRI antidepressants may cause serious or life-threatening lung problems in newborn babies whose mothers take the medication during pregnancy. However, you may have a relapse of depression if you stop taking your antidepressant during pregnancy. If you are planning a pregnancy, or if you become pregnant while taking Lexapro, do not stop taking the medication without first talking to your doctor.
It is dangerous to try and purchase Lexapro on the Internet or from vendors outside of the United States. Medications distributed from Internet sales may contain dangerous ingredients, or may not be distributed by a licensed pharmacy. Samples of Lexapro purchased on the Internet have been found to contain haloperidol (Haldol), a potent antipsychotic drug with dangerous side effects

[Giz]

Nutrition is worth investigating... Unlike herbal remedies or medicines nutritional therapy works using higher dosages of the food sourced nutrients that your body depends on to live, so they are not foreign substances, just things you should be getting..
The majority of vitamins and minerals are incredibly safe. But please note that there are some that can be harmful in large doses-namely the fat soluble vitamins, especially animal source vitamin A, Retinol, which is a poison in large doses. Vitamin E in large doses (over 800mg) can thin the blood drastically-but this dose is given to people with heart disease with positive effects. So as you can see-proper advice, or adequate research is required.

The primary vitamins involved in mental health problems are the B vitamins, which are water soluble and have to be taken in several times the dosages any responsible nutritional therapist would ever recommend in order to cause harm.

Could be worth a look, theres a very good book called Optimum Nutrition for the Mind by Patrick Holford. Or The New Optimum Nutrition Bible-same author, but be sure you get the New one, the older copy (The Optimum Nutrition Bible) doesnt have as much information.

If you would like to discuss this further feel free to PM me :)