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  1. #1
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    Panic_down under

    Are you Ian (insights) from AZ?

    I hope so, you're great and I was sad to see the door go because of you.

  2. #2
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    I've been on 50 MG of zoloft for 13 weeks. I still have quite a bit of anxiety and have even taken .25 MG klonopin the laSt 2 days. I obviously don't want to be doing that long term.

    The thing that is keeping me from upping zoloft is tinnitus. I get tinnitus from zoloft, I try to deal with it for the benefit, but it's just not enough. If I have ringing at 50 mg will I have more at 75 MG? Should I just stop worrying about the. 25 klonopin. I made myself experience a ton of panic attacks in the past 1.5 years trying to beat this wroth acceptance and therapy. The hard part of that is I now have lots of trigger situations seered into my brain. I went 8 weeks without taking any klonopin, but bro j e down and took .25 yesterday just to feel a little relief.

    I've already tried

    Cymbalta
    Lexapro
    Amitryptiline
    Alprazolam
    Propranolol
    Vistaril
    Clonazepam

  3. #3
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    Quote Originally Posted by Comoso View Post
    Are you Ian (insights) from AZ?
    Yes.

    Quote Originally Posted by Comoso View Post
    I've been on 50 MG of zoloft for 13 weeks. I still have quite a bit of anxiety and have even taken .25 MG klonopin the laSt 2 days. I obviously don't want to be doing that long term.

    The thing that is keeping me from upping zoloft is tinnitus. I get tinnitus from zoloft, I try to deal with it for the benefit, but it's just not enough. If I have ringing at 50 mg will I have more at 75 MG?
    Maybe, maybe not. Tinnitus is a weird beast, even weirder than psych meds and they are in Mad Hatter territory for weirdness, so anything is possible. There are a whole host of meds which can trigger it in some and treat it in others. It may be that at higher doses Zoloft will stop the ringing. If it doesn't then you'll need to try something else. Even if 50mg were effective, and I assume it isn't, the stress of the tinnitus will likely eventually undo whatever good Zoloft was doing.


    Should I just stop worrying about the. 25 klonopin.
    While I don't regard benzodiazepines (BZDs) as the spawn of the devil as some do, you need to be aware there is growing evidence BZDs reduce the effectiveness of antidepressants by blocking neurogenesis so taking it with what is an already low Zoloft dose is problematic. Taking them for a few weeks when weaning onto an antidepressant, or occasionally for breakthrough anxiety shouldn't be a problem, but if they need to be taken daily then it might be better to drop the AD and just take an effective BZD dose. However, BZDs as primary meds does open a can of many other potential worms so needs a lot of consideration and discussion with your doctor/s.

    I've already tried

    Cymbalta
    Lexapro
    Amitryptiline
    What was your experience with each of these? How long did you take them, at what dose and why did you stop?

    Ian

  4. #4
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    Basically, my panic and anxiety started 3.5 years ago and I've found little relief. The two .25 MG doses I took were the first I've taken in 2 months. I used to take 50 MG zoloft and 1 mg klonopin daily and it wasn't good. I did that for much of 18 months. I weaned off of both in the summer of 2015 and thought anxiety was manageable...and it largely was for 6 months. I then stayed having liver pains (at least in that area) and lots of tests that found nothing of course and then the panic resumed. I took Amitryptiline then for 6 weeks, it made my ears ring so loud I couldn't tolerate it. I went another 4 months unmedicated. Doing therapy, CBT, meditation and trying to get better the whole time experiencing high anxiety and many panics. September came and I decided to try zoloft again. I weaned up to 50 slowly.

    Pretty much the other drugs didn't give me any relief. Klonopin gives me relief, I'm prescribed 1 mg per day, I've probably taken 4 mg this year...

  5. #5
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    Oh, and MAN am I glad to find you. You were the only reason I visited AZ when I was trying medication. You are a huge help. If you were me, would you try 75 MG or jump straight to 100?

  6. #6
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    Quote Originally Posted by Comoso View Post
    I took Amitryptiline then for 6 weeks, it made my ears ring so loud I couldn't tolerate it.
    What about Cymbalta® and Lexapro®? Did they trigger tinnitus too? If not, why did you stop and what was the maximum dose before quitting?

    If you were me, would you try 75 MG or jump straight to 100?
    Definitely 75mg first for 7 days, then to 100mg if the tinnitus is still bearable.

  7. #7
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    Lexapro was about 6 weeks of massive migraines that never let up. Cymbalta I broke out in blisters from the sun which is crazy because my dad has taken cymbalta for years with success.

  8. #8
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    Quote Originally Posted by Comoso View Post
    Lexapro was about 6 weeks of massive migraines that never let up. Cymbalta I broke out in blisters from the sun which is crazy because my dad has taken cymbalta for years with success.
    Well, you've tried 4 serotonergic antidepressants which have all triggered severe side-effects, so if you end up being unable to tolerate Zoloft® I think you should give norepinephrine, aka noradrenaline (NE) reuptake inhibiting antidepressants a shot next. The meds which fit the bill are the SNRIs Savella® (milnacipran) and Fetzima® (levomilnacipran) and the older TCAs Pamelor® (nortriptyline) and Norpramin® (desipramine).

    Savella® and Fetzima® are essentially the same med, the difference is the newer Fetzima® only contains the active isomer of the chemical, its basically the same deal as Celexa® (citalopram) and Lexapro® (escitalopram), so it probably won't matter much which is chosen, however, Fetzima® is till in patent so may be more expensive. But your doctor may prefer it because Savella® isn't FDA approved for anxiety and depression. Although this is a moot point, some doctors can be sticklers, especially when they are unfamiliar with the meds. Savella® and Fetzima® inhibit NE and 5-HT (serotonin) in a ~3:1 and ~2:1 ratio respectively.

    Pamelor® is pretty much a straight NE reuptake inhibitor having very little if any affect on the serotonin transporters. Norpramin® is also mainly a NE inhibitor with a NE:5-HT blocking ratio of about 35:1. It also has very little impact on histamine and acetylcholine muscarinic receptors which produce many of the TCA side-effects so would be my pick of the 4 meds, with Pamelor® my second choice. BTW, both TCAs are on the American Tinnitus Associations list of recommended meds to treat this condition (I can't yet post links so Google: "Drug Therapies" "American Tinnitus Association").

  9. #9
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    My local pharmacies don't carry the last 2 you talked about. My daughter is a pharmacy tech, I called her... she laughed and told me to stay off of the Internet...ugh.

    I think I'm going to just try to up the zoloft. I think I've got some good out of it, I'm sure a little more could help. Mainly its just been 3 months. I shouldn't expect miracles in 3 months.

  10. #10
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    Quote Originally Posted by Comoso View Post
    My local pharmacies don't carry the last 2 you talked about.
    Can't they order them in? Pharmacies should fill whatever med has been prescribed by your doctor, not just those they prefer to stock!

    Mainly its just been 3 months. I shouldn't expect miracles in 3 months.
    After 12 weeks you're getting pretty much all the med can deliver at the current dose.

 

 

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