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- Hide quoted text — Show quoted text – Why not try this ? Take the doctor’s scripts for Xanax and Zoloft and only get the Xanax script filled. The doctor will never know that you are not getting the Zoloft script filled. Tony LOL! And after a year you can start to sell the Zoloft on the black market? Hm….;-) P. No. You wouldn’t ever buy the Zoloft. Just throw away the script if you can manage your PD without it. Just teasing, Young Zen Master Tony… P.
Ah..Ha! It’s Tony from China Town who’s the trouble maker, thanks Phil. ;^)
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I figure I have managed to live with an anxiety disorder for over 20 years with the aid of meds. But seeing the growing number of teens and young adults on meds, I also am putting a lot of faith in researchers to find "da cure" for our younger population… smiles, Elise
– Hide quoted text — Show quoted text – Dot, thanks for this article. Slowly, but surely, researchers will find answers for us. But I’m not giving up my personal ban on taking SSRIs until better forms of these medications are developed! Fig What’s the problem with SSRIs and SNRIs ? I’ve had positive experiences with Zoloft and Effexor XR. Tony So have many others. But look at the logic: Q: Which is the more effective anxiolytic class of drugs, the benzodiazepenes or the anti-depressants? A: the benzodiazepenes Q: Which of the two classes of drugs have a faster affect? A: the benzodiazepenes Q: Which of the two classes of drugs have a lower side effect profile? A: the benzodiazepenes Q: Which of the two classes cost (considerably) less than the other? A: the benzodiazepenes Yet, in the US, the SSRIs and SNRIs, the less effective, more costly drugs with more adverse effects, are the first-line choice of medications for anxiety patients, perhaps with a benzo on the side on an "as-needed" basis. I’m not saying that there isn’t a role for ADs in the treatment of anxiety. Depression tends to go hand-in-hand with anxiety, and many people have co-morbid endogenous depression which the benzos don’t help. For those people, starting with an AD and supplementing it with a benzo is probably appropriate. The ADs do have anxiolytic affects, so many people do fine on them. But an awful lot of patients suffer with the continuing side-effects, and the cost of the newer ADs is prohibitive for most people without insurance. And, of course, there are people who can’t/shouldn’t take drugs in the benzo class. BTW, invoking the YMMV law, I tried Effexor XR and it not only didn’t do a damn thing for my anxiety after 10 weeks, it had continuing adverse effects. What did (seem) to eliminate my depression, as well as reduce all my anxiety disorders was an increase in my diazepam dosage. Unfortunately, I have one of those docs who do not believe in using benzos as a maintenance med, and he refuses to give me a script for 45mg/day. So I’m doctor shopping; think I found one, but there are logistical problems I have to resolve first. So to answer your question, I don’t really have anything *against* the SSRI/SNRI ADs so much as I question the logic of using them as a first choice med. And for me personally, the benzos appear to be all I need, at least from a medication standpoint, and I’m fighting the medical establishment for the right to test my opinion. And I don’t want to have to go through sequential 6-10 week trials (with all the consequent negatives involved) of ADs to find out whether they work for me when there are simpler solutions at hand. Sorry for the lengthy reply, Tony. Fig
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– Hide quoted text — Show quoted text – Hi Fig, I agree with you on the SSRIs but I have no choice but to take them. They do control my panic but I do pay a price for it. I would much rather take klonopin twice a day to control anxiety but that is not possible with any doctor I have seen. I did tell my NP yesterday that klonopin BID really helps me but her boss still feels it should be an as needed med. I don’t. I am on Lexapro and it is a less invasive SSRI, but still there are side effects. Hopefully these doctors will get educated one day. <sigh Vicki Hey Vic, I’m not an expert on this, but Klonopin as an as-needed med doesn’t make sense to me. It has a relatively slow start-up compared to Xanax and Ativan, but does last longer making it a good maintenance med (I think). I’m planning on trying it soon myself, either twice or three times a day. I like my diazepam a lot, but aside from the fact that my doc isn’t happy over my using it regularly (I think he’s still confounded that he’s got cornered into prescribing it – hehe), the duration doesn’t cover my sleep cycle. And my "wake-up anxiety" can really impede my productivity; diazepam is cumulative in nature and I lose so much overnight that I don’t get going until my second dose starts to set-in. I won’t presume to guess whether you need an AD or not, but you could try the Anxiety Disorder Association (http://www.adaa.org/) site to see if they list an anxiety specialist in your area. Most of the listings are therapists (psychologists and LSWs), but my area has a few shrinks listed that specialize in anxiety (including one I saw for a consultation who was first-rate). I know you like your NP, but another opinion wouldn’t hurt. Fig
Fig, I actually told my NP that I was taking it regularly, BID. She didn’t bat an eye and said ok, let me get you a script for it. The bottle says as needed but I know she knows I am taking it twice a day. She gave me an ample supply of refills and it makes all of the difference in the world in my situation. I agree with you about talking to someone else. I have been checking my husband’s insurance and they are not very open about mental health doctors or therapists as far as paying. It’s not right, I know. Until the minds of the insurance companies change, I guess most of us are stuck paying big bucks to get the help we need. It’s too bad. BTW, How have you been, girl? Vic
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But I’m not giving up my personal ban on taking SSRIs until better forms of these medications are developed! hopefully better benzos and cleaner anxiolytics LM
Is that really you, Margrove?? LOL Vicki
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Why not try this ? Take the doctor’s scripts for Xanax and Zoloft and only get the Xanax script filled. The doctor will never know that you are not getting the Zoloft script filled. Tony LOL! And after a year you can start to sell the Zoloft on the black market? Hm….;-) P.
No. You wouldn’t ever buy the Zoloft. Just throw away the script if you can manage your PD without it. I don’t advocate this but in dire situations it’s a way to manage Panic Disorder until one can find a competent pdoc. It’s always best to be honest with your pdoc. I actually need an SSRI/SNRI to limit the severity of panic attacks and anticipatory anxiety. Tony ~ with the piggy bank full of Zoloft pills :-D
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- Hide quoted text — Show quoted text – Why not try this ? Take the doctor’s scripts for Xanax and Zoloft and only get the Xanax script filled. The doctor will never know that you are not getting the Zoloft script filled. Tony LOL! And after a year you can start to sell the Zoloft on the black market? Hm….;-) P. No. You wouldn’t ever buy the Zoloft. Just throw away the script if you can manage your PD without it.
Just teasing, Young Zen Master Tony… P. – Hide quoted text — Show quoted text – I don’t advocate this but in dire situations it’s a way to manage Panic Disorder until one can find a competent pdoc. It’s always best to be honest with your pdoc. I actually need an SSRI/SNRI to limit the severity of panic attacks and anticipatory anxiety. Tony ~ with the piggy bank full of Zoloft pills :-D
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- Hide quoted text — Show quoted text – Why not try this ? Take the doctor’s scripts for Xanax and Zoloft and only get the Xanax script filled. The doctor will never know that you are not getting the Zoloft script filled. Tony Tony, That makes sense to me.. and that leads me to a question I was going to post anyway. Okay. I see a new pdoc on Thursday and hopefully he will put me on a new AD that will work. Now, lets suppose this new pdoc is a benzophobe….
If the new doc is a benzophobe, start your search for another doc. I have seen people recommend to call the doc before making an appointment and see if he has a problem with prescribing benzos. I never tried this and it would take skill to somehow bring this up in the conversation. I would probably mention that you can’t see your old doc for some reason and you have had success with Xanax and would also like to try a newer AD. I’m not sure how open a pdoc will be on the phone. I’ve seen 4 pdocs since 1997 who were available under whatever HMO I was using. 2 of the 4 were benzophobes and I only saw them for one visit when I realized they were ignorant and had a phobia of prescribing benzos. Is it doctor shopping, and is it illegal — for me to keep the appointment a few weeks later with the old pdoc and get the Lithium and the Abilify and the Xanax Rxs — and only have the Xanax filled?? I don’t want to go to jail, but I thought it might be an option just in case the new pdoc is a benzophhobe, but knows his AD’s. Anybody have any thoughts about this??
I never heard of the "doctor shopping" term until Rush Limbaugh was accused of it. I would guess that it means he was seeing several doctors at the same time and getting multiple scripts each month to feed his addiction. I could see it possibly being illegal if you were seeing 2 pdocs and getting 2 benzo scripts and filling those scripts at different pharmacies to hide the fact that you were taking twice as many benzos as either doctor knew about. Maybe that’s how Rush Limbaugh was getting his fix of pain killers. Back to your situation – I don’t understand why your pdoc has you on Lithium and Abilify for Panic Disorder. I suggest you get a second opinion and definitely mention to any prospective pdocs that you have learned over the years that Xanax is a remedy for keeping panic attacks from becoming too severe and debilitating. Good luck, Tony
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- Hide quoted text — Show quoted text – Why not try this ? Take the doctor’s scripts for Xanax and Zoloft and only get the Xanax script filled. The doctor will never know that you are not getting the Zoloft script filled. Tony Tony, That makes sense to me.. and that leads me to a question I was going to post anyway. Okay. I see a new pdoc on Thursday and hopefully he will put me on a new AD that will work. Now, lets suppose this new pdoc is a benzophobe…. Is it doctor shopping, and is it illegal — for me to keep the appointment a few weeks later with the old pdoc and get the Lithium and the Abilify and the Xanax Rxs — and only have the Xanax filled?? I don’t want to go to jail, but I thought it might be an option just in case the new pdoc is a benzophhobe, but knows his AD’s. Anybody have any thoughts about this?? It probably wouldn’t be illegal and you might want to do it once but then you’re stuck with nthe same problem (unless you intend to go on with this forever). The snag is that ion a sense the pdoc (in this case the new one) is responsible for your treatment and should knowq what you’re doing in order to be able to understand and monitor it. If the new pdoc turns out to be a benzophobe it would be best to try a third one (you can even ask them on the phone if they prescribe benzos for PD, the ones who do won’t be put off by that) until you find one who wil would know a reliable, non-benzophobic pdoc in your area. Philip
Thanks, Philip. You’re right, I need a doc that won’t be a benzophobe AND will not think I’m sz, OCD, BPD or bipolar (all of my previous dx’s) ..sigh. I am going to give this guy a try on Thurs. and if it doesn’t work out, I’ll ask Margrove, but I hate to bother him. I’m sure he’s a busy man, and he’s extended himself so much for me already in answering my posts. Thanks!! 
) Sara ^..^< Anxiety, I can’t get nothin done Anxiety destroys all the fun – Pat Benetar
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Well, I think it is best to pick a doc and stay with him/her until you lose confidence in him. Discuss the drug treatment with him and then both of you agree on the treatment. If you agree to take Xanax and Zoloft, then do that until you find it doesn’t work. Most of the SSRI’s take 4 – 6 weeks to build up to levels that are effective in treating depression. You have a right to a say in your treatment. – Hide quoted text — Show quoted text – Why not try this ? Take the doctor’s scripts for Xanax and Zoloft and only get the Xanax script filled. The doctor will never know that you are not getting the Zoloft script filled. Tony Tony, That makes sense to me.. and that leads me to a question I was going to post anyway. Okay. I see a new pdoc on Thursday and hopefully he will put me on a new AD that will work. Now, lets suppose this new pdoc is a benzophobe…. Is it doctor shopping, and is it illegal — for me to keep the appointment a few weeks later with the old pdoc and get the Lithium and the Abilify and the Xanax Rxs — and only have the Xanax filled?? I don’t want to go to jail, but I thought it might be an option just in case the new pdoc is a benzophhobe, but knows his AD’s. Anybody have any thoughts about this?? Sara ^..^< Anxiety, I can’t get nothin done Anxiety destroys all the fun – Pat Benetar
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- Hide quoted text — Show quoted text – Why not try this ? Take the doctor’s scripts for Xanax and Zoloft and only get the Xanax script filled. The doctor will never know that you are not getting the Zoloft script filled. Tony Tony, That makes sense to me.. and that leads me to a question I was going to post anyway. Okay. I see a new pdoc on Thursday and hopefully he will put me on a new AD that will work. Now, lets suppose this new pdoc is a benzophobe…. Is it doctor shopping, and is it illegal — for me to keep the appointment a few weeks later with the old pdoc and get the Lithium and the Abilify and the Xanax Rxs — and only have the Xanax filled?? I don’t want to go to jail, but I thought it might be an option just in case the new pdoc is a benzophhobe, but knows his AD’s. Anybody have any thoughts about this??
It probably wouldn’t be illegal and you might want to do it once but then you’re stuck with nthe same problem (unless you intend to go on with this forever). The snag is that ion a sense the pdoc (in this case the new one) is responsible for your treatment and should knowq what you’re doing in order to be able to understand and monitor it. If the new pdoc turns out to be a benzophobe it would be best to try a third one (you can even ask them on the phone if they prescribe benzos for PD, the ones who do won’t be put off by that) until you find one who wil would know a reliable, non-benzophobic pdoc in your area. Philip – Hide quoted text — Show quoted text –
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Why not try this ? Take the doctor’s scripts for Xanax and Zoloft and only get the Xanax script filled. The doctor will never know that you are not getting the Zoloft script filled. Tony
LOL! And after a year you can start to sell the Zoloft on the black market? Hm….;-) P. – Hide quoted text — Show quoted text –
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Redundantly, I’m the third generation on my paternal side to have panic disorder w/agoraphobia. Elliott
Me too. My father had it and so his did his mom. Strangely, he had nine siblings who were very successful financially and socially, and some were world travelers. None of them seemed to suffer any anxiety that I know about. My dad though, poor guy, never made it off the farm. Dot
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- Hide quoted text — Show quoted text – Dot, thanks for this article. Slowly, but surely, researchers will find answers for us. But I’m not giving up my personal ban on taking SSRIs until better forms of these medications are developed! Fig What’s the problem with SSRIs and SNRIs ? I’ve had positive experiences with Zoloft and Effexor XR. Tony
There is most definitely a place for SSRI’sd and other AD’s in the treatment of anxiety disorders. The advantage of benzos is that they work *immediately* while antidepressants will often cause symptoms to worsen in the beginning (and add some new ones of their own)and take some time to kick in which can pout people off. Docotrs should be clear about this when they prescribe an AD but it seems many are not so we don’t know what to expect and sudddenly feel worse instead of better without having been explained the mecahnism. This is often enhanced by doctors starting their patients out on too high a dose (like 20 mg of Paxil instead of 5 mg) and ramping the dose up too quickly. The SSRI’s & SNRI’s are by no means the wonder drugs they were hyped up to be and thgey do have certain disadvantages but OTOH they do work for many and can’t be discarded as useful meds. Philip
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<< That makes sense to me.. and that leads me to a question I was going to post anyway. <BR<BR If that was addressed to me… she has made it clear that the Ativan is only to get me started on the zoloft. She is going to cut me off either when (1) I normalize on the zoloft or (2) I quit the zoloft. And she only gave me 20 Ativan pills. So yeh I can ignore the zoloft, at the moment I am trying to do what she asks in the hopes that she will treat me more reasonably. Although the moment I can get off zoloft I will. I guess i am objecting to this — SSRI first tude. << Is it doctor shopping, and is it illegal <BR<BR No. Doctor shopping isn’t illegal. And if the doctor writes you a prescripton.. it isn’t illegal.
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But I’m not giving up my personal ban on taking SSRIs until better forms of these medications are developed!
hopefully better benzos and cleaner anxiolytics LM
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Why not try this ? Take the doctor’s scripts for Xanax and Zoloft and only get the Xanax script filled. The doctor will never know that you are not getting the Zoloft script filled. Tony
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Why not try this ? Take the doctor’s scripts for Xanax and Zoloft and only get the Xanax script filled. The doctor will never know that you are not getting the Zoloft script filled. Tony
Tony, That makes sense to me.. and that leads me to a question I was going to post anyway. Okay. I see a new pdoc on Thursday and hopefully he will put me on a new AD that will work. Now, lets suppose this new pdoc is a benzophobe…. Is it doctor shopping, and is it illegal — for me to keep the appointment a few weeks later with the old pdoc and get the Lithium and the Abilify and the Xanax Rxs — and only have the Xanax filled?? I don’t want to go to jail, but I thought it might be an option just in case the new pdoc is a benzophhobe, but knows his AD’s. Anybody have any thoughts about this?? Sara ^..^< Anxiety, I can’t get nothin done Anxiety destroys all the fun – Pat Benetar
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I have NO problem with Ativan and have proven over and over again that I am not going to get addicted. I.e., gotten a script for 24 pills and used that much over a 7 month period. Nevertheless my doctor irrationally puts me on a drug that many people tell me IS addictive and gives me side effects which are 10 times worse than what I even went to the doctor for in the first place. And BTW I feel NO difference from the pill other than bad. Um is it me or does that lead to the obvious question… um maybe these drugs aren’t good for you?
No it’s not just you and I find SSRI’s to be worse than benzo’s anyway and causes no less dependency. Docs know this or maybe they don’t know anything unless they’d suck down a few SSRI’s themselves.. Do they all have a secret deal with the drug companies — whereby they get a kickback if I just get a perscription for the SSRI? I mean really.
Probably…..The only reason I was put on Paxil CR at the time was because it was new. If I waited a year it would’ve have Effexor XR. I go by the promotional stuff hanging around, like their nice Effexor clock ; ) I admit it did help my depression, but at a cost of increased anxiety. Wasn’t worth it IMO..
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Dot, thanks for this article. Slowly, but surely, researchers will find answers for us. But I’m not giving up my personal ban on taking SSRIs until better forms of these medications are developed! Fig
What’s the problem with SSRIs and SNRIs ? I’ve had positive experiences with Zoloft and Effexor XR. Tony
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– Hide quoted text — Show quoted text – I’ve been where you are Vicki. Every doc I seen kept recommending SSRI’s while I was on Xanax a neurologist had given me and basically felt helpless because I had no doctor and was trying to find one before my script ran out so I wouldn’t end up in the ER again. Anyway, I kept telling everyone Xanax works very well for me, so what’s the problem? I got one answer – it’s addictive. At the time I had no education on benzo’s, SSRI’s etc. so after finding a pychiatrist I was asked if I wanted to stick with Xanax or try Paxil. Actually believing the addictive hype I went for Paxil (Doh!) and probably the worst thing I did. But now I have no problem being prescribed Xanax. And I hope you can find the same situation. Believe me if you look, those docs are out there. BTW I don’t have your original post so just wanted to add, I’m glad overall your doctor appointment went well and you’re feeling better..
Thanks, Kevin. It’s amazing what 24 hours can do. I cannot believe how much better I feel. Vicki
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<< while I was on Xanax a neurologist had given me and basically felt helpless because I had no doctor and was trying to find one before my script ran out so I wouldn’t end up in the ER again. <BR<BR I am totally at this point right now. My doctor insists that I take an SSRI zoloft. After 2 tries at SSRIs I have had side effects. I even had to call out of work yesterday due to dizzyness. I have NO problem with Ativan and have proven over and over again that I am not going to get addicted. I.e., gotten a script for 24 pills and used that much over a 7 month period. Nevertheless my doctor irrationally puts me on a drug that many people tell me IS addictive and gives me side effects which are 10 times worse than what I even went to the doctor for in the first place. And BTW I feel NO difference from the pill other than bad. Um is it me or does that lead to the obvious question… um maybe these drugs aren’t good for you? Isn’t the doctor motto "first do no harm" well those SSRI’s do me a lot of harm and yet, it is like a conspiracy. I can’t find a doctor that doesn’t want to immediately put me on them. Even when I tell them I haven’t tolerated them in the past. In fact, it is getting the point where they are blackmailing me… they won’t give me any ativan unless I agree to take the zoloft. Do they all have a secret deal with the drug companies — whereby they get a kickback if I just get a perscription for the SSRI? I mean really. I am so sick of doctorsat this point I am seriously considering going to medical school just so I can get good medical treatment. I am hitting this wall of lazy stupid doctors that don’t seem to care about me at all… and seem to have a script that they follow. I have looked around gone to doctors recommended by friends and such and they all do the same thing. Just had to get that off my chest.
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I’ve been where you are Vicki. Every doc I seen kept recommending SSRI’s while I was on Xanax a neurologist had given me and basically felt helpless because I had no doctor and was trying to find one before my script ran out so I wouldn’t end up in the ER again. Anyway, I kept telling everyone Xanax works very well for me, so what’s the problem? I got one answer – it’s addictive. At the time I had no education on benzo’s, SSRI’s etc. so after finding a pychiatrist I was asked if I wanted to stick with Xanax or try Paxil. Actually believing the addictive hype I went for Paxil (Doh!) and probably the worst thing I did. But now I have no problem being prescribed Xanax. And I hope you can find the same situation. Believe me if you look, those docs are out there. BTW I don’t have your original post so just wanted to add, I’m glad overall your doctor appointment went well and you’re feeling better.. – Hide quoted text — Show quoted text – Hi Fig, I agree with you on the SSRIs but I have no choice but to take them. They do control my panic but I do pay a price for it. I would much rather take klonopin twice a day to control anxiety but that is not possible with any doctor I have seen. I did tell my NP yesterday that klonopin BID really helps me but her boss still feels it should be an as needed med. I don’t. I am on Lexapro and it is a less invasive SSRI, but still there are side effects. Hopefully these doctors will get educated one day. <sigh Vicki Dot, thanks for this article. Slowly, but surely, researchers will find answers for us. But I’m not giving up my personal ban on taking SSRIs until better forms of these medications are developed! The NIH press release is at: http://www.nimh.nih.gov/events/prpanicreceptor.cfm and includes images of the three brain sites under discussion. The Journal of Neuroscience site (www.jneurosci.org) has the full article available, but only if you’re a paid subscriber. Fig
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Interesting, Dot. Thanks for sharing. smiles, Elise
Panic disorder patients lack emotion-regulating protein: Study posted: January 22, 2004 Washington, Jan 22 (ANI): Researchers at the NIH’s National Institute of Mental Health (NIMH) have discovered that three brain areas of panic disorder patients lack a key component of a chemical messenger system that regulates emotion. Brain scans revealed that a type of serotonin receptor is reduced by nearly a third in three structures straddling the center of the brain. The finding is the first in living humans to show that the receptor, which is pivotal to the action of widely prescribed anti-anxiety medications, may be abnormal in the disorder, and may help to explain how genes might influence vulnerability. Drs. Alexander Neumeister and Wayne Drevets, NIMH Mood and Anxiety Disorders Program, and colleagues, report their findings in the latest issues of the Journal of Neuroscience. Panic disorder runs in families and researchers have long suspected that it has a genetic component. The new finding, combined with evidence from recent animal studies, suggests that genes might increase risk for the disorder by coding for decreased expression of the receptors, say the researchers. In the current study, Neumeister and Drevets used PET scans (positron emission tomography) to visualize 5-HT1A receptors in brain areas of interest in 16 panic disorder patients – seven of whom also suffered from major depression – and 15 matched healthy controls. A new radioactive tracer (FCWAY), developed by NIH Clinical Center PET scan scientists, binds to the receptors, revealing their locations and a numerical count by brain region. Subjects also underwent structural MRI (magnetic resonance imaging) scans, which were overlaid with their PET scan data to precisely match it with brain structures. In the panic disorder patients, including those who also had depression, receptors were reduced by an average of nearly a third in the anterior cingulate in the front middle part of the brain, the posterior cingulate, in the rear middle part of the brain, and in the raphe, in the midbrain. (ANI)
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Hi Fig, I agree with you on the SSRIs but I have no choice but to take them. They do control my panic but I do pay a price for it. I would much rather take klonopin twice a day to control anxiety but that is not possible with any doctor I have seen. I did tell my NP yesterday that klonopin BID really helps me but her boss still feels it should be an as needed med. I don’t. I am on Lexapro and it is a less invasive SSRI, but still there are side effects. Hopefully these doctors will get educated one day. <sigh Vicki
– Hide quoted text — Show quoted text – Dot, thanks for this article. Slowly, but surely, researchers will find answers for us. But I’m not giving up my personal ban on taking SSRIs until better forms of these medications are developed! The NIH press release is at: http://www.nimh.nih.gov/events/prpanicreceptor.cfm and includes images of the three brain sites under discussion. The Journal of Neuroscience site (www.jneurosci.org) has the full article available, but only if you’re a paid subscriber. Fig
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Panic disorder patients lack emotion-regulating protein: Study posted: January 22, 2004
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