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Old 09-19-2013, 02:46 PM   #1 (permalink)
 
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Default Antidepressants for Anxiety

How effective are antidepressants for social anxiety? Last time I went to the doc he prescribed me Lexapro and a small dose of beta blocker ...but I just took it for a month so I didn't really see a difference. Im not really depressed, I just wish there was something that would numb the anxiety feelings altogether.....do antidepressants really do that?
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Old 09-19-2013, 04:56 PM   #2 (permalink)
 
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My psychiatrist just put me on Paxil and told me it should take care of my anxiety. We shall see. I took Effexor (only went up to 150 mg) for about a month, and it did nothing for me.
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Old 09-19-2013, 05:17 PM   #3 (permalink)
 
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Quote:
Originally Posted by erikabear View Post
How effective are antidepressants for social anxiety? Last time I went to the doc he prescribed me Lexapro and a small dose of beta blocker ...but I just took it for a month so I didn't really see a difference. Im not really depressed, I just wish there was something that would numb the anxiety feelings altogether

.....do antidepressants really do that?
Yes. It can take between six weeks and three months to really feel the effect of an antidepressant in terms of reducing your anxiety. When you go back to your doctor, promise yourself you'll stay on it longer than a month, and likewise you should have the dosage level increased, since you probably started at a low dose and never went up. A higher dose would have more effect. You won't really get the full effect in just a month, because antidepressants take time to work.

If you didn't have any serious side effects, while taking Lexapro, this is a good sign that the medication is a good match for you, so your doctor can prescribe higher levels of this medication to alleviate your symptoms.

When you start an antidepressant, you should make a contract with yourself to stay on for at least a year, and to never miss a dose on any day. The reason for the extended time period is that antidepressants take time to work, unlike benzodiazephines, they stimulate the growth of brain receptors in the Hippocampi that were killed by stress hormones, which takes a few weeks to accomplish, and not overnight. After a few weeks, your body will have adjusted its new levels of serotonin, especially your brain, since when depressed or anxious, the brain had too much serotonin.
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Old 09-19-2013, 05:34 PM   #4 (permalink)
 
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The SSRI anti-depressants like Lexapro are therapies to help you over the long term. They are not a "feel good pill" like what used to be given in the decades before. I started with Prozac in 1989 after a terrible break-up where I had to call off my marriage. It was only through use of the med for months that I could tell a world of very small nuanced things that were different about me and how much better I was dealing with all of the things that used to get me angry or nervous. I had to adjust to that pace and change my expectations. But no one could teach me what I discovered. I had to live it over months to recognize it and find the language to own it and believe in it and build on it. That's really how these things work. A dose of Xanax will put most people at ease but does not address the cause of pattern behavior. SSRI anti-depressants do. And unless they give you side effects you just can't tolerate, try to keep your dose on the low side and your expectations ow too. After a few months you should be able to gauge whether you've started handling things better and stopped falling into patterns of obsession. In fellowships they say don't give up before the miracle happens and that's pretty-well true of medication therapy too.

If you have persistent anxiety after months of SSRI use you anxiety could be related to an under-production of a neurotransmitter called gamma-amino butyric acid which help your cellular biology in the brain. There are ways to knock that off kilter and only a few to repair it. I have had that myself. You can PM me if you stick out the SSRI meds for a couple of months and still have general anxiety disorder. I have knowledge that might help.
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Old 09-19-2013, 10:45 PM   #5 (permalink)
 
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...since when depressed or anxious, the brain had too much serotonin.
Could it also be that the brain had too much dopamine?
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Old 09-19-2013, 11:00 PM   #6 (permalink)
 
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Could it also be that the brain had too much dopamine?
If we're talking about social anxiety disorder, people with this disorder appear to show less serotonin and dopamine activity at postsynaptic receptors and greater potential for transporter binding with these neurotransmitters.

So it looks like there's too little dopamine and serotonin in people with social anxiety disorder.
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Old 09-20-2013, 01:32 PM   #7 (permalink)
 
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When you start an antidepressant, you should make a contract with yourself to stay on for at least a year, and to never miss a dose on any day. The reason for the extended time period is that antidepressants take time to work, unlike benzodiazephines, they stimulate the growth of brain receptors in the Hippocampi that were killed by stress hormones, which takes a few weeks to accomplish, and not overnight. After a few weeks, your body will have adjusted its new levels of serotonin, especially your brain, since when depressed or anxious, the brain had too much serotonin.
Thanks so much for the good info. I will definitely wait it out this time and see what happens.
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Old 09-21-2013, 04:57 AM   #8 (permalink)
 
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I found Sertraline helped me, but I felt worse the first 3 months. Now I am free of the pills, it's best to find other ways to deal with the issues I am certain.
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Old 09-26-2013, 06:03 PM   #9 (permalink)
 
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If we're talking about social anxiety disorder, people with this disorder appear to show less serotonin and dopamine activity at postsynaptic receptors and greater potential for transporter binding with these neurotransmitters.

So it looks like there's too little dopamine and serotonin in people with social anxiety disorder.
The research I've come across shows evidence that people with mental disorders have too much serotonin in the brain.
http://www.ncbi.nlm.nih.gov/pubmed/18180427

Serotonin is a component in managing stress, however it is used mainly in the gut, about 95% of serotonin is found here:
http://serendip.brynmawr.edu/exchange/node/7378

Depression and stress kill brain cells. Antidepressants, through neurogenesis, reverse this process, and boost the production of new brain cells in anxious and depressed patients. This is why antidepressants can take up to six to twelve weeks to get into effect.

http://www.sciencedaily.com/releases...0104101423.htm
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Old 09-26-2013, 06:14 PM   #10 (permalink)
 
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The research I've come across shows evidence that people with mental disorders have too much serotonin in the brain.
http://www.ncbi.nlm.nih.gov/pubmed/18180427
Yes, this appears to be true for some disorders such as depression. Although there are also findings of decreased serotonin activity in depression depending on where in the brain you look. In social anxiety disorder, the existing evidence points towards decreased serotonin activity. If you have found evidence to the contrary in social anxiety disorder, I would be very interested in reading it
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Old 09-26-2013, 06:22 PM   #11 (permalink)
 
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Originally Posted by Dylan2 View Post
Yes, this appears to be true for some disorders such as depression. Although there are also findings of decreased serotonin activity in depression depending on where in the brain you look. In social anxiety disorder, the existing evidence points towards decreased serotonin activity. If you have found evidence to the contrary in social anxiety disorder, I would be very interested in reading it
Serotonin is mostly produced in the gut (95%) and not in the brain.
http://www.nytimes.com/2005/08/23/he...ewanted=1&_r=3
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Old 09-26-2013, 06:25 PM   #12 (permalink)
 
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I have not found any antidepressant to put a dent in my anxiety (GAD), and I've tried them all over the decades. It depends how functional I have to be. For example in a simple job or in between I might be able to put up with the zombie effect they give me. But if I have a very high end technical or professional job, I need to be 100% functional, I ditch all antidepressants and still with only Wellbutrin for my depression. It's the only one I have no side effects on whatsoever. For my anxiety I take low doses of benzos as needed. Right now xanax .25 mg. Very low dose but enough to cut my anxiety and anger down to nothing. I feel normal, not sedated, dizzy, high, or any thing. I feel nothing and I love that feeling. Even buspar is a zombie pill for me. But after a long time trying every thing, since the 80's. I know what works best for me. And that's the key because they all work different for some people.
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Old 09-26-2013, 06:37 PM   #13 (permalink)
 
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Serotonin is mostly produced in the gut (95%) and not in the brain.
http://www.nytimes.com/2005/08/23/he...ewanted=1&_r=3
I don't understand why you're linking this article. Do you mean that findings could be confused by serotonin production in the gut? If so, research on social anxiety disorder looks specifically at the brain:

"We found a significantly lower 5-HT1A BP in several limbic and paralimbic areas but not in the hippocampus (p = .234) of SAD patients."

http://www.ncbi.nlm.nih.gov/pubmed/1...?dopt=Abstract
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Old 09-27-2013, 05:19 AM   #14 (permalink)
 
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I found Sertraline helped me, but I felt worse the first 3 months. Now I am free of the pills, it's best to find other ways to deal with the issues I am certain.
Sertraline is one of my favourite SSRIs. In tests done it was less likely to produce cognitive issues than the other ssris.

It does cause a dopamine increases in the PFC. Though it is too weak of a DRI to actually be the cause of it. My guess is it's the Sigma-1 antagonism that increases the dopamine.
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Old 09-27-2013, 05:21 AM   #15 (permalink)
 
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Originally Posted by Dylan2 View Post
Yes, this appears to be true for some disorders such as depression. Although there are also findings of decreased serotonin activity in depression depending on where in the brain you look. In social anxiety disorder, the existing evidence points towards decreased serotonin activity. If you have found evidence to the contrary in social anxiety disorder, I would be very interested in reading it
People who have committed suicide usually had a higher density of 5-ht2a receptors. It could explain the initial increases suicidal ideation some get with SSRIs and then eventual calming with downregulation.
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Old 09-27-2013, 07:30 AM   #16 (permalink)
 
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I've written this a few times before, so the regular forum members might think I'm a broken record on repeat.

But a Monoamine oxidase inhibitor (MAOI) called Nardil (Phenelzine) has been a lifesaver for me. I was an isolated recluse for many years that had trouble speaking to other people, making eye contact, doing the grocery shopping etc. My life was a living hell. But this medication removed my anxiety by 100%, now i love every moment of my life, I'm truly living now, where before i was dead inside. Talking to people, making new friends and lovers is the best thing i know. I can talk to anyone anywhere, and i truly enjoy it.

So i have to recommend MAOIs, because I've tried almost every SSRI/SNRI, and a few TCAs without any positive effects. Nardil changed the way i live. And never give up until you've tried them.
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Old 09-27-2013, 01:55 PM   #17 (permalink)
 
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Hi Dylan2,

You wrote:

Quote:
Originally Posted by Dylan2 View Post
I don't understand why you're linking this article. Do you mean that findings could be confused by serotonin production in the gut? If so, research on social anxiety disorder looks specifically at the brain:

"We found a significantly lower 5-HT1A BP in several limbic and paralimbic areas but not in the hippocampus (p = .234) of SAD patients."

http://www.ncbi.nlm.nih.gov/pubmed/1...?dopt=Abstract
Our discussion was too much serotonin (my stance) or too little serotonin (your stance) in the brain for people with mental health disorders (such as SAD).

I've come across findings that serotonin is mostly produced in the gut, about 95% of the body's production of serotonin is in the gut, and not a lot of serotonin is produced in the brain.

And so I referenced this article in an earlier post about serotonin being produced mostly in the gut:
http://www.nytimes.com/2005/08/23/he...ewanted=1&_r=3


I am implying that the hypothesis (which a lot of mental health professionals and doctors advocate) is that a chronically depressed or anxious person (diagnosed with a psychiatric disorder, such as SAD, through the DSM-IV) has a chemical imbalance in the brain - which normally implies the person's brain produces too much serotonin - actually, isn't very accurate, if the gut produces the majority of the body's serotonin, and not the brain.

I know you are stating that SAD (a diagnosed psychiatric disorder) is the result of too little serotonin, and an AD such as a SSRI would increase serotonin in the brain, however, that may be questionable if there are findings which imply depression (also another diagnosed psychiatric disorder) is the result of too much serotonin. Ironically when I look at your article, about too low serotonin, the source is also the one I referenced, which documented too high serotonin. **

http://www.ncbi.nlm.nih.gov/ **

http://www.ncbi.nlm.nih.gov/pubmed/18180427
http://www.ncbi.nlm.nih.gov/pubmed/1...?dopt=Abstract

However, I don't want to use this thread to make it you're wrong, and I'm right, about the serotonin theory. I will say that the chemical balance theory, in regards to serotonin, isn't well proven, as hyped by the media. If you have some extra time, this source does some extensive research to diss-pell the serotonin theory. The material is well written so it should be engaging to review, especially if you're prone to study psychological disorders such as SAD.

http://link.springer.com/content/pdf...115-007-9047-3

I will say that antidepressants work through the concept of neuro-genesis*, by creating new cells in the brain, which were killed off due to prior psychological stress. Without the antidepressant, a brain (damaged by prolonged psychological stress, which leads to problems in handling anxiety or depression) cannot produce these new cells on its own.

For me, this is a better theory on how antidepressants work, than to say antidepressants produce more serotonin in the brain, due to a chemical imbalance. If depressed subjects have too much serotonin, then too little serotonin may not be the best hypothesis as the the cause of mental illness, such as SAD. Ramping up the serotonin would then be unproductive.

Consequently the same antidepressants (such as an SSRI) can be treated for both anxiety (such as generalized anxiety disorder) or depression (such as major depressive disorder), so the antidepressant shouldn't be working on serotonin in the brain, instead the serotonin is being operated in the gut. Other parts of the brain, through neuro-genesis, are what the antidepressant is used for.

* http://www.nature.com/mp/journal/v16/n7/full/mp201126a.html
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Old 09-28-2013, 05:56 PM   #18 (permalink)
 
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So.... should we be working on healing our guts, then? I've heard that the gut is connected to mental health. Our second brain.
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Old 09-28-2013, 06:39 PM   #19 (permalink)
 
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Tried celexa, effexor, mirtazapine, zoloft, paxil and trazodone for anxiety. Of all those antidepressants I took effexor and mirtazapine made me on edge and didnt work for me.. but I can see them being very effacious for some. Trazodone made me tired ... that was all so groggy and tired there was no way I could be sociable. I was like most people and argued that antidepressants were for depression not anxiety and only benzos like clonazepam, ativan and xanax were for anxiety (my severe anxiety anyways). I stayed on clonazepam for a few years but depression came again badly so I went on Zoloft. It really did help me feel a bit better.. made me always feel nervous though ,, happy but nervous for no reason. I got a few side effects with zoloft but put up with them seeing as how it was the only AD that was helping me. After 2 years on it I came off because the side effects were getting worse! I was back solely on clonazepam again! I knew my depression was still there so I went to the doctor and last but not least he prescribed me Paxil. I took 5mg for 3 days and 10mg for 4 days then up to 20mgs. I can honestly say that the very first day I took the Paxil I felt eerily better. Not high, or drugged like the others.. I felt the same actually just it calmed down my mind and made me see my anxiety and it made me feel comfortable with my anxiety. Over time I didnt lose my anxious ways but it allowed me to slow down enough to start seeing what triggered me, made me realize that my anxiety was killing me and that I dont need to be anxious all the time! I didnt kill the anxiety like clonazepam or any benzo does but it made me feel comfortable in my own skin and from their I learned to manage my anxiety and little by little I have become a lot less anxious person. I can now look outside and appreciate the outdoors and life in general. When you are able to work with your anxiety so it doesnt interfere with your life the feeling you get will be overwhelming. I started to feel like I did as a kid... care free. Like for example if I had an appointment in the morning I would be up all night thinking about it and playing it out in my head. I have stopped that and now realize its just an appointment. So I dont have to go over things and situate things to fit my anxiety.. i can do things I WANT without anxiety keeping me held back. I can honestly say that Paxil (an antidepressant) works for my extreme anxiety and I have been on all the benzodiazepines!! I am more along the lines of a anxious-depressive so for me Paxil has been a very very useful anxiolytic .. one of the only ones that works for me as a matter of fact! But none of the other ssri's, snri's and other AD's did anything but make me sweat and sleepless which provoked my anxiety. So paxil helping my anxiety gear down massively allows me to do what I want and live my life and that has also had the greatest impact on my depression as well.
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Old 09-29-2013, 12:40 AM   #20 (permalink)
 
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So.... should we be working on healing our guts, then? I've heard that the gut is connected to mental health. Our second brain.
Antidepressant do increase serotonin but its more in the gut (referred to as the enteric nervous system). However when serotonin increases in the brain, this may explain why many people experience more anxiety when first starting an antidepressant, if the brain in a depressed/anxious patient already has too much serotonin. After the initial weeks, serotonin is rebalanced in the brain and gut. Likewise the brain through neurogenesis begins creating new brain cells, damaged by psychological stress, in areas of the hippocampus and prefrontal cortex. Since antidepressants can take between nine to twelve weeks to show results, the waiting time is due to the brain undergoing neurogenesis.

http://www.scientificamerican.com/ar...t-second-brain
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