Social Anxiety Support

americandancer · 11-01-2008, 05:58 AM

I was fortunate enough for my doctor to prescribe me xanax xr (I chose the slow release version over the immediate release), but I could only take it a few days at a time, due to the fatigue it caused me. I went to see a nurse practioner in the same office to see what her opinion might be, and she gave me a bunch of samples for pristiq. I've taken a few days worth and really don't have any side effects, except for nervousness, which I expected at the beginning. I just don't know now if I should try it for the 5-6 weeks to see if it helps, or if I should just be grateful that my doctor let me have the xanax xr and continue on that to see if the fatigue goes away. I have to see him in Dec. and I am not sure what he is going to think about me seeing the nurse practioner and starting on another med. What do you guys think?

Noca · 11-01-2008, 10:16 AM

Ahh Pristiq, sounds like Effexor XR's patent is running out.

Medline · 11-01-2008, 12:17 PM

LOL, just like when Celaxa's patent ran out and the "novel" Lexapro came on the market. Funniest thing was with Paxil, it has a long enough half life for once daily dosing, but when the patent ran out GSK created the "novel" controlled-release form.

americandancer · 11-01-2008, 08:08 PM

The fact that it is newer is a concern for me. I haven't checked to see how much it costs, because right now I have samples. I don't want to pay a huge amount for it, unless it will really work well!
The nurse practioner did say it was similar to effexor, but had less side effects and was better for anxiety. I guess that is what the reps told her....So, should I try it or just stick with the xanax? The xanax xr is great for me during the day, but I just get so tired and irritable in the late afternoons. I was hoping taking another anti-depressant would give me my motivation back. I really think anxiety is my main problem, but how can I tell if I have some depression also, or if it just a result of being tired from the xanax? Once my system gets used to it (if I take it continuously for a few weeks), will I get my energy back, yet still feel calm and normal at the same time, or will I always be tired?
Sorry so many questions....I am just feeling desperate.

KurtG85 · 11-01-2008, 08:45 PM

Its likely always going to make you tired.

Frankly I wasn't able to grasp the scope of or even recognize my major depression until I got on a med which treated it and then it was a light bulb moment of "oh, because normal people feel like this is why everyone else isn't choking back tears every minute of the day like me". Point: take the new class of med and see if it helps, simple.

Pristiq makes me nervous just like effexor. Every SSRI/SNRI is different and will have different effects on every individual.

americandancer · 11-02-2008, 11:58 AM

It seems to be making me nervous, too, but I've only been taking it about 5 days. I expected it to make me anxious, but I am guessing it is similar to cymbalta, and that made me really nervous, too. I just hate to take 5-6 weeks worth and it not work, and then have to go through the weaning off of it. I'm also a little worried my doctor will want to stick with this, since I went in for another opinion. I am just wondering if I should be grateful for the xanax and just deal with the fatigue.

KurtG85 · 11-02-2008, 03:19 PM

If you want to try something else, just let your doctor know. If he refuses, get a new doctor.

About two weeks is as long as most people need to see if a med such as this is going to help or not. I need about 5 days at most.

Cymbalta does not make me anxious in near the same way pristiq does. Effexor and pristiq lead to a more aggressive nervousness than cymbalta does in myself although it still does increase my irritability to an extent.

Just today I decided to try just cymbalta for awhile (stopped my 30mg lexapro today). I am sick of the flatness I feel from lexapro.

americandancer · 11-03-2008, 04:48 AM

Good luck with the cymbalta. It worked pretty well for my anxiety once I moved back down to 30mg. The 60 seemed too much for me, but after a couple of months on the 30, I seemed much better. My blood pressure was a little high, so that is why my dr. took me off of it and just prescribed the xanax xr. That was back in May and I've yet to try the xanax for more than a few days at a time.

I didn't know I would be able to tell if the Pristiq would work in just a couple of weeks! If the way I feel now is a sign of how it is going to work, then I won't be able to take it. I'm just really jumpy and irritable. I think I would be fine taking it with the xanax, but then I might just be fine with the xanax alone. I just don't know if I have depression or not....I really just need something to take the edge off.

I don't want to change doctors because I feel very lucky that mine is willing to give me xanax. It seems like so many others have problems getting it. Even the nurse practioner gave me pristiq and didn't discuss other options with the xanax when I told her it was making me tired. That is one reason I was scared to complain about it. I don't want my regular doctor to just write it off as not working. I can deal with the fatigue it causes me...it's more the irritability that worries me.

KurtG85 · 11-03-2008, 05:36 PM

Wound up having to stop the cymbalta due to the nervousness it causes me. I cant figure the **** out, so im back on friggin lexapro.

:

SNRI's have much greater potential to 'add' to edginess than SSRIs. I would try a low dose of lexapro if you are looking to take the edge off. That is pretty much the perfect description of what a low dose of lexapro does for me.

americandancer · 11-04-2008, 05:17 AM

Yea, that is what I was thinking too. I tried lexapro a long time ago, and it worked almost immediately, but then I started itching, so my doctor took me off of it. I may see if I can try it again. I know it is supposed to be really good for anxiety. I guess anything, including my situation with xanax xr, is a trade-off. It gets rid of the anxiety, but you just have to deal with the fatigue/flatness. Bleh..... Sorry the cymbalta didn't work for you. I have a doctor's appt. early December, so I guess I could either stick with the pristiq until then, or just go back on my xanax er and see how I do, and then discuss the lexapro with him, if I still feel depressed. Which do you think I should do?

KurtG85 · 11-04-2008, 10:01 AM

You should try and give the pristiq as long as you can. Sometimes it takes a bit of time to really notice the potential positive effects on your functioning that meds can have. The longer you are on it the more perspective you will have on its effects on your psyche and functioning levels. Things may not get any better but these thorough observations can really help you to zero in on a med that works best for you in the future by fully understanding each meds effects on you and relating this to their mechanisms of action. If you haven't yet I would start keeping a journal that documents the effects you feel from each med in painful detail.

Many people think that their psychiatrists are perfectly adept at finding the best med for them and thats why they are paid so well. The fact is they are pretty much next to worthless compared to the (very well informed) treated individual's ability to effectively zone in on a med that will be effective for them (provided the treated individual is not too significantly.... messed up). You just have to do a very good deal of research and reading to sufficiently understand the very limited knowledge of modern psych meds.

I would give pristiq another week or two and then go back to xanax if you don't feel any positive benefits. There are a crap load of meds you have yet to try. It shows your intelligence that you already have recognized that there are almost always going to be some amount of trade offs instead of just damning all meds to hell just because we must take some negatives along with their positives.

americandancer · 11-05-2008, 03:11 PM

Thanks so much for your responses! I will stick with the pristiq a little longer, but I kinda have my doubts it will work. I have a hard time handling anything that gives me additional anxiety. At least I have the xanax to go back to, at least for now! That does give me some comfort...

I am actually getting my meds from my gp. I have seen a psychiatrist in the past for cbt, but that was a long time ago. I like your idea regarding keeping the journal. I think that will help me.

11-01-2008, 05:58 AM	#1 (permalink)
americandancer Status: SAS Member Join Date: Mar 2006 Posts: 215	Pristiq? I was fortunate enough for my doctor to prescribe me xanax xr (I chose the slow release version over the immediate release), but I could only take it a few days at a time, due to the fatigue it caused me. I went to see a nurse practioner in the same office to see what her opinion might be, and she gave me a bunch of samples for pristiq. I've taken a few days worth and really don't have any side effects, except for nervousness, which I expected at the beginning. I just don't know now if I should try it for the 5-6 weeks to see if it helps, or if I should just be grateful that my doctor let me have the xanax xr and continue on that to see if the fatigue goes away. I have to see him in Dec. and I am not sure what he is going to think about me seeing the nurse practioner and starting on another med. What do you guys think?

11-01-2008, 10:16 AM	#2 (permalink)
Noca Status: Permanently Banned Join Date: Jun 2005 Location: Ontario Gender: Male Age: 23 Posts: 14,079	Ahh Pristiq, sounds like Effexor XR's patent is running out.

11-01-2008, 12:17 PM	#3 (permalink)
Medline Status: SAS Member Join Date: Sep 2008 Gender: Male Posts: 1,860	LOL, just like when Celaxa's patent ran out and the "novel" Lexapro came on the market. Funniest thing was with Paxil, it has a long enough half life for once daily dosing, but when the patent ran out GSK created the "novel" controlled-release form.

11-01-2008, 08:08 PM	#4 (permalink)
americandancer Status: SAS Member Join Date: Mar 2006 Posts: 215	The fact that it is newer is a concern for me. I haven't checked to see how much it costs, because right now I have samples. I don't want to pay a huge amount for it, unless it will really work well! The nurse practioner did say it was similar to effexor, but had less side effects and was better for anxiety. I guess that is what the reps told her....So, should I try it or just stick with the xanax? The xanax xr is great for me during the day, but I just get so tired and irritable in the late afternoons. I was hoping taking another anti-depressant would give me my motivation back. I really think anxiety is my main problem, but how can I tell if I have some depression also, or if it just a result of being tired from the xanax? Once my system gets used to it (if I take it continuously for a few weeks), will I get my energy back, yet still feel calm and normal at the same time, or will I always be tired? Sorry so many questions....I am just feeling desperate.

11-01-2008, 08:45 PM	#5 (permalink)
KurtG85 Status: SAS Member Join Date: Sep 2008 Location: Missouri Gender: Male Age: 24 Posts: 472	Its likely always going to make you tired. Frankly I wasn't able to grasp the scope of or even recognize my major depression until I got on a med which treated it and then it was a light bulb moment of "oh, because normal people feel like this is why everyone else isn't choking back tears every minute of the day like me". Point: take the new class of med and see if it helps, simple. Pristiq makes me nervous just like effexor. Every SSRI/SNRI is different and will have different effects on every individual.

11-02-2008, 11:58 AM	#6 (permalink)
americandancer Status: SAS Member Join Date: Mar 2006 Posts: 215	It seems to be making me nervous, too, but I've only been taking it about 5 days. I expected it to make me anxious, but I am guessing it is similar to cymbalta, and that made me really nervous, too. I just hate to take 5-6 weeks worth and it not work, and then have to go through the weaning off of it. I'm also a little worried my doctor will want to stick with this, since I went in for another opinion. I am just wondering if I should be grateful for the xanax and just deal with the fatigue.

11-02-2008, 03:19 PM	#7 (permalink)
KurtG85 Status: SAS Member Join Date: Sep 2008 Location: Missouri Gender: Male Age: 24 Posts: 472	If you want to try something else, just let your doctor know. If he refuses, get a new doctor. About two weeks is as long as most people need to see if a med such as this is going to help or not. I need about 5 days at most. Cymbalta does not make me anxious in near the same way pristiq does. Effexor and pristiq lead to a more aggressive nervousness than cymbalta does in myself although it still does increase my irritability to an extent. Just today I decided to try just cymbalta for awhile (stopped my 30mg lexapro today). I am sick of the flatness I feel from lexapro.

11-03-2008, 04:48 AM	#8 (permalink)
americandancer Status: SAS Member Join Date: Mar 2006 Posts: 215	Good luck with the cymbalta. It worked pretty well for my anxiety once I moved back down to 30mg. The 60 seemed too much for me, but after a couple of months on the 30, I seemed much better. My blood pressure was a little high, so that is why my dr. took me off of it and just prescribed the xanax xr. That was back in May and I've yet to try the xanax for more than a few days at a time. I didn't know I would be able to tell if the Pristiq would work in just a couple of weeks! If the way I feel now is a sign of how it is going to work, then I won't be able to take it. I'm just really jumpy and irritable. I think I would be fine taking it with the xanax, but then I might just be fine with the xanax alone. I just don't know if I have depression or not....I really just need something to take the edge off. I don't want to change doctors because I feel very lucky that mine is willing to give me xanax. It seems like so many others have problems getting it. Even the nurse practioner gave me pristiq and didn't discuss other options with the xanax when I told her it was making me tired. That is one reason I was scared to complain about it. I don't want my regular doctor to just write it off as not working. I can deal with the fatigue it causes me...it's more the irritability that worries me.

11-03-2008, 05:36 PM	#9 (permalink)
KurtG85 Status: SAS Member Join Date: Sep 2008 Location: Missouri Gender: Male Age: 24 Posts: 472	Wound up having to stop the cymbalta due to the nervousness it causes me. I cant figure the **** out, so im back on friggin lexapro. : SNRI's have much greater potential to 'add' to edginess than SSRIs. I would try a low dose of lexapro if you are looking to take the edge off. That is pretty much the perfect description of what a low dose of lexapro does for me.

11-04-2008, 05:17 AM	#10 (permalink)
americandancer Status: SAS Member Join Date: Mar 2006 Posts: 215	Yea, that is what I was thinking too. I tried lexapro a long time ago, and it worked almost immediately, but then I started itching, so my doctor took me off of it. I may see if I can try it again. I know it is supposed to be really good for anxiety. I guess anything, including my situation with xanax xr, is a trade-off. It gets rid of the anxiety, but you just have to deal with the fatigue/flatness. Bleh..... Sorry the cymbalta didn't work for you. I have a doctor's appt. early December, so I guess I could either stick with the pristiq until then, or just go back on my xanax er and see how I do, and then discuss the lexapro with him, if I still feel depressed. Which do you think I should do?

11-04-2008, 10:01 AM	#11 (permalink)
KurtG85 Status: SAS Member Join Date: Sep 2008 Location: Missouri Gender: Male Age: 24 Posts: 472	You should try and give the pristiq as long as you can. Sometimes it takes a bit of time to really notice the potential positive effects on your functioning that meds can have. The longer you are on it the more perspective you will have on its effects on your psyche and functioning levels. Things may not get any better but these thorough observations can really help you to zero in on a med that works best for you in the future by fully understanding each meds effects on you and relating this to their mechanisms of action. If you haven't yet I would start keeping a journal that documents the effects you feel from each med in painful detail. Many people think that their psychiatrists are perfectly adept at finding the best med for them and thats why they are paid so well. The fact is they are pretty much next to worthless compared to the (very well informed) treated individual's ability to effectively zone in on a med that will be effective for them (provided the treated individual is not too significantly.... messed up). You just have to do a very good deal of research and reading to sufficiently understand the very limited knowledge of modern psych meds. I would give pristiq another week or two and then go back to xanax if you don't feel any positive benefits. There are a crap load of meds you have yet to try. It shows your intelligence that you already have recognized that there are almost always going to be some amount of trade offs instead of just damning all meds to hell just because we must take some negatives along with their positives.

11-05-2008, 03:11 PM	#12 (permalink)
americandancer Status: SAS Member Join Date: Mar 2006 Posts: 215	Thanks so much for your responses! I will stick with the pristiq a little longer, but I kinda have my doubts it will work. I have a hard time handling anything that gives me additional anxiety. At least I have the xanax to go back to, at least for now! That does give me some comfort... I am actually getting my meds from my gp. I have seen a psychiatrist in the past for cbt, but that was a long time ago. I like your idea regarding keeping the journal. I think that will help me.