What to take? GAD/SA

[radiohead]

I am new here, so bear with me.

I am an ex-addict of opiates, and currently tapering off of Suboxone(buprenorphine, a partial agonist opiate). Now that I am almost off of it completely after 2 years in which it helped me in recovery, I realize that it was masking many of my personality disorders and anxiety. I am starting to feel more like I did before I used drugs/opiates(they "cured" my anxiety momentarily).

My current state of mind is pretty much a constant for me. I suffer from GAD(general anxiety) as well as Social Anxiety, and I am not sure if I might be Bi-Polar in a more slight degree(I don't have any mania, just bouts of depression). Since getting off of the suboxone, my disorders are now resurfacing. I have a pretty constant level of anxiety, but it gets worse around random people, especially crowds, but even in what should be normal, comfortable settings I find myself over-anxious, analytical and insecure. It's becoming a bit unbearable as I am avoiding communication at a much larger scale now.

I have taken Lamictal before, and it did an OK job at helping my overall anxiety at 200mg a day, but I did have some side effects that weren't great. I currently only take Librium 5mg/3x daily(yes the old school Benzo nobody prescribes anymore). I am wondering if that is a relatively low dose, and if I could pretty much just stop taking it. I know Librium is lest potent and longer acting than Xanax/Valium and is used to taper off of those, so I should be fine if I stop right? Also, I recall the Librium helped for the first month with my anxiety, but lately it's almost gotten worse, if anything, as I wake up sweaty in the morning.

I am curious what many of you take for your GAD/SOcial Anxiety/Anxiety in general. SSRI's have never seemed to do much for me(Lexapro/Zoloft/Prozac I have tried), and Lamictal is the only thing I know helped a little bit. I've read about Neurontin(gabbapentin) and some other medicines and wonder if they are helpful. Sorry for ranting here, not sure where this post belongs, but I am currently struggling to find myself.

I see a psychologist/addiction specialist only once every 3 weeks currently(he prescribed me the suboxone). I am thinking about seeking further counseling/therapy, but I have an appointment with my current doc on Saturday. I am going to talk to him about my recent problems resurfacing, but I am not sure if I should take Lamictal again, or possibly try other medicines? THanks for listening to me rant here, just trying to figure out what to do. I know he will probably just recommend Lamictal again, but I want to educate myself more on other similar medications that can be helpful with Gad/SA.

Thanks.

[MissMay1977]

I take 40mg of Paxil and it has helped me. I also take Benadryl 25 mg prn as needed.

[dss]

I would suggest an MAOI but considering the contradictions thy have with opiates and your past I'm not sure it would be the best idea , or if you would even get them.

If lamictal helped you then that would be where I would start. I don't have much knowledge on it but I'm pretty sure I have read people here who take it along with a SSRI or SNRI. You will have to do some reading or someone might post here with more info on that but that's probably what I would do.

Try something like Cymbalta + Lamictal (Provided they can be taken together without problem)

[MavenMI6Agent009]

I took zoloft for two years and helped my depression now im taking wellbutrin sr generic form and doesnt do squat for my depression. Im trying paxil next because I read that anything other than ssris like maois or trycyclics can have nasty side effects no wonder its been ten years since my doctor has prescribed a maoi.

[dss]

Originally Posted by MavenMI6Agent009

I took zoloft for two years and helped my depression now im taking wellbutrin sr generic form and doesnt do squat for my depression. Im trying paxil next because I read that anything other than ssris like maois or trycyclics can have nasty side effects no wonder its been ten years since my doctor has prescribed a maoi.

The reason most doctors don't prescribe MAOI's is because they have the potential to be lethal. Instead of trying to deal with that they go with the safe and easy route and hand out SSRI's. If anything the SSRI's have equally bad if not worse everyday side effects compared to MAOIs.

[UltraShy]

Originally Posted by MavenMI6Agent009

I read that anything other than ssris like maois or trycyclics can have nasty side effects no wonder its been ten years since my doctor has prescribed a maoi.

I'm guessing you didn't read that on this forum where SSRI side effects are almost a daily rant by somebody who discovered they are far from the wonder drugs they're made out to be by big drug companies with big marketing budgets.

[Attica! Attica!]

Originally Posted by MissMay1977

I take 40mg of Paxil and it has helped me. I also take Benadryl 25 mg prn as needed.

Benadryl, the allergy stuff? Does that help with SA??

[xboxfreak]

Originally Posted by Attica! Attica!

Benadryl, the allergy stuff? Does that help with SA??

It can. It is supposed to sedate you/make you drowsy. So in that regard it is thought to help with SA.

[livingnsilence]

Originally Posted by xboxfreak

It can. It is supposed to sedate you/make you drowsy. So in that regard it is thought to help with SA.

Benadryl can make you drowsy, but some people have the opposite response. 25-50mg of Benadryl doesn't make me drowsy at all so my GP told me I can take up to 100mg for my insomnia. I tried it a couple times and either it does absolutly nothing or it makes me feel real anxious/panicky and makes it harder to sleep depending on how much food I have in my stomach when I take it.

However, Benadryl can help with anxiety in a differnt way than just providing sedative affects. Benadryl taken daily actually has been shown to provide mild SSRI effects, along with several other antihistamines. Chlorpheniramine was considered the one that had the most effects though and led to the development of the first marketed SSRI.

[Noca]

Adderall XR has helped the most with my SA.

[radiohead]

Thanks for all the replies everyone.

I think I am going to just go back on Lamictal(now that I have a clear mind and will be able to distinguish what specific medicines are doing). Maybe I'll just start with that, and if it doesn't work try an SSRI like Lexapro again, but in combination.

So many of the times I started a medication I was using opiates daily, so it was really hard to tell if anything worked(because I was nodding off and high :P). I have been reading about the SNRI's, as they seem relatively new to me. So they are just basically an SSRI with added chemicals that affect the noripinephrine and thus affecting dopamine?

I'm sure once I start either therapy or group counseling, if I end up choosing to, it could help quite a bit more than any other medicine. Same with exercise....but it's so hard to go out and run. You know what I mean?

[dss]

SNRI is serotonin-norepinephrine reuptake inhibitor. Essentially the same as a SSRI but they work on Norepinephrine as well. Effexor apparently inhibits dopamine slightly at higher doses and I'm not sure about Cymbalta.

Wellbutrin is a dopamine and norepinephrine reuptake inhibitor if you were thinking dopamine would help you more.

[radiohead]

Yea, from what I can remember taking Wellbutrin actually made me kind of edgy/anxious.....that's a weird reaction isn't it? I always thought that anxiety was related to me having a lack of dopamine, but is it possible it's from excess or damaged dopamine or receptors?

So the SNRI's and noripinephrine isn't directly related to dopamine increases?

Also, after reading about Lamictal I am still not even sure what it works on.....maybe GABA receptors or something? It seems they don't even know how it exactly works, which is kind of odd to me......how is it safe? haha

[Noca]

Originally Posted by radiohead

Yea, from what I can remember taking Wellbutrin actually made me kind of edgy/anxious.....that's a weird reaction isn't it?

no, its quite normal

[Attica! Attica!]

Originally Posted by livingnsilence

Benadryl can make you drowsy, but some people have the opposite response. 25-50mg of Benadryl doesn't make me drowsy at all so my GP told me I can take up to 100mg for my insomnia. I tried it a couple times and either it does absolutly nothing or it makes me feel real anxious/panicky and makes it harder to sleep depending on how much food I have in my stomach when I take it.

However, Benadryl can help with anxiety in a differnt way than just providing sedative affects. Benadryl taken daily actually has been shown to provide mild SSRI effects, along with several other antihistamines. Chlorpheniramine was considered the one that had the most effects though and led to the development of the first marketed SSRI.

oh, huh.. interesting!

Originally Posted by Noca

Adderall XR has helped the most with my SA.

How easy is it to get a prescription for adderall? I'm probably going to go to a doc soon to get meds for the first time, and it sounds the most promising..

[Noca]

Originally Posted by Attica! Attica!

How easy is it to get a prescription for adderall? I'm probably going to go to a doc soon to get meds for the first time, and it sounds the most promising..

In order to get prescribed Adderall you need two things, have tried Wellbutrin before and have ADD(or one VERY open minded doctor).

[Attica! Attica!]

Originally Posted by Noca

In order to get prescribed Adderall you need two things, have tried Wellbutrin before and have ADD(or one VERY open minded doctor).

Ok. I guess that won't be an option for me..