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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 4 of 4. This is the beginning of the thread.
Posted by searching on March 12, 2002, at 11:06:47
Hi Everyone. I'm new to this site but you all seem very helpful and understanding.
I've suffered with panic disorder for about 20 years now. Sometimes have been better than others, but now I never leave my house alone, I'm dependent on my family for just about everything, and I had the worst "episode" yesterday where I was certain it was a heart attack and I would die right then and there in my house. My heart was pounding and racing like never before, I was shaking uncontrollably, I couldn't think straight, and it was more frightening than any panic attack I've ever had, so I thought it had to be physical. I was taken to my doctor who said that I did not look like someone who just had a heart attack and that it was just the panic disorder. She wanted me to start Zoloft and was perturbed when I told her I've been unable to tolerate anti-depressants in the past. She seems to think I'm lying.
Am I the only person who can't tolerate anti-depressants? I get strange symptoms like a tightening and a headache around my forehead, and my mind starts to race with thoughts. I don't "hear" voices, but my mind seems very busy and I can hear my thoughts. I can't sleep and I have nightmares. I get very anxious. My doctor tells me that few people have side effects, and that I will never get better if I don't take anti-depressants.
She gave me a starter pack and I took one this morning because my sister (a nurse) wanted me to. But now I'm scared about all those symptoms and I've read many horror stories about trying to get off of Zoloft.
I do so want to get better and I'd really do anything because I can't live this way anymore, but I feel like it's not my fault I can't tolerate these medicines. Is there any other alternative to anti-depressants for the treatment of panic disorder?
Posted by johnX2 on March 13, 2002, at 6:04:29
In reply to afraid to start zoloft, posted by searching on March 12, 2002, at 11:06:47
hi there,What kind of doctor are you seeing?
I hope you can get into see a psychiatrist/psychopharmacologist for these attacks.
People with panic disoder can be very sensitive to medicines, and the SSRI class of medicine (Zoloft, Paxil, Celexa, Prozac), can take weeks to ease panic symptoms. Sometimes SSRIs aren't the
best solution for a particular individual. (But many people do well on SSRIs).Because of people with panic disorders sensitivity
to medicine, usually the doctor needs to "titrate"
or increase the dose of the medicine more slowly
that for other patients. Otherwise the side effects can be extremely unbearable when you start the medicine.Can you list the medications you did not tolerate?
Was the issue that they made you more anxious when
you started them? This is not unusual for panic
disorder and is generally addressed by titrating the dose up more slowly.Also, have you ever had discussions with your doctor about taking medications that are not SSRIs? MAO inhibitor (Nardil sound familiar)?
Has a doctor ever had you take a benzodiazepine type medication like Xanax, Klonopin. These sound familiar?
I had very bad panic attacks for 1 week, and I understand how not getting it treated corretly can make someone agorophobic. So please hang in there. ok?
Sorry for all the questions.
hope to help you
john> Hi Everyone. I'm new to this site but you all seem very helpful and understanding.
>
> I've suffered with panic disorder for about 20 years now. Sometimes have been better than others, but now I never leave my house alone, I'm dependent on my family for just about everything, and I had the worst "episode" yesterday where I was certain it was a heart attack and I would die right then and there in my house. My heart was pounding and racing like never before, I was shaking uncontrollably, I couldn't think straight, and it was more frightening than any panic attack I've ever had, so I thought it had to be physical. I was taken to my doctor who said that I did not look like someone who just had a heart attack and that it was just the panic disorder. She wanted me to start Zoloft and was perturbed when I told her I've been unable to tolerate anti-depressants in the past. She seems to think I'm lying.
>
> Am I the only person who can't tolerate anti-depressants? I get strange symptoms like a tightening and a headache around my forehead, and my mind starts to race with thoughts. I don't "hear" voices, but my mind seems very busy and I can hear my thoughts. I can't sleep and I have nightmares. I get very anxious. My doctor tells me that few people have side effects, and that I will never get better if I don't take anti-depressants.
>
> She gave me a starter pack and I took one this morning because my sister (a nurse) wanted me to. But now I'm scared about all those symptoms and I've read many horror stories about trying to get off of Zoloft.
>
> I do so want to get better and I'd really do anything because I can't live this way anymore, but I feel like it's not my fault I can't tolerate these medicines. Is there any other alternative to anti-depressants for the treatment of panic disorder?
Posted by Frankie on March 13, 2002, at 21:52:46
In reply to afraid to start zoloft, posted by searching on March 12, 2002, at 11:06:47
> Hi Everyone. I'm new to this site but you all seem very helpful and understanding.
>
> I've suffered with panic disorder for about 20 years now. Sometimes have been better than others, but now I never leave my house alone, I'm dependent on my family for just about everything, and I had the worst "episode" yesterday where I was certain it was a heart attack and I would die right then and there in my house. My heart was pounding and racing like never before, I was shaking uncontrollably, I couldn't think straight, and it was more frightening than any panic attack I've ever had, so I thought it had to be physical. I was taken to my doctor who said that I did not look like someone who just had a heart attack and that it was just the panic disorder. She wanted me to start Zoloft and was perturbed when I told her I've been unable to tolerate anti-depressants in the past. She seems to think I'm lying.
>
> Am I the only person who can't tolerate anti-depressants? I get strange symptoms like a tightening and a headache around my forehead, and my mind starts to race with thoughts. I don't "hear" voices, but my mind seems very busy and I can hear my thoughts. I can't sleep and I have nightmares. I get very anxious. My doctor tells me that few people have side effects, and that I will never get better if I don't take anti-depressants.
>
> She gave me a starter pack and I took one this morning because my sister (a nurse) wanted me to. But now I'm scared about all those symptoms and I've read many horror stories about trying to get off of Zoloft.
>
> I do so want to get better and I'd really do anything because I can't live this way anymore, but I feel like it's not my fault I can't tolerate these medicines. Is there any other alternative to anti-depressants for the treatment of panic disorder?
Hello,I will tell you a few secrets. I feel where you are coming from. I was there before. Numerous times. I don't have traditional panic disorder, but I do have multiple anxiety and ADHD problems. I am currently being treated pretty effectively with Celexa, Buspar, Xanax, and a decent dose of Vitamin's C & E. These 2 are very good for stress and anxiety. I will tell you this. Your doctor is only partially right, in my opinion. I had a really rough time tolerating antidepressants initially too. That represents GAD. Generalized anxiety disorder. The racing mind is a GAD symptom. No doubt about it! I did not do well on Zoloft, but only because it made me really spaced out. It stopped the panic and anxiety at just 50 mg. in it's tracks. I switched to Celexa because it is milder. It sounds to me like you have some OCD in there too. The fear of taking medications is an obsession. Not taking it, or taking it with constant worry after you took it, is a compulsion. You do need an antidepressant. For sure. I tell you that you should give the Zoloft a shot. But, I also think you should ask your doctor for Klonopin. I have read that panic disorder is actually a form of epilepsy, especially as bad as you seem to be. I believe this too, because a panic attack acts like a partial seizure. Sometimes, the two disorders are confused. I was misdiagnosed with partial seizures in the past, and in actuality, it turned out to be panic and GAD. But, in your case, Klonopin will yield excellent results, in conjunction with the Zoloft. I am completely legitimate in these statements. Trust me.
Initially, the SSRi's will all worsen the panic disorder and GAD. Over time though, say like 3 or 4 months, they become tremendously beneficial. Initially, you will definitely need a benzo like Xanax or Klonopin, to help the SSRI along for the first few months. The combination of these two medications together will stop the attacks in most people. Buspar is good too with the SSRI's to stop the racing mind, or at least slow it down. So, here is my suggestions for you. Take the Zoloft daily, but don't elevate the dosage too fast. I would stay on the 25 mg. starter dose for about 2 months, before raising it to 50 mg. Seriously! But, you must get the Klonopin, or even Neurontin, to add to this Zoloft. It is an absolute must, in your case. If not, your anxiety will worsen very much for a few months. If your doctor will not prescribe these to you, I would advise you to find one that will give it to you. In about 3 months, the Zoloft will be working very effectively. I would say that you should stick with about 50-100 mg. daily, if you can reach that amount. I have not taken Klonopin, but I would advise this over Xanax because it has more of an anticonvulsant effect. Please take my advice. I am not a doctor, but I am very knowledgable about medication, primarily when it concerns anxiety disorders. You are not crazy, as your doctor may suggest. It is very normal for people to experience a worsening of their anxiety from the SSRI's. Remember. If you get the Klonopin, let that do most of the work for the first 3 or 4 months. Then, the Zoloft will probably work very well. Good luck. Keep us updated.
Frankie.
Posted by Bette Powers on March 14, 2002, at 21:51:06
In reply to Re: afraid to start zoloft, posted by Frankie on March 13, 2002, at 21:52:46
Dear Frankie, First of all, I am thinking of you, and will keep you in mind and in my prayers......I have been where yu are......the people who wrote to you yesterday are right.....and we all are speaking from experience. Initially, you need Xanax, and I am not sure why they haven't given it to you.....in 20-30 minutes.5 to 1 mg., you will feel in control again......it is situational.....it is not a drug that needs to build up in your system......you take it, it stops the mind racing, the butterflies in your tummy, the heart pounding, the fear of dying.....it is a wonderful drug. And you need it. You need to feel some control. I had my first panic attack in 1984. I am on Zoloft, but that takes time to get in your system. Celexa is good too, and I have friends who use klonopin (SP?)...but again, that is a long-term plan. And you need to talk to a psychologist once a week for now. Believe me....I stayed in bed for weeks and weeks....and didn't leave my room, and then my house, for months.......I went on to own my own law practice with 2 office and 14 employees....but I stil take my zoloft and I always have my xanax for any high stress situations or if I think I might not sleep, then I take .5 mg or even 1 mg.....try to rest....I will write back tomorrow.....you are going to be OK....you need to find the right medications and the right Drs. for you.
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