Anxiolytics

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I've been posting quite a bit about anxiety recently because mine is through the roof, and I'm desperate to find a solution, because it's evolving into agoraphobia now, and it's affecting my relationship. When my anxiety is really severe, I'm completely powerless to stop it.

I'm seriously considering medication now. I take Valium occasionally, and it works very well - better than anything else - but it's not really something I want to be taking every day. I generally take it when panic strikes, and it calms me down a lot.

What I'm hoping for is some advice on what I could take that might give me a more consistent feeling of relaxation, something that I could take every day, for a while. A few things have been recommended to me already - Taurine, Myo-Inositol, etc. I've seen a few reports about Phenibut and Tianeptine as well.

Thing is, if I go to my doctor she'll most likely recommend an SSRI, and I'm very reluctant to do that. A lot of people say that SSRIs just made things worse. Does anyone have positive testimonials about SSRIs?

I'd really appreciate some advice on this! I'm hoping to gather up more recommendations so I can sort through them and work out what'll be best for me.

Edit: it's worth mentioning that the panic attacks started from an awful drug trip nearly three years ago. I've had good spells as well as bad spells, but recently it's been really bad.
 
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first thing I'd try is pregnenolone. 100mg then building up to 500mg. That seems to really kill anxiety for many people.
 

mattyb

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Have you considered taking propranolol or cyproheptadine? Low dose cyproheptadine (1-2mg 2-3 times per day) for a few months worked extremely well to reduce my anxiety and some of the symptoms I got as a result (chest pain and hives). It inhibits CRH (corticotropin stimulating hormone), and by extension it should reduce adrenaline. Just don't take it too close to bed or you'll wake up feeling like crap in the morning. The drowsiness will go away after the first week. Nowadays I only take it as needed, which is 1-2 times per week.

I have some propranolol sitting on my shelf, since it's used to treat adrenergic urticaria. I never had to use it though, by the time I got it the cypro fixed my issues. I think the propranolol would be much more effective to have on hand when getting anxiety attacks - a low dose of that should be sufficient to keep any anxiety attacks underway. Just having it on hand can prevent anxiety attacks, knowing that you can take it whenever you need it.

Have you looked into any cognitive behavioral therapy? It sounds like you may be suffering from PTSD. A (not-so) new idea behind PTSD is that there are issues behind context processing, which can be reprogrammed through training. In some CBI courses you work on really simple things in order to improve your memory of events, and it indirectly improves your brains ability to differentiate between your past stressful events and what's happening now. My brother did a course of it, and he said it helped immensely. They focused on really simple things like recalling memories around specific objects, and trying to remember as much detail as possible (both internal and external details). They rarely focused on the actual stressful event that initiated the PTSD.

I would try any of these options out before trying out an anxiolytic SSRI like Cymbalta (I know one person on it and she seems to do okay with it, but she's also prone to flying completely off the hook from time to time).
 

mattyb

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Oh yeah, and if you go to a doctor and she recommends an SSRI - just say that you won't take it. They can't really argue with you, because the call is ultimately yours. Try and negotiate another drug (like the ones I've talked about), and explain your reasoning. They may not like it, so you may just have to go see another doctor. I have an open minded physician and it worked with him, but I had to visit 5-6 physicians before him.
 

tara

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I don't know what you've tried so far.
In addition to the other possibilities suggested above, here are some other ideas that may be relevant:
  • Are you eating enough and enough carbs? Energy deficit can create ongoing stress and anxiety, so good to check that you are not creating unnecessary stress this way. When blood sugar drops too low, stress hormones kick in to bring it up agian, and it's hard to relax with high stress hormones running.
  • Base metabolic rate reasonable? Check body temps (eg thermometer in armpit for 10 mins) and resting heartrate and other sigs and symptoms of low thyroid. If cellular energy production is low, they are more likely to have trouble meeting energy demands, and this is stressful.
  • Enough magnesium and other alkaline minerals in diet? Other micronutrients?
  • Tried niacinamide (with adequate carbs)?
  • Not reacting to a regular food allergen?
  • Gut transit time is reasonable? If not, consider measures to help this - eg a little aged cascara sagrada.
  • If CO2 levels are low (blood test/noticable open mouth or chest breathing/ Buteyko Control Pause), tried any breathing related ways of restoring it? This can take time, and other factors like diet probably have an effect. Good CO2 levels are needed for many (all?) functions to go well, including for the nervous system to calm itself. Stress tends to promote hyperventilation, often unaware, and this can get into a self-reinforcing cycle. In the midst of stress, a short walk with a focus on breathing just enough or slightly less than you want can sometimes make a difference in the short term. Or even just breathing out and holding till you need to inhale again. Or reduced breathing exercise, like relaxed breath out followed by smaller breath in, for a dew minutes - allowing slight air hunger. Or bag-breathing for a minute or two. Longer term resilience takes more systematic training, not just emergency measures.
  • Regular sunlight on skin? Or supplemental red light if there isn't enough sun in winter?
If you have done what you can with basic health, and still want drugs, I think there may be advantages to trying SSREs rather than the SSRIs. Or cyproheptadine in low doses as suggested above.
 
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tara

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Dopamine

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Pregnenolone never really helped me personally and last time I took it I felt some alice in wonderland syndrome, extreme neck tension, anxiety, and almost had a panic attack. Felt kind of like a bad trip. No idea why it happened because it never happened before but just mentioning it because people on here tend to consider these drugs relatively benign but they can cause problems. I think the concentration was higher than I realized maybe or something.

Tara has good advice.

I find gut problems to be a huge source of anxiety and agitation- Rays carrot salad helps a lot. Maybe follow it up with some easy to digest fibre free juice.

Niacinamide and tianeptine have helped me in the past.

I think @DaveFoster and a few others have had good luck with Mirtazapine for a medication but you'd have to ask him.
 

InChristAlone

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I don't know what you've tried so far.
In addition to the other possibilities suggested above, here are some other ideas that may be relevant:
  • Are you eating enough and enough carbs? Energy deficit can create ongoing stress and anxiety, so good to check that you are not creating unnecessary stress this way. When blood sugar drops too low, stress hormones kick in to bring it up agian, and it's hard to relax with high stress hormones running.
  • Base metabolic rate reasonable? Check body temps (eg thermometer in armpit for 10 mins) and resting heartrate and other sigs and symptoms of low thyroid. If cellular energy production is low, they are more likely to have trouble meeting energy demands, and this is stressful.
  • Enough magnesium and other alkaline minerals in diet? Other micronutrients?
  • Tried niacinamide (with adequate carbs)?
  • Not reacting to a regular food allergen? Gut transit time is reasonable? If not, consider measures to help this - eg a little aged cascara sagrada.
  • If CO2 levels are low (blood test/noticable open mouth or chest breathing/ Buteyko Control Pause), tried any breathing related ways of restoring it? This can take time, and other factors like diet probably have an effect. Good CO2 levels are needed for many (all?) functions to go well, including for the nervous system to calm itself. Stress tends to promote hyperventilation, often unaware, and this can get into a self-reinforcing cycle. In the midst of stress, a short walk witha focus on breathign just eough or slightly less than you want can someties make a difference in teh short term. Or even just breathingout and holding till you need to inhale again. Or reduced breathing exercise, like relaxed breath out followed by smaller breath in, a few times - allowing slight air hunger. Longer term resilience takes more systematic training, not just emergency measures.
  • Regular sunlight on skin? Or supplemental red light if there isn't enough sun in winter?
If you have done what you can with basic health, and still want drugs, I think there may be advantages to trying SSREs rather than the SSRIs. Or cyproheptadine in low doses as suggested above.
:+1 I agree with all of this. I went through panic disorder. I thought I'd never be my normal self again, but I am almost there 2.5 yrs later! The only drug I've used on and off is cyproheptadine. I also had to avoid caffeine when my adrenaline was going. But now I am tolerating a mug of coffee in the morning again. :partydance
 

sladerunner69

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L-Lysine power definitely has a nice strong effect that lowers anxiety, however I found that it also makes me feel a little to emotionally flat and is more difficult to form thoughts and be motivated. Two sides to every hat I suppose. High dose niacinimide is what I have been relying on lately, especially before bed. I feel quite relaxed and pleasant the next day, although maybe a bit too sleepy. Niacinimide may also help me particularly well because I have a 5-AR deficiency that calls for it :darts:

I would second looking into gut health, ti seems to be indirectly but strongly related to anxiety and cognitive ability. When my gut is clear and comfortable I feel totally content and sort of happy-go-lucky, and then once I eat something with fillers or gritty starches, that quality of calm and solidarity in my consciousness seems to escape me much easier.:pompous:
 
OP
M

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Have you considered taking propranolol or cyproheptadine? Low dose cyproheptadine (1-2mg 2-3 times per day) for a few months worked extremely well to reduce my anxiety and some of the symptoms I got as a result (chest pain and hives). It inhibits CRH (corticotropin stimulating hormone), and by extension it should reduce adrenaline. Just don't take it too close to bed or you'll wake up feeling like crap in the morning. The drowsiness will go away after the first week. Nowadays I only take it as needed, which is 1-2 times per week.

I have some propranolol sitting on my shelf, since it's used to treat adrenergic urticaria. I never had to use it though, by the time I got it the cypro fixed my issues. I think the propranolol would be much more effective to have on hand when getting anxiety attacks - a low dose of that should be sufficient to keep any anxiety attacks underway. Just having it on hand can prevent anxiety attacks, knowing that you can take it whenever you need it.

Have you looked into any cognitive behavioral therapy? It sounds like you may be suffering from PTSD. A (not-so) new idea behind PTSD is that there are issues behind context processing, which can be reprogrammed through training. In some CBI courses you work on really simple things in order to improve your memory of events, and it indirectly improves your brains ability to differentiate between your past stressful events and what's happening now. My brother did a course of it, and he said it helped immensely. They focused on really simple things like recalling memories around specific objects, and trying to remember as much detail as possible (both internal and external details). They rarely focused on the actual stressful event that initiated the PTSD.

I would try any of these options out before trying out an anxiolytic SSRI like Cymbalta (I know one person on it and she seems to do okay with it, but she's also prone to flying completely off the hook from time to time).

I think you're right there: I'm essentially suffering from a form of PSTD and should treat myself with that in mind. The initiating event was indeed a massive trauma, and all of my fears are related back to that. I may need to try CBT again, but cyproheptadine seems to be the concensus here, so I'm going to speak to my doctor, who seems to be quite open-mind and has prescribed anti-histamines before.
 

X3CyO

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An aspirin with some baking soda and a redbull gets me goin in the morning with a caffiene theanine pill. Some phenibut added in kicks ****.

I still have anxiety (Asperger like tendencies/social isolation at a young age), but to act normally in society, this stack is more than enough for me (without phenibut primarily.)

PTSD... If thats the case, just keep any eye out on Tianeptine; Ive heard views on it going both ways as bad and good specifically on that. Personally it gave me what id imagine cypro would feel like when i mixed it with my current stack and phenibut.


After taking activated charcoal every other night, anxiety has improved although not drastically.

If its really a big issue, id try using a bcaa with some tyrosine too.

Hell. First things first; if you arent taking a multi... take one. I reccomend the powder from autism coach . com after searching for months for something that wasnt filled with some bs herbs or was mostly inactive forms.
Its not perfect, but its better than all ive seen so far.

Good luck man. I feel for you.
 

Quality

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Not sure if your open to go the herbal road or if you are only after pharma solutions?
Anyway things that I have found effective and sometimes still take:
* Taurine ( higher doses needed ) but can definatly feel a huge weight off your shoulders and takes away possible hostility towards others
* Chamomile tea, zipping it through the day, dont overdo the chamomile tea, it can end up being dulling then. You want to be able to response normally to things and just get rid of the excessive anxiety ( some anxiety is good by the way ).
 

MB50

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I will say that I am not somebody who suffers from anxiety. However, over the past few months I have had more anxiety than normal due to job and school stress, which has also been exacerbated by some days with short sleep/messed up circadian rhythm. Combine this with high dose caffeine experiment I was doing and I was feeling on edge a lot of the time. One of the things that immediately and SIGNIFICANTLY ameliorates this and makes me feel like my normal self is exercise. I have always been an athlete and the lack of movement and exercise is one of the biggest reasons in the shift in how I feel. I know some compromised people should not exercise too much, but for me the benefits of several high intensity workout sessions (I stick to mostly crossfit style workouts or barbell exercises to failure, which while there is an endurance component, it is not endurance running or anything) a week are incredible for my mind/body.

Another thing to remember, feelings are a state and not permanent. They never are. Your body and emotions are trying to tell you something. It could be that your work environment, diet, friends/family, or sleep schedule is not ideal. Once fixed, you will feel better. Take whatever medication or supplements you need for now, but realize that your body and mind are changing by the second and at some point you will need to address underlying issues.
 

tara

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Some phenibut added in kicks ****.
Look out for withdrawal trouble (there are posts if you search). I've never seen Peat recommend phenibut.
 

X3CyO

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Look out for withdrawal trouble (there are posts if you search). I've never seen Peat recommend phenibut.
Forgot to reccomend dosages:
I use .5-.7G sporadically once a week at most, and 1.5 on special occasions once every two or so months. Only withdrawal experienced is sleepiness. Ive heard optimizing dht helps "reupregulate the gaba receptor" phenibut hits very quickly.

I prefer it to alcohol and most drugs. Personally Since using it, my want for other drugs has diminished substantially, as well as for phenibut itself.
 
OP
M

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Thanks to all of you for your advice. You have been very kind.

I'm going to start with Taurine, and maybe try that for a few weeks. I'm hoping that can slow down my brain action a bit: when I'm anxious, that's exactly what I need (and is why Diazepam works so well). I'll speak to my doctor about cyproheptadine too.
 

mattyb

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Thanks to all of you for your advice. You have been very kind.

I'm going to start with Taurine, and maybe try that for a few weeks. I'm hoping that can slow down my brain action a bit: when I'm anxious, that's exactly what I need (and is why Diazepam works so well). I'll speak to my doctor about cyproheptadine too.

Make sure to ask about propranolol. It works great in acute anxiety attacks, even to have on hand as a sort of "safety blanket". I know many people who've had success with it. I'd also consider it very "Peat friendly".
 

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