SSRI

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I thought you said panic disorder is something we need to solve within ourselves? But clearly that approach is not working for you. And it is generally not working for me during this flare. I've studied it for 2.5 yrs now and I'm not so sure it is ever simple. But you could try the SSRI and please report back! Could you list things you've tried?? Panic attacks can be caused by an overactive stress response. What is your diet like? I think I definitely react to foods and causes my nervous system to be on fire. Now to find out what those sensitivities are you just have to keep a very detailed food log which I've been doing now for a long time since this started. One thing that is very common in all them are things like chocolate, too much caffeine, too much protein like beef, in fact I think the beef yesterday is why my nervous system is crazy today. But it wouldn't happen so strongly if I was well fueled to begin with which I'm not. How many calories do you typically eat?

If I try Citalopram I'll make sure to let you know how it goes. I'm seeing my GP tomorrow so it's possible I'll be starting soon.

The point I wanted to make was that we can spend a lot of time on health forums at the expense of real self-examination. This was a realisation I had. I've recently been keeping a diary and I think the idea that maybe I should try an antidepressant has come from that.

I'm definitely getting enough calories and no matter what I eat, I'm still prone to anxiety. I've realised that the problem is not going to be solved by eating well. In my case, I suffered a massive trauma back in 2013 and I've basically never got over it. I've had better periods which were only possible because of Diazepam. I'm developing agoraphobia now, and need something which will profoundly alter my brain chemistry. I think antidepressants may be the way to go. Maybe in your case, fine-tuning your diet to identify possible triggers is what will work, but it hasn't for me. In fact the stress if trying to work it out has possibly made things worse, or clouded my vision.
 
OP
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Low dose SSRI (subtherapeutic in a mainstream sense) have helped some people, and this study, published in an important journal, seems to explain why:
http://link.springer.com/article/10.1007/s00213-005-0213-2

Also consider asking a doctor for adjuvant therapy with t3:
Fluoxetine and norfluoxetine stereospecifically and selectively increase brain neurosteroid content at doses that are inactive on 5-HT reuptake
Liothyronine - Wikipedia

Thanks for the studies, I'll check them out.
 

InChristAlone

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Here is a list of things to try as well. TREATING ANXIETY SAFELY & EFFECTIVELY - Mental Health someone mentioned they have severe panic disorder in that thread and Bacopa was helpful.
Just thought I'd give more options. I was on lexapro as a young adult and it worked for a while to blunt the emotions, also made me want to sleep all the time at first. But after about 9 months I became extremely depressed, there was absolutely no life left in me. While I didn't have panic disorder back then, I think those drugs should only be used short term to get you out of a slump.

If I try Citalopram I'll make sure to let you know how it goes. I'm seeing my GP tomorrow so it's possible I'll be starting soon.

The point I wanted to make was that we can spend a lot of time on health forums at the expense of real self-examination. This was a realisation I had. I've recently been keeping a diary and I think the idea that maybe I should try an antidepressant has come from that.

I'm definitely getting enough calories and no matter what I eat, I'm still prone to anxiety. I've realised that the problem is not going to be solved by eating well. In my case, I suffered a massive trauma back in 2013 and I've basically never got over it. I've had better periods which were only possible because of Diazepam. I'm developing agoraphobia now, and need something which will profoundly alter my brain chemistry. I think antidepressants may be the way to go. Maybe in your case, fine-tuning your diet to identify possible triggers is what will work, but it hasn't for me. In fact the stress if trying to work it out has possibly made things worse, or clouded my vision.
Ok, try it out, let us know how it goes, I may need an intervention as well. My phobias seem to surround eating and having a reaction, which is quite possibly the worst phobia to have because you have to eat to survive! I can usually do tapping to get out of it, but I've never experienced such strong nervous system stress lately. I've basically stayed home the last 4 weeks, trying to get better.
 
OP
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Here is a list of things to try as well. TREATING ANXIETY SAFELY & EFFECTIVELY - Mental Health someone mentioned they have severe panic disorder in that thread and Bacopa was helpful.
Just thought I'd give more options. I was on lexapro as a young adult and it worked for a while to blunt the emotions, also made me want to sleep all the time at first. But after about 9 months I became extremely depressed, there was absolutely no life left in me. While I didn't have panic disorder back then, I think those drugs should only be used short term to get you out of a slump.


Ok, try it out, let us know how it goes, I may need an intervention as well. My phobias seem to surround eating and having a reaction, which is quite possibly the worst phobia to have because you have to eat to survive! I can usually do tapping to get out of it, but I've never experienced such strong nervous system stress lately. I've basically stayed home the last 4 weeks, trying to get better.

Wow, that's a really comprehensive list, thanks. Interesting that the only SSRI he advocates as being both safe and effective is Escitalopram (ie. Lexapro, what you were on), not Citalopam. Something I ought to talk to my GP about.
 
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allblues

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With my n = 1 of a bad experience with sertraline, the studies i've read and others' testimonies i'd strongly recommend against taking these drugs before trying tri/tetracyclics, or other things. Risk of personality changes, numbing, sexual dysfunction, bone loss (!), to name just a few. Inhibiting and downregulating the serotonin transporter as these drugs do seems unwise.

I've had OCD and panic disorder issues myself so i understand wanting to get help, but in hindsight having tried them myself, i'd definitely exhaust most other options before trying an SSRI.
 

PeatThemAll

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Wow, that's a really comprehensive list, thanks. Interesting that the only SSRI he advocates as being both safe and effective is Escitalopram (ie. Lexapro, what you were on), not Citalopam. Something I ought to talk to my GP about.

Whoah. Some Peat-land regulars: Taurine, Caffeine, Niacinamide... to be avoided. And I haven't made through all the list yet.
 
OP
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With my n = 1 of a bad experience with sertraline, the studies i've read and others' testimonies i'd strongly recommend against taking these drugs before trying tri/tetracyclics, or other things. Risk of personality changes, numbing, sexual dysfunction, bone loss (!), to name just a few. Inhibiting and downregulating the serotonin transporter as these drugs do seems unwise.

I've had OCD and panic disorder issues myself so i understand wanting to get help, but in hindsight having tried them myself, i'd definitely exhaust most other options before trying an SSRI.

What did you take Sertraline for? Did you try another SSRI when it didn't work? Also how long were you taking it for?
 

allblues

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What did you take Sertraline for? Did you try another SSRI when it didn't work? Also how long were you taking it for?

I had OCD issues, anxiety, depression, some panic attacks. I took it for about 2 years, ages 18-20ish. Didn't realize things weren't going well until it was obvious. Never tried another one.
I have taken mirtazapine & cyproheptadine earlier this year, mainly for depression/anxiety, OCD isn't an issue anymore.
 

InChristAlone

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Yeah the list includes anything that is a GABA agonist is to be avoided. But I think a lot of people do well on niacinamide or taurine or some of the herbs, but I've heard of tolerance building up to everything besides niacinamide which is a nutrient not a drug.
 
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Can you expand on this? I'm assuming your suggestion is that doctors are misinformed and so I shouldn't listen to them.

If you feel such a reliance on them... then this forum won't be much help I'm afraid...
 
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If you feel such a reliance on them... then this forum won't be much help I'm afraid...

I take your point, but it's not quite so black and white for me.
I certainly don't take what my doctor says as gospel, but she's perhaps better informed than most and has been very helpful to me. As has this forum!
 

InChristAlone

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I think you might be desperate for something to work, but really the SSRI will only be bandaid just like everything else. Use it wisely to get you out living your life, then slowly wean off. I think our brains can be healed. Our body is shouting at us for a reason and we should tune in, listen to what it is saying. You should get help from someone who wants to see you completely healed not just get you on prescriptions. Thats my honest opinion. Its why I've been doing all my work on my health by myself all these years.
 
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I take your point, but it's not quite so black and white for me.
I certainly don't take what my doctor says as gospel, but she's perhaps better informed than most and has been very helpful to me. As has this forum!

Even if it were an option for the doctor to prescribe this kind of stuff (which it isn't), you can't just go to the doctor and ask what you want... they aren't pharmacists... especially if you trust their judgement...
 

TurtleNeck

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Serotonin is highly involved in hibernation, lowering body temperature and more.

Serotonin is fattening and triggers insulin resistance.

Serotonin plays a primary role in seasonal affective disorder (SAD)

Serotonin causes depression

Serotonin exacerbates and may even cause asthma

Serotonin may play a causal role in schizophrenia, autism, and countless other neurological disorders.


Just a short list but SSRI's seem really dangerous.
 

TurtleNeck

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Consider this too


Its so hard to tell what medication is the best for someone. The only way to tell is by using it unfortunately. Personally, the best drug there is in my opinion is Stablon (tianeptine). I've been researching alot about how the brain works and used most of my energy of the last year doing just that. I have to admit, it became a little bit of an obsession for me, allthough i rather like to call it a survival mechanism. I lived a crappy life due to this disorder so my one and only priority is/was to get better. I don't want to brag but my psychiatrist admitted I probably know more about my condition then she does.

Anyway theoraticly speaking stablon is the number one drug to try because:

- It's proven to induce neurogenisis ("brain healing") in areas of the brain that are damaged by stress. Other antidepressants do this aswell, and it is now believed it might be there sole mechanism of action. Stablon however does this in a stronger degree.

- Stablon doesn't mess with your monoamine transporters or responders. It does enhance the reuptake of serotonin (opposite of an ssri) and thereby increasing dopamine by a small amount. This means stablon has hardly any side effects, if not none. It doesnt cause agitation in the first weeks, it doesn't cause sedation, it doesn't cause sexual side effects and it doesn't cause cognitive problems.

- Stablon lowers cortisol levels where SSRI's higher them. Cortisol is one of the reasons we get anxiety symptoms.

- Stablon doesnt cause dependance or withdrawal effects.

- Stablon's toxicity is extremely low. Some people have taken over 60 amounts of the recommended dose without serious problems.

- Stablon usually starts working a little faster then SSRI's. For some people in less then a week. The long term benefits however take time.

So why its not available in the US? I garantuee you the only reason is money. For detail about this story and more info on this drug, look at the independant website tianeptine.com. I ordered it from the internet, and while i dont recommend this without really researching this drug i'm glad I did. I'm on it for 2 weeks and i begin to notice the first subtile changes, especially regarding mental clarity and a slight decrease in depression and anxiey. My pdoc knows i'm using it, and she's understanding. She admitted this drug seems like a very good one and also agrees about the reason it is not available in some countries.

And of course, medication alone will note cure you. But combined to therapy and/or coping stategies it can be a very useful tool.
 

khan

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Low dose SSRI (subtherapeutic in a mainstream sense) have helped some people, and this study, published in an important journal, seems to explain why:
http://link.springer.com/article/10.1007/s00213-005-0213-2

Also consider asking a doctor for adjuvant therapy with t3:
Fluoxetine and norfluoxetine stereospecifically and selectively increase brain neurosteroid content at doses that are inactive on 5-HT reuptake
Liothyronine - Wikipedia

How much low dose of Fluoxetine is required in mg's to
increase brain neurosteroid content without inhibiting 5ht?
 

LeeLemonoil

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I see I double posted the study, here is what I wanted to add:
T3 augmentation of SSRI resistant depression

T3 augmentation of SSRI resistant depression. - PubMed - NCBI

I have only anecdotal evidence regarding the low-dose/upping neurosteroid approach, and it's with Sertraline, with which 10-15mg seem sufficient. I have tested it on myself and I occasionally pop 10-15mg of Sertralin before sleep when I expect a very stressful day. It induces a nice calm and is in act energizing. But I only do this maybe a dozen times a year.

Here is a study of dose-equivalents of SSRIs, don't know if this is applicable:
http://www.jad-journal.com/article/S0165-0327(15)00151-2/abstract

40mg of Flux = 98,5mg of Sert. So maybe 4-5mg of Flux? Try it out and see if you notice any effects.
 

allblues

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I remember Ray saying in a KMUD-interview that the "irritation in the brain" from the SSRIs would be the mechanism for increasing the neurosteroids. I don't know the sources for making that claim, but it's something to consider.
 

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