Posted by Elizabeth on April 20, 2002, at 10:34:31
In reply to Bi polar or depression/anxiety, posted by Marie416 on April 11, 2002, at 16:06:29
I agree with what everybody else has said. :-)
A lot of people who have panic attacks have difficulty tolerating SSRIs and Effexor -- they feel nervous, agitated, wired, "jumping out of my skin"-ish when they take these ADs. Sometimes TCAs cause this too, although less often. It doesn't necessarily mean you're bipolar.
The jitteriness goes away with time (whereas a bipolar person could get worse and perhaps start rapid-cycling), but often if you're going to treat panic disorder with ADs, you have to start out at a low dose and increase it very slowly. By "low" I mean, say, 12.5 or 18.75 mg of Effexor (half of a 25- or 37.5 mg immediate-release tablet), taken twice a day. By "slowly" I mean "as tolerated" -- if a particular dose makes you a little jittery, for example, you don't want to try raising it until you adjust to that dose. Note that this can be very frustrating and can take a **long** time. Some people are never able to tolerate antidepressants.
Also, Wellbutrin isn't an effective treatment for panic disorder. It is a very jittery, stimulating drug for a lot of people, though. Like Kate, I felt jittery and yucky when I tried Wellbutrin (some of my symptoms also got worse, notably sleep and appetite). Now I take Effexor. I didn't get jittery on it until I increased the dose from 300 to 375 mg/day. I went down to 337.5 for a while, and then when I increased it to 375 afterwards (the dose I'm on now), I was okay.
If one type of treatment doesn't work for you it doesn't necessarily mean the diagnosis is wrong. Unfortunately, it's difficult to predict what will work for whom, even within a diagnostic category. Have you tried anything besides Effexor and Wellbutrin?
best wishes,
-elizabeth
poster:Elizabeth
thread:102783
URL: http://www.dr-bob.org/babble/20020416/msgs/103636.html