Posted by g_g_g_unit on March 4, 2011, at 2:54:08
As I've noted on here before - countless times I imagine, so my apologies in advance if you're already familiar with my case history - I've suffered from relatively severe OCD since age 19, and am not exactly a stranger to anxiety. Looking back, however, what I've come to realize is that the hyper-vigilance induced by the OCD became a convenient mechanism for overcoming my ADD symptoms (a theory my psychiatrist very much agrees with).
Since immigrating a year ago though, I've been experiencing a strain of anxiety that's far more insidious, and which basically resembles a 24/7 panic-attack, typically accompanied by feelings of dissociation, mental blankness, a fear of losing control, etc. I am usually the kind of person who will force my way through a problem, but even relatively simple things like journeying into the city or riding a train have now become problematic. I should add that the anxiety has never actually erupted into a real panic attack, thankfully.
Since this problem has arisen, I've tried clomipramine, which didn't help, as well as Buspar, which made me wanna crawl out of my skin, and even Stablon, which again didn't work out. Neurontin completely suppressed the feeling, but was accompanied by daytime sedation, intense apathy, brain fog, etc.
My new psychiatrist is trying to treat my attention issues and has prescribed Dexedrine, which just seemed to push me further into a state of overstimulation, and now Strattera, which isn't as bad Dexedrine, but still seems to leave me in variable states of feeling either stoned and sedated or attentive and wired.
I called him yesterday to update him on Strattera and he said that we'd need to find a way to treat the anxiety. He asked me if I'd ever tried benzodiazepines, to which I replied no, but mentioned the positive reaction I had to Neurontin, and he said he's going to investigate it before our next meeting (since it's more typically prescribed by neurologists).
I'd really prefer not to take Neurontin again. He's under the impression that SSRIs were a total bust for me, but that isn't necessarily true - they simply made my attention a whole lot worse, but given the ADD thing, that retrospectively makes sense.
I was wondering if it would make sense to possibly revisit SSRIs now? Do they work for severe, phobic anxiety? I really can't recall much from the brief amount of time I spent them. I'm not aiming to get rid of the OCD, since CBT helps with that, but I need to find a way to keep my physical anxiety (and the associated dissociation, etc.) under control. From the little amount of research I've done, it seems like low levels of 5-HT (due to depression) might be resulting in a norepinephrine excess.
I really don't want to make my ADD worse or end up in a stupor, so would prefer not to take atypicals or anything. The one I did try - Seroquel - just gave me akathisia anyway.
I was thinking of suggesting Effexor?
Nardil also seems ideal - in fact, I've developed this unfortunate, compulsive fixation on it - but I already tried it about 2 years ago and only lasted 3 months due to the insomnia, etc. I also don't thinking it would be very helpful for ADD; I recall feeling pretty spacey.
Thanks!
poster:g_g_g_unit
thread:980074
URL: http://www.dr-bob.org/babble/20110220/msgs/980074.html