Open-ended Medication Question

[sun seeker]

I wish I could be more specific about this question. Possibly the replies will help me narrow it down.

I'm going through a PTSD exacerbation, and recently met with a psychiatrist who wanted very much to prescribe SSRIs, insisting they are THE treatment for PTSD and will lessen the risk of eventual brain damage. Failing that, she wanted me to look at other types of antidepressants. We came to a compromise and I came away with sleeping pills (Zopiclone, which I've taken for several months now) and Clonazepam amounting to enough to take once every three days. All my request.

I have long lists of reasons for resisting antidepressants of any shape or form, beginning with the considerable and dangerous side effects, continuing with knowing them to be not significantly more effective than placebos, going on with the fact that I have tried several over the years and gotten no benefit from them whatsoever and some pretty severe side effects from some of them. And a few other reasons.

However. I am finding my current regimen not enough. The Clonazepam helps; Benadryl helps; but I can't take either of them enough to keep a steady stream of whatever it is I'm needing to calm down. And I seem to need that pretty much all the time.

I've taken amitryptyline in the past, and it worked, though I found it numbing, and though the claim is it's not addictive, in my case it took six weeks for my sleep to get back to normal after I stopped taking it, much to the surprise of the psychiatrist. I'm toying with the idea of trying it again for a short time to get through the worst of this, though damn it all, it's another three weeks at least until I see the psychiatrist again so I guess that would mean finding a GP. But I really don't want an SSRI - don't want the wait to find the right one - yet again - don't want the potentially devastating side effects. I need something that works fast, is non-addictive, and has minimal side effects.

Just to clarify, yes I have symptoms of major depression, but the anxiety is what is causing me the most distress. It's enough to get in the way of doing other things that might make me feel better.

Any suggestions? This is where the open-ended part comes in. At this point I'm open to anything that stands a chance of stopping this near-constant flooding.

 

[Neverthesame]

I used to use Amitriptyline as my go to drug, until inexplicably stopped working.

While I don't personally suffer withdrawals from it, you most certainly can. Rebound insomnia, definitely is a thing with any drug one uses for sleep. Any drug. Including Benadryl. Though it referred to as a dependence rather than a withdrawal.

Semantics. Is the other term to bear in mind when dealing with doctors and drugs.
Antidepressants are not classified as addictive substances (in Canada at least) as they lack the negative effects as result of use. (while also somewhat untrue) physically they are harmless. Whereas drugs with addictive potential such as heroine, meth, morphine, alcohol, cocaine, nicotine, ect, ect. Are all supposed to be bad for you even if used responsibly.

At least, this was how my doctor explained it to me, after I got upset with her when I realized I had become addicted to the antidepressant she prescribed me. (Effexor, SNRI)

Needless to say I was a tad cross.

Sadly there really isn't a whole lot I can suggest, other than stuff you most likely already are aware of, but here they are just for the sake of being thorough.
- Meditation
- Breathing exercises
- Avoid stimulants like caffeine.
- Excercise
- Avoid alcohol
- Herbal tea

Though there is a thing I did want to mention as you may not know.
I assume you are taking Benadryl drowsy formula (dipenhydramine) for it's sedating effects right?
That could actually be part of your problem, that drug is known to actually exacerbate anxiety/depression for hours after it has "worn off". Especially if you are taking more than the recommended maximum dosage on the bottle. (not saying you are, just as information as it something people frequently do, as the drug is quickly tolerated by the body. I am guilty of doing this with Benadryl)

So while it may be helping with sleep, or keeping you too sedated to fly off the handle about things, it may very well be adding fuel to the fire you are trying to control.

Anyway, just some thoughts.

 

[sun seeker]

Semantics. Is the other term to bear in mind when dealing with doctors and drugs.

Yes, I learned that the hard way, the difference between addiction and dependence. Not something you'd think to brush up on before visiting the doctor wanting ANYTHING to make you feel better.

- Meditation
- Breathing exercises
- Avoid stimulants like caffeine.
- Excercise
- Avoid alcohol
- Herbal tea

You're right - as is the friend who just gave me a list of supplements to try. I feel, though, that this has gotten to another level, and eventually I'd like to be able to manage it more naturally, but at this point it goes deeper than natural treatments can touch. Unfortunately.

I assume you are taking Benadryl drowsy formula (dipenhydramine) for it's sedating effects right?
That could actually be part of your problem, that drug is known to actually exacerbate anxiety/depression for hours after it has "worn off".

Hmm. No, I didn't know that. Thank you. This intensifies my need to look for something else.

Damn it all, why do benzoids have to be addictive when they actually work?!

 

[sun seeker]

It's a toss-up - do I take amitryptyline for a short time because I know it does numb my anxiety, even though it numbs everything else as well, or not because I want to be able to actually feel while working through intensive trauma therapy? Where is the fine line between being calm enough I can have some semblance of a functional life, and being so sedated that I can't focus to work on visualization exercises etc.? Don't know if anyone has an answer to this. If there were an easy answer, we'd all know about it already. Sigh.

 

[City Slicker]

Hi @sun seeker - I don't have too much more to offer except to ask if you are able to do any physical activity, nothing crazy, just even moving your body to give the anxiety something to work against.

Also check out Gabapentin as I didn't see that mentioned in your post. It's originally for seizures but the off-label use by Drs is frequently for anxiety. I know many folks that have had good results, however, your mileage may vary.

Keeping good thoughts for you that you are able to find a combination of things that will work.

 

[Neverthesame]

I hear you, honestly felt bad repeating the list of shit-that-dont-work-when-redlined.

I just can't think of anything better. As yeah, benzos are on my list of things I shouldn't take because I like them too much.

Hopefully someone else may have something better to suggest.

 

[sun seeker]

I don't have too much more to offer except to ask if you are able to do any physical activity, nothing crazy, just even moving your body to give the anxiety something to work against.

I'd like to say yes. The odd (or perhaps not so much?) situation I am working with is although I have extreme anxiety, it manifests in a freeze response. I am both physically and emotionally afraid to move, if that makes sense. I tried just pushing against the desk just now to illustrate to myself what happens, and got an immediate sense of heightened (but more focused) fear, in particular, wanting to scream. Not a bad thing with support, but I'm not sure it's a good thing for me to go that deep on my own.

I'm looking for a medication that will relax me to the point where I can move freely and do other kinds of self care. One thing I like about benzoids is they do relax the muscles, which makes it easier to move. Gabapentin hadn't occurred to me. I'll do some research on that.

I hear you, honestly felt bad repeating the list of shit-that-dont-work-when-redlined.

Well, the thing is they do work, but more as maintenance. I'm more at the stage of "would someone please knock me over the head with a sledgehammer so I can get some relief?" I didn't take offense at all, please no worries there.

 

[sun seeker]

Does anyone take amitriptyline prn? Or does it have to be a steady dose?

 

[Neverthesame]

Does anyone take amitriptyline prn?

I still have a bottle of it from the last time I was prescribed it. I do occasionally drop one when I am too wound up to get even the rubbish non-sleep I'm used to.

I can't say if it's a bad idea or not. Not just because I am unqualified, but also because I really don't know.

I have found it does seem to work as a temporary sedative. I do also want to mention that I am not currently on any other prescribed medication. So I don't have to worry about interactions. Other than a wicked case of heartburn the next day, I have not had a problem doing that. No weird depression or anxiety spikes. I also don't take a full dose either, half max.

So... Yeah. But I can't suggest it...
Because I am unqualified.... If I am making sense... Ya know, saying something without saying something...

Just be careful, antidepressants can do weird shit.

 

[sun seeker]

So... Yeah. But I can't suggest it...
Because I am unqualified.... If I am making sense... Ya know, saying something without saying something...

Yes, I get it. No worries, if I decide to do this I'll check with the pharmacist to make sure there are no drug interactions.