Hello! My brother (he's almost 27) has anxiety attacks when he's around people (my dad had the same problem but was never treated...his sister has agoraphobia and is being treated).

What is the typical protocol for this? He can't stand it and made an appt today to see the dr tomorrow morning (I'll be driving him there). He was adamant about doing something by Monday (he's hoping to go home tomorrow with a prescription).

I know they'll most likely do tests but what tests do they usually do (I'm assuming they'll check his thyroid...my mom's entire family has thyroid disease including myself and my twin brother).

Is it likely he'll get treatment tomorrow? What meds are usually prescribed for this type of anxiety disorder (assuming that's what it is)?

Thanks for any help!

Kelly

Hi,

I was diagnosed many moons ago...I was just a kid and I'm now in my late 30's...but I do remember a few of the tests they did.
Thyroid was one, they also checked for high or low blood sugar...I also had some heart tests, but for the life of me I can't remember which ones!!!

They SHOULD run a number of tests before they tell him that he suffers from Anxiety...since there is no test for Anxiety the only way they can really tell is to rule out everything else.
If he walks in and tells them his problem and they tell him he has Anxiety without any testing, then he needs to find a different Doctor!

As for medication, that varies from Doctor to Doctor.

I wish you and your Brother good luck.

Ditto everything Graciecat said.

The doctor may also decide to go ahead and start your brother on a prescription for either an antidepressant (i.e. Zoloft, Paxil, etc.) or an antianxiety medication (i.e. Xanax, Klonopin, etc.), or a combination of both. The antianxiety medication should give some immediate relief, but will probably make him sleepy until he gets adjusted to the dose. I take Xanax .5 mg. (generic name is alprazolam) and I usually cut them in half if I take them during the day, so I don't get too sleepy.

I also recommend that your brother buy or check out some books on anxiety, panic and agoraphobia. They help to understand the illness and several books give great relaxation techniques that are helpful whether he takes medication or not.

Good luck :)

self help books or tapes on panic disorder have much helpful advice, also see the panic disorders board here
this type of anxiety is often inherited, so your brother shouldnt feel guilty about it

Well, he went to the dr today and they prescribed Effexor. He's starting at 32.5mg and by next week he'll be on 75mg. He has an appt two weeks from now for follow up.

They didn't order any bloodwork because he's not having symptoms outside of the anxiety attacks (he's having 2-3 or more per day).

How do you all feel about Effexor? She initially prescibed Xanax and I expressed concern because we've had family members who literally couldn't function while taking Xanax due to the side effects. I asked about Paxil CR or Zoloft. She was going to prescribe Zoloft (had samples) but came back with a script for Effexor :confused: . I've heard so many good things about Paxil and Paxil Cr that I had hoped she'd try that first.

I was also shocked at the cost of the Effexor :eek: !

Hopefully it'll be helpful for him though. She suggested he see a counselor or psychologist but he told me later that he's not interested in seeing "a shrink".

Thank you for your help!

Kelly

xanax helps a lot and goes well with any antidepressant, sedation is the main side effect and this is dealt with by reducing the dose, everyone needs a different dose of these valium type meds

effexor is as likely to help as any other antidepressant is, paxil is often very difficult to eventually quit
ask if generic effexor is available, if he has problems with taking it, he should halve the dose by splitting the tablet for a while

Well, my brother ended up in ER last night due to a severe anxiety attack. He had only had one dose (32.5mg) of the Effexor but they're assuming it was a side effect of that (it occured about 12 hours after he took it). The ER dr instructed him to stop taking it (as did the pharmacist). His dr is not available until Monday.

They gave him a sedative in the ER and after he had calmed down a little they sent him home. He's still extremely jittery and was wondering if there's anything he can take that would do the same thing the sedative did just so he can get some sleep.

His wife bought him an OTC sleep med but he's nervous about taking it. He doesn't want to make his condition worse than it already is.

Does anyone know of anything he can take? Is it likely that he's going to have this reaction with other anti-depressant/anxiety meds (such as Paxil...which the ER dr suggested)?

Sorry to keep asking questions...I know he really needs to speak with his dr about this but I think just hearing from others who have "been there" will help him calm down a little (I've been relaying the posts to him). He went to a different dr today (they're open 7 days a week) but they said they can't do anything without his records from his other dr (he's only been to the "other" dr once). He's extremely anxious about waiting until Monday to do something about how he feels.

Thank you for your help!

Kelly

anxiety sufferers often have a severe reaction to their first antidepressant tablet, resulting in ambulance trips to hospital, sadly many docs wont accept this can happen
xanax if he has any, will help a lot, OTC sleep aids are mild and cant hurt

if he later tries another antidepressant, effexor is a SNRI type and obviously doesnt suit him, paxil is a proxzac type and may be OK but it has a reputation of being difficult to eventually quit so I suggest prozac which is usually cheaper in generic and just as good

He did end up stopping the Effexor but ended up at ER again last night (my brother has not been to the dr since he was very young, so this is not a habit for him :) ).

They gave him Ativan to settle him down and ran blood tests (came back normal). He went home with a prescription for Klonopin and was told to follow up with his PCP in the morning.

I took him in this morning and they gave him a script for Paxil. We'll see how that goes.

hry33, we've been a little hesitant to have him try the Xanax because we've had family members that have reacted poorly to it (depression and extreme sleepiness). That's what they'll try next though if the Klonopin and Paxil don't help.

I requested thyroid antibody testing for him today and they may do adrenal testing if he hasn't improved some in the next two weeks (he has a follow-up appt then).

Thank you all for your help. I'll post when I have more questions :) .

Kelly

ASDGRMama,

I meant to say this in the first post I made on this thread and I forgot to.

I just wanted to say that you're to be commended for standing by your Brother.
It warms the heart to see someone who doesn't think it's "All in our Heads".

I had a wonderful support system too...well all except one Sister who would tell me to "Just get over it." :rolleyes:
Funny thing is now that I'm better she wants to be my best friend...I don't think so :nono:

I just wish that everyone on this board had caring family and friends like I did and like your Brother does.

Hats off to you!

Kelly...I am very sensitive to meds too, so when I first took Xanax .5 mg. it made me too sleepy. Then, I cut it in half and took it only when I could feel my anxiety climbing. The half (or .25 mg.) was great...made me feel calmer and not too tired. I've heard Klonopin is good, but also can make a person very sleepy. If he is sensitive to meds, like it sounds like he is, the lowest dose will probably be the most helpful.

I also want to suggest he talk to his PCP about trying a beta-blocker med. It is used to control blood pressure, but also is prescribed to people with anxiety/panic problems, and people who are performers or public speakers who have stage fright, because it helps to keep the heart rate steady so the adrenaline won't spike and cause unnecessary panic. I think this is a very valuable medication and worth a try. I take Atenolol and have no side effects that are bothersome.

I hope the next antidepressant will work. I've tried many and they all have side effects that are bothersome to me...Paxil being the worst. I also had to take Xanax and sleeping pills just to counteract the side effects while taking them. It might be a good idea to speak to an actual psychiatrist, not necessarily for therapy if he doesn't want it, but psychiatrists are much better qualified to prescribe psychiatric medications than PCP's. I think a low dose of Zoloft or Prozac would be easier on his system if he wants to try again (I'm not a doctor, that's just my opinion) and also easier on his wallet because they come in generic form.

He needs to learn more about these attacks so he won't get so scared he ends up in the ER. With the help of meds like Klonopin or Xanax, he can learn calming breathing techniques to help himself relax. I know this is scary, but as long as his heart and general health are checked out and okay, panic attacks are a bummer, but they won't kill him. When he understands he'll be okay, the attacks will start to be less severe.