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  • What makes a doctor decide on a certain anxiety med?



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    Old 01-13-2009, 04:13 PM   #1
    Lourage
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    What makes a doctor decide on a certain anxiety med?

    Like, i read up on here a million posts of people going to the doctor and being prescribed this or that first. Some say they were given lexapro, others time it's a different anxiety med altogether and not a SSRI. But what i'm wondering is what is the guidelines they use on which a doctor prescribes, is it just by what they have seen work for other people? Like why isn't whats usually prescribed first, such as an SSRI , not always a first choice from one doctor. My old psychologist actually told me it has to do with what company pays them more money when they prescribe their medication, but thats scary to think and he was anti-medications to begin with, so who knows.

    Like i was prescribed lexapro first, then paxil, then my doctor didn't even want me to try anymore SSRi's and go right to Effexor, which is a SSNRI. Yet other doctors will have a patient go through as many SSRI's as possible before moving onto something different.Then you have the doctors who will have a patient start out on something like Buspar, or something thats more along the lines of a OCD medication. Is it pretty much just a personal preference on how a doctor wants to start anxiety treatment?

    Last edited by Lourage; 01-13-2009 at 04:14 PM.

     
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    Old 01-13-2009, 04:23 PM   #2
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    Re: What makes a doctor decide on a certain anxiety med?

    That's an interesting question to pose. I went to the doctor yesterday and he prescribed me BuSpar. He originally wrote me a prescription for Xanax but then decided on the BuSpar instead. He said that he didn't feel comfortable giving me a benzo because I am already taking Celexa, an SSRI. However, I did some research at home and found several websites saying that taking Celexa and BuSpar together can be a dangerous combination because it can lead to the developement of Serotonin Syndrome. So I don't know..I think it may depend on the severity of your anxiety or if you are currently taking any other psychotropic medications.

    *~ Krystal

     
    Old 01-13-2009, 04:43 PM   #3
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    Re: What makes a doctor decide on a certain anxiety med?

    Damn! that reminds me of what i'm dealing with right now. My doctor prescribed me Effexor ( i didn't know about the side effects until recently, i'm usually not one to worry, cause i don't really get side effects from medication, but the stories i read... I'm definitely going to tell her i'm not going to be taking them)

    But the fact that she prescribed them, and i'm on a beta- blocker, i read they interact! and the effexor can actually cause high blood pressure and negate the effects of the beta blocker. I worry enough about my blood pressure that spikes from anxiety, i don't need constant high blood pressure in my life! Why would a doctor even do that though? like they should know what meds interact with other meds. Next time i'm going to go with a list of some meds i read about working for people, and see what she says! cause i mean, It just seems like some doctors have no clue when it comes to prescribing anxiety medications. Wish i could find a good psychiatrist in my insurance network.

    But yea, it seems like when you ask " hey i heard about this medicine, maybe we should try that" they just change the subject and be like " well lets try this or that instead" and just ignore what you ask! and not even talking about benzos, like SSRi's! whats the difference anyway on what you try and why do they decide on something that seems so out of left field sometimes i wonder? I doubt the doctor is reading anxiety boards in her off time like some of us and know what might work better than something else, man it has to have something to do with contracts or something the medication company pays them to prescribe their medicine i bet. I'll know for sure next time when i ask about a different med. I'll be like " ok you are 0-3 with prescribing the medication, now can i ask to try something that i heard works well for others" LOL ok i probably wont say that, but i'm just trying to make a point. I keep telling these doctors, get me off this beta blocker metorpolol and let me try propanolol! everything i read says it's the best type of beta blocker for anxiety symptoms! BUT nope! " try labetalol instead" 5 days later my BP was elevated and my heart rate was jacked!

    Last edited by Lourage; 01-13-2009 at 04:45 PM.

     
    Old 01-13-2009, 07:17 PM   #4
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    Re: What makes a doctor decide on a certain anxiety med?

    "Why would a doctor even do that though? like they should know what meds interact with other meds. Next time i'm going to go with a list of some meds i read about working for people, and see what she says! cause i mean, It just seems like some doctors have no clue when it comes to prescribing anxiety medications."

    I couldn't agree more!!! It's so frustrating because you put trust into your doctors to decide what is medically best for your specific situation, and at times, it seems as though they aren't thinking within your best interest. For example, I went the doctor yesterday about SEVERE anxiety and panic attacks that I think were largely due to the fact that I was very recently raped. Any tramatic experience is probably going to induce severe anxiety problems. So instead of prescribing me a medicine that works quickly and effectively for severe anxiety, he ultimately decided to give me BuSpar which is ineffective for severe anxiety and can take a few weeks to a month to notice any changes in anxiety levels. Even with that, it still isn't as effective as lets say Xanax or Klonopin. Not to mention that it can pose as a fatal combination with Celexa, my anti depressant. It bothers me to know that some doctors are so willing to pass out medicine without really knowing what they're giving people. It's not only unsafe, but it's unfair to the people that put their trust into these health care professionals to make the best medicinal choices possible.

    *~Krystal

     
    Old 01-13-2009, 08:43 PM   #5
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    Re: What makes a doctor decide on a certain anxiety med?

    Wow...I'm sorry that happened to you. It's crazy but i don't understand why doctors wont even give like a months supply of something like xanax, and or klonopin just to see how you react, and for people who really need it? If they are so worried about their patients getting hooked ( which makes no sense, since they prescribe a SSRI which also makes people hooked) then why wouldn't they prescribe something that helps them get through the day? Next time tell them that you are going to to just drink cause thats the only thing that helps settle your anxiety. To this day, after trying a bunch of SSRI's .. the only thing that has helped my anxiety has been alcohol! and i don't feel like drinking myself to death. But my docs have yet to find the right medication for me.

    Last edited by ms_mod; 01-14-2009 at 07:57 AM. Reason: Don't discuss what a Mod might or might not delete!

     
    Old 01-14-2009, 08:09 PM   #6
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    Re: What makes a doctor decide on a certain anxiety med?

    "the only thing that has helped my anxiety has been alcohol!"

    I know that feeling all too well. Ever since the rape I've been drinking quite excessively, especially at night when my anxiety is the worst. It's awful...I'm sorry you haven't been able to find a successful treatment for your anxiety. Have you gone to therapy before? I know it can be frustrating, but just hang in there. They will get it right sometime.

    *~Krystal

     
    Old 01-14-2009, 08:20 PM   #7
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    Re: What makes a doctor decide on a certain anxiety med?

    Yes! i been to a psycologist who tried hypnotizing me lol. I can't be hypnotized, I'm too anxious. He thought itwas working even though i would just lay there fully awake and aware, being told the same things over and over again.( heck for 185 bucks for a half hour i would tell someone it's working too if i was paid that!) Plus ,most of the time he did it i would hear him ruffling around with paperwork LOL. The CBT was also a joke with him, it was just one on one with him. It was too much money also, and i have like NONE in my insurance network. He was out of network. Wish i could find a good pysch in my network and get the good stuff! Not the ever so common "lets try lexapro" you always hear from a GP doctor. I need to be sedated lol

    About the drinking, i cut back to once a week ( still need to have friends and thats what we do lol) but there were times when my anxiety was so bad i was drinking daily! I exercise all the time now and that makes me not want to drink as much. Even though i cut back to once a week, when that day comes i can polish off like 14 beers with no problem ( i'm only 150 pounds, 5'5") I even need to have a few before going to my friends house, the few times i went sober i felt like i was going to have an anxiety attack in the car everytime. It's getting worse and my metabolism is WAY to high! hence the need for some anxiety medication that works, before i have no liver left! Then i would atleast be able to hang out with friends and not have to drink to keep my anxiety at bay.

    I have this script for effexor but i don't know about it.

    Last edited by Lourage; 01-14-2009 at 08:31 PM.

     
    Old 01-15-2009, 05:42 PM   #8
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    Re: What makes a doctor decide on a certain anxiety med?

    Remember, dr's are practicing medicine and I tend to think they prescribe med's that they are familiar with. I have and have always had side affects to medicines--so it has been a difficult time over the last 5-6 years for me. Even on medications, I still have deep depression, anxiety, and I socially withdraw from everything.

    I take effexor xr daily, with generic xanax as needed. I take ambien cr at night and the occasional muscle relaxer when my body is tense. This tenseness is from anxiety--I have no doubt. My muscles get so tense and flairs up neck and back problems all of the time. When I have to take muscle relaxers--even just one, I sleep for over 12 hours and am in a fog after waking.

    If I take too many xanax, I get headaches--so I have to be careful with them--plus the grogginess I get from taking them.

    Anxiety and depression is a vicious cycle to be in. It sucks!!!

     
    Old 01-15-2009, 06:51 PM   #9
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    Re: What makes a doctor decide on a certain anxiety med?

    I finally got up enough courage to decide i'm going to go ahead and start my effexor. I don't want to wait until the 26th. I need to start getting this in my system, but i'm just worried cause i also take metoprolol for BP spikes ( brought on by anxiety) and everything i read says effexor interacts with metoprolol ( only by making it less effective) So now i'm even more anxious and going to be worrying even MORE about my blood pressure lol i can't win, but i know i'm going to have to feel even more worse before i start to feel better.

    I just took the dose a few minutes ago and already feel like my BP is up ( just cause i'm stressed about what will happen) I know it can't already be the med, and that it's in my head. But i feel hot right now. - like that lol.

    But now after reading about people taking it at night, most say morning is better. So evene though i took it tonight, can i take it again tomorrow during the day and start taking it during the day? I usually take my metoprolol in the morning. I don't know what i'm going to do if it makes my beta blocker less effective. I guess go on another one? I really want to give this effexor a chance now, as who knows, maybe it can be the right med for me

    Last edited by Lourage; 01-15-2009 at 06:51 PM.

     
    Old 01-15-2009, 09:13 PM   #10
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    Re: What makes a doctor decide on a certain anxiety med?

    lol, ok i'ts been a few hours now and i feel perfectly fine. Not hot anymore, i did take my BP like a half hour later and it was 145/76 with a pulse of 76, so yea i was nervous. I just took my nightly dose of metoprolol along with my omega 3 supplements and just even taking that beta- blocker for some reason just calms me down! even though it doesn't work that fast, just the fact of taking it i relax , i guess cause i know relief is coming and my heart wont be racing anymore, well atleast for a while, while it lasts.

    So like with every anxiety med and when i start it my doc needs to see me two weeks after starting, for dose changes/make sure i don't start talking to trees or start bugging out on it. But will i know with effexor if it's starting to work by then? two weeks seems too short. I started on 75 mg too.

     
    Old 01-16-2009, 12:42 PM   #11
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    Re: What makes a doctor decide on a certain anxiety med?

    I doubt it has anything to do with the effexor, but last night i got NO SLEEP! Maybe 3 hours! Anyways , i took another dose of effexor around 1 pm along with my beta blocker Metoprolol. Once again i was nervous. I feel out of it today, BUT it can't be from the effexor already, and i'm going with getting no sleep as causing it. My eyes feel weird, and i feel depersonalized sort of.

    So i thought " yep, my BP has to be high" I took it and it's 112/66! pulse of 68!! which is really good, but see how my brain works and how messed up i am? I even think and "FEEL" it's high when it's not. I hope i don't get permanent high BP though while on this.

    Last edited by Lourage; 01-16-2009 at 12:43 PM.

     
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