Where To Treat For Anxiety With Ssri

[drronnie]

At the time being I am having problems dealing with my anxiety. My doctor at the hospital has prescribed me with Xanax so that I can calm down and sleep. However i am not happy to take this as it is addictive and the medicine becomes useless once there is a tolerance.

Is there anywhere in Bangkok where I can be treated with SSRI selective serotonin reuptake inhibitor which is a safer way to treat my anxiety. Thanks for help

[Benjie]

Xanax will be OK for a short course and often a quick blocking of the anxiety will allow yourself to settle into a state more normal within a few weeks.

SSRI's will likely take a few weeks to even start to work, may well make you more anxious to start with and will likely be a longer course that is useful if you will be going to some sort of therapy to sort out the underlying causes of the anxiety.

Any medicine that you rely on to combat anxiety will have addictive properties, in that relying on a medicine to stop you from feeling bad will obviously make you want to continue taking the medicine.

I'm not a Doctor but If I was you I would follow the prescription, it may well be that once the Xanax has taken off the edge your Dr might move you onto a SSRI.

[FBN]

SSRIs may increase anxiety initially and it may be useful to use Xanax either in combination with one of the SSRIs for a short time or just Xanax alone; also short time as it also has a mild anti-depressant effect.

It can cause dependency problems and, as with all these drugs, need to be taken in the smallest dose that will do the job and for the shortest time needed.

[pete66]

SSRIs may increase anxiety initially and it may be useful to use Xanax either in combination with one of the SSRIs for a short time or just Xanax alone; also short time as it also has a mild anti-depressant effect.

It can cause dependency problems and, as with all these drugs, need to be taken in the smallest dose that will do the job and for the shortest time needed.

Any SSRIs available in BKK pharmacies, round Nana for instance? List courtesy of wikipedia:

--------

* citalopram (Celexa, Cipramil, Cipram, Dalsan, Recital, Emocal, Sepram, Seropram, Citox)

* dapoxetine (no trade name yet; not yet approved by the FDA)

* escitalopram (Lexapro, Cipralex, Esertia)

* fluoxetine (Prozac, Fontex, Seromex, Seronil, Sarafem, Ladose, Fluctin (EUR), Fluox (NZ), Depress (UZB), Lovan (AUS))

* fluvoxamine (Luvox, Fevarin, Faverin, Dumyrox, Favoxil, Movox)

* paroxetine (Paxil, Seroxat, Sereupin, Aropax, Deroxat, Rexetin, Xetanor, Paroxat)

* sertraline (Zoloft, Lustral, Serlain)

* zimelidine (Zelmid, Normud)

----------

Also, is the supplement 5-HTP available?

Edited September 5, 2009 by pete66

[losworld]

Prozac does not work in majority of depressed patients

The antidepressant Prozac and related drugs are no better than placebo in treating all but the most severely depressed patients, according to a damaging assessment of the latest generation of antidepressants.

SSRIs, or selective serotonin reuptake inhibitors, were supposed to revolutionise care of depression - by treating symptoms without the side effects of older drugs, such as tricyclics.

But despite selling in vast quantities, a new meta-analysis of these drugs, from data presented to the US Food and Drug Administration (FDA), appears to suggest that for most patients they do not work. A previous study had indicated that the benefits of antidepressants might be exaggerated.

UK and US researchers led by Irving Kirsch of Hull University, UK, studied all clinical trials submitted to the FDA for the licensing of the four SSRIs: fluoxetine (Prozac), venlafaxine, nefazodone, and paroxetine (Seroxat or Paxil), for which full datasets were available.

They conclude that, "compared with placebo, the new-generation antidepressants do not produce clinically significant improvements in depression in patients who initially have moderate or even very severe depression".

<h3 class="crosshead">Dishing out drugs</h3> They did detect some benefits in the most severely depressed patients. But conclude that in this group the small effect is "due to decreased responsiveness to placebo, rather than increased responsiveness to medication".

Given these results, they say that there is little reason to prescribe SSRI medications to any but the most severely depressed patients.

David Healy, a psychiatrist at Cardiff University, UK, specialising in the use of SSRI drugs, says the latest study confirms suspicions that the drugs' effectiveness had been dramatically overstated.

"Most importantly this new study shows that the people who did respond to the drugs would have responded to placebo, anyway.

"It confirms that GPs should not be dishing these drugs out as first-line treatment for mild depression," he told New Scientist. The drugs were, he notes, "routinely being given to people who would get better without them".

<h3 class="crosshead">Positive results</h3> Eli Lilly, which manufactures Prozac, says that "extensive scientific and medical experience has demonstrated it is an effective antidepressant". It adds that: "More than 50 million people with depression have been treated with Prozac since its launch."

A spokesman for GlaxoSmithKline, which makes Seroxat, points out that the study only looked at a "small subset of the total data available".

Healy notes however, that drug companies have tended to publish studies showing positive results of the SSRIs in mildly depressed patients.

He says too that there have been concerns that SSRI drugs, particularly paroxetine, may cause dependence in some patients, and this underlines the need to avoid their unnecessary prescription.

<h3 class="crosshead">Placebo benefit</h3> Healy warns however, that anyone taking SSRI antidepressants should not suddenly stop taking their medication and should consult their doctor before coming off the drugs.

David Nutt, a psychopharmacologist at Bristol University, UK, points out that if SSRIs provided some sort of placebo benefit, this should not be discounted. He notes that "the true drug effect is that of the drug added to that of placebo which is not the same as no treatment".

Earlier this month, New Scientist reported claims by US lawyers that they had obtained documents suggesting that an inappropriate analysis of clinical trial data by researchers at GlaxoSmithKline had obscured suicide risks associated with paroxetine for 15 years.

[drcracknell]

At the time being I am having problems dealing with my anxiety. My doctor at the hospital has prescribed me with Xanax so that I can calm down and sleep. However i am not happy to take this as it is addictive and the medicine becomes useless once there is a tolerance.

Is there anywhere in Bangkok where I can be treated with SSRI selective serotonin reuptake inhibitor which is a safer way to treat my anxiety. Thanks for help

most of the replies deal with treating the symptom

get to the cause

have you tried meridian tapping ? free download at www.emofree.com

a practioner (hypno stherapist, meridian tapping therapist and most psych therapists) will help immensely

castor oil packs on the abdomen will raise serotonin levels ( as will acupuncture and SCENAR therapy)

but again medications will not alleviate the dis-ease - get to the 'root' of the cause

yours in health

Richard

[Sheryl]

SSRIs may increase anxiety initially and it may be useful to use Xanax either in combination with one of the SSRIs for a short time or just Xanax alone; also short time as it also has a mild anti-depressant effect.

It can cause dependency problems and, as with all these drugs, need to be taken in the smallest dose that will do the job and for the shortest time needed.

Any SSRIs available in BKK pharmacies, round Nana for instance? ..................

Also, is the supplement 5-HTP available?

Sertraline (in both brand name Zoloft and a less expensive generic), paroxetine (under nrand name Seroxat) and fluoxetine (under brand name Prozac and several local generics) are all available at any pharmacy and do nto require a prescription in Thailand. I definitely do not recommend fluoxetine tho due to its long half life which makes it slow to take effect and also hard to taper the dosage.

That said, note FBN's comments re SSRIs and anxiety. If anxiety rather than depression is your main complaint treatment with SSRIs is likely to make matters worse at first. Management of the combination of anxietry and depression is tricky and best done under the care of a qualified mental health professional.

I think (not 100% sure) you can get 5-HTP at GNC.

You can also get Valerian, an herbal treatment for anxiety that is mild but effective for many people, at GNC and also at many Boots and other pharmacies, Mega brand.

Another group of drugs which are sometimes used to manage severe anxiety are the newer anticonvulsants such as Gabapentin and Lyrica. Lyrica in particular has been found effective in treatment of anxiety disorders that do not respiond to other drugs. These meds have significant side effects and are indicated only for true anxiety disorders as opposed to the temporary anxieties that most people experience from time to time. Altho I believe they are sold OTC, self-medication is not advisable; if you have a severe enough anxiety diosorder to need that level of treament you should find a good psychiatrist to oversee your care.

Anxiety is an alarm signal from your mind, telling you that all is not well. While it is sometimes necessary to take something temporaily to enable you to function, it is important not to lose sight iof this basic fact. If a smoke alarm began ringing in your house, you would not respond by putting in ear plugs -- you'd investigate the source of the smoke and take care of the cause. Likewise, anxiety. Need to respect the warning it represents and find out where the problem lies and attend to it. Unfortunately the anxiety itself makes this hard to do since it clouds the mind and distorts thinking. This is why a trained therapist is so helpful. Please see the pinned list of such in LOS.

Other measures that are helpful: go easy on caffeine and sugar (inlcuding white rice/white bread/pastas) , eat meals high in protein, don't skip any meals. This will help keep your blood sugar stable which in turn helps reduce feelings of anxiety.

[pete66]

SSRIs may increase anxiety initially and it may be useful to use Xanax either in combination with one of the SSRIs for a short time or just Xanax alone; also short time as it also has a mild anti-depressant effect.

It can cause dependency problems and, as with all these drugs, need to be taken in the smallest dose that will do the job and for the shortest time needed.

Any SSRIs available in BKK pharmacies, round Nana for instance? ..................

Also, is the supplement 5-HTP available?

Sertraline (in both brand name Zoloft and a less expensive generic), paroxetine (under nrand name Seroxat) and fluoxetine (under brand name Prozac and several local generics) are all available at any pharmacy and do nto require a prescription in Thailand. I definitely do not recommend fluoxetine tho due to its long half life which makes it slow to take effect and also hard to taper the dosage.

That said, note FBN's comments re SSRIs and anxiety. If anxiety rather than depression is your main complaint treatment with SSRIs is likely to make matters worse at first. Management of the combination of anxietry and depression is tricky and best done under the care of a qualified mental health professional.

I think (not 100% sure) you can get 5-HTP at GNC.

You can also get Valerian, an herbal treatment for anxiety that is mild but effective for many people, at GNC and also at many Boots and other pharmacies, Mega brand.

Another group of drugs which are sometimes used to manage severe anxiety are the newer anticonvulsants such as Gabapentin and Lyrica. Lyrica in particular has been found effective in treatment of anxiety disorders that do not respiond to other drugs. These meds have significant side effects and are indicated only for true anxiety disorders as opposed to the temporary anxieties that most people experience from time to time. Altho I believe they are sold OTC, self-medication is not advisable; if you have a severe enough anxiety diosorder to need that level of treament you should find a good psychiatrist to oversee your care.

Anxiety is an alarm signal from your mind, telling you that all is not well. While it is sometimes necessary to take something temporaily to enable you to function, it is important not to lose sight iof this basic fact. If a smoke alarm began ringing in your house, you would not respond by putting in ear plugs -- you'd investigate the source of the smoke and take care of the cause. Likewise, anxiety. Need to respect the warning it represents and find out where the problem lies and attend to it. Unfortunately the anxiety itself makes this hard to do since it clouds the mind and distorts thinking. This is why a trained therapist is so helpful. Please see the pinned list of such in LOS.

Other measures that are helpful: go easy on caffeine and sugar (inlcuding white rice/white bread/pastas) , eat meals high in protein, don't skip any meals. This will help keep your blood sugar stable which in turn helps reduce feelings of anxiety.

Just wanted to say thank-you for a simply fantastic post, so thank you.

1) I asked about 5-HTP at GNC and also searched their website. Nothing I'm afraid.

2) Any way to get some of the local generic names for Sertraline, paroxetine? Or is it just easier to ask for "local" or "generic" version at a pharmacy when they try to sell you the brand name?

3) Just in case someone can't find it, the pinned mental health resource list is: http://www.thaivisa.com/forum/Mental-Healt...ist-t90910.html

Again, thanks for the great post.

[pete66]

SSRIs may increase anxiety initially and it may be useful to use Xanax either in combination with one of the SSRIs for a short time or just Xanax alone; also short time as it also has a mild anti-depressant effect.

It can cause dependency problems and, as with all these drugs, need to be taken in the smallest dose that will do the job and for the shortest time needed.

Any SSRIs available in BKK pharmacies, round Nana for instance? ..................

Also, is the supplement 5-HTP available?

Sertraline (in both brand name Zoloft and a less expensive generic), paroxetine (under nrand name Seroxat) and fluoxetine (under brand name Prozac and several local generics) are all available at any pharmacy and do nto require a prescription in Thailand. I definitely do not recommend fluoxetine tho due to its long half life which makes it slow to take effect and also hard to taper the dosage.

That said, note FBN's comments re SSRIs and anxiety. If anxiety rather than depression is your main complaint treatment with SSRIs is likely to make matters worse at first. Management of the combination of anxietry and depression is tricky and best done under the care of a qualified mental health professional.

I think (not 100% sure) you can get 5-HTP at GNC.

You can also get Valerian, an herbal treatment for anxiety that is mild but effective for many people, at GNC and also at many Boots and other pharmacies, Mega brand.

Another group of drugs which are sometimes used to manage severe anxiety are the newer anticonvulsants such as Gabapentin and Lyrica. Lyrica in particular has been found effective in treatment of anxiety disorders that do not respiond to other drugs. These meds have significant side effects and are indicated only for true anxiety disorders as opposed to the temporary anxieties that most people experience from time to time. Altho I believe they are sold OTC, self-medication is not advisable; if you have a severe enough anxiety diosorder to need that level of treament you should find a good psychiatrist to oversee your care.

Anxiety is an alarm signal from your mind, telling you that all is not well. While it is sometimes necessary to take something temporaily to enable you to function, it is important not to lose sight iof this basic fact. If a smoke alarm began ringing in your house, you would not respond by putting in ear plugs -- you'd investigate the source of the smoke and take care of the cause. Likewise, anxiety. Need to respect the warning it represents and find out where the problem lies and attend to it. Unfortunately the anxiety itself makes this hard to do since it clouds the mind and distorts thinking. This is why a trained therapist is so helpful. Please see the pinned list of such in LOS.

Other measures that are helpful: go easy on caffeine and sugar (inlcuding white rice/white bread/pastas) , eat meals high in protein, don't skip any meals. This will help keep your blood sugar stable which in turn helps reduce feelings of anxiety.

Just wanted to say thank-you for a simply fantastic post, so thank you.

1) I asked about 5-HTP at GNC and also searched their website. Nothing I'm afraid.

2) Any way to get some of the local generic names for Sertraline, paroxetine? Or is it just easier to ask for "local" or "generic" version at a pharmacy when they try to sell you the brand name?

3) Just in case someone can't find it, the pinned mental health resource list is: http://www.thaivisa.com/forum/Mental-Healt...ist-t90910.html

Again, thanks for the great post.

And, oops, sorry I forgot ...

4) Also interested in Bupropion as an alternative - no weight gain, sexual dysfunction etc. Is this available OTC in LOS, and if so, are local versions available?

5) Any SNRIs available OTC, although I suppose generic versions are unlikely as SNRIs are relatively new.

Edited September 14, 2009 by pete66

[Sheryl]

There is a GPO form out, just called sertraline -- ask for "sertraline GPO" . There are also a local commercial brands called Serlift and Sertra.

Bupropion is available only in brand name Quomem, an import and thus costly.

Re SNRIs, Venlafaxine is available under brand name Efexor and duloexetine under brand name Cymbalta. Both are imported, expensive. They are approved for OTC b grade one licensed pharmacists but likely to be harder to find than SSRIs. In my experience, even more likely than SSRIs to cause increased anxiety when first started.

All of these drugs have serious side effects and significant contraindications. You are best advised to take them under medical suoervision; if you chose to do otherwise, be sure to read up on them, heed the warnings and contraindications, and also get your liver enzymes checked periodically (ALT/AST).

[sleepyjohn]

Excellent posts Sheryl I particularly liked the fire alarm analogy.....

People should realise that with psychoactives there is no free lunch (same with recreational drugs). A rebound, a payback really, is the price to be usually paid. It is then just a question of whether the rebound is acceptable and whether conditions from without or within have improved for the patient to then deal with that new event's impact better than the original one.

Also important to realise as a general principle that mental episodes tend to be self correcting. What drugs usually get praise for is more often the natural self repair of the mental systems that just requires a little time. A habitual association between mental illness and drug therapy is not very salubrious.

cheers John

Edited September 16, 2009 by sleepyjohn