Tryptonal alternative

[sefty]

Hello

I have anxiety issues after a heart attack 3 years ago. Consequently on top of the heart meds I take 50mg of tryptonal before bed which is worked out OK mentally but my problem now is the extra 7/8kg of weight that I've put on. I've tried Zoloft for 10 weeks but that was horrific so I'm now back on the tropical. My question is what alternatives are available here dealing with anxiety that might be non weight gaining and blood pressure sensitive.

I exercise twice daily and have a balanced diet. 

All advice appreciated. 

[Sheryl]

Are you sure you problem was anxiety? As tryptonal is not an anxiety med, it is an antidepressant, as is Zoloft.

 

Anti-anxiety meds and antidepressants are quite different drugs with different actions.

 

If your problem is depression, rather than anxiety, there are newer drugs such as  vanlaflaxine. If your problem is anxiety, there are also a number of meds including some new, non-addictive ones e.g. lyrica.

 

This is not something you should try to work out on your own, especially as you seem unclear as to the nature of the problem/type of drug needed. It is also better to use a mix of short-term cognitive therapy with meds rather than meds alone.

 

There is a listing of  counsellors in the pinned mental health thread. In addition to the benefits of the counselling itself,working with a counsellor increases the odds of getting the right medication if medication is needed, as the counsellor spends far more time with you than any doctor will and are thus best positioned to know to what extent you suffer from anxiety vs depression or both. Counsellors usually have psychiatrists they refer to when medication seems indicated.

 

If you are not willing to see a counsellor, then consult a psychiatrist specializing in mood disorders, if you tyell me where you live I may be able to suggest one. Not a good idea to experiment with different meds on your own, you can really mess up your brain chemistry doing that.

[sefty]

Hi Sheryl
I'm not positive my problem is anxiety I just presumed it was because I worry an awful lot about my heart condition which then morphed into a breakdown/panic attack which ended up in the emergency room with the doctors saying there is nothing wrong with me.
The Zoloft was prescribed for me in England and Thailand but the paranoia got so bad I couldn't leave the house.
So I then went to the pharmacy who suggested over the counter tryptonal. Benzos also work for me but obviously this can only be a short term fix. I've looked at the two drugs you suggested but both are weight gaining so are you aware of others that are not?
I appreciate your advice and thank you for posting your reply.
I live in hua hin by the way but am not aware of any phschiatryts at present apart from one at the Bangkok hospital.

[Sheryl]

Not everyone gains weight on these meds. Some lose, some stay the same. For panic attacks, beta blockers are also often helpful and don't usually cause weight gain.

 

But from what you say I re-emphasize prior advice to see a counsellor. Any medication is just a band-aid over the problem, much better to address rhe problem itself and work on developing better coping mechanisms. Also, I have real doubts about whether your problem has been correctly diagnosed. Panic attacks are pretty obvious (once physical cause ruled out) and entirely different from depression (though depressed people can also have them). Hard to understand why an antidepressant would have been prescribed other than that some GPs are not clear on the diffference between anxiety disorders and depression.

 

You are not going to find the help you need in Hua Hin, need to come into Bangkok. It can be as infrequent as once every 2 weeks, Bangkok counsellors are used to people coming in from provinces and will make accomodation for that, for example back to back sessions on consecutive days rather than weekly sessions. I suggest you try to get appointment with Ben Weinstein at PSI (see pinned thread) and wait until you see how it goes in counseling before considering further medication. You sound like you already have some insight into your problem which bodes well for progress in counselling.

 

An advantage to coming into Bangkok is that you can also access much better cardiologists. Being in really good hands with a Western trained cardiologist who speaks fluent English will in itself help with your anxiety. I'm posting from my phone now, will append a cardiologist recommendation later