AIBU to ask my GP for different anxiety medication?

[QuestionableMouse]

My mum died in Jan after a five year period of very bad health and multiple medical emergencies. She was in hospital seriously ill 20+ times.

It's left me with severe anxiety, agoraphobia, panic disorder and I think PTSD.

I'm currently taking 200mg Sertreline per day which isn't helping. My GP keeps saying I need to give it more time to work but I've been on this dose for three months now and I still can't go outside without having a panic attack. I've just been sitting on the couch trying to do some work and had such a strong surge of anxiety I had to have a cold shower to stop it.

I've already stopped caffeine, massively reduced how much sugar I eat, have a treadmill and have walked on it so much I've bruised my toenails (I walked for 6+ hours yesterday) I have no life. I don't see my friends or family. On a really bad day it's a struggle for me to get out of bed and on bad weeks my house is disgusting.

I also get air hunger which is absolutely miserable and is contributing to the panic attacks. I'm absolutely exhausted and totally fed up of feeling like this.

The only time I've felt normal this year was the week of my mam's funeral when I had a prescription of Diazepam. It didn't make me feel good or high, just stopped the physical anxiety. I'd really like to try some pregablin or gabapentin but I keep getting refused because it's not prescribed for anxiety according to my GP. I genuinely don't know what to do next.

Forgot to say I'm also have CBT, use the Calm app for bilateral audio, take magnesium daily and have tried guided meditation.

Yes just switch.

Rather than requesting a particular type, why not ask your GP for recommendations?

At least one you cite have restricted use due to potential dependency issues.

Lexapro worked with a very similar situation for me. Life changing, very quickly. Good luck

Absolutely - Sentra.ine did nothing but make me worse but citalopram has always worked for me ( and this is the key bit , what works on one patient doesn’t work for another )

I have and he kept telling me to increase the sertreline.

Sertraline didn't work for me. Sadly you some time have to try different anti depressants before finding the right one for you. Very frustrating!

GP will never prescribe diazepam long term as too addictive.

but there are loads of antidepressants and you might be worth asking to switch to a different one as different ones suit different people.

Have you tried CBD? The gummies worked for my husband's anxiety. Previously he was on Propranolol from the doctor but wanted to stop that due to weight gain

You need to try a different SSRI first.

Quote the NICE guidelines at him. I am astonished at how mental health care differs between GPs.

‘Drug treatment — offer a selective serotonin reuptake inhibitor (SSRI) first line.

• If sertraline is ineffective, offer an alternative SSRI, for example, paroxetine or escitalopram, or a selective serotonin-noradrenaline reuptake inhibitor (SNRI), such as duloxetine or venlafaxine.
• If the person cannot tolerate SSRIs or SNRIs, consider offering pregabalin’

cks.nice.org.uk/topics/generalized-anxiety-disorder/management/management/

It sounds like you've given it a fair try and it hasn't worked. SSRIs don't suit everybody, they made my anxiety worse even after the initial couple of months.
If your GP won't give you pregabalin or gabapentin how about a more sedating antidepressant such as mirtazipine, amitriptyline or trazodone?

3 months isn't really long enough for sertraline. But you can ask for something else. Something should work. Beta blockers were enough for me.

If your gp won’t change your medication can you change your gp?

Diazepam and pregabalin both are poor choices due to dependency.

Have you been offered any talking therapies? Pregabalin and gabapentin are both neuropathic painkillers not anti anxiety medications.

I've been on it for over a year now and 200mg for three months.

Both are used to treat anxiety per the nhs.

https://www.nhs.uk/medicines/pregabalin/about-pregabalin/

You poor thing, you're obviously having an incredibly hard time. That level of anxiety and agitation is so exhausting and you're already doing everything you can to try to help yourself, in addition to taking medication.

I think asking to try something different is totally reasonable. I take Sertraline and it's been good for me, but everyone's different and you might respond better to a different SSRI or a different type of drug entirely.

Beta blockers might be an option if you're getting that horrible adrenaline-surge feeling of panic all the time.

I’d suggest trying a different anti-depressant first. I’ve tried pregabalin for anxiety and it did absolutely nothing but I’ve had some success with trazodone and the occasional diazepam when I need it.

Maybe a different therapist and new medication. 💐

The two you mention are class C drugs, which are unlikely to be prescribed having only had one POM antidepressant. Maybe ask to try a different type of prescribed antidepressant. Have you been offered specific bereavement counselling - as you cite this as an issue leading up to your current situation? Also some Gp practices offer social prescribing to support patients if you think that might help?

there are different types of antidepressants that work in different ways.

Medication is not enough to help you. You need counselling and support with the medication as you’re feeling so low and suffering.

The medication you mentioned are used for calming but will dope you past functioning, they’re highly addictive, the Steraline with counselling would be better.

I am sorry for your loss. Is there any community services you can try for support.

I would ask for a different SSRI - citalopram worked for me and I am currently on fluoxetine which is also working well. Perhaps ask for some propanolol to take during times of panic. You would be absolutely withing your rights to try a different medication but it sounds like the NICE guidelines need you to have explored SSRIs first - they are not all the same and don't all suit everyone.

Sorry to go off on a bit off a tangent but has the air hunger been investigated? It can be a sign of iron deficiency / low ferritin, which, in turn, could be exacerbating your anxiety while untreated.

Sorry for your loss.

You need to resolve the stuff underneath not mask it.

they won’t prescribe diazepam or similar for this I’m pretty sure.

get a good psychological therapist and try a different ssri.

you would need a private psychiatrist for anything consideration of anything you fancy trying

even then they won’t just give it to you without digging deeper.

I'm anemic and take prescription iron every other day. Also take B12 because I read it can cause air hunger too.