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.

I've had propranolol in the past for migraines and it didn't really help the anxiety.

6 is very low and won’t be helping, that’s for sure. I hope you can get your numbers up quickly. Another vote for asking your GP to change your meds - a year is more than long enough to trial an SSRI, imo.

Edited to add: I’m so sorry for everything you’ve been through. 💐

Citalopram 💚

This is great advice. Not all therapists are equal. The best one I had was a psychotherapist who also was trained in cbt & dbt.
sorry for your loss, keep looking after yourself 🧡

I'm so sorry for your loss, OP. It sounds like you are taking some good steps to help yourself and I'm sorry it's not working enough, yet.

Some of this is actually just... grief. You know, grief is just massive when it's a major loss. You've lost your mum. Go easy on yourself. It can take a long time.

Diazepam is the absolute business for anxiety, I agree. I took it every day for a year when my late partner was terminally ill. Had no problem coming off it at all, actually. Meanwhile I hear of awful withdrawal effects from some SSRI's. We're all individuals.

Nonetheless, I think a lot of doctors are reluctant to prescribe diazepam for more than occasional use. They might give you a small amount.

I think you should look at switching SSRI. Possibly to an SNRI? That's worked for people I know when SSRI's haven't been working out.

But bear in mind, the pills might help your mind but your soul, so to speak, needs its own time to recover.

I wish you well.

Pregablin and Gabbapentin are fucking evil and coming off them is hell.

Try Promethazine 40mg for sleep, available otc and ask doctor for Propanalol. You might need to try a different antianxiety pill. I found Venlafaxine to be the only one that worked for me.

You also need to reset your nervous system. Google this and also The Dropped Anchor Technique.

Is there a crisis team you can conyact?

Good luck, you can and will feel better.

Not sure how old you are OP but just wondering whether perimenopause could be a factor as that can cause awful anxiety and air hunger as you describe. HRT could be helpful if that's the case. I know from experience.

I'm 41. GP says it can't be menopause because my periods are still regular!

Sertraline made my DD aggressively suicidal, a symptom she had never previously experienced. Do not increase the dose if it isn’t working for you. There are other options.

Your ferritin is 6?! That is horrifically low and will be causing crushing fatigue, shortness of breath and palpitations. can you get an iron infusion? By far the quickest and most effective way to get your iron levels up.

I'm already on the max dose.

I don't meet the criteria according to my GP.

I think I need a new GP now, after posting this thread.

Can you afford to go private for the infusion?

In that case please be very careful coming off it. Current thinking is that you should withdraw very slowly, tapering off rather than just stopping. If your GP doesn’t advise this, and give you clear instructions for how to do it, you need a different one.

Oh gosh, that sounds absolutely bloody exhausting, mate. It must be so frustrating when you're doing everything you can and still feeling like this. Are you finding it difficult to get your GP to listen properly?

Air hunger? Have you been tested for anaemia? Your haemoglobin and ferritin levels? Sounds like you might need some iron.

EDIT: sorry I can now see I was right and you’re anaemic. You need an Iron IV. You will feel a lot better in the weeks after. DO was offered one on NHS with ferritin 13. We went private to avoid the wait time. £140 per infusion.

Potentially. My car payment ends next month which will free up £120 a month. I'm just not sure how I'd manage to get there because I really struggle to leave the house! (I'm not driving obvs, my sister has the car to use)

Yes. I feel like they're not believing me when I say how bad it is and how much impact it's had on my life. This was the response I got from my GP after doing an econsult. I can't go to the surgery and they won't visit me or discuss it over the phone so I'm totally stuck.

I've asked about it multiple times now and been told I don't qualify. I'm going to look into doing it privately.

OP I would suggest going back to your GP and letting them know your anxiety is impacting your daily life and you cannot function, and ask for more help. If they refuse, ask them to write on their notes that they have refused you further help.
Might be an idea to have a private iron infusion and look into counselling as well, there are some places that will offer subsidized rates depending on where you live. You could complain to the practice manager if you feel you are not being taken seriously. They have a duty of care to you and you shouldn't need to be this unwell (reiterating this is not your fault)

Not sure if you resolved the pregabalin issue or not but that may be worth a try (but I'm not a dr of course). Diazepam is fab for short term relief but you are only likely to get 5/6 tablets,

I had/have terrible anxiety and it does increase when I'm going through a stressful time like it sounds you are at the moment. Try not to be so hard on yourself, and remind yourself that this will pass and you will get better.

To add, air hunger can be caused by anxiety, not necessarily anything physical.

Was on sertaline and it did nothing. Changed to Duloxetine and things have improved.

Sorry to hear you have been through a rough time and are feeling awful. How terrible that the GP is no help. I’d definitely see if you can speak to another Doctor. It sounds like you are trying all you can yourself.

You can certainly ask for and should try an alternative medication. However if you go in demanding benzos and gabas you appear drug seeking as both are drugs of abuse (potentially....im not saying you are but that is how it seems). And I knew from your 1st paragraph that is what you wanted. (Ive been a GP for over 20 years)
Both are terrible treatments for anxiety.

Sertraline made my anxiety significantly worse, and each time my gp told me to increase the dose and said I needed to be patient.

After 3 months and being barely able to function I saw another gp and requested citalopram. The difference in just 3 weeks, on 20mg, was amazing.

It’s so difficult when you have anxiety and your GP prescribes anti depressants. However, although diazepam makes the world seem a far better place, it’s highly addictive and GPs just don’t prescribe it much any more.

Like PP, I find duloxetine helps massively with my anxiety.

You are probably right that you need a different GP who will take a fresh look at you. Good luck.