What medication actually works for anxiety?

[Wenchelda]

I've posted a couple of times in the past about my anxiety - I may even have asked this exact question but in my current state of fear, I can't think how to look for my previous threads so hope it's ok to post again.

I have suffered anxiety for over 4 years, mainly centred around my health and, in particular, a huge fear of cancer. I've had over 12 months of CBT, which helped at the time and I've mostly been able to keep on top of it but recently feel like I've been struggling again.

Twice during major anxiety attacks, my GP has prescribed me diazepam but I've been too scared to take it and never collected the prescriptions. (Not quite sure why I feel scared to take them. If I was prescribed medication for a physical illness, I would more than likely have it without question but this feels different somehow)

Anyway I don't want to keep having these horrible attacks and suffer the overwhelming fear for days at a time. I'm sure I've read about people taking low levels of something just to keep on top of it and prevent the anxiety taking over. I think I might ask my gp for something but would like to go prepared with a bit of knowledge about what options there are and what might be best.

So that's my very long winded way of asking if anyone takes anything for anxiety and if you would recommend it.

Trying to distract myself from my current panic by focusing on this instead. Sorry it's so long. Thanks for reading if you got this far.

Hello
There are anti depressants that can help with anxiety, but everyone is different and there are lots of different ones so you'd need to speak to the gp if that's the route you want to take.
Diazepam is good for when you're in a very high state of panic and can't calm down, however they are addictive so shouldn't be relied on.
Also look into alternative therapies, acupuncture can be really helpful for anxiety.

My own GP prescribed me amitripyline daily at a low dose (10-20mg) which helped me to manage my long term anxiety.

propranolol was the only thing that worked for me.

I've read some very convincing testimonials about CBD oil, on its own and in conjunction with other medications.

Diazepam and sertraline with a course of CBT.

Do you mind me asking you how old you are?

Propanalol did work for me but I’m going back to the doctors as I’m much worse since my son was born so watching with interest

@Cosmos45 Im 39 - would that make a difference to what might help me?

Thanks for all the replies. I guess I was hoping for a "magic pill" that will definitely cure me of this awful feeling of dread, but of course it's not that simple and what works for others won't necessarily work for me.

I didn't know about acupuncture helping anxiety so perhaps that is something I should look into. Thank you for suggest that.

I don't really want to rely on medication to keep me going but equally I cannot cope with this constant feeling of fear. It's always there on some level, even when I'm not In The midst of a panic attack. And then when it's a full on anxiety attack, it's like I can't breathe and feel faint and sick at the same time and my brain won't accept any rational explanation nor believe anything other than that I have incurable cancer. Then of course the anxiety causes physical symptoms and then those aches / pains / tensions just add fuel to the thought that I must be seriously ill. The whole left side of my body feels "bad" and it's like I can feel that badness spreading up and down my body (but only on the left - the right side is ok for some reason)

It's so stupid. I hate the way my brain works like this. My thoughts spiral out of control and it's so hard to get on top of them. I learnt some really useful techniques when I was doing the CBT but in the midst of an attack, I struggle to remember them and regain control.

Sorry I am rambling now.

I had CBT which was a bit shit and ADs which were good - I had depression and anxiety perinatally and continuing on for years.

ADs were about a year now I have propanolol (sp) that I take as and when. It slows your heart so the thoughts are still there but the spiralling doesn't happen as the panic response in body is suppressed. Making the thoughts easier to rationalise away.

Tbh I think you should get your prescription filled and try the drugs they have prescribed. As you say, you wouldn't hesitate if they were for a physical issue.

Everyone is different. Sertraline is the most widely tolerated AD but I can't tolerate it. I do get on well with Amitriptyline though, which most people don't. Propranolol is quite good for the physical symptoms of anxiety.

I should say that the propanolol was prescribed when I was nearly better> they wouldn't have cut the mustard when I was properly ill with it.

Try what you have been prescribed, they should calm you and take the edge off, enabling you to think clearly about options.

I found CBT next to useless - I think it's a bit marmite. So don't feel bad if you can't control it with what they taught you :)

dd2 takes ami as well. It works for her.

Low doses of SSRIs (eg citalopram) can be helpful for anxiety.

It might be possible to do short course of computer based CBT as a refresher.

You say it started about 4 years ago - what was going in your life around that time?

For me, proper psychotherapy (CBT is a bit of a sticking plaster really) and propanolol was the most effective combination.

I find diazepam doesn't do anything for me (I wasn't even a heavy drinker ) but propranolol was brilliant for tackling the symptoms of racing heart, nausea, shaking etc. The only thing that's worked for me with the dread - nameless and otherwise - is CBT techniques, in all honesty - but to be honest, once the physical symptoms have gone, the rest never seems to get as bad.

Honestly, pick up your prescription or go back to the GP, OP - you don't have to keep suffering

I’m a psychiatrist.

I’m always nervous of answering threads as I can’t give specific medical advice out online - only general info.

My general advice:

• Diazepam and other benzos: effective, but addictive. Fine to use VERY sparingly, but if you’re using it every day then that’s a problem. I’d generally try to avoid.
• Antidepressants: Worth a go, particularly if anxiety is severe and chronic. Best to go with an SSRI such as Sertralind
• Propranolol: also worth trying. Can cause dizziness. Good for taking irregularly, if you anticipate a difficult situation for example
• Promethazine: a sedating antihistamine. Can be good for emergency use, but can be sedating. So don’t drive on it. Not addictive.

No evidence at all for CBD oil etc.

I've been on various ones over the years which did very little for me.
Two years ago I suffered a breakdown and was given very low dose Diazepam for afew weeks which made me feel worse so I would never touch them again tbh.

I've also tried just about every therapy there is too with little effect.

With this in mind I'm now looking in a different direction of the three principles which discussed how the mind works and is having alot of effect on mental health and even big businesses are using the approach. If you search on YouTube there are loads of free videos by different teachers in the field. Another useful site is 'A Little Peace of Mind' where there are loads of excellent podcasts where this is all discussed.

I also look at diet now too as alot of research now pointing to gut health being linked to mental health. There are loads of resources out there on this too. A couple of books particularly useful we're 'Mad Diet' and 'The Gut Makeover'.

Now, I'm not saying medication is the enemy here because it can be really useful to some. All I'm saying is it hasn't helped me as an individual and so I began to look elsewhere. I hope this is helpful to some.

Wenchelda, the reason for asking your age was in case it could be hormonal - I am not expert but can only speak from experience after suffering really bad anxiety over the last few years - it was becoming quite a nightmare and it was affecting my day to day life. I was prescribed Anti D's but these did nothing for the anxiety (I had other symptons though which they helped with. Eventually I went on HRT and it stopped the anxiety almost overnight. I had worked out though that my anxiety was much much worse during my monthly cycle so I was halfway there with realising it was hormonal. I am 47 though so I am sure this is not applicable for you.

And you have also described perfectly how my anxiety attacks felt - faint and sick and unable to breathe.. I didn't even attribute it to anxiety when it first started - I thought it was blood pressure or something viral. So sorry you are feeling like this, it's horrible and so uncontrollable at times.

Thank you again.

I don't have a current prescription for the diazepam so would need a new one if I want to try that (I'm still scared of it) I have booked an appointment to see my GP about longer term solutions but the soonest one I could get is Xmas Eve, ffs! I guess I could just ring and ask the receptionist if I can have a new prescription - not sure if they would just give me one without seeing a doctor as it's something I've been prescribed before? But it's just another stress to try and ring the surgery and explain.

I've also never heard of mental health being related to gut health so I am definitely going to look In to that as I am aware my diet is not as good as it should be. I know I also need to force myself to do a bit of exercise - I really struggle with this as I can't seem to find anything I enjoy so any form of exercise is a challenge but I know exercise is also linked to mental health so I think this is something I must push myself to do. I have an exercise bike so going to try and make myself get on that as much as I can. (I did 5k on there this morning when I couldn't sleep)

I am feeling slightly less anxious and panicky than I was last night when it was spiralling out of control and I was awake until the early hours. However the physical symptoms are still there and even though I keep telling myself that these aches and pains and tensions are caused by my heightened state of anxiety, there's always the "what if" that never seems to go away. I am trying so hard to not let myself focus on that and distract my thoughts in another direction. Easier to distract myself when I've got the dcs around and I am trying to seem "normal" for them, but once they go to bed and I'm alone with my thoughts (DH works shifts and not home until 10pm) then it's so easy for it to get on top of me again.

I hate this. Stupid stupid brain

Thanks cosmos. Interesting about it possibly being connected to hormones. As it happens it is my time of the month. I had another bad attack a couple of months ago but I can't remember if that was around the time of AF or not. I will make a note of dates when it happens again and see if there is any connection.

I'm taking Escitalopram and propanol for anxiety at the moment. They seem to have helped as my anxiety was rapidly getting worse and seems to have settled at a just about manageable level at the moment.

I suffer severe anxiety. I've asked my gp for diazepam but she says they don't prescribe it anymore. As far as i know it's the only thing that helps immediately but is very addictive.

Propanalol only treats the physical effects of anxiety, e.g racing heart.

Some antidepressants help with anxiety, Sertraline helped me but had side effects i couldn't cope with. I'm currently taking dulixetine which is meant to help too. It can be trial and error to find one that suits you.

I'd second trying cbd oil, I've heard good things about it. It's quite expensive. Try simplycbd or fortheageless, i think they're quite good companies, or so I've been told. I read recently that gps will soon be able to prescribe cbd but unsure when or what for.

It seems to depend on surgery - possibly area - as some are relatively happy to dole out diazepam and others are very unkeen.

It's really not a good solution for ongoing anxiety imo as one rapidly builds tolerance and dependency. And any problems anyone has will be magnified x100 having to go through a benzo withdrawal which takes a long, long time and will be considerably more unpleasant than the condition one took it for in the first place.

That said, it's useful for occasional specific situations of high anxiety.

I have bad generalised anxiety and I won't touch it at the moment although I've actually got some in the house.

I quite like passion flower and valerian for occasional use, they do seem to work although they're relatively subtle, and are a safe option for most of us.

I think antidepressants are a far better option for actually getting you feeling normal again although they do take a few weeks to work and can initially worsen things, at least the SSRIs can.

If SSRIs aren't tolerated there are the older style ADs like amitryptaline, there's mirtazipine, some people are given low doses of anti-psychotics like quetipine.... just mentioning this so you know there are a range of options if you don't get on with the first-line medication.

I know someone taking pregabalin who says it's amazing. Paddy what are your general thoughts on it?