Anxiety and OCD Medications - Treatment of Anxiety Disorders and Obsessive-Compulsive

Written by HealthyPlace.com Staff Writer

pavanne: What is your opinion of using Buspar instead of Zanax and the like?

Dr. Watkins: BuSpar is less likely to be addictive. However, it takes longer to kick in. If I need something to work really fast, I would go with a Benzodiazepine. However, I like to consider SSRI medications first.

David: Roughly, how long does it take for a medication to be effective?

Dr. Watkins: A Benzodiazepine can be effective in a matter of minutes or hours. An SSRI such as Zoloft or Prozac may take longer (a week to six weeks). BuSpar takes several weeks. A beta blocker may take effect fast, but mostly just covers the external manifestations of anxiety, such as tremor and palpitations. People with stage fright sometimes take a small dose of a beta blocker before a performance to block the tremulousness. If they can control that external part, they may be able to manage the internal feelings.

murkyangel: I've tried over ten medications: Serezone, Welbutrin, Effexor, Trazadone, Buspar, Remeron, Depakote, Zanax, and am currently on 450mg Welbutrin (again), 1mg Risperdal, and usually 10mg valium a day. It's better than no meds, but not really taking away the anxiety during the day (I take the valium at night). Anyway, what else do you suggest? And yes, I've tried therapy and groups and all that other stuff). I'm at my end in all of this and I don't know what to try next. I've tried many combinations of those medications that I listed.

Dr. Watkins: It is difficult to say. It would depend on the subtype of anxiety. It would also be useful to find out what relatives have taken and what helped them. A MAOI such as Parnate or Nardil might be a consideration. You would need to discuss this with your psychiatrist and get counseling about the MAOI diet. No beer, aged cheese and several other things.

terrjohn: Does a person have to be weaned off of Paxil? My doctor just changed my meds.

Dr. Watkins: Some people who stop Paxil suddenly, feel like they have the flu. It feels uncomfortable for some people. Same for Effexor.

terrjohn: How well does Wellbutrin work compared to Paxil for panic and anxiety disorder?

Dr. Watkins: I think that Paxil would generally be a better choice. Wellbutrin is a great medication for some depression and can also help ADHD, but is not as good for panic. I have occasionally seen it make panic worse. I might add Wellbutrin to an SSRI if the person's anxiety was better, but he or she was still depressed and lethargic. I might also add it to help with sexual dysfunction associated with an SSRI.

Veralyn: I am on Paxil and I was on Prozac a few years ago. I have both depression and anxiety with it. What is the difference between Paxil and Prozac?

Dr. Watkins: They are both selective serotonin reuptake inhibitors. (SSRIs). They have the effect of increasing the availability of serotonin between nerve synapses. Prozac tends to be more stimulating and lasts longer. Paxil is likely to be more sedating and wears off quicker. When you stop Prozac, it stays in your system for weeks or more and gradually goes out. Paxil goes out faster. That is why you may need to taper Paxil but not Prozac. A few people get sleepy on Prozac and are more alert on Paxil but they are in the minority.

David: Thank you, Dr. Watkins, for being our guest tonight and for sharing this information with us. We will see you tomorrow night to talk about "Bipolar and Depression Medications". Dr. Watkin's website is here.

And to those in the audience, thank you for coming and participating. I hope you found it helpful. We have very large Anxiety and OCD communities here at HealthyPlace.com. Also, if you found our site beneficial, I hope you'll pass our URL around to your friends, mail list buddies, and others, http://www.healthyplace.com.

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Good night everyone.

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