Posted by SpratNZ on March 23, 2014, at 15:52:49
In reply to Re: Best antipsychotic to augment SSRI for panic? » SpratNZ, posted by phidippus on March 23, 2014, at 15:27:22
> Have you been on any TCAs? Mirtazapine? SNRIs? There are a lot of antidepressant choices out there. What SSRIs have you been on?
>
> Using antipsychotics to treat panic disorder is counterintuitive-they antagonize seratonin which is in short supply. If I were to choose one, I'd go with Geodon - it agonizes key seraotonin receptors and is a SNRI to boot.
>
> Have you tried GAbitril or Keppra? Both have had some positive studies in regards to treating panic disorder.
>
> EricI've been on imipramine which didn't work - I actually suggested Mirtazapine and Effexor to my pdoc. He reckoned I wouldn't like Mirtazpine because it would cause weight gain (which wouldn't bother me to be honest) and I think he thought that Effexor would be too activating. It's hard because I'm going by his advice and have to trust that he knows best. (And I've been on every SSRI they have in NZ - paxil (3x!!), citalopram, escitalopram, prozac and zoloft. All pooped out or didn't work).
Gabitril isn't subsidised over here. I tried sodium valproate but it made my panic attacks so much worse! Not sure if this would be the same with other anti-epilitics.
I have to admit I was stunned when my pdoc suggested an anti-psychotic, but I realise they're kind of 'in vogue' at the moment.
Do you know if the weight gain from Mirtazapine is because it effects your metabolism, or if it just increases your hunger? Because that I could easily control.
Thanks
Jackie
poster:SpratNZ
thread:1063080
URL: http://www.dr-bob.org/babble/20140307/msgs/1063118.html