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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 3 of 3. This is the beginning of the thread.
Posted by Anderson on March 19, 2000, at 17:35:00
I have a great question inside me. I had Panic Disorder and Social Phobia. So, I looked for the help of a psychatrist and a psychologist.
The psychiatrist prescribe me the medication antidepressant Anafranil. I begin taking 10 mg, later 25 mg and so 50 mg. I take it for more less one year, and I stopped the medication suddenly, without decrease the dosage, and I suffer all the effects of the abstinence.But three or four months latter the disease returned (come back) and I suffer one year the symptons of the disease struggling to not use the medicine again. But my body is being bomb, and I understand that will-power is not enough to heal me. Last year I almost lost the year on the faculty, because my frequent absences.
So I take the decision to looking for the psychiatrist again, because another year like the last I will not support. During the time that I token the medicine I was a normal person, and feel very well. I´m understanding that it may be a physcial problem, a chemical problem.
But my great question is about the real risk of the tricyclic antidepressants (which is the better on my situation, ther more efficient e less risks: tricyclic antidepressants, MAOIs, or SSRIs?) when it is necessary. What is better: suffer the symptons of the disease or take the medicine? I scares it provoke damages in my nervous system. I scares only to read the directions of the medicine. Please say me that
will not be any problem. I think it is because the people all says about this kind of medication, on his ignorance, putting thinks on our head.
I consult psychiatrists that said to me that there are no problem with the medication, anyone, none. Is there any influence in my studies? I have workshops on my class that I will not have courage to exhibit present if I will feel all symptons only to think in this
situation.Thank you!
Posted by Carolyn on March 19, 2000, at 17:53:21
In reply to Panic and social phobia, posted by Anderson on March 19, 2000, at 17:35:00
Andrew...it is far better to take the medication than to suffer...and perhaps lose your job...due to symptoms of the illness. I took Anafranil myself for several years with no ill effects. I have been taking some form of antidepressant for the past ten years continuously. I have had no ill effects...indeed I would be unable to live a normal life without them! Of course only you can make the final decision...but I strongly recommend going back on Anafranil. If it worked for you before, it probably will again. Luvox is the SSRI most similar in result to Anafranil as far as I know...Cam could probably tell you more.
But it's what works for you that is important!
Good luck. I know you'll have a much better year on medication!
Carolyn
Posted by Cam W. on March 20, 2000, at 7:30:06
In reply to Panic and social phobia, posted by Anderson on March 19, 2000, at 17:35:00
Anderson - I have to agree with Carolyn. Sometimes medications need to be taken. The one to take is the one that works for you. I know this is extremely vague, but our medicine isn't good enough yet to make exact choices. As to classes of antidepressant drugs; as a whole, the SSRIs are safer (ie safer in overdose, far less potential cardiac problems), but they are not as effective as the TCAs or MAOIs in some instances. The rule of thumb is: if it has worked before, it will probably work again. TCAs work on a spectrum of inhibiting serotonin reuptake more than norepinephrine reuptake (eg Anafranil) or vice versa (eg Desipramine). Social phobia and panic disorder are thought to be problems with serotonin regulation, so that is probably why Anafranil worked for you. Anafranil is similar in action to the SSRIs, but has a few more actions than the newer class. Anafranil may work better for you than the SSRI class, but in my opinion they are similar in efficacy for social phobia and panic disorder to Anafranil. Do not be surprized if the doc puts you on an SSRI rather than Anafranil, but do tell him/her that Anafranil has worked in the past. Also, your concerns about long term effects is appropriate. Recent studies suggest that it is better to be treated with these drugs and live a relatively 'normal' life than have another year like you have just had. Last year was probably worse for your body than the drugs would be. Hope this helps - Cam W.
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