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Spelljean posted 3/4/2014 21:46 PM

Saw my new psychiatrist for my one week follow up agter starting Zoloft and Klonopin. (Was on xanax before and was having major trouble tapering it)

Zoloft, even though she had me cutting the pill, made me very sick. Stomach, headaches from hell, just off feeling. My primary care doctor had me on Lexapro just before seeing the psychiatrist, to try to get me started on something while I waited for an appointment. I felt pretty good on it, mild side effects, seemed to work on a lot of the panic within a few days, though not at full force yet of course.

On my first visit with the psych a week ago, I told her I felt good so far on the Lexapro, and wanted to give it a shot, but she said no, she said it doesn't treat panic disorder. (I know a few people that take it for that though) She said, take the Zoloft, and the Klonopin. I'm fine with the idea of the Klonopin, since its supposed to be easier to taper off of than Xanax.

But on my one week recheck today, I asked her to go back to Lexapro since it seemed to be helping with pretty easy to manage side effects. She got angry, said "no", repeated to me that Lexapro isnt for panic disorder and said she would not prescribe it.

So lost now.

Jrazz posted 3/4/2014 22:23 PM

I don't have a lot of personal experience with this, but Crazz was put on Lexapro for a while for depression, and when he didn't like the side effects they switched him to Zoloft. I know they're not perfectly interchangeable, but it doesn't seem like you're making a ridiculous request. Lexapro is a big step down from Xanax, anyway...

Can you get a 2nd opinion? Sometimes changing dosages helps, too. Has that been offered?

Spelljean posted 3/4/2014 22:55 PM

Well, she said to cut the dose of Zoloft even smaller, but it didn't do much.

She basically said she wouldn't prescribe me anything, anymore at all and was yelling at me for preferring to "treat myself" Which I wasn't. My doctor prescribed the Lexapro. It wasn't as though I decided to down handfuls of the Klonopin, and flushed the Zoloft, and expected her to condone this new plan of mine. I just said no to the Zoloft. Had bad reactions to the older SSRIs in the past...prozac, paxil...and just asked if I could give the Lexapro a few more weeks possibly.

Its an SSRI too. My panic has already lessened on it. At full dose, I feel positive this might just work great.

purplejacket4 posted 3/4/2014 23:05 PM

I think that is just her ego talking. Although the SSRIs have different indications by the FDA that is just based on what the drug company itself did research in. Later independent research shows they are all fairly comparable.

She may have wanted to decrease your dose for due to your side effects. We often have to wean up the dose. It does take higher doses for anxiety and panic and Zoloft can get a lot higher.

If she really pissed you off go to another doctor.

Spelljean posted 3/4/2014 23:35 PM

Thanks, going back to my primary care Thursday.

Will get another opinion or see if someone will just let me give the Lex a fair shot.

sad12008 posted 3/4/2014 23:46 PM

Though I can't speak to its possible efficacy relative to panic disorder, I can say that Lexapro definitely has helped around here with anxiety disorder-related issues. My H takes it as part of his regimen, as does my DD. It has a clear impact on the anxiety, though it is technically prescribed for the depression.

I would be inclined to find another doctor, if just for the fact that she doesn't seem to be open to 'hearing' you. My H's doctor is great in that there are good docs out there.

It sounds as though the Lexapro was making some headway, and that maybe a little booster would've done the job.

I've seen stuff about Klonopin...maybe check out googlescholar and crazymeds and see what you think. A lot of times it seems to boil down to the lesser of the evils, but it's a good idea to know what the possible issues could be (sounds like you've done some checking already).

How'd you find the new pdoc? If you decide to switch, check out every online review site you can think of. We actually have to pay out of pocket and file a claim w/our insurance for H's pdoc; he's non-network and we have to pay our point-of-service deductible before we even get the 50% back. However, I'd pay 100% just to see this doc. It makes a BIG difference.

Best of luck. Sorry you're dealing with someone who doesn't sound like she's wanting to work with you versus work on you.

Spelljean posted 3/5/2014 00:30 AM

Thanks, Sad. Appreciate the feedback.

I've actually read up on the Ashton method of benzo withdrawl which is supposed to be widely accepted as safe, and effective. A very slow raper program, which actually switches one over from xanax to valium first, then off completely. It is a very slow process, but supposedly works with minimal symptoms. Yet some doctors prefer Klonopin. I'm open to any taper method for the benzos.

From my research into SSRis, they are selective and the only neurotransmitter they affect is serotonin. So they all have the potential to work. Now everyone is different, but It seems odd to me that the SSRIs that are officially "approved" for panic disorder happen to be the older ones...Paxil, Prozac, Zoloft. Lexapro and Celexa are slightly newer drugs, but they are supposed to act on the seratonin in the same way.

I have tried for years to get on an SSRI successfully. So many horrible side effects. I can't take the older classes of drugs (tricyclics, etc) because of my arrhythmia. Once I was successful on Prozac...18 years ago. Long standing panic disorder and agoraphobia. Tried to get on Prozac, and Paxil...was like having 6 shots of espresso and trying to go to bed. Started out with very tiny doses. Didn't matter. After a few days, major side effects.

Finally I try the Lexapro last month and have had minimal side effects. Just want to go with it for now and just see. Celexa gave me horrible tinnitus. Running out of options!

ETA: found the psych on my insurance website.

[This message edited by Spelljean at 12:31 AM, March 5th (Wednesday)]

Kelany posted 3/5/2014 06:42 AM

Can you get a new psychiatrist? Arguing with you? No. Just no.

I was diagnosed with MDD and anxiety. I'm on lexapro. It's amazing for my anxiety. Zoloft did shit for my anxiety.

I'd stay on the lexapro your primary put you on. Get a new psych.

tushnurse posted 3/5/2014 09:28 AM

I'm fine with the idea of the Klonopin, since its supposed to be easier to taper off of than Xanax.

But on my one week recheck today, I asked her to go back to Lexapro since it seemed to be helping with pretty easy to manage side effects. She got angry, said "no", repeated to me that Lexapro isnt for panic disorder and said she would not prescribe it.

Um as a medical professional I would say step number one. FIRE the Psych.

If you and your PCP were doing well with managing things with the Zoloft, and Klonopin, then I would say continue.

Listen there are a BAZILLION Anti-D's, Anti-A's on the market because we are all effected differently, and if you are having problems with a drug, and you know it, and the Dr tells you to continue it, then you need a new Dr. Sorry. Esp if she got mad at you.

There are studies and protocols on what we as medical professionals are supposed to do, and how we are supposed to treat people. There are gold standards of treatment, and generally they work well for most folks. HOWEVER there are exceptions to every rule, and you obviously are one, just the horrible time you were having with the Xanax shows that . If you Dr is unwilling to to take the time to listen, and take those things into account then, well.....I say new Dr.

Spelljean posted 3/5/2014 14:33 PM

thank you tush nurse, yes seeing my primary care tomorrow and will ask for a new psych referral.

Funny, I rarely ever look up doctor reviews online, but I found this doctor and there are many complaints about her attitude...her controlling behavior, her yelling at people, her "my way or the highway" protocol, not listening to what the patients are telling her about their experiences on certain meds, and how she won't let the patients have any input on what pills they want to take.

I wasn't asking her something so far out of line that it was unthinkable in the psychiatric realm. I asked to continue the Lexapro and see if it helped. That was it.

She got insulted when I said I would return to my primary care and see what she thought. I like my primary a lot. She has an attitude of "hey, if something is working, lets see how it turns out."

She doesn't force something on me that is making me ill.

Threnody posted 3/5/2014 15:24 PM

I was diagnosed with PTSD (which I didn't know about) and agoraphobia (which I *did* know about) and moderate depression. I was prescribed Lexapro immediately and within 3 weeks the panic attacks had stopped. I continued it for 4 or 5 years -- I can't remember now. I went off it 5 years ago, when I hadn't had a panic attack in 3 or more years.


I've been panic free for 5 years now, even off the meds. Lexapro, on the smallest dose possible, gave me the space to rebuild. My primary care physician was the one who prescribed it, and I simply informed my psychologist what I was taking. She didn't get a say in it because she couldn't write prescriptions, but it was useful information to her.

Fire the psychiatrist and find a psychologist. Stick with your GP who knows all sorts of other things about your health history as well.

Sending hugs. This stuff is tough enough without feeling pressured by the medical team who is supposed to be treating you.

[This message edited by Threnody at 3:24 PM, March 5th (Wednesday)]

Spelljean posted 3/5/2014 17:05 PM

Thanks so much Threnody for the positive side of Lexapro on Panic attacks. I went on some other forums and found countless others that are treated successfully for panic disorder on this medication.

Hey, maybe in the long run it won't work out for me, all I asked the doctor for was a chance to try it first, since I have minimal side effects from it, and it an SSRI.

waiting2see posted 3/5/2014 20:01 PM

Took it for years for panic and anxiety. It worked perfectly. She is wrong. Period. Sorry she was such an ass to you when you were just trying to get the help you need. Pisses me off. Hugs!

Spelljean posted 3/6/2014 01:00 AM

Thank you, waiting. Appreciate hearing about your experienc on this med. its always a difficult decision, deciding to medicate at all. I was looking to my psychiatrist for some understanding, compassion, and to open a dialogue at least.

Spelljean posted 3/6/2014 14:23 PM

Well, saw my doctor again today and she thinks its a reasonable request to at least try a couple of months of the Lexapro before switching, since I'm having low, to no side effects from it.

(Which is half the battle in ADs)

She is sending me to another psych for another opinion, and if I'm unhappy with their recommendations, then she will gladly prescribe the Lexapro and Klonipin herself for me.

I want to taper off any sedatives hopefully after being stable on an AD for a couple of months at least.

tushnurse posted 3/6/2014 14:57 PM

I thought of you last night.
I am glad your PCP is willing to work with you.

I have a dear friend that was going through a very difficult time at work and home, and someone prescribed him Xanax.....Guess what???
He ended up addicted, and had to take a LOA from his job to get things straightened out. He is weaning off it now. He was resistant to go on the Klonapin, as he was under the impression is was the same thing as Xanax. After we talked he was going to give it a try.

I wanted you to know that this is a man who has dealt with a lot of shit in life, and he ended up having horrible panic attacks, and all the physical symptoms of withdraw when he missed a dose of Xanax.

You are not alone. I wish more MD's were cognizant of this issues with this med, and were more careful in prescribing it.

((((and strength))))

getnbtr1 posted 3/6/2014 15:06 PM

As a mental Health provider I have seen many, many people report feeling better from medications that I didn't think would wind u being helpful, but they were. Nice thing is when you do find something that works. If its working, stick with it!! Her attitude stinks. You need to feel safe with a provider, and they HAVE TO work with you or you won't wind up getting better. Lexapro and Zoloft aren't different enough that she should be so rigid regardless. I'm glad you are going to work with your PCP. Perhaps consider finding a nurse practitioner at some point for your Rx meds. Lastly, Lexapro is often quite good for anxiety-based disorders of all kinds and if your body responds better to it, then it is the right fit for you. Good luck and good for you for advocating for yourself.

Spelljean posted 3/6/2014 18:17 PM

thanks for all the responses. I rarely see doctors at all, and I hate to take medication and its just discouraging when you finally break down and admit you may need the assistance of anti-depressant, that you come across such hostility out there.

ProbableIceCream posted 3/6/2014 18:24 PM

Klonopin is easier to come off than Xanax. Valium easier yet. And some people don't seem to have major issues coming off anything.

However, there are people who have HUGE issues coming off benzodiazepines (klonopin, valium, xanax, etc). Please be very careful. I think they're best used on a very short term basis (2 months or less) for extremely high anxiety as a stopgap.

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