# Antipsychotics, Lamictal, Benzos, or SSRI's for Obsessions, Depression, and Existential Thoughts



## feministcat (May 4, 2010)

I've been taking Lexapro or some form of SSRI medication for panic disorder for 13 years. I also have Ativan to use as needed for anxiety. I rarely use the ativan unless I'm really freaking out. Over the past year I have noticed depression worsening for me and about 4 months ago I started having bad DP for the third time in my life.







I'm having alot of trouble with obsessive thoughts and existential thinking and agoraphobia. In the past, my psychiatrist has recommended Abilify to help with these things. I have not taken it or any antipsychotic medications because of the side effects. I am going to see my psychiatrist in a couple weeks and I am considering med changes because of the increased depression and the DP. I'm wondering if anyone here has ever benefited from taking antipsychotic medications for obsessions and/or DP. My psychiatrist has never treated anyone with DP, but she always tells me it is just anxiety manifesting itself in different ways. I think Ativan is probably the only thing that can help me with anxiety, and I'm not afraid to take it because I have never become addicted to it and I use it so rarely. But the Ativan does not help with DP or obsessions. It just quiets my mind temporarily when it is racing. I'm also thinking I may need a different SSRI since the depression started coming back over the last year. I am also curious about Lamictal because I've read that others have benefited from it. I am terrified of changing meds because I don't want to feel any worse, but at the same time if there is something out there that can help me with these symptoms, I don't want to avoid taking it just because of the fear of getting worse. Any thoughts or shared experiences regarding obsessions and medications would be appreciated.


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## aloof (Nov 18, 2008)

Klonopin


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## Mario (Oct 26, 2009)

Though i can't take any type of antidepressants as they make me feel a lot lot worse,I would suggest "Remeron (mirtazapine)".It's a tetracycle antidepressant and it works not only by increasing the serotonin levels in the brain but also increases the noradrenaline.My psychiatrist says that this is one of the best antidepressants on the market.Of course,this is her own personal opinion because everyone is different and reacts differently to the same medication,but i guess that maybe you should consider speaking to your doctor about Remeron.In my non doctor opinion,i think that changing a SSRI by another would be a complete waste of time as the way all SSRIs work is quite similar. 
Just my 2 cents


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## aloof (Nov 18, 2008)

Mario said:


> Though i can't take any type of antidepressants as they make me feel a lot lot worse,I would suggest "Remeron (mirtazapine)".It's a tetracycle antidepressant and it works not only by increasing the serotonin levels in the brain but also increases the noradrenaline.My psychiatrist says that this is one of the best antidepressants on the market.Of course,this is her own personal opinion because everyone is different and reacts differently to the same medication,but i guess that maybe you should consider speaking to your doctor about Remeron.In my non doctor opinion,i think that changing a SSRI by another would be a complete waste of time as the way all SSRIs work is quite similar.
> Just my 2 cents


SSRIs suck i agree...but remeron makes many people sleep and eat and get fat.


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## Kpanic (Sep 12, 2010)

feministcat said:


> I've been taking Lexapro or some form of SSRI medication for panic disorder for 13 years. I also have Ativan to use as needed for anxiety. I rarely use the ativan unless I'm really freaking out. Over the past year I have noticed depression worsening for me and about 4 months ago I started having bad DP for the third time in my life.
> 
> 
> 
> ...


Xanax helped me somewhat with DR. The Pristiq I take does not help at all. I am adding Lamictal to the Pristiq along with Xanax prn. I would for sure try the AC route before the AAP route no doubt about it. But, people I know with this have been helped by low dose Seroquel XR or Zyprexa at low dose as well. But again, I would go the AC route first, Lamictal or Depakote. The AAP's will wipe out the anxiety, and that should break down the DR. But the AAP's come with some hellish side effects - but what's worse, living with DR or having a few side effects and having this shit gone!


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## Nihil Dexter (Sep 9, 2010)

Kpanic said:


> Xanax helped me somewhat with DR. The Pristiq I take does not help at all. I am adding Lamictal to the Pristiq along with Xanax prn. I would for sure try the AC route before the AAP route no doubt about it. But, people I know with this have been helped by low dose Seroquel XR or Zyprexa at low dose as well. But again, I would go the AC route first, Lamictal or Depakote. The AAP's will wipe out the anxiety, and that should break down the DR. But the AAP's come with some hellish side effects - but what's worse, living with DR or having a few side effects and having this shit gone!


which AAP wipes out the anxiety ? I was on Risperdal and it made me worse. Zyprexa 2,5mg did also nothing.


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## Kpanic (Sep 12, 2010)

danxiety said:


> which AAP wipes out the anxiety ? I was on Risperdal and it made me worse. Zyprexa 2,5mg did also nothing.


I would try Seroquel XR no more than 200mg. If the Zyprexa did not work at 2.5, did you try 5 or 10? I have never heard anyone say that Zyprexa did not wipe it out. If I were you, I would at least try the Seroquel XR.


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## Nihil Dexter (Sep 9, 2010)

Kpanic said:


> I would try Seroquel XR no more than 200mg. If the Zyprexa did not work at 2.5, did you try 5 or 10? I have never heard anyone say that Zyprexa did not wipe it out. If I were you, I would at least try the Seroquel XR.


Zyprexa wipes out DR/DP ?


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## Kpanic (Sep 12, 2010)

danxiety said:


> Zyprexa wipes out DR/DP ?


Zyprexa at low doses should wipe your ANXIETY. Seroquel XR no more than 200 should also wipe out ANXIETY. If you reduce the anxiety, your DP/DR should follow suit. Since everyone is wired differently and you said you did not get anything off 2.5 did you try more Zyprexa? I take 150 Seroquel XR and it wiped my anxiety out and my DR is about 80% gone.If I had a choice, I would try the Seroquel XR first and then tirate up on Zyprexa.

You could be a paradoxical responder - have you tried Lamictal yet? Worth a shot before going up on Zyprexa.


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## Nihil Dexter (Sep 9, 2010)

Kpanic said:


> Zyprexa at low doses should wipe your ANXIETY. Seroquel XR no more than 200 should also wipe out ANXIETY. If you reduce the anxiety, your DP/DR should follow suit. Since everyone is wired differently and you said you did not get anything off 2.5 did you try more Zyprexa? I take 150 Seroquel XR and it wiped my anxiety out and my DR is about 80% gone.If I had a choice, I would try the Seroquel XR first and then tirate up on Zyprexa.
> 
> You could be a paradoxical responder - have you tried Lamictal yet? Worth a shot before going up on Zyprexa.


No, I stopped Zyprexa at 2.5 mg because I didn't noticed any difference. I would like to try Seroquel, but I have a major problem: I can't swallow pills, no matter how small they are. So i tried Riserpal Quicklet => Epic Fail. I have an appt on Tuesday, and I will discuss restarting the zyprexa again, on higher doses. I want to add Lamictal as well. If Zyprexa doesn't make any difference, I will give perphenazine a shot, as I read a success story about it in this forums.

cheerio


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## Kpanic (Sep 12, 2010)

danxiety said:


> No, I stopped Zyprexa at 2.5 mg because I didn't noticed any difference. I would like to try Seroquel, but I have a major problem: I can't swallow pills, no matter how small they are. So i tried Riserpal Quicklet => Epic Fail. I have an appt on Tuesday, and I will discuss restarting the zyprexa again, on higher doses. I want to add Lamictal as well. If Zyprexa doesn't make any difference, I will give perphenazine a shot, as I read a success story about it in this forums.
> 
> cheerio


Good luck to you. Usually the algorithm for any anxiety issue is SSRI or SNRI first possibly with a light benzo. Second, it's the SSRI SNRI + Benzo + a mood stabilizer. Some people respond well to Lamictal, other are better responders to Depakote. The other AC's don't really have much kick in terms of anti-anxiety properties. Last resort is SSRI SNRI + AAP + Benzo. Last resort simply because of the SE's of AAP's. I would highly suggest Seroquel XR when you meet with your pdoc. It has been shown in many placebo and open label tests to help out in terms of anxiety. If that does not kick it try Zyprexa at 15 or 20 mg, I promise you that should take care of it, ZOMBIE feeling should fade over time. YMMV. I have not done much research on perphenazine, since it is a Typical, I try not to look at it to much. Maybe I should, I just think the AAP work better. But the thing is YMMV and we are all wired differently. Looks like it is time for the next horsie on the med go round.


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## Nihil Dexter (Sep 9, 2010)

I will def. go for an antipsychotic and an anticonsulvant. When the first panic attack hit me, i felt extremely manic and agitated.


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