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View Full Version : Anti-depressants and anxiety pills



ElizaFaith13
06-01-2011, 03:58 AM
I'm looking for a bunch of pills that can be prescribed together, maybe zanax, and two others?

backslashbaby
06-01-2011, 05:41 AM
Anti-anxiety meds are prescribed with SSRIs fairly frequently, so you could have Xanax with Lexapro, for instance. Then, depending on a lot of things, docs can add in drugs like Wellbutrin or Abilify. This is mainly for major depression, but Abilify is used frequently for bipolar disorder, too.

There is another new one that isn't out yet, I don't think, that is not really used as a standalone antidepressant but can help when added to an antidepressant that isn't working enough.

If you are talking bipolar disorder or anything that could require antipsychotics, the combinations are really varied!

Wayne K
06-01-2011, 05:42 AM
When ya find someone send them my way :D

They're for a friend

missouridalton
06-01-2011, 06:01 AM
There are also blood pressure/anti-anxiety medications that are proscribed with anti-depressants. Lexapro is very commonly paired with other drugs.

BunnyMaz
06-01-2011, 06:22 AM
It depends on the meds you're on, I think. Before I gave up hope of finding a med that didn't make me worse than I was without them I was on citalopram, then sertraline, then something else I've forgotten the name of, then I was moved onto a non-SSRI called erm... mirtazapine I think?

The support group I was with online suggested that, with citalopram, I could take valium if my GP was willing to prescribe (he wasn't), but that everything from valerian tea to kalms was strictly off limits, and only a very limited range of anxiolytics were considered okay with citalopram. I was also not allowed to take any painkillers that included aspirin or that contained anti-nausea ingredients, or anything that could effect blood pressure levels. A whole list of supposedly gentle, herbal depression and anxiety supplements were strictly off limits, such as st john's wort, which can cause fatal side effects mixed with citalopram! I also found that the paracetemol/codeine blend painkillers I took for migraines and "women's problems" were off limits personally, because shortly after taking them I would feel what I can only describe as "really wierd" and would have to go lie down for an hour or three.

I didn't get anywhere the same list of instructions on sertraline, but the impression I got was that restrictions were similar, and my GP maintained a flat "no" to my queries about supplementing with herbal remedies. After that I didn't even bother asking when he tried me on the other meds.

Mirtazapine was the only non-SSRI med he tried me on, as a last ditch attempt after finally accepting that these newfangled, modern and trendy meds just didn't work for me. One big change was that on mirt I was allowed to take things like bach's rescue remedy. I also knew people on the forums who were prescribed propranolol with mirt.

It really comes down to what specific meds your MC is taking and what for. As an aside, my issues are pretty solidly in the anxiety/self harm side, with occassional irrationality, but all my meds were ostensibly depression meds that "also help anxiety". and were prescribed with nothing else to back them up.

Don't know if that was much help, sorry. If you want side effect advice though, I'm your girl! :D

ElizaFaith13
06-01-2011, 06:30 AM
wow. thanks everyone! That's a lot of drugs!

archetypewriting
06-01-2011, 08:20 AM
If you can tell us what you're trying to accomplish, and for what disorder/s, we might be able to give you a fairly specific cocktail. :)

ElizaFaith13
06-01-2011, 03:24 PM
A prescriptive cocktail? Sounds fun.

the MC has just lost her mother (father already dead). She petitions her rich step-dad to take her to the doctors for meds, so she can finish her last year of HS, get a scholarship, and leave.

Because she tries to ignore her feelings, they manifest as panic attacks, and she has very intense-depressive-mood swings. She's not suicidal though.

KQ800
06-01-2011, 03:40 PM
A prescriptive cocktail? Sounds fun.

the MC has just lost her mother (father already dead). She petitions her rich step-dad to take her to the doctors for meds, so she can finish her last year of HS, get a scholarship, and leave.

Because she tries to ignore her feelings, they manifest as panic attacks, and she has very intense-depressive-mood swings. She's not suicidal though.


Xanax is good against panic attacks, you can take them both as a suppressor, and as an emergency boost when you feel an attack coming on.

If you have no personal experience of these drugs, read up on their side effects. Most people get at least something annoying out of them.

Lithium is good against mood fluctuations and bipolarity. But it is something that is a bit iffy to get unless you tried other things and that didn't work.

Lithium will cause permanent damage to your kidneys if you mismanage the dosage, so you will have to go and take blood test every month to make sure that you have the right dose.

BunnyMaz
06-01-2011, 05:27 PM
Citalopram is generally the first medication depression and anxiety sufferers are prescribed these days; it is one of the newer, more recently tested, SSRI meds. SSRIs in general are the "in" thing right now, and citalopram is supposed to be better because in theory it has fewer side effects. In practice though it can be rather erm... exciting.

As with any SSRI, the dosage is gradually increased. Your MC will likely be given a prescription for 5mg for the first week or 2, up to 10mg for a month after than, then 15mg, then maybe 2-3 months down the line up to 20 or 25mg. I was put up to 30mg over a six month period before my GP accepted it wasn't working for me and tried another one.

For the first week, I was told to sign off work. The side effects when you first start taking the meds can be varied and quite unpleasant, and although they generally persist for up to 6 weeks (although sometimes longer), a week or 2 is presumed to be long enough for you to work out what side effects you'll get and find a workaround.

One thing- the meds info leaflets in the packets list side effects according to how common they are. General consensus amongst users is that the commonality was determined by throwing darts at a board, since the "very rare" effects seem anecdotally to be actually very common. I've bolded the ones I had to give you an idea of how much of a range people can get. Side effects can include;

feeling sick
dry mouth - I got this. Also started gurning and chewing my face like I was on ecstasy.
sleepiness
shakiness of the arms and legs
diarrhoea
headache
dizziness
visual disturbance
sleeping difficult
constipation
weakness
increased sweating
palpitations
agitation
nervousness
pins and needles
increased anxiety
problems concentrating
confusion
increased suicide risk
abnormal dreams (very common - in my support forum we often had threads about "what did you dream last night". Think vivid, bizarre fever dream adventures that seem to span whole new worlds. Bes. Side effect. Ever.)
tiredness
yarning
abnormalities of vision
migraine
memory loss
listlessness
feeling faint after standing
rapid heart rate
loss of appetite or aversion to food
increase in appetite
weight gain or loss
indigestion
stomach pain
wind
vomiting
abnormalities of taste
increased salivation
runny nose
sinusitis
impotence
reduced libido
anorgasmia
problems passing water
period pains
rash
itching
muscle pain
jerky movements
fits
ringing in the ears
false sense of wellbeing
increased sex drive
coughing
malaise
sensitivity to sunlight
changes in liver function
slow heart rate
fainting
allergic reactions
bleeding in the skin, bruising, stomach and from the vagina
increased bleeding time
changes in the salt balance in the body
hallucinations
mania
feeling of unreality - I didn't get this but apparently it is really, really common
panic attacks
production of breast milk
swelling of the lips, eyes and tongue
joint pain

Many of the side effects dissipated after a couple of weeks. The dosage is a slowly increased thing and it is normal for it to take anything up to 6 weeks before users feel any of the benefits of the medication. If the meds prove unsuitable, it is also normal for patients to be gradually weaned off citalopram and on to something else, because the withdrawal symptoms can be as bad, if not worse, than the side effects. There were times when I was coming off one med onto another and would be having withdrawal symptoms of one, side effects of another and none of the benefits of either. Fun times!

If I had to describe the "benefits" as I experienced them, it would be as a numbing effect. The panic was still there, the depressive sensations and the desire to self harm. But I felt detatched from it, numb to it. The meds weren't intended to fix me but to give me space to be rational and to have some distance from my problems whilst I sought therapy.

Oh! If for any reason you give your MC a non-SSRI like mirtazapine, side effects there are very different. I experienced violent mood swings and increased violent desires/tenencies. When things got really bad I'd disappear off to the work loos, close myself in a cubicle, and thrash around until I felt better. I'm just gald I had somewhere to go hide before I had to throw a wobbler! I also had severe difficulty waking. One time, my other half patiently encouraged me out of bed and went to make me a cuppa while I got dressed. He came back to me half-naked, asleep on the floor cuddling the clothes I'd been trying to dress into.

PinkAmy
06-01-2011, 06:29 PM
A prescriptive cocktail? Sounds fun.

the MC has just lost her mother (father already dead). She petitions her rich step-dad to take her to the doctors for meds, so she can finish her last year of HS, get a scholarship, and leave.

Because she tries to ignore her feelings, they manifest as panic attacks, and she has very intense-depressive-mood swings. She's not suicidal though.

Yup, they call it a cocktail.

A competent doctor is going to look hard at a girl who goes into a doctor's office looking for medication to finish HS. The dr. is going to want to assess whether or not she needs medication or whether therapy can alleviate her symptoms.
Xanax, or any other schedule three drug (controlled substance) is not going to be the first med. prescribed. Psychiatrists and MDs know that teens sell their meds and go to Pharm parties. The psychiatrist would start with one drug and then add to it, not start with three drugs.
There is a non-addictive anti-anxiety medication called buspiprone (brand name buspar) that had a longer half-life than meds like xanax and adivan. She's more likely be started the lowest level.
The issue with cocktailing is that anti-anxiety medications can have depression side effects and anti-depression meds can have anxiety-medications.
Depending on what the primary symptom is, depression or anxiety, that would be the first drug prescribed---IF the doctor decided to try medication before or in conjunction with therapy.
Most doctors aren't going to prescribe anti-depression or anxiety medication without therapy for a teen. At the very least she should be followed closely by the prescribing psychiatirst.
Buspar is compatible with SSRI medications like prozac, paxil etc. When prescribing two anti-depressants at the same time, psychiatrist want to be sure they work synergistically. A patient won't be given prozac and paxil, because they work on the same neurotransmitters (serotonin, norepinephrine, and dopamine. Wellbutrin might be added to a SSRI or Effexor.

backslashbaby
06-01-2011, 11:51 PM
I agree. High school makes the prescribing a problem.

Things have changed since I was in school for this, I'm sure, but it used to be that studies on 'children' weren't really done enough, so the prescribing directions say to avoid in anyone under 18. I don't know how that is handled in practice. Surely 'kids' can take antidepressants, but it's something you might want to check into.

archetypewriting
06-02-2011, 07:33 AM
Backslashbaby makes a good point about the black box warning on teens and children. SSRIs (the newest class of antidepressants, which includes drugs like citalopram/Celexa, Prozac, Zoloft, etc.) have what's called a black box warning on them because suicide risk goes UP in young people. So theoretically someone would be monitoring your character a little more carefully b/c of her age.

Sometimes general practitioners (physicians) will prescribe more readily than a psychiatrist, because that's what they're used to doing for conditions -- writing a prescription. In fact, research shows that MOST SSRIs prescribed in the US are prescribed by general practitioners, not by psychiatrists. And if your character's father has a lot of money and power, maybe the practice he visits would be more willing to prescribe something for your character than someone out of the blue.

I do agree that Xanax is probably not where someone is going to start, as it's a controlled substance. An SSRI is probably more likely, though Buspar is another good suggestion. And of course, a good physician would recommend therapy.

Lithium is also one that has to be watched very carefully. In addition to the effects it can have on your internal organs, it's very easy to overdose on. In fact, when I was writing the meds chapter in my book, one of the psychiatrists I consulted said it may be the most dangerous drug available for depression. (That surprised me -- before that I thought another drug class, the MAOIs, was the most dangerous.)

I think it was Pink Amy who also made the point that they'd start with one drug and work their way up, which is also true.

I don't know that citalopram is actually prescribed more than the other SSRIs, at least here in the US. Lexapro is a newer version of citalopram/Celexa and has even fewer side effects. I think that often a doctor gets attached to particular meds and just uses them repeatedly, though someone who really understands the differences among the SSRIs will choose different ones for different reasons. Lots of problems with anorgasmia? Try Lexapro, Wellbutrin, or Effexor. Other SSRIs aren't really helping the depression? Try Prozac or Zoloft if the symptoms are primarily sadness, appetite, and sleep; try Wellbutrin and Effexor if there are also lots of concentration, motivation, and energy problems. And so on.

If you really want to mix drugs that she'd probably have trouble getting from a doctor, you could have your character swiping her Xanax from Mom or Dad's medicine cabinet, or buying it at school...

missouridalton
06-02-2011, 09:18 AM
Lexapro was prescribed for myself while I was in high school for depression and then in college for panic attacks.

While it's not noted for side effects, it can lend a person to being...weird. I (while fairly odd anyway) would blurt our things randomly, count ceiling tiles, find the most interesting patterns in water stains and in general act like someone who'd just smoked a bit of pot.

My pothead friends thought I was smoking pot. I was then informed I could sell my pills for $20 a piece if I so desired. I never did do that. I also found that Lexapro made me moody, and prone to crying.

So yeah...it's got odd side effects for teenagers.

Mom'sWrite
06-02-2011, 09:29 AM
A prescriptive cocktail? Sounds fun.

the MC has just lost her mother (father already dead). She petitions her rich step-dad to take her to the doctors for meds, so she can finish her last year of HS, get a scholarship, and leave.

Because she tries to ignore her feelings, they manifest as panic attacks, and she has very intense-depressive-mood swings. She's not suicidal though.

Could the cocktail be originally prescribed to the mother so they would be accessible to the girl? My ex took a cocktail of Lexapro, mirtazipine, and Valium (or you could use any one of the previously mentioned mixtures). If step-daddy won't take her to the doc, she might just help herself to mommy's leftovers.

Darren Frey
06-02-2011, 06:49 PM
Im bipolar and I take Celexa (an anti depressant similar to Lexapro) and Abilify, a mood stabilizer. I used to take xanax because my racing thoughts kept me awake at night. If you want an anti depressant that keeps you knocked off your ass go with Geodon

Anninyn
06-02-2011, 10:37 PM
I was prescribed mirtazapine for my panic attacks and insomnia. It worked, but had a whole host of side effects. I wasn't prescribed anything along side it though, and my Dr said it was OK to take rescue rememdy alongside it.

GeorgeK
06-04-2011, 07:33 PM
I'm looking for a bunch of pills that can be prescribed together, maybe zanax, and two others?


Just because the book says don't mix X with Y doesn't mean it's not going to happen. Many patients see multiple physicians and don't say anything about what the other Dr's are prescribing. At least once a week I'd see a new patient who's problems stemmed from multiphysician polypharmacy.


Yup, they call it a cocktail.

A competent doctor is going to look hard at a girl who goes into a doctor's office looking for medication to finish HS.

True, but you'd probably be surprised about the number of times that when trying to get to the heart of a patient's problems I'd ask, "and who has you on that medicine?"

"Dr. X."

In my head I'd think, "But Dr. X is a surgeon. That's not a normal medicine for a surgeon to be prescribing." To the patient I'd ask, "What did you see that Dr for?"

"I didn't. Dr. X plays golf with my dad and he got me the prescription."



What I've noticed is that the Dr's with the most law suits against them eventually get so apathetic about the risk of lawsuits that it actually makes them worse with regards to their prescribing habits."

PinkAmy
06-04-2011, 10:18 PM
True, but you'd probably be surprised about the number of times that when trying to get to the heart of a patient's problems I'd ask, "and who has you on that medicine?"

"Dr. X."

In my head I'd think, "But Dr. X is a surgeon. That's not a normal medicine for a surgeon to be prescribing." To the patient I'd ask, "What did you see that Dr for?"

"I didn't. Dr. X plays golf with my dad and he got me the prescription."



What I've noticed is that the Dr's with the most law suits against them eventually get so apathetic about the risk of lawsuits that it actually makes them worse with regards to their prescribing habits."

Not at all surprised. I've seen a lot in my work as a psychologist. My first job after grad school was at a clinic that was later closed and the owner indicted for medicaid and medicare fraud. The owner was the psychiatrists and he's prescribe whatever the patients wanted. Sometimes he'd even ask the patients what they wanted. (needless to say I didn't stay long and I reported him and the clinic--but they already had an investigation going before I my meeting with the feds. I don't think I added much.)

boron
06-06-2011, 02:01 PM
Lithium can make you stiff (phisically and mentally). It is a commonly prescribed drug for a bipolar disorder, but I wouldn't recommend this for someone who intends to finish her studies.

ElizaFaith13
06-11-2011, 05:22 AM
Lexapro was prescribed for myself while I was in high school for depression and then in college for panic attacks.

While it's not noted for side effects, it can lend a person to being...weird. I (while fairly odd anyway) would blurt our things randomly, count ceiling tiles, find the most interesting patterns in water stains and in general act like someone who'd just smoked a bit of pot.

My pothead friends thought I was smoking pot. I was then informed I could sell my pills for $20 a piece if I so desired. I never did do that. I also found that Lexapro made me moody, and prone to crying.

So yeah...it's got odd side effects for teenagers.

thanks for info. That's really interesting.

ElizaFaith13
06-11-2011, 05:26 AM
Xanax is good against panic attacks, you can take them both as a suppressor, and as an emergency boost when you feel an attack coming on.

If you have no personal experience of these drugs, read up on their side effects. Most people get at least something annoying out of them.

Lithium is good against mood fluctuations and bipolarity. But it is something that is a bit iffy to get unless you tried other things and that didn't work.

Lithium will cause permanent damage to your kidneys if you mismanage the dosage, so you will have to go and take blood test every month to make sure that you have the right dose.

I've taken xanax and valium before. The xanax used to be in a blue bar and all it did was knock me out...

ElizaFaith13
06-11-2011, 05:37 AM
Citalopram is generally the first medication depression and anxiety sufferers are prescribed these days; it is one of the newer, more recently tested, SSRI meds. SSRIs in general are the "in" thing right now, and citalopram is supposed to be better because in theory it has fewer side effects. In practice though it can be rather erm... exciting.

As with any SSRI, the dosage is gradually increased. Your MC will likely be given a prescription for 5mg for the first week or 2, up to 10mg for a month after than, then 15mg, then maybe 2-3 months down the line up to 20 or 25mg. I was put up to 30mg over a six month period before my GP accepted it wasn't working for me and tried another one.

For the first week, I was told to sign off work. The side effects when you first start taking the meds can be varied and quite unpleasant, and although they generally persist for up to 6 weeks (although sometimes longer), a week or 2 is presumed to be long enough for you to work out what side effects you'll get and find a workaround.

One thing- the meds info leaflets in the packets list side effects according to how common they are. General consensus amongst users is that the commonality was determined by throwing darts at a board, since the "very rare" effects seem anecdotally to be actually very common. I've bolded the ones I had to give you an idea of how much of a range people can get. Side effects can include;

feeling sick
dry mouth - I got this. Also started gurning and chewing my face like I was on ecstasy.
sleepiness
shakiness of the arms and legs
diarrhoea
headache
dizziness
visual disturbance
sleeping difficult
constipation
weakness
increased sweating
palpitations
agitation
nervousness
pins and needles
increased anxiety
problems concentrating
confusion
increased suicide risk
abnormal dreams (very common - in my support forum we often had threads about "what did you dream last night". Think vivid, bizarre fever dream adventures that seem to span whole new worlds. Bes. Side effect. Ever.)
tiredness
yarning
abnormalities of vision
migraine
memory loss
listlessness
feeling faint after standing
rapid heart rate
loss of appetite or aversion to food
increase in appetite
weight gain or loss
indigestion
stomach pain
wind
vomiting
abnormalities of taste
increased salivation
runny nose
sinusitis
impotence
reduced libido
anorgasmia
problems passing water
period pains
rash
itching
muscle pain
jerky movements
fits
ringing in the ears
false sense of wellbeing
increased sex drive
coughing
malaise
sensitivity to sunlight
changes in liver function
slow heart rate
fainting
allergic reactions
bleeding in the skin, bruising, stomach and from the vagina
increased bleeding time
changes in the salt balance in the body
hallucinations
mania
feeling of unreality - I didn't get this but apparently it is really, really common
panic attacks
production of breast milk
swelling of the lips, eyes and tongue
joint pain

Many of the side effects dissipated after a couple of weeks. The dosage is a slowly increased thing and it is normal for it to take anything up to 6 weeks before users feel any of the benefits of the medication. If the meds prove unsuitable, it is also normal for patients to be gradually weaned off citalopram and on to something else, because the withdrawal symptoms can be as bad, if not worse, than the side effects. There were times when I was coming off one med onto another and would be having withdrawal symptoms of one, side effects of another and none of the benefits of either. Fun times!

If I had to describe the "benefits" as I experienced them, it would be as a numbing effect. The panic was still there, the depressive sensations and the desire to self harm. But I felt detatched from it, numb to it. The meds weren't intended to fix me but to give me space to be rational and to have some distance from my problems whilst I sought therapy.

Oh! If for any reason you give your MC a non-SSRI like mirtazapine, side effects there are very different. I experienced violent mood swings and increased violent desires/tenencies. When things got really bad I'd disappear off to the work loos, close myself in a cubicle, and thrash around until I felt better. I'm just gald I had somewhere to go hide before I had to throw a wobbler! I also had severe difficulty waking. One time, my other half patiently encouraged me out of bed and went to make me a cuppa while I got dressed. He came back to me half-naked, asleep on the floor cuddling the clothes I'd been trying to dress into.

Sometimes I wonder if the side effects are worth it? But I've only dealt with panic attacks, nothing life endangering. Thanks again for all that info. It's quite a lot!

I hope these days you're feeling better : )