# Non-SSRI/SNRI Anxiolytics?



## Unlimited00 (Feb 24, 2011)

Besides the obvious group (benzos) are there any non-ssri/snri anxiolytics that any of you have used that seemed to help with the anxiety? I ask because every time I take anything that touches serotonin, I go completely crazy. I just got off Celexa which I took for 21 days, starting at 5mg and going to 20mg. I couldn't sleep, couldn't eat, lost 14 pounds in 21 days, had completely erratic moods where I would go from on top of the world to yelling at someone and about to tear their head off to the deepest depression where I contemplated just about any and every possible method of suicide while curled up in a ball in my trunk (I'm 6' 1" and I have a Mustang for what its worth). All in the course of an hour. I also jumped off a balcony, kicked down a door, and smashed my bathroom window in that time frame. When I was 16 I tried Zoloft, pretty much to the same effect. Lesson learned. I literally don't think I could physically survive another SSRI.

I also tried Buspar up to 60mg/day, but that did absolutely nothing besides giving me weird electric shock sensations in my head right after I took it.

So, is there some class of medication that I'm missing here? Or is it just either something that messes with serotonin or a benzo?


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## broflovski (Feb 1, 2011)

I have great impression from tianeptine. It actually touches serotonin, but in the way opposite/different from SSRIs. Phenibut (non-benzo nootropic GABA-ergic and slight dopaminergic) is a good anxiolytic as well, though fits not for everybody. Both a widely discussed here! That are the alternatives I mostly deal with, and may provide you more info.


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## sombersolitude (Feb 9, 2011)

You might be bi-polar. That is a unusual reaction to a ssri. Buspar is not very effective. I'd recommend in your situation a SNRI such as effexor, wellbutrin, or cymbalta. If the anxiety is debilitating then I'd reach benzodiazapines as a last resort


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## Darrio (Jan 26, 2011)

Unlimited00 said:


> Besides the obvious group (benzos) are there any non-ssri/snri anxiolytics that any of you have used that seemed to help with the anxiety? I ask because every time I take anything that touches serotonin, I go completely crazy. I just got off Celexa which I took for 21 days, starting at 5mg and going to 20mg. I couldn't sleep, couldn't eat, lost 14 pounds in 21 days, had completely erratic moods where I would go from on top of the world to yelling at someone and about to tear their head off to the deepest depression where I contemplated just about any and every possible method of suicide while curled up in a ball in my trunk (I'm 6' 1" and I have a Mustang for what its worth). All in the course of an hour. I also jumped off a balcony, kicked down a door, and smashed my bathroom window in that time frame. When I was 16 I tried Zoloft, pretty much to the same effect. Lesson learned. I literally don't think I could physically survive another SSRI.
> 
> I also tried Buspar up to 60mg/day, but that did absolutely nothing besides giving me weird electric shock sensations in my head right after I took it.
> 
> So, is there some class of medication that I'm missing here? Or is it just either something that messes with serotonin or a benzo?


I don't know exactly what it was in SSRIs that made you kick off it that way, however if you are looking for another class of meds which relieve anxiety, with FAR more efficacy than SSRIS - (I don't believe SSRIs help with anxiety at all - or anything else for that matter) then look at MAOIs; Particularly Nardil.
It is the absolute gold standard of meds that help with social anxiety other than benzos, but can be difficult to get prescribed by many doctors nowadays due to their lack of education and medical myths surrounding them.


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## mikoy (Aug 12, 2010)

Maybe some stabilizer with low dose SSRI?


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## Unlimited00 (Feb 24, 2011)

broflovski said:


> I have great impression from tianeptine. It actually touches serotonin, but in the way opposite/different from SSRIs. Phenibut (non-benzo nootropic GABA-ergic and slight dopaminergic) is a good anxiolytic as well, though fits not for everybody. Both a widely discussed here! That are the alternatives I mostly deal with, and may provide you more info.


I have always been very interested in tianeptine, but unfortunately it doesn't seem readily available in the states. That would be the only thing that touches serotonin that I would still try.

As for phenibut, my only issue is that although it is not a benzo (nor does it bind to the BZD receptor?) it seems to carry the same risks of addiction/tolerance as them. I have no problem getting a benzo because on most days my anxiety is very severe, and am looking for more long term options that can be taken daily.



sombersolitude said:


> You might be bi-polar. That is a unusual reaction to a ssri. Buspar is not very effective. I'd recommend in your situation a SNRI such as effexor, wellbutrin, or cymbalta. If the anxiety is debilitating then I'd reach benzodiazapines as a last resort


You are absolutely correct. The two reactions like this, separated by 5 years, was the last nail in the bipolar coffin, so to speak. My GP ended up dropping me since it was past her scope because of it. I see a psychiatrist tomorrow, and will in all likelihood end up on a mood stabilizer.

As for the SNRIs, I still won't touch them. They still inhibit the action of the serotonin transporter. That is a no-no for me. I am also on 300mg/day of wellbutrin, so I already have inhibition of both the dopamine and norepi transporters. When the celexa was combined, I was hitting all three (5HT, DA, and NE) and the issue still persisted.

Unfortunately, the wellbutrin is great for depression 80% of the time, but does nothing for SA what so ever.



Darrio said:


> I don't know exactly what it was in SSRIs that made you kick off it that way, however if you are looking for another class of meds which relieve anxiety, with FAR more efficacy than SSRIS - (I don't believe SSRIs help with anxiety at all - or anything else for that matter) then look at MAOIs; Particularly Nardil.
> It is the absolute gold standard of meds that help with social anxiety other than benzos, but can be difficult to get prescribed by many doctors nowadays due to their lack of education and medical myths surrounding them.


Same as above, it seems to be a big red flag for bipolar. MAOIs seem pretty damn good, but it also seems like doctors are more hesitant to give that than a benzo. If I was ever offered it, I would try it right away. I'm just worried the same issues may apply because it still modulates the serotonin system.



mikoy said:


> Maybe some stabilizer with low dose SSRI?


At some point I will most likely try this since it seems to be fairly hit-or-miss as far as bipolar is concerned.

-----

Thanks for all the replies!! If anyone else has suggestions, I am more than happy to hear about them!


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## metamorphosis (Dec 18, 2008)

You can try pregabalin or gabapentin. People have been having some success with those. Or buspirone that has the infamous "sugar pill" name. Pdocs seem to be using it more. When it first came out it appears that it wasn't being prescribed at a high enough dose. Plus the fact that it takes around a month or so to feel therapeutic effects. Where with the benzos., gabapentin, and pregabalin you can start feeling the med. in 30-45min.


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## Unlimited00 (Feb 24, 2011)

metamorphosis said:


> You can try pregabalin or gabapentin. People have been having some success with those. Or buspirone that has the infamous "sugar pill" name. Pdocs seem to be using it more. When it first came out it appears that it wasn't being prescribed at a high enough dose. Plus the fact that it takes around a month or so to feel therapeutic effects. Where with the benzos., gabapentin, and pregabalin you can start feeling the med. in 30-45min.


Trust me, I know Buspar is a sugar pill. 60mg/day for weeks did absolutely nothing for me except upset my stomach really.

And do you know if pregabalin or gabapentin have much of an effect on memory and do they form a tolerance? I haven't been able to find a lot on them, especially in relation to SA


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## Arisa1536 (Dec 8, 2009)

What about trazodone? or the pregabalin thats been mentioned?
Moclobemidecan be good for SA supposedly but is it as good as the other MAOI's like parnate and nardil for SA? u would have to ask someone on here who has tried them or takes them regularly.

Hydroxyzine (Atarax) is an old antihistamine that has sedative effects, i found taking diphenhydramine did sedate me quite a lot but it came with a lot of typical side effects like dizziness, dry mouth, constipation, tiredness but inability to sleep, lethargy and lower mood. 

there are azapirones, Buspar is one of them and i admit it did nothing for me except make me more depressed so i ate heaps and i got terrible migraines on it.
other azapirones tandospirone (Sediel). Gepirone (Ariza, Variza) might work, if u can get them where u are? 

Zopiclone is effective as an hypnotic sedative but it is habit forming although not addicting in the same way as a benzo because its a non benzodiazepine class of drug

i hope that helped 
you could ask your doctor about these drugs and see what he/she says

Antipsychotics also calm you right down and are used to augment bipolar treatments and meds, but then again they have bad side effects too, so its a process of elimination i guess but some Antipsychotics do work


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## Himi Jendrix (Mar 24, 2010)

Unlimited00 said:


> And do you know if pregabalin or gabapentin have much of an effect on memory and do they form a tolerance? I haven't been able to find a lot on them, especially in relation to SA


Pregabalin does have some effect on memory, but I would say less than benzos. It does form rapid tolerance it seems.

Mind you, I was only on 150mg total per day in 50mg doses. This is a fairly low dose and it was for nerve pain. I might try to get it prescribed for anxiety but it does cost a lot in USA.

I have SA, agoraphobia, panic attacks, and OCPD and it helps a lot with SA. It makes you feel a bit high at first and then you eventually (after 1-2.5 weeks) grow tolerant and need to take a break to feel the full effect again.

I would suspect that a dose of 400-600mg total per day would be excellent for treating SA.


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## bben (Oct 24, 2009)

let me suggest suboxone. it will work and it will work instantly. It also has zero cognitive side effects.

i went from treatment resistant depression to pretty dang good.


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## Noca (Jun 24, 2005)

Adderall XR or Nardil


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## jimmythekid (Apr 26, 2010)

Maybe Seroquel. I take it and I think it keeps me calm.


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## metamorphosis (Dec 18, 2008)

Unlimited00 said:


> Trust me, I know Buspar is a sugar pill. 60mg/day for weeks did absolutely nothing for me except upset my stomach really.
> 
> And do you know if pregabalin or gabapentin have much of an effect on memory and do they form a tolerance? I haven't been able to find a lot on them, especially in relation to SA


Yeah tolerance does build in both of them. Perhaps cycling them would work or just going for something new like agomelatine. it works on two melatonin receptors-MT1, MT2 agonist and 5-HT2c antagonist which are both good things. Its new to have a psych. med come out that works on circadian rhythms and also increases noradrenalin and dopamine release in the frontal cortex. D,Stein (2008 reported efficacy in generalised anxiety disorder. I haven't looked at that study yet.


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## broflovski (Feb 1, 2011)

metamorphosis said:


> Yeah tolerance does build in both of them. Perhaps cycling them would work or just going for something new like agomelatine. it works on two melatonin receptors-MT1, MT2 agonist and 5-HT2c antagonist which are both good things. Its new to have a psych. med come out that works on circadian rhythms and also increases noradrenalin and dopamine release in the frontal cortex. D,Stein (2008 reported efficacy in generalised anxiety disorder. I haven't looked at that study yet.


Agomelatine (Valdoxan) is an interesting option indeed. But its affinity for 5HT2c receptor is nearly twice lower as fluoxetine's (as I rememder). Melatoninergic action is a disputable mechanism itself, and may be promoted mainly to claim for "novelty" of the drug.
We have widely sold anxiolytic "afobazole" there I am, that acts as _antagonist_ at M1 and M3 receptors (though it is not its primary mode of action and goes along with GABA-benzodiazepine positive allosteric modulation, sigma1-agonism and reversable MAO-A inhibition).


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## shakeyness (Apr 30, 2011)

I don't know about everyone... But I've been on the antidepressent merry go round and buspar and I can't stand most of them. But what does seem to help me is remeron, its not a ssri or snri for a matter of fact I read that it can be used to treat serrintonin syndrome. I take it once a day at night helps me sleep a bit ( I'm a insomniac ) the only side effect I notice is the munchies and horny. Lol and I take xanex and atavan switching now n then so I don't develop a tolerance. I don't know if this works 4 u but its the best combo I've been on.


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