Question:
I would really appreciate if somebody could give me some advice. I suffer
from anxiety and depression and my pdoc prescribed Manerix 300mg/day. The
drug (the active ingredient called moclobemide, a selective and reversible
MAOI) is known as an activator with no sedative properties. It made my
anxiety even worse, though I haven't experienced any more panic attacks
since the begining of the therapy the anxiety has turned into an overall,
persisting and generalized anxiety instead. I also experience lots of
extrasystols and palpitations all the time.
Two years ago I was prescribed Prozac, which made me crazy. I made the same
experience with Zoloft that even triggered a panic attack...
Does anybody know of a drug that helps with depression along with anxiety
or is a combo the only solution?
Answer:
The combination of anxiety and depression is indeed difficult to treat
effectively. It might be more appropriate for you to think of them as
separate problems, rather than linking them together. Two problems require
two solutions. I take moclobemide, and I am satisfied that it is the best
med I've tried for treating my depression. Like you, standard
antidepressants are inappropriate for me, as they trigger mania in me. Anxiety involves hyperactivity in the HPA axis, the hypothalamus,
pituitary, and adrenal glands. They work in concert to regulate the
activity of all the metabolic processes. If these glands are too active,
you become hyper-responsive to what others would think of as normal
stimuli. Alternatively, some people feel that anxiety is caused by
hypersensitivity of the receptors in the brain that monitor HPA activity.
Whatever. Small things trigger big reactions. Standard therapy for anxiety usually involves benzodiazepine tranquilizers
(e.g. Valium, Klonopin), as these meds block the receptors in the brain
which register the adrenal hormones leading to stimulation. However, kava
kava, a natural product, also blocks the same receptors. Some people feel
it is more gentle in action than the benzos, although chronic use of the
benzos or kava kava is not usually a good thing. The body adapts to the
presence of the active ingredients, and activity is lost over time. Have you considered cognitive therapy? Even though there is a major
biological imbalance likely already present in an anxious person, thinking
processes can either enhance or reduce the effect of the biological part.
Cognitive therapy should help you learn to cope a little better, despite
the discomfort you commonly experience. Nutrition may also play a key role in the chronicity of your anxiety.
Anxiety is a huge stress on all body systems, and may deplete many
essential nutrients in the body, due to the constant activation. The B
vitamins in particular are often at very low levels in anxiety sufferers.
For B vitamins to have the greatest effect, vitamin C is also necessary.
You might want to try 1000 mg/day B-vitamin complex, with 2000 mg/day
vitamin C, taken in the morning with a meal. Selenium and zinc are also a
good bet, as they help maintain normal body enzyme levels. And make sure
you're getting calcium and magnesium in good amounts. You'll excrete any
extra, if you take a lot in your diet. Fish oil (e.g. salmon oil), at up to
3000 mg/day will help with blood pressure and mood. I have anxiety and depression, and my doc has prescribed me Remeron (Zispin
here in the UK).... and it has worked wonders. Although I think I am going
to be taken off it because of it lowering my WBC-, bad mouth ulcers and
other oral infections. If you dont get that then its great. I have been on imipramine for panic and it
worked.I have been on it for 15 yrs.It also
helps you sleep.The draw back is you will gain some weight.
