Question:
Hi Doc..
2 years ago, during an illness that lead to surgery, I became depressed and severely anxious. I was diagnosed when I was a teen with GAD (I'm 30 now). Since the surgery, the anxiety is basically constant. Mostly constant worry, jaw clenching, extreme fatigue and lethargic most of the time. I can sleep 12 hours a night and still be tired. (I do wake up briefly a few times a night.)
I’ve tried all the SSRI’s, the one that helped was Celexa for the depression and anxiety, but made me too sleepy and unmotivated. The rest were disastrous. I’ve tried BuSpar for 2 weeks, 10mg 2x day, but I couldn’t tolerate the dizziness and headache (and it did not seem to do anything). I’ve tried Neurontin, too tired. Wellbutrin, anxious and wired.
Benzo's scare me. My doc mentioned Effexor? Any suggestions?
Thanks.
Dr. Heller's Answer:
In my experience those with the GAD who get symptom worsening with BuSpar have an elevated serotonin 2 receptor, usually associated with post traumatic stress disorder. The addition of Remeron to BuSpar could have a dramatic effect.
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