QUESTION:
Dear Dr. Heller,
Hi doctor, I hope you can get to this one! I have had many problems and diagnoses in the past. I'm struggling with OCD and lot of anxiety. I don't usually get depressed but I get very angry at myself and at others. I have tried all of the SSRI's (no help at all). They made the symptoms worse, especially the tics! Xanax is about the only thing that helps, a little. I am reluctant to try Neurontin because of the dermatological, hirsutism side effects. Any suggestion?
ANSWER:
Every patient I've had for many years who complained of increasing anxiety
symptoms with an SSRI had the generalized anxiety disorder - particularly the cognitive
component (mind always going). When treated with BuSpar, it then becomes possible to take
the SSRI medications. There is a likely imbalance going on - anxiety with high levels of
the serotonin receptor #1, and the others with low serotonin. BuSpar lowers the high one
so the SSRI's can raise the low ones without causing the anxiety problems.
If BuSpar also caused side effects, temporary use of Remeron can control that side effect.
