QUESTION:

Dr. Heller, I am 37, and I think that I have suffered from anxiety and depression since childhood.  At about the age of 30, I was diagnosed by my doctor with GAD and depression.  According to my experience and your screening criteria, I think that “fractured happiness” and the inattentive type of ADD are also parts of my overall condition.  I have tried almost all of the SSRI’s, and generally they let me see what non-depressed, non-anxious thinking was like.  What a revelation! However, side effects have been a big problem.  Prozac made me hyper.  Paxil made me feel the best, but it also caused a rapid weight gain.  Zoloft made me feel wired.  Adding Trazodone caused a quick addition of 10 pounds despite a lot of exercise.  I tried Wellbutrin with Paxil and Celexa respectively but this did not lessen my side effects.  This includes memory glitches that were very disturbing.  Currently, I am on Serzone by itself, and it seems to have made my anxiety worse. Many family members, from both sides, have ADD, depression and anxiety.  Are these conditions related to one another?  Considering the fact that I have multiple issues, which medications would you suggest for me? (I have had my thyroid checked on several occasions.  It has always been normal.)

ANSWER:

The problem is the GAD and an overactive serotonin 1-A receptor.  This is the gene involved in the cognitive generalized anxiety disorder.  SSRI’s increase most serotonins, including this one.  BuSpar lowers that receptor so that SSRI’s and stimulants can be taken.

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