PTSD and panic attacks

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:How often are the panic attacks? If often and the PTSD is pretty bad, I would recommend Lamictal.

A lot of doctors will go to SSRI’s but in my opinion unless they are extremely anxious or extremely depressed, the side effects and how long they take to titre up in your system don’t make them worth it for panics attacks/PTSD.

Lamictal is a mood stabilizer and is very mild. You have to start with a low dose and move up every week to a slightly increased dose to prevent the side effect of rash. But when I tell you that medication can do wonders with no side effects like weight gain, nausea, sweats, etc… My daughter took it for anxiety/PTSD and it was amazing. Once a day at bedtime. I could see changes within 7-10 days even with a low dose.

This is really upside down. Lamictal is a much heavier duty drug than SSRIs. No competent doctor would prescribe it as a first step for panic or anxiety

Not sure what SSRI side effects OP fears but you can start at a very low dose and take an Ativan for the first few days.

As for therapy, treating panic attacks is the bread and butter of therapists specializing in anxiety. The main thing is to find a specialist.

Also SSRIs are very effective for anxiety and take less time to work than for depression. Gently, your and your child’s fear of SSRIs is an anxiety symptom and not rational. Obviously there can be side effects but the costs of not treating panic are high.

I don’t think that our fear of side effects is irrational. His psychiatrist doesn’t think it is. I don’t see how you can say that without knowing the specific reaction.

Did he actually refuse to prescribe an SSRI?

Refuse would imply that I asked him to. He said he didn’t recommend it because of the family history, and I agreed.

I’d probably get a second opinion in that case.

Why do you say that, if you don't even know what happened?

Because SSRIs are an extremely effective medication for anxiety so I would get a second opinion and also be sure that I had communicated correctly and understood what the psychiatrist said. Not really any different from my approach to my kid’s penicillin allergy.

[Anonymous]

I have anxiety and also a panic disorder, and anxiety medication has not worked for me - it worsens the panic attacks.

I've learned to live with it. Thanks, PP, for the sour candy trick, I didn't know about it! What I do is lie on my back on my bed, with my head nearly off the edge, so that it dips a little. This apparently triggers the parasympathetic system to lower blood pressure and heart rate. When I panic, I feel like I'm about to die from a heart attack, my blood pressure goes up and so does my heart rate. So this trick is quite helpful. Sometimes, when the panic is overwhelming, I cannot lie still at all. I open the freezer and stand over it; then pull out ice packs to put on my person, and walk about the house with my ice packs. The cold plus the pacing eventually calms me down.

When I've had panic attacks out of my house, I've had to call 911. Or if the attack is milder, I walk about outside until I calm down.

It's hard. I hope your child learns to manage their condition.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:How often are the panic attacks? If often and the PTSD is pretty bad, I would recommend Lamictal.

A lot of doctors will go to SSRI’s but in my opinion unless they are extremely anxious or extremely depressed, the side effects and how long they take to titre up in your system don’t make them worth it for panics attacks/PTSD.

Lamictal is a mood stabilizer and is very mild. You have to start with a low dose and move up every week to a slightly increased dose to prevent the side effect of rash. But when I tell you that medication can do wonders with no side effects like weight gain, nausea, sweats, etc… My daughter took it for anxiety/PTSD and it was amazing. Once a day at bedtime. I could see changes within 7-10 days even with a low dose.

This is really upside down. Lamictal is a much heavier duty drug than SSRIs. No competent doctor would prescribe it as a first step for panic or anxiety

Not sure what SSRI side effects OP fears but you can start at a very low dose and take an Ativan for the first few days.

As for therapy, treating panic attacks is the bread and butter of therapists specializing in anxiety. The main thing is to find a specialist.

Also SSRIs are very effective for anxiety and take less time to work than for depression. Gently, your and your child’s fear of SSRIs is an anxiety symptom and not rational. Obviously there can be side effects but the costs of not treating panic are high.

I don’t think that our fear of side effects is irrational. His psychiatrist doesn’t think it is. I don’t see how you can say that without knowing the specific reaction.

Did he actually refuse to prescribe an SSRI?

Refuse would imply that I asked him to. He said he didn’t recommend it because of the family history, and I agreed.

I’d probably get a second opinion in that case.

Why do you say that, if you don't even know what happened?

Because SSRIs are an extremely effective medication for anxiety so I would get a second opinion and also be sure that I had communicated correctly and understood what the psychiatrist said. Not really any different from my approach to my kid’s penicillin allergy.

I am confident that we communicated correctly.

[Anonymous]

Anonymous wrote:

Anonymous wrote:How often are the panic attacks? If often and the PTSD is pretty bad, I would recommend Lamictal.

A lot of doctors will go to SSRI’s but in my opinion unless they are extremely anxious or extremely depressed, the side effects and how long they take to titre up in your system don’t make them worth it for panics attacks/PTSD.

Lamictal is a mood stabilizer and is very mild. You have to start with a low dose and move up every week to a slightly increased dose to prevent the side effect of rash. But when I tell you that medication can do wonders with no side effects like weight gain, nausea, sweats, etc… My daughter took it for anxiety/PTSD and it was amazing. Once a day at bedtime. I could see changes within 7-10 days even with a low dose.

This is really upside down. Lamictal is a much heavier duty drug than SSRIs. No competent doctor would prescribe it as a first step for panic or anxiety

Not sure what SSRI side effects OP fears but you can start at a very low dose and take an Ativan for the first few days.

As for therapy, treating panic attacks is the bread and butter of therapists specializing in anxiety. The main thing is to find a specialist.

How old are you? This is old school advice. Kids should not be on Ativan. It is highly addicting and it just snows you. Doesn’t retrain the chemicals in the brain

SSRI’s take 4-6 weeks to even start working, have a ton of negative symptoms, and long terms issues with use. weight gain and sexual function issues are two of the top side effects. Neither will help a teens depression or anxiety and will make it worse. Some may stop abruptly. Also bad.

There are many new options.

Prazosin or Hydroxine for sleep

Buspar, Propolanol, Lamictal, and Clonidine are all good options too. A lot of meds are used off label and have less side effects than SSRI’s.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:How often are the panic attacks? If often and the PTSD is pretty bad, I would recommend Lamictal.

A lot of doctors will go to SSRI’s but in my opinion unless they are extremely anxious or extremely depressed, the side effects and how long they take to titre up in your system don’t make them worth it for panics attacks/PTSD.

Lamictal is a mood stabilizer and is very mild. You have to start with a low dose and move up every week to a slightly increased dose to prevent the side effect of rash. But when I tell you that medication can do wonders with no side effects like weight gain, nausea, sweats, etc… My daughter took it for anxiety/PTSD and it was amazing. Once a day at bedtime. I could see changes within 7-10 days even with a low dose.

This is really upside down. Lamictal is a much heavier duty drug than SSRIs. No competent doctor would prescribe it as a first step for panic or anxiety

Not sure what SSRI side effects OP fears but you can start at a very low dose and take an Ativan for the first few days.

As for therapy, treating panic attacks is the bread and butter of therapists specializing in anxiety. The main thing is to find a specialist.

How old are you? This is old school advice. Kids should not be on Ativan. It is highly addicting and it just snows you. Doesn’t retrain the chemicals in the brain

SSRI’s take 4-6 weeks to even start working, have a ton of negative symptoms, and long terms issues with use. weight gain and sexual function issues are two of the top side effects. Neither will help a teens depression or anxiety and will make it worse. Some may stop abruptly. Also bad.

There are many new options.

Prazosin or Hydroxine for sleep

Buspar, Propolanol, Lamictal, and Clonidine are all good options too. A lot of meds are used off label and have less side effects than SSRI’s.

It is very common to prescribe Ativan to get over some of the initial symptoms of starting an SSRI. like 4-5 days, not long term. Since OP claims to be worried about side effects, it is worth asking about.

Your other list of meds is pretty random and in no way superior to SSRIs in terms of side effects. SSRIs are very, very well studied and effective for anxiety, which is why doctors start with an SSRI. Also it does not take 4-6 weeks for anxiety to start being effective. You don’t have to be on the SSRI forever.

Maybe OP’s kid truly has a medical contraindication to SSRIs (not sure) but that is very rare and not the reason to make ridiculous claims about them.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:How often are the panic attacks? If often and the PTSD is pretty bad, I would recommend Lamictal.

A lot of doctors will go to SSRI’s but in my opinion unless they are extremely anxious or extremely depressed, the side effects and how long they take to titre up in your system don’t make them worth it for panics attacks/PTSD.

Lamictal is a mood stabilizer and is very mild. You have to start with a low dose and move up every week to a slightly increased dose to prevent the side effect of rash. But when I tell you that medication can do wonders with no side effects like weight gain, nausea, sweats, etc… My daughter took it for anxiety/PTSD and it was amazing. Once a day at bedtime. I could see changes within 7-10 days even with a low dose.

This is really upside down. Lamictal is a much heavier duty drug than SSRIs. No competent doctor would prescribe it as a first step for panic or anxiety

Not sure what SSRI side effects OP fears but you can start at a very low dose and take an Ativan for the first few days.

As for therapy, treating panic attacks is the bread and butter of therapists specializing in anxiety. The main thing is to find a specialist.

How old are you? This is old school advice. Kids should not be on Ativan. It is highly addicting and it just snows you. Doesn’t retrain the chemicals in the brain

SSRI’s take 4-6 weeks to even start working, have a ton of negative symptoms, and long terms issues with use. weight gain and sexual function issues are two of the top side effects. Neither will help a teens depression or anxiety and will make it worse. Some may stop abruptly. Also bad.

There are many new options.

Prazosin or Hydroxine for sleep

Buspar, Propolanol, Lamictal, and Clonidine are all good options too. A lot of meds are used off label and have less side effects than SSRI’s.

It is very common to prescribe Ativan to get over some of the initial symptoms of starting an SSRI. like 4-5 days, not long term. Since OP claims to be worried about side effects, it is worth asking about.

Your other list of meds is pretty random and in no way superior to SSRIs in terms of side effects. SSRIs are very, very well studied and effective for anxiety, which is why doctors start with an SSRI. Also it does not take 4-6 weeks for anxiety to start being effective. You don’t have to be on the SSRI forever.

Maybe OP’s kid truly has a medical contraindication to SSRIs (not sure) but that is very rare and not the reason to make ridiculous claims about them.

Some of the meds that the PP listed were meds the doctor told me would be considerations if we decided to do medication.

[Anonymous]

I would never put a teen on an SSRI or SRNI unless absolutely necessary. The side effects are terrible. It doesn’t seem like the case.

[Anonymous]

Anonymous wrote:I would never put a teen on an SSRI or SRNI unless absolutely necessary. The side effects are terrible. It doesn’t seem like the case.

^someone who has never experience acute anxiety themselves…

SSRIs have side effects … but when you are really sick you need meds. I’m sure there are a lot of kids on them who can do without them, but they are amazing for panic, GAD and OCD.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:How often are the panic attacks? If often and the PTSD is pretty bad, I would recommend Lamictal.

A lot of doctors will go to SSRI’s but in my opinion unless they are extremely anxious or extremely depressed, the side effects and how long they take to titre up in your system don’t make them worth it for panics attacks/PTSD.

Lamictal is a mood stabilizer and is very mild. You have to start with a low dose and move up every week to a slightly increased dose to prevent the side effect of rash. But when I tell you that medication can do wonders with no side effects like weight gain, nausea, sweats, etc… My daughter took it for anxiety/PTSD and it was amazing. Once a day at bedtime. I could see changes within 7-10 days even with a low dose.

This is really upside down. Lamictal is a much heavier duty drug than SSRIs. No competent doctor would prescribe it as a first step for panic or anxiety

Not sure what SSRI side effects OP fears but you can start at a very low dose and take an Ativan for the first few days.

As for therapy, treating panic attacks is the bread and butter of therapists specializing in anxiety. The main thing is to find a specialist.

How old are you? This is old school advice. Kids should not be on Ativan. It is highly addicting and it just snows you. Doesn’t retrain the chemicals in the brain

SSRI’s take 4-6 weeks to even start working, have a ton of negative symptoms, and long terms issues with use. weight gain and sexual function issues are two of the top side effects. Neither will help a teens depression or anxiety and will make it worse. Some may stop abruptly. Also bad.

There are many new options.

Prazosin or Hydroxine for sleep

Buspar, Propolanol, Lamictal, and Clonidine are all good options too. A lot of meds are used off label and have less side effects than SSRI’s.

It is very common to prescribe Ativan to get over some of the initial symptoms of starting an SSRI. like 4-5 days, not long term. Since OP claims to be worried about side effects, it is worth asking about.

Your other list of meds is pretty random and in no way superior to SSRIs in terms of side effects. SSRIs are very, very well studied and effective for anxiety, which is why doctors start with an SSRI. Also it does not take 4-6 weeks for anxiety to start being effective. You don’t have to be on the SSRI forever.

Maybe OP’s kid truly has a medical contraindication to SSRIs (not sure) but that is very rare and not the reason to make ridiculous claims about them.

Some of the meds that the PP listed were meds the doctor told me would be considerations if we decided to do medication.

Ok. It’s not standard of care though. I’d get a second opinion.

[Anonymous]

Anonymous wrote:I would never put a teen on an SSRI or SRNI unless absolutely necessary. The side effects are terrible. It doesn’t seem like the case.

Please stop saying stuff like this. One, something tells me you are not even remotely qualified to offer medical advice. And two, because you are so uninformed you could be risking a teen’s life.

I always wonder why people feel the need to chime in on these very serious medical issues with zero medical knowledge. You would not be telling someone what kind of chemo to take. You would refer them to the oncologist. I suggest you refrain going forward.

As others have said, OP needs a second opinion.

[Anonymous]

Anonymous wrote:

Anonymous wrote:I would never put a teen on an SSRI or SRNI unless absolutely necessary. The side effects are terrible. It doesn’t seem like the case.

Please stop saying stuff like this. One, something tells me you are not even remotely qualified to offer medical advice. And two, because you are so uninformed you could be risking a teen’s life.

I always wonder why people feel the need to chime in on these very serious medical issues with zero medical knowledge. You would not be telling someone what kind of chemo to take. You would refer them to the oncologist. I suggest you refrain going forward.

As others have said, OP needs a second opinion.

OP here,

You say you wouldn’t tell someone what medication to take, and then you question the psychiatrist who treats my child?

I don’t see a difference between you and the poster you quoted. Both of you are out of line.

— OP

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I would never put a teen on an SSRI or SRNI unless absolutely necessary. The side effects are terrible. It doesn’t seem like the case.

Please stop saying stuff like this. One, something tells me you are not even remotely qualified to offer medical advice. And two, because you are so uninformed you could be risking a teen’s life.

I always wonder why people feel the need to chime in on these very serious medical issues with zero medical knowledge. You would not be telling someone what kind of chemo to take. You would refer them to the oncologist. I suggest you refrain going forward.

As others have said, OP needs a second opinion.

OP here,

You say you wouldn’t tell someone what medication to take, and then you question the psychiatrist who treats my child?

I don’t see a difference between you and the poster you quoted. Both of you are out of line.

— OP

I have 30 years of experience with depression/anxiety and panic attacks from PTSD. I have been treated by various medical professionals. I know what the standard of care is. I wonder why you are so defensive about getting a second opinion. Don’t you want the best possible outcome for your child? It’s not like you can’t still decide to do whatever you’ve made up your mind to do.

[Anonymous]

I am not sure how you can know what the standard of care is when you haven’t even asked what the specific side effect?

[Anonymous]

Anonymous wrote:I am not sure how you can know what the standard of care is when you haven’t even asked what the specific side effect?

Who are you taking to?

[Anonymous]

Anonymous wrote:I am not sure how you can know what the standard of care is when you haven’t even asked what the specific side effect?

Ok why don’t you tell us? Your OP describes you and your kid being scared of side effects, not the doctor determining that an SSRI was totally contraindicated.