PTSD and panic attacks

[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.

Not PP you replied to, but no, it's not common to prescribe Ativan to get over side effects of SSRIs. Also SSRIs are well-known to provoke serious mental side effects in a small subset of patients. And yes, sometimes it takes more than a month for an SSRI to "work" and for side-effects to diminish. This is why there is a moderate rate of medication abandonment for SSRIs, because some patients cannot tolerate the side effects while still waiting for the benefits to kick in.

SSRIs can be a Godsend to certain patients, so I agree they're wonderful in the right situation. But please don't claim that SSRIs are easy to manage in most cases. The reality is more nuanced.

I agree that OP cannot tell in advance whether or not an SSRI would work for her child. The only way to know is by trying a low dose, and it's important not to scare the patient into thinking it's going to be a terrible experience, because sometimes this ends up being self-fulfilling! It's a shame that OP's child absorbed a fear of SSRIs from their family; also, it can be true that they might suffer from side-effects. I know there's cognitive dissonance there, but that's just how it is.

Proceed with caution, OP.

[Anonymous]

Anonymous wrote:

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.

Ahh so the other poster was right. You are old school and you are only one person.

Meds work differently on every person. Lots of trial and error.

A gene test is a great start OP and there are plenty of options besides SSRIs

[Anonymous]

Anonymous wrote:

Anonymous wrote:

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.

Ahh so the other poster was right. You are old school and you are only one person.

Meds work differently on every person. Lots of trial and error.

A gene test is a great start OP and there are plenty of options besides SSRIs

Where is your medical degree from?

SSRIs are still the standard of care and to say “you’d never put your teen on SSRIs” is dangerous and ignorant. If you don’t treat the mental illness teens are much more likely to self medicate with drugs. How are the side effects on those?

[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.

I agree. There is a great medication for PTSD at night. Starts with a P? And an anti-depressant is not the start for someone with panic attacks. Maybe Zoloft, but otherwise I would avoid. My child went thru Lexapro, Zoloft, Prozac, and Paxil. A year of hell before we switched doctors because they wouldn’t think outside of the box or care about the suffering and side effects. There are so many medicines now. Do your research. I know it seems crazy but forums, reddit, tik tok etc.. you can gather feedback and then talk with medical professionals. But ultimately you decide what to try. Until then, look into supplements like high B and high D multivitamin, l-theanine, magnesium, ashwa, fish oils etc…

[Anonymous]

OP, do not put your child on any benzodiazepines. I can not believe anyone would recommend that. Absolute last option

[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.

I agree. There is a great medication for PTSD at night. Starts with a P? And an anti-depressant is not the start for someone with panic attacks. Maybe Zoloft, but otherwise I would avoid. My child went thru Lexapro, Zoloft, Prozac, and Paxil. A year of hell before we switched doctors because they wouldn’t think outside of the box or care about the suffering and side effects. There are so many medicines now. Do your research. I know it seems crazy but forums, reddit, tik tok etc.. you can gather feedback and then talk with medical professionals. But ultimately you decide what to try. Until then, look into supplements like high B and high D multivitamin, l-theanine, magnesium, ashwa, fish oils etc…

Please do not listen to this poster. Do not do your research on those sites.

Also, for anyone else who is under the impression that all over-the-counter supplements are totally safe and do not have side effects, they very much do.

[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.

I agree. There is a great medication for PTSD at night. Starts with a P? And an anti-depressant is not the start for someone with panic attacks. Maybe Zoloft, but otherwise I would avoid. My child went thru Lexapro, Zoloft, Prozac, and Paxil. A year of hell before we switched doctors because they wouldn’t think outside of the box or care about the suffering and side effects. There are so many medicines now. Do your research. I know it seems crazy but forums, reddit, tik tok etc.. you can gather feedback and then talk with medical professionals. But ultimately you decide what to try. Until then, look into supplements like high B and high D multivitamin, l-theanine, magnesium, ashwa, fish oils etc…

Please do not listen to this poster. Do not do your research on those sites.

Also, for anyone else who is under the impression that all over-the-counter supplements are totally safe and do not have side effects, they very much do.

Vitamin, fish oil, are for anyone. Magnesium glycinate is in every calm gummy out there. L-Thea is very mild focus and is in ALL green tea.

So calm down

[Anonymous]

Anonymous wrote:OP, do not put your child on any benzodiazepines. I can not believe anyone would recommend that. Absolute last option

+1
Benzos is so 90’s

[Anonymous]

Anonymous wrote:

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.

I agree. There is a great medication for PTSD at night. Starts with a P? And an anti-depressant is not the start for someone with panic attacks. Maybe Zoloft, but otherwise I would avoid. My child went thru Lexapro, Zoloft, Prozac, and Paxil. A year of hell before we switched doctors because they wouldn’t think outside of the box or care about the suffering and side effects. There are so many medicines now. Do your research. I know it seems crazy but forums, reddit, tik tok etc.. you can gather feedback and then talk with medical professionals. But ultimately you decide what to try. Until then, look into supplements like high B and high D multivitamin, l-theanine, magnesium, ashwa, fish oils etc…

Please do not listen to this poster. Do not do your research on those sites.

Also, for anyone else who is under the impression that all over-the-counter supplements are totally safe and do not have side effects, they very much do.

Vitamin, fish oil, are for anyone. Magnesium glycinate is in every calm gummy out there. L-Thea is very mild focus and is in ALL green tea.

So calm down

No one should be taking any supplements without talking to the doctor first. Perhaps you'd know that if you didn't do your research on Tik Tok.

[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.

Not PP you replied to, but no, it's not common to prescribe Ativan to get over side effects of SSRIs. Also SSRIs are well-known to provoke serious mental side effects in a small subset of patients. And yes, sometimes it takes more than a month for an SSRI to "work" and for side-effects to diminish. This is why there is a moderate rate of medication abandonment for SSRIs, because some patients cannot tolerate the side effects while still waiting for the benefits to kick in.

SSRIs can be a Godsend to certain patients, so I agree they're wonderful in the right situation. But please don't claim that SSRIs are easy to manage in most cases. The reality is more nuanced.

I agree that OP cannot tell in advance whether or not an SSRI would work for her child. The only way to know is by trying a low dose, and it's important not to scare the patient into thinking it's going to be a terrible experience, because sometimes this ends up being self-fulfilling! It's a shame that OP's child absorbed a fear of SSRIs from their family; also, it can be true that they might suffer from side-effects. I know there's cognitive dissonance there, but that's just how it is.

Proceed with caution, OP.

If the main side effect is insomnia from starting an SSRI, indeed prescribing a benzo for *short term* use is common.

Serious side effects are very rare and SSRIs are very well tolerated by most patients - that doesn’t mean no side effects but tolerable.

For anxiety the effects are often felt much sooner than for depression. I take Lexapro and feel significantly better in just a few days.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

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.

I agree. There is a great medication for PTSD at night. Starts with a P? And an anti-depressant is not the start for someone with panic attacks. Maybe Zoloft, but otherwise I would avoid. My child went thru Lexapro, Zoloft, Prozac, and Paxil. A year of hell before we switched doctors because they wouldn’t think outside of the box or care about the suffering and side effects. There are so many medicines now. Do your research. I know it seems crazy but forums, reddit, tik tok etc.. you can gather feedback and then talk with medical professionals. But ultimately you decide what to try. Until then, look into supplements like high B and high D multivitamin, l-theanine, magnesium, ashwa, fish oils etc…

Please do not listen to this poster. Do not do your research on those sites.

Also, for anyone else who is under the impression that all over-the-counter supplements are totally safe and do not have side effects, they very much do.

Vitamin, fish oil, are for anyone. Magnesium glycinate is in every calm gummy out there. L-Thea is very mild focus and is in ALL green tea.

So calm down

No one should be taking any supplements without talking to the doctor first. Perhaps you'd know that if you didn't do your research on Tik Tok.

Not the PP but no one talks to their doc about vitamins lol

[Anonymous]

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.

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.

Not PP you replied to, but no, it's not common to prescribe Ativan to get over side effects of SSRIs. Also SSRIs are well-known to provoke serious mental side effects in a small subset of patients. And yes, sometimes it takes more than a month for an SSRI to "work" and for side-effects to diminish. This is why there is a moderate rate of medication abandonment for SSRIs, because some patients cannot tolerate the side effects while still waiting for the benefits to kick in.

SSRIs can be a Godsend to certain patients, so I agree they're wonderful in the right situation. But please don't claim that SSRIs are easy to manage in most cases. The reality is more nuanced.

I agree that OP cannot tell in advance whether or not an SSRI would work for her child. The only way to know is by trying a low dose, and it's important not to scare the patient into thinking it's going to be a terrible experience, because sometimes this ends up being self-fulfilling! It's a shame that OP's child absorbed a fear of SSRIs from their family; also, it can be true that they might suffer from side-effects. I know there's cognitive dissonance there, but that's just how it is.

Proceed with caution, OP.

If the main side effect is insomnia from starting an SSRI, indeed prescribing a benzo for *short term* use is common.

Serious side effects are very rare and SSRIs are very well tolerated by most patients - that doesn’t mean no side effects but tolerable.

For anxiety the effects are often felt much sooner than for depression. I take Lexapro and feel significantly better in just a few days.

My husband is a doctor and he says the bolded is wrong. They work for some people, they don't for others. We'd need to dig up peer-reviewed articles and their statistics to further the discussion.

You're not talking to uneducated idiots here, PP. I'm not a doctor, but I'm a research scientist in biology, and I am aware that SSRIs as a group of meds are by no means innocuous.

OP already knows all this. What matters are the feelings of the child and the family. At one point, they will need to decide whether the symptoms are so bad that they are ready to risk potential side effects. It's their decision. Good luck, OP. Severe anxiety and panic attacks are very difficult to live with.

[Anonymous]

Normal people don’t put their teens on drugs.

[Anonymous]

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.

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.

Not PP you replied to, but no, it's not common to prescribe Ativan to get over side effects of SSRIs. Also SSRIs are well-known to provoke serious mental side effects in a small subset of patients. And yes, sometimes it takes more than a month for an SSRI to "work" and for side-effects to diminish. This is why there is a moderate rate of medication abandonment for SSRIs, because some patients cannot tolerate the side effects while still waiting for the benefits to kick in.

SSRIs can be a Godsend to certain patients, so I agree they're wonderful in the right situation. But please don't claim that SSRIs are easy to manage in most cases. The reality is more nuanced.

I agree that OP cannot tell in advance whether or not an SSRI would work for her child. The only way to know is by trying a low dose, and it's important not to scare the patient into thinking it's going to be a terrible experience, because sometimes this ends up being self-fulfilling! It's a shame that OP's child absorbed a fear of SSRIs from their family; also, it can be true that they might suffer from side-effects. I know there's cognitive dissonance there, but that's just how it is.

Proceed with caution, OP.

If the main side effect is insomnia from starting an SSRI, indeed prescribing a benzo for *short term* use is common.

Serious side effects are very rare and SSRIs are very well tolerated by most patients - that doesn’t mean no side effects but tolerable.

For anxiety the effects are often felt much sooner than for depression. I take Lexapro and feel significantly better in just a few days.

My husband is a doctor and he says the bolded is wrong. They work for some people, they don't for others. We'd need to dig up peer-reviewed articles and their statistics to further the discussion.

You're not talking to uneducated idiots here, PP. I'm not a doctor, but I'm a research scientist in biology, and I am aware that SSRIs as a group of meds are by no means innocuous.

OP already knows all this. What matters are the feelings of the child and the family. At one point, they will need to decide whether the symptoms are so bad that they are ready to risk potential side effects. It's their decision. Good luck, OP. Severe anxiety and panic attacks are very difficult to live with.

There are many many studies showing SSRIs are well tolerated. That doesn’t mean no side effects or that eventually you opt to go off them. People do have a weird fixation on SSRIs relative to other drugs that all also have side effects. If OP’s kid has severe anxiety then SSRIs are the most studied drug out there potentially effective.

I dislike the side effects of SSRIs but it’s a medication - and medications have side effects.

[Anonymous]

Is there also a diagnosis of ADHD? Guanfacine has had some promising results for PTSD sufferers. It’s been a game changer for my child’s adhd with anxiety.