How do countries other than the U.S. treat panic disorder with or without agoraphobia?
Thursday, August 26th, 2010 at
6:24 pm
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Generally, the standard of care includes benzodiazepine drugs (Valium, Librium, Ativan, Xanax, Klonopin, etc.) along with a form of talk therapy.
In America, it is more common to use SSRI/SNRI drugs first, then sedating anti-histamines, before trying benzodiazepines. SS/N/RI drugs are anxiogenic (anxiety-creating) substances, and therefore a very poor choice for anyone with even mild anxiety or panic. In depressed patients (who also don’t gain much benefit from the drugs, sadly), "anxiety" is listed as one of the most common effects of the SS/N/RI drugs (Prozac, Paxil, Zoloft, Effexor, etc.), and depressed patients are often given a two to four week course of benzodiazepines in order to control the anxiety that the anti-depressant invoke.
Treating anxiety with SSRIs is literally homeopathy – "like cures like". Homeopathy believes that a fever-inducing substance will cure a man with a fever (in reality, it will make his fever worse), and an anxiety-inducing substance will cure a person of anxiety (in reality, it makes anxiety worse).
I believe SSRIs are used for treating anxiety because they are non-controlled substances, and therefore the doctors prescribing them draw no attention from the DEA (which, unfortunately, is trying to tell doctors how to practice medicine, and cracking down on those who don’t toe the party line – cops shouldn’t be telling doctors what to do, nor vice-versa – this is the reason that many people do not receive adequate pain management in America, nor adequate treatment for psychiatric conditions, besides schizophrenia or bipolar disorder). They are addictive, just like benzodiazepines (which is an argument put forth by many uninformed doctors: "Antidepressants aren’t addictive!" – take Effexor for two months and then quit – and tell me they’re not addictive then) and the treatment of psychiatric patients has been harmed greatly because of it.
It’s a travesty – treating anxiety with anxiety-inducing drugs. Treating depression with pills that are no more effective than placebo, and many times more harmful (cf. medical study reviewed in current Newsweek, a meta-study of EVERY WELL-CONTROLLED STUDY ever conducted on anti-depressants).
In addition to neuroleptic drugs like Abilify, Risperdal, and Seroquel, which cause depression directly through dopamine and serotonin-antagonism (if serotonin deficiency is the cause of depression, how can both serotonin-agonists and -antagonists help it? answer: neither do.), and have a whole host of deforming, disabling, possibly permanent and deadly side-effects (Parkinsonism, Diabetes, Neuroleptic Malignancy, Prolactinemia, etc.).
These drugs were approved because they were designed to sedate the acutely-agitated psychotic (hallucinating, hearing voices) and violent patient – more dangerous side-effects are considered tolerable when dealing with controlling someone who is being told to kill the psych ward staff by the television.
I know this as a psychologist who personally suffers from panic disorder, currently taking 1mg of (brand-name: don’t settle for generic in psych drugs unless you can’t afford them: the difference is sometimes over 25% active ingredient, under law, up to 20% weaker is permissible in generics) Klonopin (clonazepam, a long-acting benzodiazepine) three times a day, along with 150mg of Lyrica, three times a day, and 10mg of baclofen three times a day for panic disorder and anxiety. The only meds that have ever worked, and I have taken everything from MAOIs, TCAs, neuroleptics, both typical and atypical, SSRIs, SNRIs, sedating antihistamines, anti-epileptics, and the works – over 30 different drugs – before finding ones that worked, and will work for mostly anyone. The other shut functions through placebo effect, and all of the anti-depressants, excluding a few of the TCAs (Nortriptiline and Amitriptiline) worsen anxiety.
Along with 22mg of buprenorphine a day for my heroin addiction, all’s peachy. I’m still nuts, and don’t feel normal (the only times I have in my life were the four hours after each shot of heroin) and not yet fit to practice again, but as good as I’ve ever felt on legal, prescribed medication.
Don’t let the doctors give you bullshit for anxiety. Demand a benzodiazepine (stay away from Xanax, IMO), and if not, at least Lyrica or Neurontin. The others range from ineffective to hellish.
You’d be surprised how many headshrinks are diagnosed themselves. It’s usually why they get in to the field – at least it was for me.
In the U.K people tend to be pretty accommodating towards anxiety sufferers.
But the care from physicians leaves a lot to be desired, they tend to decide very quickly you need to see a counselor and most likely drugs of some sort.
In my experience with counselors they just pretty much read off a list of what they are supposed to tell you and the goals they are to set you. They never asked me anything about myself or how i was feeling. Just told me to gradually intergrate myself more in society…well duh!