Antidepressants

Sedative tricyclics such as trimipramine are often given in anxiety disorders. Their full benefit may take several weeks in depression, but their useful hypnotic and anxiolytic properties are immediate and dose-related. For example, trimipra-mine 25 mg nocte regularly plus 25 mg mane p.r.n. will help sleep and make available a safe antianxiety treatment for daytime use in a patient with mild anxiety symptoms. Antidepressants are effective in panic disorder. MAOIs should be tried if other antidepressant classes are ineffective.

SSRIs are widely used in general practice; some patients probably benefit. However, in some patients, they can exacerbate anxiety, with troublesome agitation and gastrointestinal upset; the problem is so significant that some have recommended 'covering' a newly started SSRI with a second drug such as the notably sedative trazodone or a benzodiazepine. Unfortunately, it is not possible to predict which patients will experience these adverse effects.

I rarely if ever prescribe SSRIs for anxiety; cheaper and, in my hands, more effective drugs - tricyclics - are to be preferred. Trazodone, trimipramine, or, among the newer drugs, mirtazepine, have predictable and dose-related anxio-lytic effects, and are much more suitable.

Emergency Panic Remedies

Emergency Panic Remedies

Eliminate Your Panic And Anxiety Attacks Instantly With These Proven Techniques! There’s
 very
 little
 in
 this 
world
 that 
is
 as 
frightening
 and
 uncomfortable
 as 
a panic
 attack. 

Once
 they
 start,
 panic
 attacks
 can
 send
 you
 spiraling
 out
 of control.

Get My Free Ebook


Post a comment