What to do next?

[LittleCloud]

About a year ago I asked my doctor to change meds. Cymbalta worked really well for depression, but didn't do anything for my anxiety and I was experiencing prolonged panic attacks. I changed through a few different meds- didn't find anything that worked until paroextine which started working after about 3 months. That was good for about 9-10months but more recently anxiety and depression have become a real problem and make things much harder with eating. My doctor referred me to the community mental health psychiatrist as he wanted someone with more expertise to look at my meds but the mental health team tried to send me back to my doctor to make the decision. They asked me questions from a form- they told me there was no more local treatment for EDs and tried to send me away with no change. I begged and they doubled my paroextine dose but for the last week and a half since then I've been getting late night anxiety, being really unable to sleep until 2-4am and then really unable to wake until 12 and dozy and not all with it. I cut back to what I was on before yesterday because I really couldn't do it. I want to be able to work- I don't want these things to drag me down. When I rang my doctor to check my appointment- thankfully it's the 13th, not the 18th- it made me wonder what is coming next. I feel really angry with myself that I let someone I didn't know mess with my meds because I had years of that through my childhood. The paroextine isn't working, but double dose is too much. The other suggestion the psychiatrist made was prozac. I'm not quite sure what to ask my doctor for- a change, to go to 1 1/2 times my dose? I've been told there isn't more support even though I'm struggling a lot. Sorry to double post but I just wondered what had helped others with anxiety, depression and ED type symptoms?
I've tried Zoloft, Edronax, Cymbalta with little success and the paroextine 20mg seems to have stopped working

[ParanormalChickenGeek]

I'm surprised they doubled your dose instead of gradually increasing it... Why don't you ask your GP if it's ok to try that first? I'm guessing the late night anxiety and sleeping issues are a result of increasing the dosage too rapidly.
Don't beat yourself up about letting them change your meds- they're the professionals and they're supposed to know best, unfortunately that isn't always the way but that isn't your fault at all.
As you know I've found Venlafaxine helpful for anxiety and slightly for depression but it suppresses my appetite so I wouldn't recommend it for an ED.
Big hugs x

[sherlock holmes]

I think the meds you've tried so far have all been SSRIs? None of that class of antidepressant had any affect on me. It wasn't until I tried Mirtazapine, and later Trazodone, that I noticed any change. Additionally I take Pregabalin for my anxiety and it works well in combination with my Trazodone.

I'm quite pro-active where my medication is concerned and my psychiatrist lets me ask about medication and trying things, though she ultimately makes the decision about changing it. Can you suggest to your doctor some different options? Especially as SSRIs don't suit everyone.

[LittleCloud]

Prozac was suggested by a friend. Weight gain from meds is a huge no- I said no to my doctor about Mirtazapine because huge random weight gains were reported by people on here, online through a number of sites. I'm terrified of having my control ripped away. I'm thinking of asking for a referral to a psychiatrist 3 hrs away because I just can't take this much more

[Epicene]

I wonder if another alternative could be going back on cymbalta for the depression, and taking something else as prn for extreme anxiety and panic attacks? I think its probably a more sensible plan to play around with things you know to work in some respects rather than making huge changes.

[LittleCloud]

I don't know with the Cymbalta- depression is a problem for me but anxiety is the main issue and because the cymbalta really didn't cover that I don't think just having a prn would work. I hate changing this stuff around. It makes me feel like a guinea pig but the anxiety is making my life a living hell. I wonder about trying the paroextine at 30mg (I was put up to 40 and that was too strong). I can make a doctors appointment for 2-3 weeks after and if that is working stick with it, but if not we can try something else. For me the main issue is getting more support because everything in my head is saying "restrict, lose" and the shame and guilt is indescribable. There is a possibility I could book an appointment with a psychiatrist out of town and I might be more likely to get someone with more experience. When I see the uni counsellor I will be talking about needing more support right now because I don't feel any hope any more. I just feel like I've lost so much of the progress that I made when I first went on the paroextine. Anorexia is whispering to me just to reach my goal, which is not so low and I wonder if that would help, but I just feel so entirely lost. Thanks for the replies- it helps. I just feel really nervous about changing things when I'm already in such a vulnerable position

[ParanormalChickenGeek]

I know I've advised this before but olanzapine could help greatly with your intrusive thoughts and associated anxiety. It's known to be quite effective in treatment of EDs.
Maybe seeing a different psychiatrist would be a good idea as they have much better knowledge of psychotropic medication than a GP.
*hugs*

[Sneckie]

I was prescribed buspirone for my anxiety. It seems to have minimal side effects and Ive not heard of ppl having weight gain on it.

[Steel Maiden]

I actually lost weight on mirtazapine.

[LittleCloud]

Thanks to you both. I think what scares me most is changing while things are so bad and when I don't feel like I have enough support. I am going to talk to my doctor about this and say how awful I felt with the mental health team psychiatrist. My doctor is also hesitant with changing my meds because he is unfamiliar- worst luck with the pychiatric worker I saw- he didn't really want to talk about stuff like that. It's almost like I was a curiosity, not someone he really wanted to help. I'll try with those suggestions to my doctor- he's pretty good, just not really sure what to do with me I think