Is there any new medicine for anxiety as SSRI not helping me?

Question

Hello doctor,

I cannot get any SSRI medicine to work anymore after 25 years. I have anxiety only from morning to mid-afternoon. Doctor put me on Oxcarbazepine 300 mg daily for anxiety but this seizure medicine is making me dizzy and very tired and off-balance. My head feels weird. I just weaned completely off Zoloft three days ago.

What new family of medicines do you suggest for me to try for my anxiety? Lately, I can get it under control for four to five hours taking 1/4th of a 0.25 mg of Xanax. I take a Sliver tablet of 0.25 mg three to four times a day or maybe once. Anxiety ends every day at around 3-4 PM each day and I sleep fine too.

Answer 1

Hello,

Welcome to icliniq.com.

Considering your age, it will be difficult to try a low dose of TCA (tricyclic antidepressant), but if nothing works that is always an option. Apart from an SSRI (selective serotonin reuptake inhibitors), there is always SNRI (serotonin-norepinephrine reuptake inhibitor) like Venlafaxine which is pretty effective for anxiety.

Also instead of Oxcarbazepine, you could try a low dose of may be 200 mg of Sodium valproate. Also, there are some dietary supplements like L-Theanine 200 mg which can be taken two times a day or on SOS basis.

Finally, instead of Xanax (Alprazolam), you can try Tofisopam which is a different type of benzodiazepine with lesser addictive potential, no sedation or impairment in work performance.

Also, consider doing deep breathing exercises daily and when you have an anxiety attack do more repetitions of deep breathing. Also, consider starting with yoga, meditation, progressive muscle relaxation or other types of calming exercises.