Back again

Long story short, had major anxiety attack on Dec 19th. Felt awful for two days after, went to urgent care and was given Lorazepam (Ativan) which I took 1mg twice a day for maybe 2-3 days before seeing my primary, then dropped to .5 mg twice a day while starting Zoloft. Zoloft was horrible for me. After just a couple days on Zoloft (25mg) anxiety was at a peak, along with restlessness and agitation, plus horrible insomnia. Decided to try and push through it for a day more but ended up in ER after 3 days of no sleep. They said to cease Zoloft and suspected Serotonin syndrome, and gave me 3 lorazepam shots until I finally fell asleep and then sent me home with script for Ambien. Felt awful the next day after and for several days after. Continued taking the Lorazepam (.5 mg twice a day) and was taking half an Ambien each night to sleep. Started to feel better. Still had anxiety on and off but I had seen a therapist at this point and she assured they'd find me something that would work, and given me lots of useful tools to cope with my anxiety and panic attacks should they occur. Began to feel better, energetic, appetite, happier moments (more hopeful as well) in the week that followed, using only Lorazepam. Saw my primary doctor on Jan 14th and she said therapist (after much consideration) suggested Paxil. I agree'd to give it a try because I'd read many good things. But I was reluctant to take it because I had been feeling a lot better. So I held on to it until Saturday January 16th and finally started off with 5mg once in the morning. The first four days were great! No side effects besides mild nausea and dizziness. By this time (that I started taking the Paxil) I had cut down to .25 mg Lorazepam twice a day and then 2 days after starting Paxil, down to .25 mg once a day. All the while still taking the Ambien for sleep (down to .25 mg nightly). Then on this past Wednesday, I felt like I could stop taking the Lorazepam. Felt fine that day, Thursday I felt more nauseous and headaches than before, and by yesterday (Fri Jan 22nd) I was feeling like I had when I was taking the Zoloft. Restless, agitated, shivers and chills, no appetite whatsoever, reflux, constipation and rapid heartbeat. At first, last night I thought, Lorazepam withdrawal. Even though I took such a low dose for only a month, I assumed that's what I was dealing with. Ambien helped me fall asleep, woke up at 5 am in a full sweat, shaking, horrible thoughts and tingling in my extremities and face. Now thinking possible Serotonin syndrome again. Is this possible? I know it seems far fetched with such a low dose of Paxil but what if I don't need it? After all, I primarily have GAD, not depression. Could I have too much Serotonin after a week? I didn't take the Paxil today and took .5 mg of Lorazepam to see if that helped at all. I am more calm but still feeling awful, so my guess is it's the Paxil. I know you aren't Doctors but any thoughts?

My primary doesn't take calls on weekends. Urgent care by me closes at 4, which leaves me time but they don't do a whole lot of anything there (no IV, no oxygen, nothing) so I'm not sure they'd help much. Could go to ER though I would hate to. Can side effects like this arise after a week of an SSRI? This is the same type of reaction I had to Zoloft, though I was only taking the Zoloft for a couple of a days when it occurred. That's why I assumed it was from too much Serotonin.

Thank you SC,

I guess I might not be tolerating it very well. Which has me feeling very discouraged because Zoloft didn't work either. I just want to feel better. I have a 2 1/2 year old and fiancé that needs me. I'm so upset over this. :(

Sorry this is so rough. It's hard enough by itself yet alone adding the guilt of feeling like you have to be "well" for your family.

Just a few thoughts: I'm wondering if your increase in symptoms has more to do with you cutting the Ativan down suddenly. Going from .5/day to .25/day can be a big drop for some people (me being one of them). The first time I tried to wean myself off of klonopin (clonozopam) I tried to drop by 1/2, the first day I was fine, but by the third day I was sure I had the flu on top of a massive increase in my symptoms, something about the halflife of the drug. I went back up to my original dose, once I stabilized, I would cut the dose down by .25 and stayed there for over a week. I won't lie, I've been having a rough time coming off, BUT the benefit is making the longer taper time worth it (as of today, I'm down to .25mgs/day, whoo hoo!).

And SSRI's take a long time to work, I'm not 100% sure that mine does anything really since I'm not convinced that the medicine makes me feel better or the "idea" of medicine makes me feel better.

Long story short, maybe wait on decreasing the benzo, you deserve to feel calm and strong and take a brief vacation from the anxiety. Also, the medicine is only going to do so much, a friend of mine had a great analogy, the meds are just scaffolding, a tool that holds you up while you build a solid foundation. Learning coping skills & behavior modification will have the largest and long term impact.

Are you seeing a therapist or did your dr just consult w one?

Thank you guys so much for your input. I truly appreciate it. After ceasing the Paxil, I find myself leveling out. Still needing Lorazepam as needed, which helps tons with the panic attacks/anxiety but does leave me feeling a bit down. My appetite is back almost to normal though I'm down to a weight I haven't been at since my sophomore year in high school. I truly wanted to give the Paxil a shot but I felt like I was going to crawl out of my skin after a week of it. It was worse than the Zoloft. I'm almost considering trying the Zoloft again, but at an even lower dose (12.5 mg) because I think there were a lot of other factors in play that kind of ruined the experience for me. Yes, I'm sure I had side effects to the Zoloft, which is expected. But while on the Zoloft, I was also battling a really bad bladder infection that required 2 rounds of antibiotics (at first they prescribed Cipro and that made me have a massive panic attack). On top of that, I had been recovering from almost 2 weeks of not being able to eat/drink (was on fluids and nutrients) and not sleeping at all (not even the Ativan helped). I'd been given a chest x-Ray and told I had acid reflux (most likely from vomiting so much in 2 weeks) so started Zantac 2x daily and Prilosec 1x daily. My nausea was so bad that they had me using Promethazine suppositories, which caused me to be so out of it that I couldn't see straight, and in turn highly agitated me. The day that I felt really awful was New Year's Day, where I was dealing with a mixture of Reglan, Lorazepam, different fluids, on top of the Zoloft. I felt so overwhelmed and in turn that seriously increased my panic. I didn't sleep for 3 days straight when I finally went to a much nicer ER at a better hospital and was told it was the Zoloft and given several shots of Lorazepam until I fell asleep in the hospital. It was like.. No matter how tired I was, how much I tried to relax, I couldn't get to sleep. I was in a constant state of panic. I don't know.. I see my primary today and my P-Doc on Feb 2nd but we've been chatting on the phone daily, she's awesome. May also try Celexa, which was the first recommendation from my P-Doc, but I ended up going with Paxil because I'd heard/read mostly good things. Hate feeling like a test subject but I really want this under control.

Thank you SC,

Researching and reading as much as I can is very therapeutic to me. That is one part of my OCD that I actually consider a blessing and a curse. It's nice to be fully informed but at the same time it can be frightening and at disheartening because there are so many varying amounts of information out there. I am learning to just trust God and have faith that everything will fall right where it needs to be and I can enjoy the little things in life instead of fearing them. I see that you did CBT. How was that for you? The real work for me starts on Feb 2nd when I meet with my P-Doc again.

That's good news. I'm hoping and praying that it is beneficial to me. I've had my panic attacks under control since yesterday but definitely still anxious, even socially... Which never happened to me before my first panic attack last month. I was a very socially outgoing person before this all started. It's like.. Now, people that I know and am close to (fiancé, family, friends) come near me and my anxiety heightens. The only person I can be close to without feeling strange is my 2 1/2 year old daughter. Otherwise I just feel awkward and overwhelmed. It makes no sense to me. How could my brain just flip a switch like that? I absolutely hate it. This feeling depresses me and I also was not a depressed person before either (that I know of). I'm really struggling. What if I never get better? I know that these thoughts are negative and they don't help at all, but it's so hard not to think like that.