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Should I see the doctor?

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Posted 9/12/2015 7:37 PM (GMT 0)
Hi everyone

I'm going through a really rough time at the moment, I have bad digestive issues causing me a lot of pain and nausea, and I've been like this for coming up to 2 months now and am starting to get very anxious. When the pain is bad it feels like acid is burning in my stomach or chest and this makes me really stressed which then starts a vicious circle of more acid and pain.

I'm currently taking Mirtazapine for anxiety and depression, but this last week I am feeling nervous all the time and just have to keep myself constantly distracted otherwise I dwell on feeling ill and get worried that I'll never feel better. The Drs are pretty much lost on the physical side I think it's a case of I have to wait and hope it gets better, I'm on medication for it but it seems to take ages to heal, but on the mental side its wearing me down.

I feel like I need something to keep my anxiety down, I don't have panic attacks but feel on edge a lot and have to constantly do relaxation exercises to keep calm. Is there something a doctor can give me for this, like Xanax or something? Can you take this on top of an antidepressant? Just not sure what to do, I've started seeing a therapist about it and have been on Mirtazapine for a while and was doing OK but when I'm feeling ill my anxiety naturally gets higher. I'm having to resort to taking painkillers at times because they dull the pain but also seem to calm me down a bit, they're slightly narcotic.
Posted 9/12/2015 8:18 PM (GMT 0)
Hi Andy,

It is safe to take benzos (like Xanax) with anti-depressants. Many of us here do exactly that! Although benzos are habit-forming so many doctors will limit your supply.

Xanax is the shortest acting benzo of them all (3-4 hour lifespan), so I wouldn't recommend Xanax for your situation. There is another drug in the same family called Klonopin which lasts much longer so you would only need to take it once a day. With that said, taking benzos daily is not typically a good idea, unless it is for a short period of time (like while you are starting a new antidepressant and have start-up anxiety). You can become dependent on benzos, and sometimes withdrawal can be a beast. On the flip side, they really, really help with anxiety so they provide excellent results during short-term use.

How long have you been on Mirtazapine? If you are still in the first few weeks, the anxiety should go away once your body has gotten used to it, and perhaps adding Klonopin to your daily routine for the next few days to help you with your transition would be a good idea. If you have been on Mirtazapine for awhile, you may want to consider switching to another antidepressant, or possibly asking your doctor about increasing your dose (since it isn't taking care of your anxiety).

Of course I am not a doctor, so please ask your doctor what he/she thinks your best move would be.

Good luck,

-Cat
Posted 9/12/2015 8:21 PM (GMT 0)
Hi Andy and welcome to the A/P

I am glad you joined us...though sorry to hear about your recently increased anxiety.:(

I am assuming you are on a PPI for your GERD issues? It can take time to heal the GI tract...and GERD can make you feel more unwell than would be expected, right?...and yes, like you said, it is cyclical.:(

However, you are getting the help that you need to treat this as a two pronged approach...physically and mentally, so feel good and hopeful about that!

It takes time and commitment, but you will meet your recovery goals.:)

As for your questions...you have some options.

One is, yes, you can ask your doctor about a temporary benzo Rx for when you are having acute episodes of anxiety. Your doctor may or may not write on however...as some doctor are now hesitant due to the fact that for some people, they can be problematic in addictive tendencies.

Another thought is to simply up your current med. You may have reached a plateau, and need to bump up to the next level to find therepeutic benefits. You'll of course have to discuss this with your doctor...this is just an option to discuss.

Still another option is to consider another class of A/D's. Some people respond better to an SSRI or SNRI rather than a tetracylic A/D. (Mirtazapine/Remeron) This would of course be another thing to talk with your doctor about.

What you can't do is take a benzo (if you end up getting a script) with a narcotic class of med...

...so be sure that your doctor(s) know ALL of the Rx's that you are taking...to avoid interactions.

Last but NOT least is coping skills! It is fantastic that you are in therapy to gain tools in anxiety management!! You can also hope to move forward with self help...of which we have great material available right here in our Resources. See the top of the main forum page, and have a look! The Stress Relieving Exercises would be a good place to start!

Keep posting with us if you find it helpful. We are here to listen, understand...and support is key!

Scaredy Cat
Posted 9/12/2015 8:22 PM (GMT 0)
Hi

Sorry to hear you are having a tough time at the moment.

Yes I would go and speak with your doctor and maybe talk about an increase in your Mirtazapine or the possibility of adding a benzodiazepine which you can take along with your AD.

I live with chronic pain so know what your going through and how miserable it can make you feel but you can get through this and I am sure your therapist will be of great help to you. In the meantime have a look at our resources thread for some useful self help links.

Keep us posted.

Hibee
Posted 9/12/2015 8:23 PM (GMT 0)
I've been on Mirtazapine for months now, don't really want to switch as its other effects like anti nausea I think help my physical symptoms. I'm on 45mg a day, not sure it can go higher. I think I will go on on Monday. My anxiety is usually fine when I'm not feeling ill its just during this latest flare up of my symtpoms the anxiety seems to be increasing. I would hope that I'll be feeling better in a few weeks but I thought that a few weeks ago..

I've been on a couple of other ADs in the past, venlafaxine and amitriptyline, in terms of mood amitriptyline was that best but I had to ween right down as it gave me really bad constipation

Post Edited (Andy1986) : 9/12/2015 2:28:50 PM (GMT-6)

Posted 9/12/2015 9:03 PM (GMT 0)
Yes, it looks like you are at the max dose of the Mirtaz...but you'll find out what your options are when you consult with your doctor...

...there will be something you can do...a second Rx, or an add-on that could help.

Do you see a GP only for your psychotropics, or do you have a P-doc for this?

A psychiatrist may be worth consulting with as they would be the most knowledgeable in this area.

Best wishes!

S.C.
Posted 9/12/2015 9:07 PM (GMT 0)
Just my GP. In the UK its pretty hard to get referred to a psychiatrist as its costs more money
Posted 9/12/2015 9:45 PM (GMT 0)
Ah Andy I have a similar problem with psychological drs here in Sweden. It's like almost impossible to get a proper treatment from them. But my issue is, they won't send me to the hospital psychiatry clinic because they think that Hypochondria doesn't need such attention... What the...?? :(
My only choice is paying for private psychology dr, which costs a fortune per session ://

As for your problem, I agree with all others. When you can talk to your dr ro do something about your medication and episodes of GERD, anxiety will reduce and the anxiety circle will also break.

Hope you feel well soon.
Sending healing...
Posted 9/13/2015 10:17 AM (GMT 0)
Is it possible to take low doses of benzos longer term like for a few months? I took sleeping pills, zopiclone, for a few months a couple of years ago and managed to ween off them without too much trouble. Are benzos more addictive than them?

I think I can do without the narcotic pain killers if I have something for the stress, the pain isn't that bad its more for the slight sedative effect that they seem to help tbh.

I've also been taking Reglan for the last couple of weeks but think I will stop, maybe the anxiety is a side effect of that? It doesn't seem to help that much with the nausea anyway tbh
Posted 9/13/2015 3:15 PM (GMT 0)
I'm starting to think these are side effects from Reglan which I've been on for almost 3 weeks now, mentally I'm not really stressing about anything in particular but I'm getting all these physical symptoms of stress like a tight chest and increased acid in my stomach and heartburn.

I can't really sit or do anything at the moment as I just feel really stressed, I'm having to just keep playing some games to keep the stress down and relieve the symptoms somewhat.

I am definitely going to the Dr tomorrow and asking for something to ease all this tension I'm feeling.
Posted 9/13/2015 3:39 PM (GMT 0)
Andy,

I am not very familiar with the Reglan, but it certainly is possible that you are not reacting well to it...

Can you attribute the onset of the increased anxiety with the commencement of it?

I hope that you get the needed answers you need at your appointment tomorrow!

Let us know how it goes, and how we can continue to support you.

S.C.
Posted 9/13/2015 3:53 PM (GMT 0)
Well its only really been this last week that I've felt more nervous, and my physical symptoms did get suddenly worse during that time which is what I put it down to, but now I'm thinking actually it was the stress that caused the physical problems. Apparently people with anxiety are not supposed to take Reglan and the Dr did say it was a bit risky to go on it but I was a bit desperate suffering from nausea rly bad at the time. But its not really helped the nausea a lot so I don't see a reason to keep taking it tbh.
Posted 9/13/2015 3:59 PM (GMT 0)

Well there you go! 

Yes, I did just look it up, and restlessness was one of the more common s/e's!

Also some physical side effects that could be associated with anxiety were there as well.

So good discovery!  Hopefully abatement of this Rx will help!

Here are some self-help ideas for now to get you through this rough patch.:)

http://www.stress-relief-exercises.com/

S.C.

Posted 9/13/2015 9:10 PM (GMT 0)
Hi Andy
I'm new here as well.

I'm sorry your going through so much. My doctor put me on xanax due to my increased anxiety but I only take them as needed. But 2 weeks ago I started to throw up and have extremely bad heart burn with it. My doctor said it was due to the anxiety and cause a up roar in my body. It was so bad everything I ate made me puke. So my doctor put me on Pantoprazole 20mg and ondansetron(for nausea) for 2 weeks it's only been a week but it has been a blessing. The Pantoprazole helps heal my stomach and cuts down the acid and the to stop me from throwing up. I'm not a doctor but maybe you could ask yours if it could work for you.

Wishing you the best Andy.
Posted 9/14/2015 11:14 AM (GMT 0)
Thanks I am on Esomperazole which is like pantoprazole and does help with the burning.

I saw the Dr today and she was pretty much useless, couldn't see my usual GP for some reason and this young trainee dr woman didn't even know what Reglan was, had to look it up and said on yeh its listed as a possible side effect so u might want to stop it. I asked to be put back on domperidone but she refused saying it can cause heart problems, didn't matter I'd been on it for 2 years without issue. Unsurprisingly she wouldn't give me anything for anxiety either but luckily I've been feeling a lot less stressed ,think most of the Reglan is out of my system now and its easier for me to relax.
Posted 9/14/2015 3:40 PM (GMT 0)
Hmmn,

Sorry your appointment was not more productice today.;/

...but glad that you are starting to feel better anxiety speaking!

Maybe you can re-schedule when your regular doctor is in, so you can reevalute your meds.

Peace and progress!

S.C.
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