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Dr_Anderson
Dr_Anderson, Doctor
Category: Mental Health
Satisfied Customers: 335
Experience:  Psychiatrist
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I have anxiety/depression and take cybalta 60mg and alprazolam

Resolved Question:

I have anxiety/depression and take cybalta 60mg and alprazolam 1mg 2x a day. They do help but still if feel anxious. Is there a better combo I could use?
Submitted: 2 years ago.
Category: Mental Health
Expert:  Dr_Anderson replied 2 years ago.

Dr_Anderson :

Greetings, and thank you for your question. If Cymbalta is the only medicine you have ever used for depression and anxiety, and if it has worked but not 100%, a logical option would be to increase the dose of the Cymbalta to 90 or even 120 mg. Many of my patients need doses like that to get the full control they are looking for.

Dr_Anderson :

Also, you know the medicine is working well if the Xanax (alprazolam) becomes an as-needed and rarely used medicine rather than a daily one.

Dr_Anderson :

If the idea of going up on the dose does not appeal to you, there are many other good options for depression and anxiety control.

Dr_Anderson :

The SSRI class is commonly used in these cases, because it has a fairly low side effect profile and good effectiveness.

Dr_Anderson :

Medicines in that family include Prozac, Lexapro, Celexa, Paxil. Zoloft, Luvox, and Viibryd.

Customer:

I have used others, just lost my job and need too good to find another one.

Dr_Anderson :

In that case, it is also important to find a medicine that is generic or inexpensive. Cymbalta is not generic yet, so it can be very expensive! However, given that you have no income from losing your job, the makers of Cymbalta have a "Patient Assistance Program."

Dr_Anderson :

If eligible, they will ship you your medicine, 3 months at a time, for free.

Dr_Anderson :

So, if you want ot stick with but go up on the Cymbalta, they can provide it for you at no cost to you.

Customer:

But the anxiety does not go away only lessens..I have patch with alcohol to patch the difference

Dr_Anderson :

If the anxiety is less on the 60 mg, it may go away completely with 90 or 120 mg. also, the alcohol can actually make the medicine LESS effective if a person drinks too much, so alcohol moderation is important, too.

Customer:

I don't want to drink and sometimes don't...but this feeling is overwhelmingly dreadful and drives my bp up to 180/120 or more soI I have meds for that too.

Dr_Anderson :

Yes, the anxiety is quite a problem not only for your peace of mind, but for your heart and blood pressure, too! So, if going up on the Cymbalta to 120 mg does not alleviate the anxiety (you'll know in a few weeks if it is helpful or not), then switching to a different medicine (like one of the ones listed above) would be very reasonable to do.

Dr_Anderson :

Until it begins to work, you may also wish to ask your doctor about switching you to Ativan or Klonopin. Both of them last longer than Xanax, so you may get better coverage of your anxiety with one of them.

Customer:

Well thanks I guess I'd better see a P-doc from my md..thanks.

Dr_Anderson :

You are welcome! Please let me know if I may be of further service, and best wishes to you!

Dr_Anderson :

Regards,

Dr_Anderson :

Dr. Anderson

Customer:

Good answers will keep in mind.

Dr_Anderson, Doctor
Category: Mental Health
Satisfied Customers: 335
Experience: Psychiatrist
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Dr_Anderson
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