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Elliott, LPCC, NCC
Elliott, LPCC, NCC, Psychotherapist
Category: Mental Health
Satisfied Customers: 7662
Experience:  35 years of experience as a Licensed Professional Clinical Counselor, National Certified Counselor and a college professor.
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I have been on pristiq for 2 years and have been panicking

Resolved Question:

I have been on pristiq for 2 years and have been panicking a lot more lately die to excess stress. I often have herb anxiety. I have tried several ssri's prior to pristiq. Pdoc is suggesting lamictal and weaning off pristiq. Thoughts?
Submitted: 1 year ago.
Category: Mental Health
Expert:  Elliott, LPCC, NCC replied 1 year ago.

Elliott Sewell, LPCC, NCC :

Seeking expert counseling is a sign of strength. A personal relationship with a caring professional is proven clinically effective.

Elliott Sewell, LPCC, NCC :

Dear friend,

Elliott Sewell, LPCC, NCC :

It seems that your condition is basically anxiety, driven by circumstances.

Elliott Sewell, LPCC, NCC :

If that is the case then you would be diagnosed with Adjustment Disorder with Anxiety.

Customer: Would the lamictal help
Elliott Sewell, LPCC, NCC :

The drugs you have been given, however, are mostly SSRI antidepressants, and then a similar SNRI, Pristiq, which has as a potential side effect, increasing anxiety.

Elliott Sewell, LPCC, NCC :

Lamical is a an anticonvulsant drug

Elliott Sewell, LPCC, NCC :

Used in treating epilepsy and also in treating bipolar disorder, particularly helpful in the depressive side of bipolar disorder.

Customer: Could it by itself help the anxiety and depression since the ssri's and sbrkd
Elliott Sewell, LPCC, NCC :

Anxiety is also a side of effect of lamictal.

Customer: Snris have not helped long term
Customer: So you have a suggestion since not much else has helped
Elliott Sewell, LPCC, NCC :

For short term, the Xanax and Klonopin would be most effective.

Customer: And long term? Since the benzos are addictive and can leave me weepy
Elliott Sewell, LPCC, NCC :

I don't know what your Pdoc has in mind, but from my understanding of psychotropic drugs, lamictal is not effective. I am getting to your answer. I'm just trying to be thorough.

Elliott Sewell, LPCC, NCC :

There is one SSRI that is supposed to be helpful with anxiety, and that is sertraline (Zoloft), but

Customer: That was my thought. Not sure i want to try lamictal . She thought maybe the anxiety was related to a manic episode
Elliott Sewell, LPCC, NCC :

SSRIs have other side effects, including weight gain and loss of libido.

Customer: That was my experience on the ssri's and they ultimately pooped out on me
Elliott Sewell, LPCC, NCC :

A much more effective medication would be bupropion (Wellbutrin) which can actually help you lose a little weight, or at least not gain it, and help restore any lost sexual drive rather than lower it.

Elliott Sewell, LPCC, NCC :

That would be my recommendation of choice.

Elliott Sewell, LPCC, NCC :

Others would be BuSpar (buspirone) or Remeron (mirtazepine).

Customer: Wellbutrin by itself?
Elliott Sewell, LPCC, NCC :

Discuss all of these with you Pdoc.

Elliott Sewell, LPCC, NCC :

Yes, Wellbutrin by itself. Like all antidepressants (it is antidepressant and antianxiety) is takes a few weeks so you might want to supplement with the benzo of your choice on an AS NEEDED basis.

Customer: Thank you!!
Elliott Sewell, LPCC, NCC :

I wish you great success. You do NOT need to be overmedicated.

Elliott Sewell, LPCC, NCC :

One more thing:

Elliott Sewell, LPCC, NCC :

If you can deal with the stressors in your life (by counseling or self-help) then this will lower your anxiety.

Elliott Sewell, LPCC, NCC :

Remove the cause.

Elliott Sewell, LPCC, NCC :

I wish you great success.

Elliott Sewell, LPCC, NCC :

Warm regards,

Elliott Sewell, LPCC, NCC :

Elliott Sewell, LPCC, NCC, CCMHC

Elliott Sewell, LPCC, NCC :

I see that you have left the chat but you can get back to me later if you wish.

Elliott Sewell, LPCC, NCC :

I will switch you over to Q & A mode in 2 minutes if you do not return to the chat, from where you can get back to me later if you wish.

Elliott, LPCC, NCC, Psychotherapist
Category: Mental Health
Satisfied Customers: 7662
Experience: 35 years of experience as a Licensed Professional Clinical Counselor, National Certified Counselor and a college professor.
Elliott, LPCC, NCC and other Mental Health Specialists are ready to help you
Expert:  Elliott, LPCC, NCC replied 1 year ago.
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