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Dr. Keane
Dr. Keane, Therapist
Category: Mental Health
Satisfied Customers: 1371
Experience:  Clinical Psychology PhD, Licensed Professional Counselor with experience in marriage/family, teens and child psychology.
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I know this may be difficult to answer but I need help

Customer Question

Hello, I know this may be difficult to answer but I need help with finding the right medication to try. I don't have insurance due to financial troubles so I want to try and get the most information I can before I pay out of pocket for a doctor visit and medication. I have been having trouble for a couple years now with anxiety and depression. I've had a few major things happen and I just cant pull myself out of my own head and this funk I am in. So my issues are, I cant stop thinking about everything that went wrong and how I could have changed it. It brings me to the point of not moving from my couch for days. These are things that have happened over the past years. Most of them were completely out of my control. Yet I just dwell. I am angry all the time even though I really do have good friends and family. I am impatient. I have panic attacks for no reason at wall where I cant breath and just cry. I don't like to sleep because I have a lot of nightmares. I just don't know what to do. I don't like being like this and I am afraid because I fear I will always be this way. I just sit in my apartment when I am not at work alone. I hate myself this way. This is not the person I used to be or the person I want to be. I was put on Xanax for years which helps with the panic attacks. I was on Adderall which I felt helped me focus my thoughts to being more productive. also, venlafaxine. I think the venlafaxine helped -I started it after my apartment burned down last spring- but it made me very zombie like. I'm not sure if the combination is good to request again or if I should try something new. If anyone can help me I would greatly appreciate it. I just want myself back. Thank you in advance for your time.
Submitted: 6 months ago.
Category: Mental Health
Expert:  Dr. Z replied 6 months ago.
*This website DOES NOT constitute treatment and only provides information and advice in a Q&A format. For treatment (therapy and/or medications) you must go to a licensed professional in your area. Please note that anything said here is not private or confidential, as this is a public forum. Hello and thank you for using JustAnswer. Truthfully the use of psychotropic medications is a trial and error process so what works for some people may not work for others, so I cannot tell you with 100 percent assurance this medication will "cure" you. Given that, you can consider trying the Venlafaxine again, but at a lower dosage or you can consider not combining it with the Xanax as the combination of the two at moderate to high doses can cause that "zombie" effect you noted. You can also consider Escitalopram, which is very effective for both depression and anxiety/panic. Escitalopram will also still interact with the Xanax and may cause a "zombie" effect at moderate to high doses, but I cannot say for certain until you try the combination, I can only say that it is a possibility. The other medication possibility would be Mirtazapine and this would be taken at night because it has a sedative effect, which will help you sleep, but this is a very effective antidepressant for anxiety and depression as well. The last medication you can consider trying would be Lamotrigine, which is a mood stabilizer, that is very effective for both depressive and anxiety symptoms...this will also not interact with any Xanax use though so that "zombie" effect is usually not associated with Lamotrigine. Also Lamotrigine is weight neutral and will not cause sexual dysfunction either