Cortisol

[taks]

Specifying a specific medication as the gold standard is deceptive, when there are tons of other medications equally effective. The abstracts you listed don't even mention alprazolam.

not sure what your issue with xanax/alprazolam is, but the point was simply that it is either considered the best for such things, or at least the most prescribed. i specifically got the term from wiki, actually on the sertraline page (which compared it to alprazolam) and linked to a NEJM article. i'm not a subscriber and you can't get the abstract. anyway, you said:

 

"Not even benzos as a whole, and especially not Xanax specifically."

which is kinda contrary to all three of those links. heck, the original is valium... little yellow helper and all that.

 

You also make it sound like you're pushing a hidden agenda, though you probably aren't, since no one on this forums has any sort of psychiatric problem.

uh, whatever. i wouldn't be so quick to say nobody in here has a psychiatric disorder, btw.

 

You're probably better off giving cognitive-behavioral therapy a try, anyway. Combination works better. Pro-tip: nothing in medicine is 100%

i realize that there is no 100%, at least not in general. it worked 100% for me, for a short time, then didn't work at all. oh well. CBT is also listed as helpful for about 1/3 of the people that undergo it. what i ended up having was almost post-traumatic stress. my panic attacks had very little to do with "worry," at least not that i was aware of (i was reading a technical paper online when the one hit that put me in the hospital). i have always been a anxious/fidgety person, just part of my personality. oddly, i'm also fairly laid-back in many ways, too (though you could never tell from in here).

 

(are you getting sexual dysfunction? )

hehe, nope. like i said, none but the 2% side effects. i actually wish i had the "takes longer" problem, but alas, i do not.

 

taks

[taks]

oh, i should add, not only does xanax no longer work, it actually triggered an attack last time i took it. so no, i'm not pushing it for any agenda. that's the reason i haven't taken it in two months, really.

 

taks

[taks]

oops... that should be "mother's little helper," from the stone's tune.

 

taks

[Llyranor]

The main issue is that it has nothing to do with it being a gold standard. Yes, benzos are widely used in GAD. That still doesn't make alprazolam the gold standard. Angiography is the gold standard of pulmonary embolism, but virtually no one will use it in a clinical setting, unless part of a study or everything else being inconclusive.

 

Though, you get the gist of it. If anything, benzos should be used in the first few weeks while waiting for the SSRIs/SNRIS/TCAs/etc/etc to start having an effect. Prescribing benzos long-term is just a bad idea, and not just for its tolerance. Again, combination. Pharmacology or psychotherapy alone isn't going to be as effective as both for the most part. Though, yes, some people can get away without it.

 

But geez, stop using wiki as your source. Any idiot like you or me could have written in it. In any case, I looked it up quickly. Assuming you're referring to this http://en.wikipedia.org/wiki/Sertraline and this article "Fiseković S, Loga-Zec S (2005). "Sertraline and alprazolam in the treatment of panic desorder [sic]". Bosn J Basic Med Sci 5 (2): 78

[Laozi]

Two phrases that sum my attitude up: "I'll go where the wind takes me." and "When one door closes, another opens."

 

It's worked great in life so far. I can't recall ever having something like a panic/anxiety attack.

 

 

Yeah, thats good stuff, hippie. I was torn between duty and desire.

[taks]

Though, you get the gist of it. If anything, benzos should be used in the first few weeks while waiting for the SSRIs/SNRIS/TCAs/etc/etc to start having an effect.

that's what i mean by "gold standard," and also what the article meant. they (benzodiazapines in general, alprazolam in particular) put the smack down on anxiety, particularly panic attacks. they work immediately, too, which SSRIs cannot claim. it took nearly 12 weeks before i could say that sertraline was as effective as alprazolam.

 

Prescribing benzos long-term is just a bad idea, and not just for its tolerance. Again, combination. Pharmacology or psychotherapy alone isn't going to be as effective as both for the most part. Though, yes, some people can get away without it.

depends upon who you are and what your issues are, really. my doc doesn't seem to think i need CBT.

 

But geez, stop using wiki as your source. Any idiot like you or me could have written in it. In any case, I looked it up quickly. Assuming you're referring to this http://en.wikipedia.org/wiki/Sertraline and this article "Fiseković S, Loga-Zec S (2005). "Sertraline and alprazolam in the treatment of panic desorder [sic]". Bosn J Basic Med Sci 5 (2): 78

[Laozi]

Llyranor is a proctologist, a leader in the field

[Humodour]

My amphetamines make little johnny sad.

[taks]

oh, i should add, i DO have a friend that IS a pharmacy rep for glaxo, down in dallas. his recommendation: don't take your primary care's advice w.r.t. anti-depressants, go to a psychiatrist. they've got more experience dealing with not only the drugs and their side effects, but everything else related to such things. unfortunately, that might cause some problems with the... investigation that is being conducted on me at the moment.

 

taks

[Humodour]

You mean it's legal to get drugs off somebody other than a psychiatrist over there?

[Laozi]

I've had nurse practitioners write me prescriptions

[taks]

You mean it's legal to get drugs off somebody other than a psychiatrist over there?

i would hope that if i need an antibiotic i wouldn't have to go to a psychiatrist.

 

assuming you meant "for mental health related drugs," yes, MDs can prescribe as well as RNs and PAs. i'm not sure if a PA can subscribe outside of his/her profession, however, but i guess that would be hard to gauge.

 

taks

[Nick_i_am]

Man, shut up Llyranor, stop giving bad advice. History has proven that wikipedia is a more reliable source of medial information than dedicated medical literature.

[taks]

i do chase links, btw...

 

taks

[Nick_i_am]

I chase children.

[Humodour]

I've had nurse practitioners write me prescriptions

 

I'm surprised everybody over there isn't popping pills.

[taks]

well, these are all licensed positions... it's not like they're doing this in the dark. nurse practitioners, registered nurses and physician's assistants are all well trained in their specific areas (RNs tend to be generalists). they are prescribing under the supervision of a board certified doctor as well (an MD, for example).

 

taks

[Aram]

I was told to take oral Cordisol after I got off the steroids because, supposedly, they crippled my natural production. I didn't notice any difference between taking it and not.

[taks]

btw... nick, llyr, um... yeah.

 

taks

[Llyranor]

Ignore him.

[Dark_Raven]

I've had nurse practitioners write me prescriptions

 

I'm surprised everybody over there isn't popping pills.

Depends on what kind of pills they are.

[Nick_i_am]

btw... nick, llyr, um... yeah.

 

taks

 

What?