Agoraphobia Medication Part 2: Antidepressants

For agoraphobics experiencing severe panic attacks, antidepressants may be the most effective medication. When compared with benzodiazepines, antidepressants put a stop to panic attacks more directly (in addition to treating depression). In most cases (except for Effexor), they do not build dependance and have fewer and milder withdrawal symptoms.

You should be aware that there are several main classifications of antidepressants and know a little bit about each:

1) MAOIs (Monoamine Oxidase Inhibitors)
2) TCAs (Tricyclic Anti-depressants)
3) SSRI's (Selective Serotonin Reuptake Inhibitors) and
4) SSNRI's (Selective Serotonin and Noreprenephrine Reuptake Inhibitors).

Mental health professionals prescribe MAOIs very rarely. They have many potential side effects like dry mouth, blurred vision, drowsiness, dizziness, decreased sex drive, skin rash, and weight gain or loss. Plus you can't eat smoked, fermented, or pickled foods or drink certain beverages if you are taking MAOIs (you can’t even have wine and cheese). MAOIs also have a bad reaction with a lot of other medications and can cause high blood pressure if you mix them with the wrong chemicals.

Tricyclic Anti-depressants used to be a popular choice but have the same potential side effects as MAOIs. TCAs include drugs like Elavil, Norpramin, Tofranil, and Pamelor. For the most part, since the advent of SSRIs like Prozac, TCAs are being used less and less by medical and mental health professionals due to side effects.

Prozac, Paxil, Zoloft, Celexa, Luvox, and Lexapro are the SSRI’s most commonly prescibed for agoraphobia. They reduce the symptoms of depression and panic by stabilizing the levels of serotonin in the brain. In the central nervous system, serotonin is believed to play an important role in of pain, pleasure, anxiety, panic, arousal, and sleep.

SSRI’s have become popular partly for their effectiveness and partly because they don't have as many potential side effects as the antidepressants that were previously available. The side effects of SSRIs are manageable for most people and are usually limited to indigestion and/or a reduced sex drive.

One of the reasons that SSRIs Have become so widely prescribed by doctors and psychiatrists is because you can't use them to kill yourself by overdose. Prior to SSRIs, one of the most common forms of suicide was to overdose on the very antidepressants that were meant to cure the depression and suicidal.

There at least three serious drawbacks with SSRIs to consider:

1) SSRIs are risky to combine with other drugs. For example, SSRIs can be lethal when taken with MAOIs.

2) Even though you can't use them to kill yourself by overdose, one possible side effect of SSRIs is an increase in suicidal thinking.

3) Popular SSRI’s, such as Paxil and Zoloft, have potential side effects of sexual dysfunction and weight gain.

A close, increasingly popular cousin to SSRIs are SSNRIs. SSNRIs include Effexor and Serzone. The main advantages to SSNRIs over SSRI's are that they effect the brain’s levels of noreprenephrine in addition to serotonin and aren't as likely to produce sexual side effects. Effexor, however, is particularly hard to stop taking without going through some serious withdrawal symptoms.

If you are going to take an antidepressant to stop panic attacks,you should probably try one of the newer ones (SSRIs and SSNRIs). Since there are so many choices, you may have to shop around and try several before you find the one that works for you. Different drugs work differently on different people.

Paxil is the favorite of some doctors who claim it makes people a lot calmer than some of the other SSRIs. However, there are so many different SSRIs and SSNRIs that if you try one that doesn't work for you, you may keep experimenting under the care of doctor until you find one that does.

Article Source: http://www.agoraphobia.net

Stephen Price is a recovered agoraphobic with a master’s degree in psychology. He has an informational website on agoraphobia with a free newsletter. It is found on the web at: www.agoraphobia.ws

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