Least Harmful Potent Anxiolytic

[JustPanicNoDisco]

I have PSSD.

The reason I began SSRIs (fluoxetine) in the first place was due to GAD and panic disorder. I've seen little improvement in anxiety since coming off the SSRI and clonazepam (klonopin) over a year ago.

I want to let my brain "heal," but I really need to be able to function. The anxiety is absurd. I've tried seemingly every anxiolytic supplement under the sun, with most providing very modest results at best.

Are there any prescription anxiolytics that won't fuck my brain further than it already is? I'm deathly afraid of worsening PSSD. I'm considering going back on benzos long-term - my psychiatrist is willing to write a prescription for 1.5mg clonazepam per day. I'd rather have a horrible physical dependence on something than risk more severe brain damage from SSRIs/antipsychotics. I just want to live life and not feel physically sick constantly.

I'm currently trying moclobemide, an irreversible MAOI, which seems pretty innocuous on paper. After this, I MAY give mirtazapine a shot, but this one scares me, given that it alters neurosteroid activity, just as SSRIs do.

I've tried the typical tianeptine, ashwagandha, -racetams, SJW, inositol, magnesium, etc. I've tried propranolol, prazosin, clonidine (all somewhat effective, but seem to hinder sexual function), baclofen (decent in high doses but addictive), gabapentin (doesn't do a whole lot).

What are some safe and potent anxiolytics to try that will NOT further hinder sexual function? These two seem mutually exclusive, outside of maybe some of the GABA agonists.

 

[MoveUp]

Try CBD oil

 

[TubZy]

Gastrodin was one of the few I tried in the past that worked pretty decent. Not many companies make it (I tried the LEF one) but it works pretty well, this was a while ago though
@Area-1255

 

[MNK99]

CBD
Lithium Orotate
Alpha GPC
Possibly L-Theanine
I'm not going to tell you to stand on your head and do a rain dance.

 

[Jaxx]

I dont feel mirtazapine worsened my pssd, but that offers no guarantee for your case ofc. Some irreversible mao inhibitors are far more effective than moclobemide, but diet becomes alot more serious then.
Beta blockers are sometimes also used to calm people down.

 

[bd part 2]

noble kava - yes it's a GABA agonist but not nearly as bad as klonopin
jujuba/ziziphus
bacopa

I'm surprised ashwagandha negatively effects your libido, it generally increases it

 

[dante]

pregnenolone !!

 

[RebelWithACause]

Best thing for me are actually energy drinks or a coke, being outside and eating a lot. But it's still never strong enough for me. Most supplements do nothing in my case.

For me energy drinks help too. Caffeine seems to lower my neuroticism instead of making it worse.

 

[MNK99]

It has too much caffiene and if you're oon any other upper (or also drink coffee, I'dttake a half-size), JYM is pretty good. It has alpha-GPC, Arginine, citrulline,creatine, caffiene, etc. If you mix thatwwith some coke/orange juice/grapefruit juice, that's a GREAT energy drink, pre workout. Good for anxiety too, I find. 300mg caffiene.

 

[MNK99]

When you say"eating a lot", do you mean carbs? Serotonin effects are at play iirc.
I am def less type-A-ish aftereeating post workout and carbbackloading. But I prefer hi fathhi protein low carbs for other reasons. I do try and drink some oj /grapefruit juice in the morning for energy (diluted with water BC of the acidity). Helps crash of add, etc a lot and I'm still fairly low carb. Only other carbs pre and post workout BC that's the only time I intentionally eat.

 

[Area-1255]

I have PSSD.

The reason I began SSRIs (fluoxetine) in the first place was due to GAD and panic disorder. I've seen little improvement in anxiety since coming off the SSRI and clonazepam (klonopin) over a year ago.

I want to let my brain "heal," but I really need to be able to function. The anxiety is absurd. I've tried seemingly every anxiolytic supplement under the sun, with most providing very modest results at best.

Are there any prescription anxiolytics that won't fuck my brain further than it already is? I'm deathly afraid of worsening PSSD. I'm considering going back on benzos long-term - my psychiatrist is willing to write a prescription for 1.5mg clonazepam per day. I'd rather have a horrible physical dependence on something than risk more severe brain damage from SSRIs/antipsychotics. I just want to live life and not feel physically sick constantly.

I'm currently trying moclobemide, an irreversible MAOI, which seems pretty innocuous on paper. After this, I MAY give mirtazapine a shot, but this one scares me, given that it alters neurosteroid activity, just as SSRIs do.

I've tried the typical tianeptine, ashwagandha, -racetams, SJW, inositol, magnesium, etc. I've tried propranolol, prazosin, clonidine (all somewhat effective, but seem to hinder sexual function), baclofen (decent in high doses but addictive), gabapentin (doesn't do a whole lot).

What are some safe and potent anxiolytics to try that will NOT further hinder sexual function? These two seem mutually exclusive, outside of maybe some of the GABA agonists.

Inositol shouldn't hinder sexual function, but it doesn't really help Anxiety for me...just OCD-type stuff ["checking"]. Mirtazapine is a fairly decent medication, but its Sedating, especially at first because of this many people drop it after the first week. These sedative effects eventually wear off - but if you hop on a higher dose; say 30 MG or above, they are less apparent. Trazodone is more sedating/tranquilizing, but might have more Anxiolytic effects for people with Panic Disorder [!]. Trazodone [Desyrel] can also improve SSRI-induced Sexual Dysfunction more than most other drugs; has high Efficacy in doing so [1]. Additionally, it (Trazodone) treats Methadone/Opiate-induced Erectile Dysfunction [2] and it can improve ED in the Young [3] and Psychologically fractured/anxious [4].
Other than these, I'd say you can check into other MAO-Inhibitors...but Moclobemide is fairly safe, and for what its worth - is mentioned as a one of the "Top 5" Antidepressants that improve hormone status/sexual function [Article].

 

[gar0u87]

It has been mentioned before but Rexer (mirtazapine bucodispersable) 15mg split in half works for me pretty well for increased hunger and anxiety supression before bed. 15-30mg probably contributed to hairloss and reactive hypothyroidism, i was in adrenal exhaustion phase, and was a bit overkill in perspective but i was going to arrive there sooner or later imo. I am of the thinking that most betablockers work pretty well at only 1/4 the recommended dose or less for instance xanax, mirtazapine is the only drug of this class i would consider using because it works time and time again at a low dose. I havent tried it myself yet but i suppose transdermal or sublingual CBD could edge or compliment rexer to use during the day.

Maybe this helps narrowing down a decission:
(PDF) Mirtazapine does not influence tetrahydrodeoxycorticosterone levels in depressed patients

 

[gar0u87]

It has been mentioned before but Rexer (mirtazapine bucodispersable) 15mg split in half works for me pretty well for hunger and anxiety suppresion before bed. 15-30mg probably contributed to hairloss and reactive hypothyroidism, i was in adrenal exhaustion phase, and was a bit overkill in perspective but i was going to arrive there sooner or later imo. I am of the thinking that most betablockers work pretty well at only 1/4 the recommended dose or less for instance xanax, mirtazapine is the only drug of this class i would consider using because it works time and time again at a low dose. I havent tried it myself yet but i suppose transdermal or sublingual CBD could edge or compliment rexer to use during the day.

I will comeback to this post with a mix that inclused NALT (and theanine?) that works pretty well to both stimulate and calm you as per the users of the BB forum i frequent. I'll have to look on my notes but its worth a shot because its 'exotic' and out of usual guesses like kava etc

Good catch @ gastrodine, it works at 30 cents a day too.

 

[MNK99]

I super hate meds.

But I was in a position before fin where I felt and others did too, that I needed something. If not anticonvulsants (at a low dose for mood ), then MAOI's were considered. But my ADHD (primarily) P.doc said they're really old and there's better stuff for ADHD and mood, or it's not in his experience as beneficial. I think he'd be open to try. I probably should have been on something then bc of the severe depression (on and after finasteride. More lost on it... Then extremely lost and depressed AND physically sick after).

Can't believe all the stuff from last yr. I was bedridden and don't think I ate weeks to months except some bcaa powder/protein powder. Probably weeks. Family saw I was acting v strange and intervened. Despite our differences they helped set up the env in which I (and them) could save me. I wish they were more understanding and nicer about it... But I am thankful.

But yeah, anyways I think MAOI, or possibly Lamotrigine (that is a serious drug and can kill with a terrible syndrome, and if you're Asian, indian, etc, side effects are 10+++* more likely. I think I read some studies saying 100* more likely). So do not mess around with mood stabilizers and the like. But I'm just saying those.

I hate LTG BC it got me on fin with its major hair loss. But for ppl with "zero side effects" seems great. Can cause SJS, and several other life threatening syndromes. Sounds like a shyt drug, but trust me, the other recs for bipolar II+ ADHD are actually possibly worse (and I won't try em).


Safer Lithium Orotate.

Literally "life saving" to a lot of people that self-reliance their supplemental regimes (in lieu of medication regiments) for anxiety, bipolar, etc. I'mttaking some, still lean, not messed up, and a super small dose. Like 35 times of the last 450 days. Will take more regularly and rotate that with CBD, and some others.

I considered all these, bc, alternative recommended by experts, and those who dx'd me were in my opinion WAY WORSE. Also in my main doc's opinion but he felt it's ok to trial something (that shyt never ends well for me... One time, ADHD meds, and I guess asthma medn too. So maybe twice).

Probably the old benzos work but those are hard drugs. Nothing works for ev1 some swear by those, me they'd probably make me blackout and worse.

Some studies indicate that patients from a family in which alcoholism prevails (even if they never drink), see a reduction in anxiety as well as insomnia with Lithium (and lithium orotate - a microdose). Long term? Well I don't know... Long run, everyone goes.

 

[MNK99]

Hey man yes exactly.
Too many carbs I get water retn (although not lately but that's BC I eat lean 9/10 days if not way more... Less when I have commitments/ mandatory dinners).

TM fat or maybe TM of some sources (like peanut butter tho messes stomach up a bit anyways 1-2 spoons a day fine for me but sometimes have way more if I realize I didn't eat enough food), anything in excess in one meal can make bloated. I ate like 4000-4300 Cal's yday because of stupid weed.

Still look lean and not messed up digestion thank god. But it did irritate me till I had my juice and preworkout/caffiene/sugar/aminos, haha.


CBD is stupid expensive especially outside the US.

But hemp oil cbd can be good if 99.99% extract and lab-tested from a good online dispensary (or in person at a state/prov with reliable physical dispensaries in USA/CDA).


But I don't really like the MCT oil cbd that LP's (doctor signed licensed producers) get in Canada. Vaping or CBD powder hemp or cannabis derived is better.

I still hate weed tbh amotivnal, study, work, less.. est more crap tho I worked out 12 times last 2 weeks.. but I was fucked up sometimes. I was definitely nicer and less ... but at what cost? Being dumb is a pretty high cost. Not closing trades, deals, being stoned 4-6 h is a huge cost.

But pure bd does take tension off of stimulants and could be good before bed. I'm trying to treat all kinds of shyt naturally.

Tiny bit of lithium orotate or gpc plus cbd after taking dex (or Adderall for others), calms me down, lowering aggression, agitation, intolerance to things that delay, annoy me.

 

[JustPanicNoDisco]

Inositol shouldn't hinder sexual function, but it doesn't really help Anxiety for me...just OCD-type stuff ["checking"]. Mirtazapine is a fairly decent medication, but its Sedating, especially at first because of this many people drop it after the first week. These sedative effects eventually wear off - but if you hop on a higher dose; say 30 MG or above, they are less apparent. Trazodone is more sedating/tranquilizing, but might have more Anxiolytic effects for people with Panic Disorder [!]. Trazodone [Desyrel] can also improve SSRI-induced Sexual Dysfunction more than most other drugs; has high Efficacy in doing so [1]. Additionally, it (Trazodone) treats Methadone/Opiate-induced Erectile Dysfunction [2] and it can improve ED in the Young [3] and Psychologically fractured/anxious [4].
Other than these, I'd say you can check into other MAO-Inhibitors...but Moclobemide is fairly safe, and for what its worth - is mentioned as a one of the "Top 5" Antidepressants that improve hormone status/sexual function [Article].

Good post. Thanks for the citations.

Do you have any concern about mirtazapine's altering of neurosteroid levels? Many think that the change in neurosteroids levels from SSRI use is one of the main underlying factors of PSSD.

 

[Area-1255]

Good post. Thanks for the citations.

Do you have any concern about mirtazapine's altering of neurosteroid levels? Many think that the change in neurosteroids levels from SSRI use is one of the main underlying factors of PSSD.

No I don't. I've used Mirtazapine and Mianserin and no measurable problems with neurosteroids. They lower Cortisol a lot. They have plenty of benefits.

 

[JustPanicNoDisco]

No I don't. I've used Mirtazapine and Mianserin and no measurable problems with neurosteroids. They lower Cortisol a lot. They have plenty of benefits.

I assume you've read this? And what are the consequences of these changes? You obviously have much more knowledge about these hormones than I do. Thanks!

Influence of mirtazapine on plasma concentrations of neuroactive steroids in major depression and on 3alpha-hydroxysteroid dehydrogenase activity. - PubMed - NCBI

I know you've been fine using it, but many people also used SSRIs without lasting problems.

 

[Area-1255]

I assume you've read this? And what are the consequences of these changes? You obviously have much more knowledge about these hormones than I do. Thanks!

Influence of mirtazapine on plasma concentrations of neuroactive steroids in major depression and on 3alpha-hydroxysteroid dehydrogenase activity. - PubMed - NCBI

I know you've been fine using it, but many people also used SSRIs without lasting problems.

End result: decreased Progesterone, increased Pregnenolone and DHEA-S.

 

[JustPanicNoDisco]

End result: decreased Progesterone, increased Pregnenolone and DHEA-S.

Thanks!