Success with Anxiety Meds with no Mania?

Hi all. I suffer with a lot of anxiety. I am dx with BP I so these meds easily make me manic. Have any of you been on a long term medication that didn’t bring on mania for you?

Have you looked into Buspar or benzodiazepines ("benzos" for short)?

Buspar didn't help me, but some people swear by it. Just know that you have to take it 2-3 times a day everyday for it to work. So if you have a job or a hectic/unpredictable schedule, it may be difficult to be consistent with Buspar. You really can't miss a dose.

Benzos like klonopin, Valium, etc can be addictive and it's easy to build a dependency on them (i.e., you can get serious withdrawal problems if you're on them for extended periods of time and decide to stop taking them). On top of that, they can cause depression. I don't think it is common for them to cause depression, but they can in some people, so I thought I'd mention that as a risk.

Some people use benzos for sleep or to calm manic racing thoughts, so they do have their benefits on top of helping with anxiety. So, I wouldn't say they're "bad" because of the dependency risk and depression risk. It's just a matter of whether the pros outweigh the cons for you. For a lot of people, the pros outweigh the cons. And considering you don't have to take benzos everyday like you do with Buspar (i.e., they can be PRN), you may not develop a dependency if you don't take them daily.

Here is more info on benzos:
Benzodiazepines Drug Class: Side Effects, Types & Uses

I think that the greatest treatment for anxiety (and a great long term one) is mastery of coping skills. But if you must only look at meds, bluebicyle mentioned the main ones. I might also suggest Seroquel or Seroquel XR, though obviously Seroquel is more known for its moodstabilization and sleep assistance.

Ah yes... I forgot about Seroquel!! Seroquel XR did help me with my anxiety a lot at lower doses, but I had to go off it because it caused depression for me at higher doses. BUT not everyone gets depression at higher doses. I don't think it's super common. In fact, a lot of people on this forum say that Seroquel helps with their depression.

As far as downsides go with Seroquel, the only major downsides are the extreme sedation that some people (like myself) get from it and the possibility of increased cholesterol (like it did for me). Others experience weight gain because it can cause cravings. However, I never experienced weight gain myself, so weight gain is not a guarantee (if you're worried about that).

But if you're worried about sedation and stuff, you can always ask for it as a PRN. My grandmother had Seroquel (regular release) and would take an extra one as PRN if she had increased anxiety. I think it calms you because because of its sedative effects.

Also, I see you're in the U.S. and I don't know if they have this deal going on still, but Seroquel XR (brand name, not generic) cost me $3 a month with a manufacturer's coupon.

Gabapentin has been a lifesaver for me. I think it's off-label for anxiety, but it really works, and I've been on it for 4 years with no issue except some cognitive fuzziness at higher doses (900mg and above).

Also beta blockers like propanalol helps. It’s what I take!

I've also found it keeps me from getting inordinately worked up/pissed off over things (which was as issue for me, but not so much so much anymore). Sometimes still, yes, but not as often. If that is an issue for you too, you may find it helps.

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Mr. Robot

Makes me sick to the heart, Oh I feel so tired. And the way the rain comes down hard, that's how I feel inside.

--The Cure

I didn't even think about these. Thanks for mentioning them, HALLIEBETH! I have been taking 40 mg of propranolol for at least 9 years now, though for tachycardia. I believe that my past tachycardia was partially anxiety-related. For that, it has worked quite well. I have zero side effects from propranolol. I believe it also reduced my hand tremors when I used to be on Lithium. I don't count it in with my psych meds, though it probably should be.

I also do well with gabapentin. I'm tapering very slowly off klonopin and eventually gabapentin will be my only anxiety med (along with a very sedating AP and some mildly sedating other meds). Gabapentin works well for me and as long as my dose isn't too high I don't have side effects. I take it all at night with the occasional PRN dose earlier (almost never though).

Klonopin, worked but I was a zombie. Gabapentin did not seem to help me. Buspar did not seem to help me. Propanolol helped me a LOT. Wish I was still on it.

Thanks guys, going to talk about all these with my pdoc and some alternative therapy techniques with counseling.

I go to therapy every other week and take 1 mg of Klonopin in the evenings. I used to also take 1 mg in the mornings, but I was so sleepy and out of it much of the time I stopped it on my own. Incredibly, from what people have said here, I had absolutely no bad effects from stopping it suddenly, and I became far more awake and with better concentration.

The 1 mg at night I think helps me with anxiety overall (once it's accumulated in your system, I think it helps all or much of the day) and it helps me sleep as well, a huge bonus.

My pdoc at one time had me taking Ativan three times a day

Buspar has significantly helped with my physical symptoms of anxiety, but I’m still working on my anxious thoughts. The book “DARE” by Barry McDonaugh has really helped to change my relationship/perspective with anxiety... it has helped a lot of people, might be worth checking out

Seroquel + Klonopin helps. It is my baseline to experience anxiety, but these help provide me with some relief.