Medications against anxiety

Dear Dr. Nagler.

First of all thanks for all your answers to me and others here on the forum.
I am 6 1/2 months into T now. I can sleep well with Remeron.
But I think my biggest issue so far is anxiety during the day.
I do CBT (thanks to the book you supplied to me) and try stopping my negative thinking.

I wonder if an anti anxiety med would cut the anxiety a little bit.
I remember taking Obipramol when I was in the tinnitus clinic. But it increased my liver values.
Maybe it was only temporary (we checked after 4-5 days), but they stopped giving them to me.

Nevertheless, I would like having something bringing me a little bit more relaxed and calm through the day.
I do not want taking addictive benzos (have lorazepam here, but avoid taking them).

Do you have any recommendation like for example Lyrica? Nevertheless of course I will visit my doctor for this.
But since you have much more experience with tinnitus patients, your opinion is of high value for me.

Thanks in advance and best regards,
Martin

 

Hi @Martin69 -

Tough question because there is so much individual variability.

Most tinnitus-related anxiety can be effectively addressed through one-to-one counseling with a knowledgeable and experienced tinnitus clinician and through the simultaneous use of sound therapy as recommended by that clinician and tailored to the tinnitus sufferer's needs. Since I consider myself to be a knowledgeable and experienced tinnitus clinician, I only rarely find the need to recommend an anxiolytic - but when I do, it is most commonly the benzodiazepine Xanax (alprazolam). I do so with considerable hesitation because - at least in theory - Xanax is believed to potentially inhibit habituation, which in my opinion is the best avenue available to today for the achievement of meaningful lasting relief.

I know it's sort of a non-answer, but it's the best I can do.

Dr. Stephen Nagler

 

Hello Stephen.

Since I cannot reply in Doctor's Corner...
Thanks for your response. It is as always very much appreciated.

As you probably know, doctors in Europe seldomly give benzos to their patients. Because they say they are addictive and it will be a horror trip getting off from them. I have Tavor here (lorazepam), but have taken only one pill in about 5 months. So doctors here give lyrica, obipramol etc. against anxiety.

So maybe, as you said, I still try without meds (or better only with remeron) and go through this.

It is so strange. This morning, I was full of anxiety. Then I had lunch with my wife and we talked about our situation. How much she loves me, that we will go through it together etc. At the end I was so relaxed and happy that I didn't care about my T although it was screaming like ever (at least I think so). It was a huge relief. If this is the state of habituation at the end, this would be something to fight for. So it really seems a lot about anxiety: Anxious about the future, the job, the family and so on.

This anxiety is what I want to work against. My wife gave me safety and things were much better. Nevertheless a med calming me down would be helpful.

What do you think about taking Lorazepam (1 pill is 1 mg), once or twice a week - if really needed?
Thanks again for your support and great help.

 

Sorry, Martin, but I honestly do not have an opinion about it one way or the other. It would be far better for you to discuss this sort of thing with your own physician.

Dr. Stephen Nagler