Quote Originally Posted by gimmick View Post
Psychiatrist seems reasonable. Namely for finding medication that works for you. I assume you're not really interested in random hippy therapy that's also prescribed for GAD treatment.

With psychiatrist you need to find one that's tolerable, you don't need perfect and you can't bail instantly after the first failed drug experiment. There's a huge amount of trial and error involved in finding what works.

SSRIs are usually the first thing that's tried out. Mostly because lack of abuse potential and being generally well tolerated without too many serious side-effects (excluding mild suicide). They all do roughly the same, so the idea is to just find one that has tolerable side-effects.

SNRIs come after that. Less sexual dysfunction if that's a concern. There are also drugs that can be used to specifically combat that while taking SSRIs/SNRIs. Class of drugs called Azapirones that can also be used on their own for GAD.

If none of that works, you might be prescribed Pregabalin or Seroquel. Possibly some other drugs from their relative families are also used, but those are the most common ones. Both of them work almost instantly. They aren't first line choices because Seroquel causes heavy drowsiness and Pregabalin has a huge abuse potential.

Regarding finding how any drug is "reviewed" by the general public it's good to remember that people love to tell negative shit for anything they have to take therapeutically and love to hype whatever they choose to take recreationally.

Thing with GAD is that even though you cure whatever triggered it, it is now in your arsenal of reasonable coping mechanisms. So it's likely a bad idea to just focus on LPR and assume GAD goes away with it. It's not really how it works.
Yes, I'm afraid you're right with that last line. I wish I understood why, at certain times, the GAD fades to almost zero (without medication), and then comes roaring back for no apparent reason. Maybe unrelated stimuli are making my serotonin levels occasionally go up, and that covers the problem. Interestingly, after being completely off caffeine for weeks, a single 100mg dose of caffeine also wiped off the anxiety (for the night), but it returned the next day, and another caffeine pill didn't help. I suspect that my body was so happy to have the caffeine again that there was some kind of serotonin spike that first night, but nothing which would continue with continued use.

Definitely wouldn't want anything with heavy drowsiness, and as I said before, I really want to avoid sexual side effects. My anxiety spiked through the roof on Day 1 of Lexapro once I noticed my dick couldn't get hard no matter what. Couldn't rationally explain why that bothered me so much, given that I knew it was coming and might be temporary, but it sent me into an 8-hour super-high-level anxiety which was hard to break from. I think if I was already far along the slow, age-related road to impotence, this wouldn't have bothered me as much, but I pretty much went from 100 to 0 as far as that was concerned, and it was like I lost a part of myself.

Part of the reason it's tougher to get on long-term meds is because I've been able to manage the anxiety enough to where it might be at a preferable level over the side effects of the controlling medication. I haven't had a panic attack in several weeks, and I'm also not getting the soul-crushing, high-level anxiety where I can't do anything but pace around and feel super agitated (that was common in late August and early September).

Now when I feel the anxiety rising, I can usually put the brakes on it to the extent where it doesn't progress beyond medium-high.

Your explanation about the side effects sounds correct.

I saw the dentist today, just to discuss everything. I suggested to him that I pop a Xanax an hour beforehand, then take an Uber down there, then we start with the "easy" work and go from there. He agreed that's a good plan, so I have an appointment to get a "simple" cavity fixed on Wednesday. I'm not going to back out of that one unless something unexpected happens (like getting sick).