Anxiety problems

hope · 07-12-2006, 03:55 PM

I have been suffering from panic attacks even before being diagnosed with BC and have been taking Ativan reguarly for these. Recently these panic attacks have been waking me up at night most likely because I'm under even more stress that my lung mets are progressing, feeling that the Xeloda is not working any more, and having to get plural effusions drained every two weeks. I will get chest CT scans this week. If I fail Xeloda then there is nothing left for me to try except Lapatinib. I am eligible for the early access program for lapatinib but will have to wait like everyone else for another month until its available.

I am working with a palitive care team at my cancer center and they have suggested that I take the drug Clonazapam along with my Ativan. Clonazapam is basically a longer lasting Ativan like drug (anti-anxiety). Well I have tried this and it just makes me more dizzy and lightheadness due to my other brain lesion that has radiation necrosis. It seems like every drug that I take now that works on the brain except for the Ativan causes more of my radiation necrosis symptoms. I probably don't react to Ativan becasue I have taken it for so long that I have build a side effects resistance to it. I have even tried a couple of anti drepressants which made problems worse too.

I just wanted to know if any of you have taken clonazapam and what was your experience like? Also the pallitive care team has mentioned that if clonazapam continues to be a problem I could try a sleeping pill along with my Ativan to prevent these nighttime panic attacks. Has anyone taken sleeping pills before? and since I react to medications not so well which one is the most mildest? Thanks, Hope

Tom · 07-12-2006, 06:26 PM

Dear Hope,

I am sorry to hear you are having these problems. I know that each anti-depressant class drug effects each person in a different way for the most part. You may have to try more than a few before you find the one that works for you. Depression and anxiety are closely tied. I can tell you that years ago I suffered from severe depression and anxiety attacks after the death of my Father. After some crazy experiences with other neurotransmitter modifiers, I found the drug Effexor (venlafaxine) to be the one that worked for me. It has the unusual property of affecting not only seratonin levels in the brain, but norepinepherine as well. It is not well understood why, but Effexor has the ability to inhibit panic attacks. I know how bad a panic attack can be, so I sympathize with you. I eventually learned to cope with them "manually" by recognizing the symptoms of an oncoming attack, and "thinking" my way out of it. It's no picnic.

There may be an added benefit to you taking the clonazepam (Klonopin) I believe. It is also used as a seizure preventative. I don't know the current state of your brain mets, but it might not be a bad thing to have an seizure-inhibitor on board just in case.

I believe you may do fine on the Xeloda, as much of what I have read on it is promising. The best news is that you are pursuing lapatinib (Tykerb). It seems to me that it is the best hope for those whose Herceptin therapy has ceased to work. Please keep us informed as to how you are making out. Best wishes for improvement.

Sincerely,
Tom

Berta · 07-12-2006, 06:39 PM

Hope: I have been taking Klonopin for a while for restless leg syndrome. I only take 0.25 mg at bedtime but it is enough to help me relax and get to sleep without my legs moving around all night. It also helps with the fear of recurrance that was keeping me awake at night. From what I know about Klonipin (32 years working in the mental health field but not an expert on meds) I doubt that the Klonipin will PREVENT a panic attack. It may help you come out of one but I have always known patients who had panic disorder to be helped more by anti-depressants, whether they had depressive symptoms or not, the anti-depressants helped reduce the frequency of panic attacks. I have to agree that Effexor or Paxil would be a good choice. Good Luck, BERTA

michele u · 07-12-2006, 08:54 PM

Hope,
I'm an RN. I think you should be on Effexor and something like Xanax for the panic attacks. Effexor is something you will take every day and the Xanax would be for when you need it. Klonopin is kinda like Xanax but i'm more familiar with Xanax. We use it alot for panic attacks. You also need to learn biofeedback when you are having the attacks. A sleeping pill is not a bad choice either, but they are expensive and i take tylenol pm and it works better. If you have any questions i will answer them for you.

Barbara H. · 07-12-2006, 09:02 PM

Hi Hope,
I am also wondering if the plural effusions are making it harder for you to breathe and that is also contributing to the anxiety. I certainly feel for you and hope that you can get it under control. Lapatinip will be a good option for you because it will also deal with the brain. I hope it will be the drug that works for you. You deserve a break. You might also consider seeing a therapist that can teach you some techniques to deal with the anxiety and give you some tricks to try to diffuse it when you wake up in that state. I don't think that medications can always do it alone. I would really look for good therapist.
Good luck, and keep us informed. It is always good to hear from you.
Best wishes,
Barbara H.

Sherryg683 · 07-12-2006, 09:03 PM

I can relate to the panic attacks. I've been taking Xanax and it helps tremendously. I take it everyday (only one pill) , didn't know it was only for when you were having an attack ..oops... I hope I'm not overdosing on it. I've been on Prozac forever but it doesn't seem to be helping with this cancer thing. For the life of me, no matter how tired I am at night I can't seem to fall asleep without something, I will lay there for hours. I started taking Ambien CR and it works great...it's timed released and helps keep you asleep. I have so many freaking hot flashes at night that if I don't knock myself out, I dont' get any sleep. I hate taking pills but I feel if I have to do it to get me through this, then so be it...sherryg683

chrislmelb · 07-13-2006, 02:44 AM

My husband takes Xanax 4 times a day for panic disorder/agrophobia. He also takes anti depressant. There are certain anti-depressants out there that have an added anti-anxiety affect too. if you are stressed about your situation(understandably) i would consider a low dose of anti-depressant anyhow. Xanax does make you sleepy but if you take it only at night that wouldn't be a problem. My hubby started off on clonazepam many years ago but when he started with his guru shrink, he changed him to Xanax. I think the former drug may be a bit 'old fashioned' for anxiety now.
So, i'd try for Xanax or a sleeping tablet if it just to get you through the night. I have had my fair share of anxiety induced insomnia and it oisn't pleasant. I took Valium for it. Ativan is in the same family i think.
Good luck.
Christine

07-13-2006, 06:46 AM

Hope, I had major panic attacks way before I was dx with BC. I took paxil and within two weeks, was panic free, it literally saved my life. I have been on it for gosh 12 years now and would never go off it.

We all react differently to drugs, so I'm not saying it will work for you this is just what worked for me.

I would not wish panic attacks on anyone, they are hell.

I wish you luck in finding what works for you.

Randi

mom22girlz · 07-13-2006, 07:25 AM

I, too have had panic attacks for years. I used xanax but it became ineffective and I switched to klonopin. That worked well for years. I was on various anti depressants at the same time. Then, I tried cymbalta and I have been able to quit my "panic attack" meds all together. I no longer have panic attacks. Different meds work different for each person, but thought I'd share this in case it would work for you. I sincerely hope you find quick relief. My very best to you. sincerely, susan

Ginagce · 07-14-2006, 04:52 PM

I began having anxiety when I was caregiver for my husband who had non-hodgkins lymphoma, and was diagnosed with breast cancer myself.

That was in 1997. Since then I have tried various medications off and on. My family doctor finally suggested effexor a couple years ago (right before I was diagnosed with a recurrance) and it seemed to do the trick.

I keep ativan around for those emergency moments although the longer I'm on effexor, the fewer I have.

Best to you.

ginagce

suzan w · 07-15-2006, 02:48 AM

I also have suffered from panic attacks and depression (before cancer), and am now starting to have panic attacks again. I was on paxil for years, and am considering it again. I take trazadone to help me sleep, but I notice that it is not as effective as it once was. I also am having lots of hot flashes which wake me up. BEtween the supplements I take every day, herceptin and arimidex, trazadone...I feel like a walking pharmacy!!!