[snelsen]

#1064036

Hi Marta,
This is all my own thinking, plus some experience with working in health care. But not any of it said as a professional.
I have made a prior comment about xanax on this forum. It is a difficult thing to discuss, for some of the people on this forum are taking Xanax, prescribed by some doc. I think I recall from a past post, that the family doc prescribed it.
I suppose it can have its’ place in Graves’ if the pros and cons are clearly understood by all parties.

Just as the whole focus of this forum is for us to have valid information about treatment options, I think it is equally valuable to have information about medications. In this case Xanax. It is a concerning drug, for it can present a whole new package of issues for someone to deal with. A good pharmacist will give the following information which I am paraphrasing in my own simplified version.
1. It is highly addictive, more than than any other depressant.
2. If taken, it should be for a short period of time.
3. When it is discontinued, it is CRITICAL to slowly taper the drug, not stop it abruptly, for that can cause very very serious consequences.

My comments.
1. It is too true that SOME docs prescribe it fairly freely, and continue to do so because the patient cannot stop taking it, and the path of least resistance is to continue prescribing it. It is a very slippery slope. There is PLENTY of evidence based information on this, plus there are addiction centers for xanax addiction.
2. Withdrawal from the drug can be very hard. Needs to be managed by a doctor.
3. Having said all this, it is hell to be extremely hyper. If an anti-anxiety drug is used with the clear understanding that it is for the short term, and all parties agree to this, I am sure it can be quite helpful while someone is being treated with AT’D’s to reduce the hyper symptoms. If a person cannot take ADT’s, that can be pretty rough, for you are prevented from having the belief that your symptoms will gradually improve. In that case, I can understand the short term use i Sometimes it is more difficult to know how you REALLY feel, for xanax makes the world seem like a pretty nice, trouble free place. That is why people like it, this is very easy to understand.
There is a lot to consider. From my personal view, I do not have an addictive inclination, although some of my family members do (it could be anything, including chocolate covered cake donuts.) My own view is that I would not take the drug, because I know a lot about it, and for ME, the risk-benefit rewards come in on the risk side. But I think it has its’ place, if carefully administered and managed, with a slow withdrawal of the drug for short term use.

4. My last thought. Anti-depressants are so widely used in this country. Graves’ is a very depressing and discouraging thing to have, whether hypo, hyper, or struggling with TED. I guess this is a conversation that each individual can have with their doc. I certainly have friends who have had positive life changing results from taking an anti-depressant. It has been suggested to me by several family members that I take an anti-depressant while dealing with TED and Graves’. It was my thought that the issues would not go away, and any rational person would be discouraged by dealing with these damn illnesses. But I did not want an anti-depressant, for I did not feel that I was clinically depressed. They certainly have their place, and perhaps their place can be helping individuals deal with these long term situations we are faced with as we march through these very difficult diseases.
Long response to short question

[marta1234]

#1064037

I started the topic because there is something I don’t understand.
My GP prescribed me small dose of antianxiety pills for 60 days without any explanation. My endo didn’t comment if I should take it or not. I was hesitating, but once I started MMI I decided to take antianxiety pill just get well quickly and smoothly. I stopped it after 2 weeks and I still wonder if I should take a pill if I need it.
Today I have read on internet we shouldn’t take them as our anxiety is inducted by thyroid and not chemical imbalances in our brains. I understand that my hormones, not psychological issues make me nervous I am nervous in the morning only, I am nervous in the situations I don’t have a reason to be nervous. I never get nervous in the afternoon.
I understand that some patients may need antianxiety pill as GD is difficult to deal with, but for most of us has different kind of anxiety and still take the pill that at the end can do more damage.
Does person diagnosed with GD without any anxiety problems before, but anxious due to GD can take antianxiety pills?

[marta1234]

#1018328

I have a question. How many of You had antianxiety / antidepressant drugs prescribed and how long have you been taking them while dealing with Graves Disease?
I noticed that doctors prescribe them and I believe they shouldn’t.
Thanks!!!

[snelsen]

#1064038

I think this is a decision you and your doc can make, but I would definitely be in contact with him about how to stop the drug.
I have no idea if you can take one now and then but ask the pharmacist. They probably would be able to discuss that with you.
I think there is room for all pathways to use/not use Xanax for a short while dealing with the side effects of being hype.
Depends on the individual, too, and what they know about themselves.
Sure wish you luck with this hyper rough spot, and as you learn from many others on this site, there is light at the end of the thyroid tunnel!
Shirley

[lhc11]

#1064039

I wrote a very long post that the board won’t take, so I am going to divide it up into two.

As someone who has been on both anti-anxiety medication and anti-depressants in years before the onset of my Graves’ disease and was also prescribed them during my recent bout with the hyper phase, I feel it is practically my social responsibility to comment on this thread. Please note that the following remarks (many of which align with Shirley’s comments, just at greater length) represent my personal experiences and opinions only and should not be taken as medical advice, which can only be given by a qualified doctor. Here goes:

First, while it is true that we live in an over-medicated society in which too many doctors are too freely handing out "happy pills" to those experiencing simply normal sadness, there are those who truly can and do benefit from both benzodiazepines (i.e., anti-anxiety medications like Xanax) and SSRIs (like Zoloft and Prozac and Lexapro and…..). I have been one of those people. Xanax–years ago, prescribed under the watchful eye of psychiatrist, and along with my own worries about potential addiction and my consequent care in taking it–helped me immensely while Zoloft was kicking in. Zoloft is itself prescribed for both depression and anxiety (and often for the depression that can result from out of control anxiety), and once I was on the right level of Zoloft, I was able to not take Xanax at all–indeed, I didn’t even remember what it felt like to need it. I stayed on Zoloft until I got pregnant last year–that is, for seven years. I have no regrets about this whatsoever. The medication helped me to be not an over-medicated person, but rather the best version of myself. And I honestly believe that it saved my life. (And yes, I also saw a psychotherapist for most of those seven years).

I was in a very different place in my life when I (slowly) discontinued Zoloft upon learning of my pregnancy last summer, and I was fine for 5 months (even after a traumatic miscarriage [boy, that’s redundant])–that is, until the Graves hit me. At that point, I went back on Zoloft (because, of course, I initially thought my anxiety was a return of my anxiety disorder, and they do say that one should try not to cycle on and off psychotropic drugs for fear of relapse, which is what I initially thought was happening to me). I was also given a new Xanax prescription. I then had a strange reaction to my previously much-trusted Zoloft–palpitations, tremors, nausea–so my (new) psychiatrist had me start Prozac instead, with the same results (palpitations, tremor), leading me to beg him to let me try the Zoloft one more time (which he finally did). I did then start to feel better, but by that point the ATD’s had brought me close to euthyroid anyway, which is what I now believe really made the anxiety (and palpitations, and tremor) go away. However, the Xanax did work–and it did help, immensely, throughout the time that I was hyperthyroid and anxious. Yes, I took more than I have ever had to take before (about 3-4 mg per day, when I had once only needed a maximum of .25 mg at a time, maybe 2x per day), and I was quite concerned about that. But I was as careful as I could be, and my psychiatrist assured me that when the time came to wean me off, we would do so. As it turns out, as I said above, the anti-thyroid meds finally kicking in were what (seemed to make) the anxiety decrease, and I was able to wean myself off Xanax without his help (and he did in fact over-medicate me–he also had me on an anti-psychotic (supposedly so that the Zoloft would work better, and so I would need less Xanax, which I just *knew* I did not need, was very uncomfortable taking, and ultimately simply stopped). Since right after my thyroid surgery in June, I also weaned myself off Zoloft again because, well, I wanted to see if in fact my anxiety disorder had returned, or if it was all the Graves. So far, it would seem it was the Graves–I have a lot of stressful things going on in my life right now, and I am feeling terrific on nothing but Synthroid and a vitamin. I fully expect that at some future point in my life I may need to turn to Xanax and Zoloft again–and when that time comes, I will see my doctor about it–but that time is not now.
(to be continued in next reply)

[lhc11]

#1064040

(continued, from above):

I guess my point is this: what I think GD, like many other diseases (but, because of Graves’ definite anxiety component, perhaps more powerfully than most) shows us is that the line between the body and mind is a fine if not practically non-existent one. Many psychological problems have, we now know in stunning detail from decades of research, a biochemical side; a physical problem can be caused, or worsened, or even alleviated, by the mind (cf. the much-touted benefits of meditation/yoga). Anxiety is anxiety–in the end, it doesn’t in fact matter if its root cause is psychological or physical when the awful way it makes you feel is the same. So if Xanax–a drug that technically calms the mind–helps one deal with an anxiety problem that has "merely" physical roots (i.e., the hyperactive thyroid)–then I say, so be it, and aren’t we lucky to have it at our disposal. Same goes for the psychotropic SSRIs, though as I’ve said, they were of no help to me with the Graves (and I wish they had been!). Xanax is in fact prescribed to be taken *as needed* for anxiety; SSRIs are a more long-term commitment, taking longer (usually at least 6 weeks) to have any effect, and needing to be taken daily in order to maintain their effect once it is achieved. As Shirley has said, all of these drugs–Xanax, SSRIs–need to be discontinued slowly rather than abruptly stopped.

I feel very strongly that anti-anxiety medications and anti-depressants save lives and, even when it’s not that dire, that they can help one through very rough times–and there is no question that the hyper phase of GD is one of the roughest of times (in my experience and, as far as I can tell, in the experience of most other people on this site). Short-term use of Xanax, monitored by a doctor and taken only when needed, will not hurt you and it might help (with the important caveat that the taking of it and other such drugs MUST be monitored regularly by a doctor, whether primary care, psychiatrist, or both).

I am not recommending that anyone take a medication he or she feels is optional and is uncomfortable with; but I am saying that one should not feel badly about choosing briefly to rely on something like Xanax to get through a terrible time. Yes, it can be addictive–but someone who is worried about that is actually not all that likely to get addicted to begin with.

I will get off my soapbox now. (Marta, by the way, it is a known thing that anxiety for most people is much worse in the morning and subsides by the afternoon–that has always been the case with me, and your experience with it is very typical. I hope you feel some relief soon!).

[snelsen]

#1064041

Excellent, marvelous, well expressed, helpful wonderful email! Thank you so much for taking the time to write it. It is so darn good. Thank you so so so very much!
Shirley

[lhc11]

#1064042

Hi Shirley — my pleasure! I am a bit embarrassed to have gone on at such length, BUT also, I should have added one thing above: Xanax should generally be avoided when one is pregnant and/or suspects pregnancy or is trying to conceive, unless a doctor feels it is ABSOLUTELY necessary. It is believed to cause birth defects, and while some pregnant women are prescribed small doses of it, my understanding is that it is something that really should be avoided in that particular and crucial case if at all possible. The jury is still out on SSRI’s and pregnancy; right now the feeling in the medical community seems to be that while it may not be the best thing to take them during pregnancy, depression also puts a fetus at risk (in some cases even more risk) and that at least through the first two trimesters, someone who has been taking SSRI’s regularly should not necessarily stop taking them (something I did not know when I got pregnant and did stop, though I probably would have anyway even had I known this at the time). There’s a bit of a worry about the third trimester and the possible connection of SSRI’s to pulmonary problems in newborns.

This has not so much to do with Graves’ disease, except for the fact that so many women experience Graves’ after or during a pregnancy.

Man. I am on some kind of a lecturing roll. Must be my profession (I’m a professor, school has just started…and, well, you see the results).

[marta1234]

#1064043

thank you so much !!!
I really appreciate it!!!
I want to make my own decision and not relay on my doctor opinion.

Your story helped me a lot!!!.

[snelsen]

#1064044

Hi lhc11!
Are you, by ANY chance, going to the conference? Presume school precludes your attendance. I do know of people who took anti-depressants while pregnant. Xanax is a category D drug, which I believe is a reason not to take the drug while pregnant because of risks to baby? Wonder if there are equivalent benzodiazapines? Reflecting what you have already said, this discussion is, by extension, relevant to Graves’ b/c of the number of people who are trying to get pregnant or waiting to get pregnant while dealing with this delightful (NOT!) disease.
shirley

[lhc11]

#1064045

Hi Shirley,

No, no conference for me. And yes, I couldn’t remember which category Xanax is — it is indeed Category D, while the SSRI’s are in Category C.

Marta: you should indeed make your own healthcare decisions, but I wouldn’t discount your doctor’s opinion either.

Best,
lhc11

[Buttamama28]

#1064046

Hi Everyone,

I have never taken Xanax, but at the early stages of my GD I was given Zoloft. I didn’t like the numbing of my emotions, so I decided to figure out other ways of dealing with my depression. I won’t completely knock antianxiety drugs because without them I don’t know where I would be. Even before I was diagnosed I suffered from horrible panic attacks; and I still do. The changes in my looks and overall wellness, made life very depressing for me.

In recent months, my physical pain has become so unbearable that my doctor prescribed Amitriptyline.It was I guess to kill two birds with one stone. Although it seems to be perfect for my pain, I wouldn’t know about my anxiety because it makes me so drowsy that I can’t function. So now I am back to square one trying to find something for both anxiety and pain.

If anyone has any suggestions I could discuss with my physician I would truly appreciate it.

Thanks,
Buttamama28 (Whitni)

[huntwork]

#1064047

Hi! I’m new, saw this topic and new I had to post. I speak from experience only.

I was diagnosed 13 years ago with Bipolar Disorder…no thyroid checks, no considerations to my family history (ALL of the women in my family have thyroid disease of some sort) after years of being put on ALL imaginable psychiatric meds and experiencing no relief (yes, even Lithium) and FINALLY getting the right diagnosis…I want those years back!! I had surgery to remove my thyroid…it had gotten that bad that I had nodules, bilateral goiter (severe) and severe hypo/hyper (which mimics Bipolar Disorder)…in bed for almost a year. My choice was to have the victim removed because it was dying. Now, I am trying to wean off Lexapro and Klonopin (Lex is down to less than 5mg/day and Klonopin went from 4.5 mg/day to 2.25mg/day) The Lexapro is interacting horribly with my Armour Thyroid med (I do take them 4 hours apart) and causing severe "Hypomanic" symptoms…it’s not BP it’s a drug interaction. Which doctors NEED to be aware of and make patients aware of. I have worked in the med field. I don’t trust a whole lot of doctors, but I do trust the team I have now. And I wound up in the ER when my psych doc. tried to get me off Lexapro rapidly (Like in 3 days) my other doc’s were concerned I was having withdrawal-induced seizure/stroke. I stopped reducing the Klonopin (longer acting benzo and much safer according to psych doc’s than Xanax, which is 2 molecules away from Whiskey, thus the addictive nature of it). Eventually, once I am off the Lexapro, (in like several months) I will start going off the Klonopin. I can’t WAIT to be completely rid of these unnecessary for me drugs.

Mine is a cautionary tale: If it doesn’t feel right to you, QUESTION! QUESTION! QUESTION!

[Kimberly]

#1064048

Buttamama28 wrote: If anyone has any suggestions I could discuss with my physician I would truly appreciate it.

Whitni – I don’t know the answer to your question, but I believe from previous posts that you are dealing with a separate condition that is causing the pain. Is there any way that you can get the different members of your medical team to actually *talk* to each other? You *deserve* to feel good again…so hopefully, you have docs who will be willing to work with you until you can find some relief.

[Buttamama28]

#1064049

Hi Kimberly,

As of right now I am at a free clinic, and I only have one physician. She is waiting to do blood work at the end of October to figure out if I am going to stay hypo or not. The only thing about that; I am so intuned and sensitive to my body now, that as my TSH rises- so does my pain. But she is only an Internal Med doctor; most of the doctors at the clinic volunteer. Basically, meaning the majority are like 90 yrs. old, and have retired from mainstream. She wants to schedule another Uptake Scan, which I haven’t heard in years. I got so excited that someone want to do an actual thyroid based test, that I completely forgot about my own issues….I have a severe allergy to iodine! YIKES! So I am in the process of getting the message to her, before the county approves a test that I can’t have- and before she puts all her eggs in that basket.

Some of my pains are residuals. I have neuropathy in my feet, pretibial myxedema in my legs, reoccuring sciatica, and a bad case of the "slippies" in my hip joints. Some of my issues come from prolonged hyperthyroid that wasn’t treated, but the rest I think comes with weight (which is rising no matter how healthy I try to be). Thank God, I am not diabetic or anything, but it is really a fear of mine. I lost my best friend two years ago to diabetes.

Buttamama28

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