Question:
What I'd like to know is, has anyone else
experienced anything similar, and if so, how have you dealt with it? I am
currently in therapy and, like I said, taking Xanax on an as-needed basis
(usually about .5-1mg a day). Both my therapist and doctor have suggested
an anti-depressant, and they both mentioned Paxil. Does anyone know if
Paxil is effective in helping the kind of nocturnal attacks I'm
describing? I have wondered if perhaps my seratonin is dropping during
REM sleep, allowing my mind to "spin" out of control. Likely? If so, then
maybe Paxil *will* help. What do you think? I'd appreciate any advice and
feedback. Fear of another attack haunts me nightly, and, I think, actually
prevents me from falling into a deep level of sleep, thus ensuring that I
am constantly ill-rested.
Answer:
In my long history of panic, I have found the nocturnal attacks to
possess a greater fury and intensity than the ones I get during the day.
I believe this may account somewhat for the biological/chemical nature
of this disorder. I too could list a many symptoms (even some of your
own) that I have had waking up in a completely disoriented full blown
panic state. I think it is most scary because, you are asleep and not
prepared for the onset. Plus, who knows, your body is operating at a
different chemical level at the time. The thing about the "rock video"
thoughts is common for me. I will be thinking about screwdrivers chasing
me through space, or ruddy faced construction workers dancing on top of
flagpoles...all non sequiter flashes of patterns of reality.. askew and
disturbing. Finally, after waking up from this semi-state of
consciousness, I feel like my head is separated from my body. I often
think that my body is still asleep and it will take a few minutes for it
to catch up with my mind. Anyway, I am doing 20 mg. of Paxil along with
3 mg. of Xanax daily and why just yesterday, I started feeling really
good!!!! You may want to consider it. All the other SSRI's were complete
failures for me...too many side effects. You may want to give it a
shot...and don't be afraid to use a benzo with it...I would probably
fare better with Klonopin now because it has a longer life and the
insomnia is getting me up twice a night to pop a Xanax. Good luck and
remember, you are not alone.
Personally, I would be very cautious with Paxil.
Probably because the US FDA has approved it for use in cases
of anxiety disorder, there is a tendency for it to be regarded
as a panacea - which it isn't. As the NIMH has pointed out,
there is no reason to assume it is any better than the other
SSRIs.
My specific worry with *any* of the meds in this class is that
they *can* produce spontaneous anxiety in some people and, in
my own case, they produced exactly what you're suffering now
- spontaneous, nocturnal attacks. I think you might be advised
to consider this approach very carefully in view of this concern,
ideally with a psychopharmacologist or psychiatrist who has
wide experience with these meds.
Have you tried tricyclic antidepressants at all? They might
be one alternative.
