The Truth About Anxiety Treatments: What Really Works

Рет қаралды 11,966

Күн бұрын

In the first part of this series, we discussed anxiety and specifically generalized anxiety disorder (GAD) as a diagnosis. Now we are going to look at the research associated with treatment of GAD and let the research inform our decision making about what works when a person presents with GAD. Some of these findings may surprise you.
Time Stamps
Introduction to the video: 00:00 to 01:10
SSRIs in GAD: 01:11 to 04:25
SNRIs in GAD: 04:26 to 07:14
Does Bupropion work: 07:15 to 10:32
New Antidepressants in GAD: 10:33 to 13:03
The Hydroxyzine Debate: 13:05 to 15:09
Quetiapine for GAD: 15:10 to 18:17
View of anxiety as a less severe disorder: 18:19 to 20:48
Benzodiazepines in GAD: 20:49 to 21:49
Silexan in GAD: 21:50 to 24:09
Conclusion: 24:10 to 26:20
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Disclaimer: This is not medical advice, and the information is provided for educational purposes only. Please consult your doctor for any specific medical questions.
All content is created for informational purposes only. The Content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider. If you think you have a medical emergency, call your doctor, go to the emergency department, or call 911. We do not endorse any specific treatment, tests, or procedures. Reliance on this information is solely at your own risk.

Пікірлер: 91

@clpendygraft Жыл бұрын

From my personal experience, anxiety is just as bad as Depression. They are evil twins that move together.

@ShrinksInSneakers Жыл бұрын

I would agree, anxiety can be a little more difficult to treat and medications may help with physical symptoms but often the underlying driving forces behind the anxiety remain undiscovered by most patients. Hope the video helped

@JW-nd7nv Жыл бұрын

As a psychology student interested in anxiety research, this is a great channel. Much appreciated!

@arshadmalik5681 Жыл бұрын

Excellent information. Learned a lot. Thank you Dr. Rossi

@gmarie9507 Жыл бұрын

Love these videos, Dr Rossi!! Thank you! Great information about GAD

@ShrinksInSneakers Жыл бұрын

I'm going to do some new stuff on anxiety, it's something I struggle with like everyone else in the world and there are things I like to do to help cope with it. More to come

@montanalewis Жыл бұрын

I seriously love your videos so informative. Thank you for sharing!

@ShrinksInSneakers Жыл бұрын

I appreciate the support, help me spread the word and I promise to keep trying to get better for you guys

@DanielSRosehill 10 ай бұрын

Super interesting about seroquel and that trial performance. Thanks for the video!

@3M13s Жыл бұрын

This was amazing

@Mosfer_aldoseri Жыл бұрын

Silexan was very effective for me, but I'm also in mirtazapine which wasn't super effective for anxiety, but helped with sleep and appetite

@naifal9337 Жыл бұрын

You r wonderful dude

@ShrinksInSneakers Жыл бұрын

Appreciate it help me spread the word and I will continue to improve with better content and better Delivery

@crz033 Жыл бұрын

Is there a preference to hydroxyzine pamoate vs hydroxyzine hydrochloride?

@MakAnndCheeese Жыл бұрын

Hello Dr thanks for the informative channel. How do you decide between adding bupropion or buspirone to a patient who is a non responder to SSRIs treated for anxiety?

@ShrinksInSneakers Жыл бұрын

I will depend on a number of factors, but I do not believe buspar is an effective treatment for anxiety. The effect size is very small around 0.2 which translates to no observable clinical effect. In most cases I would go for bupropion as the evidence that it worsens anxiety is only in panic disorder not GAD. Hope this helps if you haven't subscribed to the channel please do and spread the word about what we are doing here.

@user-zs2bk4yw6u 2 ай бұрын

Dr Rossi I have treatment resistant depression and have tried almost all psychiatric medications except for MAOI’s which are not available where I live.Is there a possibility you can deliever them to me?I would be very grateful.

@clintparsons3989 Жыл бұрын

Isn't lyrica popular for anxiety?

@mikesnyder7961 Жыл бұрын

Hey Dr. Rossi. How do you feel about TCAs? I had extreme insomnia and nocturnal panic attacks last year. I tried Venlafaxine, sertraline, lexapro, seroquel, benzos, mirtazapine. Amitriptyline 50 mgs has totalled changed my life. I’m thinking about tapering this year. Are TCAs really that bad for your health? Should I try to not be on it for an extended period of time? I would appreciate your input. Thank you

@aphysique Жыл бұрын

What is TCA's ??

@mikesnyder7961 Жыл бұрын

@@aphysique a Tricyclic Antidepressant. Not an SSRI, or an SNRI. Older

@martinlutherkingjr.5582 Жыл бұрын

Idk all these meds just killed my motivation to do anything and battlung this with stimulants is a losing battle.

@wulfsorenson8859 10 ай бұрын

And the stimulants end up aggravating the initial anxiety. It’s a vicious circle

@baronemery7502 Жыл бұрын

Hey Dr rossi! Your doing a good thing here but you didnt reply to my last message on another video. Does vortioxetine work well with pregablin and clozipine and aripiprizole. Ive been in a pstchiatric hospital for over 2 year's and been put on vortioxetine for 5 months now but im still getting severe anxiety im on 400mg clozipine 30mg aripiprizole and the highest mg of pregablin, please get back to me if you can mate

@elenanicole084 Жыл бұрын

🆙☝️You can always order from him, he's legit & reliable,he's got em magic shrooms, other psychedelics and many more.

@westonbarter8309 Жыл бұрын

I just want to plug Silexan. I was informed by my psych that it may help more than any prescription med, and holy smokes was he right. It seems like Shrinks in Sneakers may have looked at similar research as my doc. I was already on lexapro 15mg and had tried buspar and psychotherapy.

@BestMotivationalVideos123 Жыл бұрын

how does buspar compare to silexan? I'm on day 2 silexan and it feels like too much almost

@sheridanwhiteside6503 Жыл бұрын

Thank you for a very informative video. Probably the most effective medicine I've taken for GAD is Methylphenidate. I do not have ADD, and anything that increases my serotonin makes me 10 times worse. Can a dopamine deficiency cause GAD?

@hallamacchadunga7702 Жыл бұрын

Dopamine not norepinephrine

@timothyayers8596 5 ай бұрын

The large release of dopamine after Ritalin will have a blunting effect for some people. If you listen to this video it’s all over the map. But that’s psychiatry in general. For example quetiapine blocks dopamine and is being suggested here. I think methylphenidate for all it’s problems is safer than an antipsychotic that we’re still unsure of all the receptors it activates or blocks.

@beeathome1064 Жыл бұрын

What are your thoughts on pristiq for anxiety ?

@timothyayers8596 5 ай бұрын

I can tell you my thoughts. Placebo effect or it will make you worse

@Eos2025 11 ай бұрын

Kudos on your work? Just a reminder that tca s, imipramine and smitriptiline are worth noting

@ShrinksInSneakers 11 ай бұрын

TCAs are always a good option when people have failed other medications. The older medications tend to work better but have largely been removed from most practices because of the side effects and risk of death from overdose. I agree we should be thinking more about these medicines

@Eos2025 11 ай бұрын

@@ShrinksInSneakers Having talked to more than 10 psychiatrists, being a GAD patient myself, i cant stress enough how TCA s made be 80% better after having failed at 4 ssris and 1 snri. Tca s very underestimated.

@katarzynasokolska9531 10 ай бұрын

Hello Doc. What about Wellbutrin and Tazadone for a Anxiety?

@hmrobert7016 2 ай бұрын

Wellbutrin is talked about at 7:15 on the video

@Kingboo1081 11 ай бұрын

That laugh at 3:31 🥹😅

@ShrinksInSneakers 11 ай бұрын

thanks for watching

@katebruno9255 Жыл бұрын

My 19 year old daughter is dealing with epilepsy as result of a recently discovered inoperable brain tumor. She’s now dealing with panic attacks either from the 2 high dose seizure meds and/or situation. She’s using Klonopin when these happen (to prevent the panic turning into seizure) but we worry she seems to need it too often. Is there another option for someone with epilepsy? Would the lavender product you mentioned be safe or lower seizure threshold?

@lolak7438 11 ай бұрын

I'm so sorry for what your daughter is going through. Please don't keep her on Klonopin very long. I was put on benzos years ago and they are very sddictive and can cause depresion and paradoxilly make anxiety worse (see the Benzo Coualition) If you decide to, pls taper off slowly under your doctors advice. Have you heard of Gabapentin? Idon't know what else she is on so just a suggestion. Also, I was put on Lexapro when I first had terrible anxiety along with benzos (for panic attacks) The Lexapro worked well for anxiety. I wish your daughter & you all the best💖

@lolak7438 11 ай бұрын

akrught-watching a video on Gabapentin- maybe not....

@katebruno9255 11 ай бұрын

@@lolak7438 thank you so much for the compassionate message! Very helpful for sure 💜

@benzapp1 9 ай бұрын

Clonazepam is a good anti seizure medication. No one on KZfaq can say it’s the best one.

@fifik3136 Жыл бұрын

Well the FDA is wrong. Ask anyone with severe anxiety it is as bad as depression and leads to depression. Treat the anxiety sufficiently and for some people it will help depression.

@ShrinksInSneakers Жыл бұрын

From a cultural perspective anxiety has not been viewed as a serious mental health problem. I would not say this is the right approach but for whatever reason this is where we find ourselves. If you see my new videos I talk about the depression spectrum and those with more chronic and persistent anxiety. It does change the treatment. I think anxiety always requires some form of therapy to address the underlying triggers driving the anxiety and while some medications are helpful in the short term they are not long term solutions to dealing with chronic anxious states.

@Kippsterama Жыл бұрын

Do you feel comfortable prescribing alprazolam or Librium to people who actually seem to need it? Or do you avoid benzodiazepines at all costs even if somebody really needs them?

@ShrinksInSneakers Жыл бұрын

I've never been anti benzodiazepines. Some clinics are that way and it doesn't make sense to me to remove a medication that can be helpful. The problem is people get on them feel a little better and do not come up with additional strategies to cope with anxiety and end up on the medication for years when that was never the intention. Yes, I use benzodiazepines clinically

@Kippsterama Жыл бұрын

@@ShrinksInSneakers is there ever times where somebody might seriously need to be on it regardless? Like if the additional coping strategies or CBT doesn’t give the expected result?

@garysimone4977 Жыл бұрын

@@ShrinksInSneakers benzo are to be used SHORT TERM NO MORE THE 4 WEEKS , 4 WEEKS.....I AM SURE YOU HAVE SEEN THE 1000S OF FKS ON KZfaq THAT HAVE BEEN HURT, LIVES A MESS ,, the oath DO NO HARM...

@emmanuelaguilar4498 Жыл бұрын

What about MIRTAZAPINE for panic disorder? I hope you can answer.

@wulfsorenson8859 Жыл бұрын

Makes you fat 🐷

@timothyayers8596 5 ай бұрын

Mirtazapine will cause some sedation due to its antihistamine action and it’s action at one of the serotonin receptors. Outside of that it’s likely useless. I suggest careful and judicious use of benzodiazepines. Yes they can cause dependency but if you have a good Dr and are careful with their use the are the most anxiolytic drug we have.

@michaelthau1007 Жыл бұрын

It seems that looking up reviews for Buspar, it seems like the only anxiety medication with very few side effects, and no potential of tolerance or withdrawl. Some reviews if this medication have been very positive by individuals, if you give it a month to work. My Dr wants me to try it for GAD and swears by it for getting relief, as do other Dr reviewing it on you tube, especially Dr Ken Landau, who gives it a great review for anxiety. Going to give it a try. SSRI have horrible side effects God Bless

@timothyayers8596 5 ай бұрын

Love to hear how it worked for you. Busbar if it works at all it is serotonin activating. So is SSRIs didn’t work (and why would they) using busbar is a poor choice.

@karend.9218 4 ай бұрын

Why not find the source and support the deficiency? I will point you to genetic variants: MTHFR, COMT, PEMT to name the top 3. My daughter has all 3 of those and more. She tried SSRI low dose and ended up with vision issues in 5 days, triple vision, usual migraine, snow, focus issues.

@scottkendall911 4 ай бұрын

I'd love to hear your daughter's progress once you've had the chance to implement Breka's protocols!

@dianelindenberger6941 Жыл бұрын

After my mother died I have bad anxiety and take 1.5 klonopin for sleep but I still have anxiety in the daytime.....I can't be alone and don't want to go out to the store alone.....

@aphysique Жыл бұрын

Diane sorry 😞 😔 😥 for your loss, My condolences 🙏🏻..Klonz work as does any benzo, unfortunately they are definitely addictive n seems like baseline anxiety gets worse when using them for long period of time ...

@Shoppinghappens Жыл бұрын

Sorry for your loss, but this video kinda said that they don’t change the thoughts. Have you tried a different doctor that also knows that?

@clpendygraft Жыл бұрын

My mothers death ended up causing a complete breakdown. I was hospitalized and given Pamelor- they didn’t have SSRI then. The medication worked really well, but I had to change medications after a couple of years. I take Bupropion and Elival right now. I have had to take meds for decades. I still take one Xanax a day-have for the last 30 years. Never have found anything better. It’s hit and miss. Have used cognitive therapy too. It is hard, but stay the course. You have to find what’s best for you. Best wishes.

@timothyayers8596 5 ай бұрын

You are correct that the Xanax is going to be your best treatment. There is fear in the medical community but if used properly they are wonder drugs and the only real drug that works on true anxiety. Anxiety is mediated via GABA activity and benzodiazepines work by modifying this receptor to allow existing gaba in your brain to do its thing and slow down the hyperactivity. There are all sorts of straits use them safely but the Dr doesn’t want to bother and thus prescribes useless medications.

@marieb9961 Жыл бұрын

@ballen1569 Жыл бұрын

Ketamine infusions! Expensive but seems to be promising! Currently on Escitalipram 20mg and is meh at best.

@timothyayers8596 5 ай бұрын

Ketamine has real promise. The SSRIs are nothing more than the worlds greatest marketing campaign. They are useless and and they only work via placebo in people who claim improvement.

@kostas9216 Жыл бұрын

what about mirtazapine for gad??

@teacherondabeat 11 ай бұрын

I tried mirtazapine. It took the anxiety and the tears away but I was tired and sleeping all day long, so much I couldn't work. It made me gain a lot of weight too. Of course, it’s a different effect for each person

@trevormunro1834 26 күн бұрын

Mirtazapine?

@user-ob1rf2kl9m 5 ай бұрын

Why won't doctors prescribe 5mg of perks to help for crippling anxiety attacks when suffering?

@regen387 5 ай бұрын

I hate abilify, severe akathesia. Seroquel made me a zombie. Zyprexa made me lost in space. Tried 4 antidepressants, no luck. I have severe chronic GAD, anxious depression, racing thoughts etc. The only combo that finally made my life much more bearable ( got at least 60% better) was sertraline+amitriptiline+perphenazine. All 3 in low doses. 50mg sertraline+40mg amitriptiline+4mg perphenazine. Seems that old school medication is better on many occasions. Do you agree?Disclaimer to everyone. Always follow your doctor's advice on everything.

@gustavocarvalho1346 21 күн бұрын

You probably need mood stabilisers (lithium, valproate). Antidepressants can exacerbate mixed depression

@natansobol1087 Жыл бұрын

Perhaps I have too many comorbidities to share what works for me. I have a disabling spinal column degeneration, that limits what I can do physically. I don't have any support network in friends, and have even been told that my specific instances of trauma are inappropriate to discuss. Double standards abound in my life, and I refuse to be anyone's refuse bin, so I tend to be introverted, because I am an empath who has been used, while knowing it was happening, so I mostly keep to myself. I take benzos for GAD, PTSD and panic disorder which work well for me. I take duloxetine for neuropathic pain, but it does little for anxiety and depression. I am definitely not a fan of my existence, as it is frothy and lacks substance, and is vapid; there's an incredible sense of an increasing gap between the poor and soon to be former middle class, and the 1%, many of whom are foul, lack class, and obtained their money in immoral, illegal and shady ways. It causes hopelessness and helplessness, to know that one will never have any quality of life. I have tried, but continue to fail, and it is difficult to hear my own voice telling me what a yutz and shlemeil that I am, and it's just getting stronger. Thank you for the work you do!!

@clpendygraft Жыл бұрын

Cognitive Behavior Therapy has helped me- in addition to my medicine.

@loopba Жыл бұрын

pretty bad to only cover pharmaceuticals

@dens2787 4 ай бұрын

Guys, none of the medicine will cure your anxiety. It can help you in short term, or SSRI’s can help your brain change faster in a positive way, combining it with therapy. But still, cure from anxiety is within you. Believe in yourself, accept the anxious symptoms, build confidence and with time you will feel less and less anxious. It is a very hard job, but it is 100% possible. I am now on my recovery journey, and I would say that I am pretty confident of the ACT therapy. The more you allow the anxiety, the less it bothers you. Of course there will be a lot of setbacks in the journey, but that is the part of healing. You must feel all your symptoms and be comfortable with it to heal it.

@cosmichealth3907 Жыл бұрын

Ask any psychiatrist how many people has he cured...Yes cured?????if the answer is yes he is a liar......

@vedatzorro Жыл бұрын

After i have been tried so many antidepressants for anxiety and depression i can't see any difference from Placebo

@chahuncoller Жыл бұрын

It is a great chance to come across this video for intelligent people who want to regain their health. Those who are not smart will not care about this video. They will expect healing from God, so they will continue to wait for miracles. They will continue to wait without knowing that there is not even a gram of miracle in life. Name of the video: THE ONLY WAY OUT OF DEPRESSION Anxiety, bipolar, obsession, apathy, panic attack treatment.

@JnTmarie 8 ай бұрын

These drugs don’t work for long

@JnTmarie 8 ай бұрын

Why don’t you talk about DIET and exercise? This should be first line of treatment . Gluten, sugar and processed foods. Get moving, take Pilates classes. drink water , start doing positive things, give of your time to yourself and others., and find caring people. Guarantee you won’t need these drugs.

@timothyayers8596 5 ай бұрын

People with major anxiety disorder likely have some dysfunction in the GABA receptors complex and will feel intense anxiety regardless of any of the things you suggest. Not that they are bad ideas , they are healthy. But it’s kind of gaslighting people who suffer from severe anxiety to suggest these things will abate their symptoms.

@garysimone4977 Жыл бұрын

Guys , this guy can't give medical advice over youtube, NO SENSE ASKING. ALSO THESE PSYCH MEDS ARE AT BEST A TAD BETTER THEN PLACEBO AND ONLY WORK FOR 30% . SIDE EFFECTS LOL.. NICE WORD FOR WHAT THE MEDS DO TO YOU.

@timothyayers8596 5 ай бұрын

Agreed. I will say benzodiazepines are effective for anxiety. They are addictive but this can be managed with careful prescribing. The rest of the meds mentioned here are junk for anxiety