Hey everyone, I know there are a lot of you out there that are fed up with drugs like SSRIs that take forever to kick in, and have awful side effects for sometimes just a minimal benefit.
I'm going to use this thread to discuss some of the fast acting anxiolytics I've used that have really helped me with my battles against anxiety and how I've used them for the most benefit.
Before starting I should say that we are all very different, so what has worked for me, may not work for you. You should, if possible, consult with your own doctor before beginning any new drug.
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Benzodiazepines: I've tried many different drugs that fall into this class, but I'll limit my review to one short acting BZD (Alprazolam) and one long acting (Clonazepam).
Alprazolam: One of the major benefits of Alprazolam is that it's onset is very quick. Upon taking it, I feel an intense relaxation within minutes. On the flip side, it's half life is much shorter than other BZDs so the effects usually wear off within a few hours. Alprazolam is great if you suffer from panic attacks or very acute situational anxiety, but for me, I needed something that lasted longer. Another downside is that it has a much greater potential for addiction as the "high" can be more prominent and some users may try to frequently re-dose to try to recapture it. Recommended start dose: .25mg (7/10)
Clonazepam:This is one of my favorites as it is longer lasting and gets me through the entire day with one dose in the morning. It takes much longer to kick in (around 45 minutes to an hour for me) so it is much more useful as a preventative anxiolytic (ie. you should take it if you know there is something in the day that will cause you anxiety). It's long half life allows it to accumulate in the body, so taking it daily longterm is not recommended. For me, I try to take it no more than twice a week. As such, I haven't had any problems with tolerance. I don't notice any cognitive dulling with this drug, making it a great all around drug to use on occasion. Recommended start dose. .5mg (9/10)
Pregabalin: This is by far my favorite anxiolytic drug. Albeit my response to this drug may be a bit idiosyncratic. It is recommended to take this drug daily; however, I find acute usage of the drug to be far more useful. The onset is quite long around 1-2 hours, but it produces a great anxiolytic, prosocial, moodlifting, and even euphoric feeling that lasts for around 24 hours. One downside is that tolerance to this drug builds quickly (but also falls quickly), as such, I only take it two times a week. The other downside is that there is some cognitive dulling and minor judgement impairment with the drug so while it may be great for social gatherings I would reconsider taking it for an interview or exam. Recommended start dose: 150-300mg (9/10)
Phenibut: Phenibut was the first fast acting anxiolytic I ever tried, and to this day it still works quite well. Like pregabalin it takes around an hour and a half to kick in and it exhibits anxiolytic and moodlifting properties. The effects also last around 24 hours. There is some cognitive dulling so it may not be useful in some situations. It can also be very addictive so do not take it more than twice a week. Phenibut seems to cause me some GI discomfort so I try not to take it very often, maybe once a week. Recommended start dose: .5-1g (7/10)
Beta Blockers: Drugs in this class may be useful if your anxiety symptoms are mostly physical (eg. heart palpitations). I found propranolol mildly helpful for presentations, but on it's own it's just not strong enough. May be more usefull when combined with other drugs like benzodiazepines. Tolerance and addiction to these drugs should not be an issue. (4/10)
Tianeptine: This is another drug that is meant to be taken daily, however the acute opiate effects kick in within an hour of dosing. To maintain these effects I wouldn't recommend taking more than twice a week. Like opiates I get a moderate anxiolytic and euphoric feeling; however, too much makes me nauseas and gives me terrible headaches. Very little cognitive dulling. Recommended start dose: 12.5mg (7/10)
Alcohol: Is a great anxiolytic and social lubricant, but has its obvious issues. Use with caution when taking it with any of the above listed drugs.
Barbiturates: Only tried this class of drugs once, very hard to get. Don't recommend as BZDs are much safer.
GHB: Very euphoric, very recreational, very addictive. Don't recommend.
Cross tolerance: I take clonazepam, pregabalin, phenibut, tianeptine, and alcohol on a weekly basis. Due to different pharmacological actions of these drugs, there should be little to no cross tolerance. After years of taking these drugs my personal experience falls in line with this claim.
As you can see many of these drugs shouldn't be used more than twice a week. As such, a rotating regiment may be useful. This is what I do, and it seems to stave off tolerance.
M:Clonazapam
T: Tianeptine
W:Pregabalin
Th:Clonazapam
F:Phenibut - alcohol
Sat: Pregabalin - alcohol
Sun: Tianeptine
This is what worked for me and has helped me tremendously in living with my anxiety. However, this is just my experience, I am an N of 1, and what worked for me may not work for you, so do your own research or talk with your doctor to find what will be best suited for you.
Let me know if you have any questions or want me to go into more detail about any of the mentioned drugs. If there is a fast acting anxiolytic that I did not mention, I'd love to learn about it.
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