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Q. Do I also need benzodiazepine to control my anxiety problem?

Answered by
Dr. Vandana Patidar
and medically reviewed by Dr. Sneha Kannan
This is a premium question & answer published on Sep 18, 2020

I currently take 5mg Trintellix and 400mgs Gabapentin a day. We have recently reduced my Trintellix from 10mg and stopped 100mg Zoloft. My anxiety is horrible. I'm very irritatable and agitated easily and really want to bust out crying many times throughout the day. My chest/throat is very heavy w pressure. I really want the right regimen so this will subside. Please help.

I have had depression and anxiety for about the past 15 years. I really like what the Trintellix has done for me but my anxiety is out of control.

Dr. Vandana Patidar

Psychiatry Psychologist/ Counsellor Psychotherapy Sleep Medicine
#

Hello,

Innova zoloft was decreased, were you facing some side effects?

In my opinion zoloft is a SSRI class of drug which is one of the best anti anxiety and anti depression medicines. if you were stable on that medicine this is not a wise decision to switch it.

if you had any side effect we could have been switched to another SSRI or SNRI class of drug class of drug medicine.

gabapentin may not work at the same level as done by zoloft

you can request your psychiatrist to reconsider this switching and make the changes according to your needs and side effect profile


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I started 10mg of Trintellix last year and continued to take 50mg of Zoloft. Starting of this year, my anxiety was extreme so my psychiatrist increased it to 100mg. It did not help. So, a month later, I decided to wean myself off of the Zoloft because I thought that was the cause. I told my doctor this at the first part of this month I wanted to decrease my dosage of Trintellix to 5mg but needed something for anxiety. He started me on .5mg Klonopin which has helped me in the past. It helped for maybe a week but then the anxiety came back. He then thought 200mg of Gabapentin would help. So, I stopped the Klonopin and the Gabapentin helped for about a week and then I noticed that if I took 100mg at 9am, 100mg at 3pm and 200mg at 9pm, my anxiety was better. Now, a week later, I need more or just something different. The Trintellix has really helped with my depression and I am so much more motivated to do things I haven't wanted to do in a long time. Is the Trintellix causing the anxiety? If not the Gabapentin, is there a benzo that is has a longer half life so I don't have to take something every 5 or 6 hours?

Dr. Vandana Patidar

Psychiatry Psychologist/ Counsellor Psychotherapy Sleep Medicine
#

hi weaning off from Trintellix and Zoloft can also cause rebound anxiety I don't think Trintellix causing anxiety because it decrease anxiety and depression Klonopin is a long acting benzo two more benzo which act longer than it are 1) librium i.e. chlordiazepoxide 2) nitrazepam both are long acting in my opinion you can start Zoloft in 50 mg dose with gabapentin Zoloft stay in blood for around 35 hours so you don't need multiple dosing in a day and it will decrease your anxiety too


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Thanks for your feedback. But I was on the Trintellix and Zoloft and my anxiety was horrible. Do you feel I will also need the benzo to control it?

Dr. Vandana Patidar

Psychiatry Psychologist/ Counsellor Psychotherapy Sleep Medicine
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