Being drunk minus the dumb behavior
April 25, 2016 12:44 PM   Subscribe

I've decided that I definitely want to get on anti-anxiety medication as I just can't go out into public without experiencing some degree of anxiety which brings on a slew of unpleasant symptoms (cottonmouth, dizziness, headaches, light-headedness, etc.). I'd like to have anti-anxiety drug recommendations that make one feel kind of like they've had three or so beers minus the whole lacking inhibition thing.

Not so long ago I was taking anti-depressants but I've come to realize that I don't really need them as my depression, in the vast majority of cases, is a result of me being disappointed in myself for not being able to act right in social situations due to me feeling strong feelings of anxiety when out in public.

I've had people offer me Clonazapam before and while I quite liked how I felt while on it—it essentially made me feel as though I was slightly drunk—I felt it made me lack a bit too much inhibition for my liking and would make me say and do really dumb things. So I think at least Clonazapam—although maybe not all benzos—is out of the question.

I recalled recently that whenever I've been on cough medication (Nyquil, which, by the way, I'm taking right now) I've felt amazing and not at all anxious while, somehow, not lacking any inhibition whatsoever. What is it in cough medication that makes me feel so good and anxiety free? Could it be the DXM? And is there a prescription anti-anxiety drug that acts in a similar way? Because, if there is, that would be a miracle drug of sorts for me. With perhaps the exception of alcohol, I can't really think of anything else that has worked so well at reducing my anxiety.

I'll be seeing my psychiatrist soon and would like to be able to talk to her about drugs suggested in here that you people think could work well for me. Because I have a strong feeling that if I don't have anything to suggest to her she'll go straight ahead and prescribe me Clonazapam, something which I'm quite hesitant to take regularly.
posted by GlassHeart to Health & Fitness (16 answers total) 12 users marked this as a favorite
 
From anecdotal evidence I understand that alprazolam is not as strong as clonazepam. Alprazolam could be one of your options.

"whenever I've been on cough medication (Nyquil, which, by the way, I'm taking right now) I've felt amazing" ...Maybe you can clarify this. If a medication gives you feelings that you are amazing, that sounds a little like a lack of inhibitions, which you say you don't want.
posted by JimN2TAW at 12:54 PM on April 25, 2016


I'm taking Prozac for my anxiety now, but last year I was taking BuSpar. It's effect was pretty mild, but it did make me feel like I'd had a bit to drink without feeling uninhibited. Like I'd had half a glass of wine or something, and was what I call "socially lubricated."

I wouldn't necessarily rule out all benzos, depending on how much Klonopin you took. I occasionally take a baby dose of Xanax (0.25mg) when my anxiety is really bad, and it doesn't cause inhibition. So you might look into a baby dose of that or another benzo. The effect is really pretty mild all things considered.
posted by schroedingersgirl at 1:01 PM on April 25, 2016


I recalled recently that whenever I've been on cough medication (Nyquil, which, by the way, I'm taking right now) I've felt amazing and not at all anxious while, somehow, not lacking any inhibition whatsoever. What is it in cough medication that makes me feel so good and anxiety free?

I get this too, and attribute it to a combination of being well-rested (seriously, NyQuil Sleep = Best Sleep) and having a little of the "edge" taken off.
posted by schroedingersgirl at 1:03 PM on April 25, 2016


I don't mean to derail, but have you considered that, if you're taking cough medication when you're sick, perhaps it's not the medication itself that's making you feel better, but the realization you get when you're sick that, since you're sick, you're free of any social or work obligations, at least temporarily? As crummy as I may feel when I have a cold coming on, I feel the same sort of relief - yay, at least I don't have to go out and talk to people today!

Anyway, back to the topic at hand: DXM does inhibit serotonin reuptake (via SERT inhibition) as do many SSRIs, so you may want to have a talk with your psychiatrist about giving SSRIs another try. Did you feel that the anti-depressants you were taking were helping your anxiety any? Off of my head, the only drug that I can think of that has a pharmacodynamic profile similar to DXM (with the weird mix of effects on serotonin/opioid/NMDA systems) is tianeptine, but that's not available in the US.
posted by un petit cadeau at 1:04 PM on April 25, 2016 [1 favorite]


Celexa with some Ritalin helps me.
posted by sperose at 1:29 PM on April 25, 2016 [1 favorite]


And is there a prescription anti-anxiety drug that acts in a similar way?

In some locations there is a drug available (sometimes medically or OTC) that, for many people, functions in this way.
posted by melissasaurus at 1:31 PM on April 25, 2016 [4 favorites]


Anxiety drugs don't make you feel drunk, they make you less anxious. I took Prozac, which I really liked, but I developed hives from it and switched to Citalopram (Celexa) about 10 years ago. It's a pretty great drug. I also take half a Trazadone at bedtime.

This has been amazing for me. I feel all my feels, (no numbness or lack of emotions) I'm just not anxious. Anxiety drugs take time to build up, so it's not like you pop one, get a bit high and then go about your day. They're really interesting actually. I know intellectually that something I've always been anxious about is happening (After the Loma Prieta earthquake in 1990, I have a HUGE fear of infrastructure crumbling, so tunnels, overpasses, bridges), but I don't feel anxious, it's almost like, "I'm on a bridge, I don't like this, but I'm okay with it." As opposed to a crippling, steering wheel gripping and crying while Husbunny is reading excerpts from a Baseball abstract. (True story, St. Petersburg, Fl bridge in a rainstorm.)

Also note, you can't drink while taking most anti-depressants. So if that's a go-to strategy for you, you may want to do low-stress situations without ETOH first before diving into a bar scene or something like that.
posted by Ruthless Bunny at 1:39 PM on April 25, 2016


Also note, you can't drink while taking most anti-depressants. So if that's a go-to strategy for you, you may want to do low-stress situations without ETOH first before diving into a bar scene or something like that.

This statement isn't accurate. You can't drink heavily, and the effect of the alcohol might be enhanced when you're on an anti-depressant. But it's not accurate to say you "can't drink while taking" anti-depressants (as long as we're talking about SSRIs). My psychiatrists have always said that as long as I limit what I'm drinking to maybe a couple of beers and don't get carried away, I'm fine. (I've been taking anti-depressants since around 1990, and believe me, I'm no teetotaler.) Obviously you should ask your doctor how you should proceed with whatever they prescribe, but you very well may not have to abstain completely.
posted by O Sock My Sock at 1:48 PM on April 25, 2016 [4 favorites]


Extrapolating from first-person anecdata, sertraline (Zoloft) has definitely been a boon in my fight against anxiety. I was originally started on clonazepam (Klonopin) because I was have extremely acute anxiety. It definitely put me in the 2-3 beers but not drunk state of mind. It also dampened my inhibitions to the point where I became a total asshole at work and home.

I'd say I actually don't feel like I'm on a drug with sertraline. I mean, I am not as anxious certainly, but there aren't any "recreational" effects. I'm basically me, just not an insanely cautious and twitterpated me.

Also, I'm sure there is some general guidance to not drink while taking this medication. Much like the guidance against alcohol that comes with my anti-coagulant meds, I haven't let that get in the way of my beer with dinner and occasional binge drinking.
posted by Fezboy! at 2:26 PM on April 25, 2016 [1 favorite]


Benzos like clonazepam basically work physiologically in a very similar way to alcohol. Both are going to increase the GABA in your brain and give you that relaxed, confident kind of feeling. My psychiatrist used to say that alcohol is actually great at treating anxiety, which is why it's so popular, but then you have all of those nasty side effects.

Clonazepam is on the stronger end of the benzos, and it has a very long half life compared to something like lorazepam or alprazolam. That said, it's all super dose dependent. The most common size pill of clonazepam is 1 mg, which for me (180 pounds, 6'1), is too much. Knocks me out too much. I always cut in half or even fourths.

What half life you want depends on what you're using it for. The problem with very short half life benzos like alprazolam is that, while great for warding off acute panic attacks, they can lead to pretty intense habits. So can any benzo, but when you're getting a constant wearing off and ramping up cycle, it can be not so great.

Now, benzos are amazing for anxiety, and some people do ok with long-term use at low dosages. But...a lot of people don't, and there is a definite dependency risk. You don't want to get into a situation where you're needing to up your dose every few months. The other thing is that benzos, IME, are a bitch to wean off.

A different antidepressant won't give you the same relaxed drunk feel, but they might do a better job of treating the underlying issues and are in general more sustainable. Things like SSRIs.

Benzos and booze really don't mix - mostly because you risk too much CNS suppression and you can pass out and stop breathing. That said, people fudge this all the time, and wine and xanax is a common middle class cocktail. SSRIs are generally fine to drink on, though you'll get drunk faster, and the FDA says not to. Lots of fear mongering about it, but zillions of people do it with no ill effects.
posted by Lutoslawski at 3:14 PM on April 25, 2016


Zoloft. OMG zoloft. I started about a month ago and it's the best. I feel like myself but without the self-doubt or self-consciousness. It's a little scary, actually, how differently I feel without feeling like I've been drugged, if that makes sense. I highly recommend it.

A friend who had debilitating anxiety had great success with Paxil.
posted by pintapicasso at 4:20 PM on April 25, 2016 [1 favorite]


I've taken a bunch of different anxiety meds, including alprazolam, and while some of them were definitely effective at reducing anxiety, none of them gave me a buzz like alcohol. The one I had the most luck with with propranolol. Then again, people's brains work differently.
posted by The Underpants Monster at 5:58 PM on April 25, 2016


You might try hydroxyzine...it's basically an antihistamine with anti-anxiety properties. Bonus: inexpensive.
posted by sexyrobot at 7:36 PM on April 25, 2016


In my experience, klonopin is more of a preventive drug you take every night before bed to tone down your anxiety in general whereas xanax is a fast-acting drug you take to deal with specific stressful situations.
posted by Jacqueline at 8:53 PM on April 25, 2016


IANAD (or a nutritionist) so please take this with as many grains of salt as you need.

I have a coworker who swears by Phenibut. It looks like it works on similar areas of the brain as anti-anxiety medications, but is only sold as a nutritional supplement in the US.

She describes the sensation of being on phenibut as "feeling like you're mellow drunk without any decrease in ability", which sounds like what you were looking for. (And which is why I bring it up when you were asking more for recs for something that could be prescribed by a psychiatrist.)

I'd probably run it by your psychiatrist if you were interested in looking into this as a supplement to make sure it's cool, but my coworker loves the stuff and says it did wonders for her anxiety levels.
posted by helloimjennsco at 7:29 AM on April 26, 2016


I'll echo what Ruthless Bunny said, my anti-anxiety medicine doesn't give me any feeling of being in any kind of altered state, I am just Not Anxious. The benzos and such are short term solutions to control sudden spikes of anxiety. What your psychiatrist will probably prescribe for you will be a long term medicine that takes time to build up in your bloodstream, so it will be a couple of weeks before you notice any effect. And the effect you notice will just be... not breaking down in tears or having a racing heart, or whatever your particular brand of anxiety looks like. The drug that worked for me is Remeron. Zoloft gave me suicidal thoughts, which I reported to my doctor right away so he could switch me to a different medication.
posted by MsMolly at 7:58 PM on April 26, 2016


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