Q:  Suspicious Thoughts and Med Options

I'm having problems with suspicios thoughts and hypervigilance. My pdoc felt like the effexor was making me agitated even though it helped my depression a lot. Although I've calmed down, I still experience hypervigilance. I don't believe aliens are coming to get me or that I have special powers, but I have moments of crazy thoughts. I've even had disturbing violent thoughts even though I would never hurt anyone. My sleep has gotten back to normal sense I've quit the effexor and I've even gained a few pounds. I'm still very restless and agitated though. I take neurontin. The doc also prescribed an antipsychotic, but I don't like it.  Is there anything else I could take to help these thoughts?  I'd rather take anything but antipsychotics.

Hello Julie -- 
I'd be inappropriate to tell you what to do, as your circumstance is complicated.  But you could read about mood stabilizers (e.g. see my site, read the sections under BPII including "treatment" and "treatment details"; you might find some other stuff of interest there) as a class of medications that might help.  There are the benzodiazepines like Valium and Xanax and a bunch of others, all of which help with anxiety and often with agitation, but they all have the potential for tolerance -- your body gets used to them, and can have pretty bad withdrawal if you stop, i.e. more than your original symptoms unless you taper slowly off.  So we don't use those for symptoms like yours very often.  

Dr. Phelps

Published June, 2001