I'm in the process of tapering off paroxetine which I have been on for 4+ years to prevent panic attacks. I'm down to 10mg/day and notice occasional unpleasant anxiety, not quite to panic attack level but enough to be highly unpleasant.
5 mg xanax has helped in these situation in the past but I don't have a script and don't necessarily trust myself to be judicious in my use if I did have one.
Can anyone recommend anything OTC I could take in such circumstances and what dose would be effective without knocking me out so I could use it at work if needed?
I have tried theanine and valerian for general relaxation at night but never "felt" anything so I don't know if these would be effective in a near-anxiety attack situation.

Your best bet would probably be a half dose of either doxylamine or diphenhydramine although even then, the sedation may be an issue.

Something like Benadryl quick dissolve strips will be very fast acting though so might be just the thing to have around if you feel an attack coming on.

I hadn't thought of that. Doxylamine knocks me out cold even at 12.5 mg so I want to avoid that but I might be able to take a reeeal small dose of benadryl. Thanks.

Also, antihistamines were the only thing that helped with the withdrawal symptoms from venlafaxine. I actually felt too sick to notice any axiety though. I might try high-dose inositol to help the transition. the answer to your questing is probably magnolia bark though.

Phenibut?

Phenibut is not fast enough for most...theanine is much quicker acting

True, but I don't think someone who can tolerate a 5mg dose of xanax would feel even a tiny blip of anything anxiolytic from theanine. Its only noticeably effective on people with "unmolested" (inside joke for any imminst readers) GABA receptors.

This is the only study I could find that compares theanine and xanax:


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: Hum Psychopharmacol. 2004 Oct;19(7):457-65.Click here to read Links
The acute effects of L-theanine in comparison with alprazolam on anticipatory anxiety in humans.
Lu K, Gray MA, Oliver C, Liley DT, Harrison BJ, Bartholomeusz CF, Phan KL, Nathan PJ.

Neuropsychopharmacology Laboratory, Brain Sciences Institute, Swinburne, University of Technology, Victoria, Australia.

L-Theanine (delta-glutamylethylamide) is one of the predominant amino acids ordinarily found in green tea, and historically has been used as a relaxing agent. The current study examined the acute effects of L-theanine in comparison with a standard benzodiazepine anxiolytic, alprazolam and placebo on behavioural measures of anxiety in healthy human subjects using the model of anticipatory anxiety (AA). Sixteen healthy volunteers received alprazolam (1 mg), L-theanine (200 mg) or placebo in a double-blind placebo-controlled repeated measures design. The acute effects of alprazolam and L-theanine were assessed under a relaxed and experimentally induced anxiety condition. Subjective self-reports of anxiety including BAI, VAMS, STAI state anxiety, were obtained during both task conditions at pre- and post-drug administrations. The results showed some evidence for relaxing effects of L-theanine during the baseline condition on the tranquil-troubled subscale of the VAMS. Alprazolam did not exert any anxiolytic effects in comparison with the placebo on any of the measures during the relaxed state. Neither L-theanine nor alprazalam had any significant anxiolytic effects during the experimentally induced anxiety state. The findings suggest that while L-theanine may have some relaxing effects under resting conditions, neither L-theanine not alprazolam demonstrate any acute anxiolytic effects under conditions of increased anxiety in the AA model. 2004 John Wiley & Sons, Ltd.

PMID: 15378679

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However xanax is widely used for acute attacks...all in all it is a cheap enough thing to try...add some chamomille tea and practice ScottL suggestions for stress relief

I made a mistake. The dose of xanax I have used is from time to time is .5 mg, not 5mg. I imagine 5mg would put me to sleep and then some. Sorry about that.

another vote for theanine

nothing is comparable to benzo's.......and i wouldnt suggest benadryl for panic attacks.....from my own experience


theanine....phenibut.....i would also suggest some meditation or a good movie thatll keep you attention....good movies tend to clear my mind

Huh? There are stronger anxiolytics that aren't benzo's. Barbiturates, for one.
Plenty of strong non-gabaergic anxiolytics out there aswell (like alkene & aldehyde hypnotics), but delerium can be a problem.

what kind of dosing of theanine do you think might be effective? I weigh about 225.

Ethanol on an empty stomach. Pills are for women, son... real men drink whiskey.

Of course, meditation is even faster than any oral drug, but you have to practice before you can significantly counteract a powerful anxiety attack on the fly.

I noticed a more powerful anxiolysis with aniracetam than with diazepam 5mg, but maybe I just don't respond well to benzos. (aniracetam is OTC. not really fast acting, tho)

Any oral drug is gonna take 30 min - 1 hour to really kick in. Sublingual absorption of something like a low dose of salvia divinorum may work I suppose, though it has too many other effects. I think they also have sublingual strips of diphenhydramine. Reduce the dose / cut the strips in half if a full dose is too much. Stay away from doxylamine, the T1/2 is too long.

Don't discount prevention and contributing factors. Counteracting a powerful attack with meditation is hard, but mindfulness of your anxiety level through the day, and meditation to head it off before it reaches critical mass is a good strategy. Further, if you are calm but know you're entering a situation where you'll feel anxious, meditate immediately beforehand and stack the deck in your favor.

Be aware of other factors that can contribute to anxiety. For me, some of those factors are: gastrointestinal pain/bloating, general physical pain/aches, fatigue / sleep deprivation, negative judgments about others or negative assumptions of their thoughts of me. Others have mentioned hiatal hernias.

Also, why aren't you getting medical treatment for this? Perhaps something like a low-dose of trazodone (and by low I mean 25mg, otherwise you get sedated) would help attenuate withdrawal. Another possibility for the withdrawal symptoms may be St. John's Wort, though I don't believe it will do much for panic attacks by itself.

200 mg would be a good place to start,if that doesn't work increase it by 100mg.

Ethanol is what got me into this mess
My panic attacks started several years ago at a time when I was drinking heavily several days a week. I think the alcohol and the lack of quality sleep, stimulant use, and the whole snowball of unhealthy habits that go with it were major factors in setting up my CNS to have a tendency to go haywire.
Now I don't drink at all, exercise regularly, eat healthy etc etc so I am hoping I can do without the paroxetine. I was just wondering if there is something with less addictive potential than benzos to get me through the occasional rough patch as I taper off. I will look into aniracetam and ask my doctor about trazodone next time I see her.

If you go naturally,I'd suggest ashwagandha,kava kava.

BTW if I were you,I'd choose Mirtazapine over Trazodone as the latter is more suited as sleeping aid than anxiolytic..If you wanna play with this class of ADs though..

You could try a beta-blocker not OTC but pretty suitable for a brief period.

It may "work in the background" so that you don´t get the racing heart etc.

Trazodone is pretty easy to discontinue, non-addictive, and has been studied specifically for that sort of stuff post-alcohol use. Onset of effects is faster with food. Also rather good for inducing sleep. Plus it gives you major