Dr. Carmen C. Vivero, M.D.

There are actually many medications indicated to treat anxiety which are not addictive. Usually, SSRI's are effective in treating anxiety long term. Although they are not addictive, they should be tapered down and not discontinued abruptly. Other long-term medication is buspirone. Not all medications work exactly the same for everybody. You should work together with your physician and let him/her know of undesirable side effects and if the medication is being effective or not. Usually, the efficacy can be improved by increasing the dose if you're not already on the highest one already. Medications like Vistaryl, trazodone, can be used on a short-term or as needed basis. Like any other symptom, it should be evaluated with a full medical history and physical exam since they may be caused by other underlying conditions such as hyperthyroidism, depression, PTSD, and others.

Buprenorphine is addictive, but one important difference from full opiate agonists is that it does not create tolerance; meaning we can gradually taper you off it. The rate at which patients taper is different for each one. This medication is not meant to be prescribed by itself, it should be used in combination with either drug counseling or 12 step meetings, be it AA or NA.

Our patients are required to attend 90 meetings in the first 90 days, then at least a minimum of 3 meetings a week. We also give them a list of websites they can access for additional support and which all patients find very helpful. There are online meetings any time, every day. The medication also has a "ceiling effect" so that it may give some opioid-like effects at the beginning, it subsides and you do not get more of an euphoria, by using more medication. If you wish to have an appointment with us, please call (904)460-0707 and request an appointment for our Buprenorphine Program, Opioid Dependence Program.

Dr C. Vivero, MD. Institute of Internal Medicine