I usually cannot tolerate serotonergic/dopaminergic medications but hydroxyzine is the least offensive and most helpful out of the ones that I've tried. Hydroxyzine helps a tiny with OCD and general anxiety, but nothing compares to a benzodiazepine in terms of how it makes you feel aka "the ahh... I feel safe and normal feeling", at least to an extent. I find serotonergic medications cause a feeling of bleakness and fatigue, even after they are supposed to wear off, while benzodiazepines feel more blissful, depending on the specific ones of course. Hydroxyzine helps in its own way, it just sort of numbs a little while giving mild feelings of relief without completely making me feel like a zombie, but it's still kind of causes those side effects that serotonin medications cause, like feeling plain, stony, disassociated, and fatigued the next day, and just these weird side effects that are not necessarily comfortable while it's doing its thing, so it can cause a different kind of hypochondria-related anxiety, but like I said, it's one of the only ones in the class of alternative pharmaceuticals for anxiety and related disorders that I can say has a benefit, at least in my case, and it's one of the only medications doctors will not hesitate to prescribe for anxiety if you ask for it instead of an SSRI/SNRI, either alone, or to substitute with a benzodiazepine. It's one of those medications that kinda forces you to go to sleep and want to stay asleep no matter how they make you feel while conscious because it is a strong antihistamine with other properties that affect serotonin and dopamine. Benzodiazepines, while making you feel more lively and normal, don't always take away the general anxiety that keeps you kind of worrying all the time, so you can still have a panic attack or heightened general anxiety and stress while taking them, at least in my case, while other medications such as hydroxyzine with different properties affecting other neurotransmitters will take care of the those other various manifestations of anxiety that may contribute to the severity of the overall anxiety disorder(s). Quetiapine (Seroquel) and mirtazepine (Remeron) were awful experiences, both are also strong antihistamines but also affect various serotonin and dopamine receptors. Quetiapine made my head spin and feel like I had no control over my body and I was in complete terror but made me feel like I couldn't express any emotion of the hell I was going through, and I had to just wait for it to pass, mirtazapine made my head spin and felt like I needed to urgently eat without actually being hungry within 5-10 minutes of taking half of the lowest dose, felt like an emotionless stone the next day, but internally was in terror, and the worst part about it was trying it twice to see if the last time was a fluke or something, but I was in bed for a while the next day with dilated pupils, and then got up just sitting on the steps outside the side door feeling like a stone feeling awful in some bleak place in my head, so I never want to touch mirtazapine again. Being that hydroxyzine is weaker, it causes some of these feelings but at a much lesser extent to where you can still feel emotions and function, and isn't horrifically uncomfortable or "stuck" feeling. I'm probably just sensitive to these kinds of medications because other people say they are a dream when it comes to their symptoms, even DP/DR.
I'm curious, what do you guys take to help with your symptoms these days, and is there a common medication that isn't a benzodiazepine which helps/helped most of us, or can agree wasn't a bad try?
Thank you.