Brief Answer:
People react differently to different medicines.

Detailed Answer:
But xanax is highly addictive and I've not seen anyone do well on it for years. It is a benzodiazepine that is both strong and short acting. This tends to put someone onto a roller coaster of going up and down. Buspar is pretty safe, though. It helps with tremor but basically shouldn't be the only drug taken.

The generally recognized medications for anxiety and depression are anti-depressants. There are a lot of them. Mirtazipine, paroxetine, buproprion, and sertraline are some of the best for anxiety and depression. Note that all of these are chemically distinct even though what they do is quite similar for this reason, another can be tried if one did not work. Latuda is a major tranquilizer. It often causes mental confusion/sleepiness/changes in personality. It is useful in the short term but unless someone has schizophrenia or other psychosis, it shouldn't be used long term.
Latuda and xanax especially are depressant and therefore can cause depression. They certainly are likely to cause concentration problems.

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Brief Answer:
I think you've answered it yourself.

Detailed Answer:
First, buspar is not addictive. Side effects from latuda are quite common both soon after taking and after years of continuous use.

But then, individuals react to medications differently. There are a lot of antidepressants and although they work by the same mechanism as zoloft they are not usually reacted to the same way. BUT, it is not easily predictable how someone will react.

Although an antidepressant is recommended in someone with depression and/or anxiety, which one is quite hit or miss.

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Brief Answer:
Thank you for the excellent question.

Detailed Answer:
And it's a guess for a particular person what they will react well with.
I can give a bunch of general statements.
My current patient is plain lying to get prescribed xanax and saying all other alternatives don't work as well. This doesn't apply to someone having problems with zoloft BEFORE going on benzodiazepines/xanax.

Zoloft is one particular type of antidepressant that paxil is closely related to and buproprion, mirtazipine, and sertraline are not very similar to. Therefore, one might avoide paxil and be more interested in most any other anti-depressant.
But it's a bit of a total guess if someone is going to react to another one as much as to paxil.

Thank you for really good replies that show a good understanding of the situation and what I said in previous statements. And, there's the chemistry of the different drugs which means paxil is like zoloft. And there's the clinical studies that the ones I am mentioning are indicated for anxiety as well as depression.
But mostly it's a guess and seeing what works.

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Brief Answer:
Totally agree

Detailed Answer:
While I can't say about a particular patient (mainly due to the unpredictability of outcomes; but also because I haven't directly talked to the patient), I can give general info. You are correct on everything.
1) xanax is FDA approved for only a very limited period of time and is not a long term solution and is quite additive with serious withdrawal that frequently occurs and it is a sedative so it generally impairs thinking.
2) Paxil wouldn't be my first 3 picks in someone who had trouble with zoloft.
3) buspar is pretty safe. Xanax is about the least and latuda isn't as safe as anti-depressants.


Then, next good question: brain recovery. Generally, I get more questions about addiction recovery which is an easier answer (get more integrated with life outside of the addiction--> faimily and work).
On the brain recovery, first avoiding drugs that make things worse. Buspar has very little potential for that. And all the others are a maybe.
THen, the literature on brain recovery is based on stroke and concussion and not direclty on this but the situation is probably similar.
First rest. Then graded increasing activity. Avoid trauma. Avoid alcohol.

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