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I Suffer From Mixed Generalized/ Social Anxiety Disorder Since Few

Posted on Mon, 19 Dec 2022

Question: I suffer from mixed generalized/social anxiety disorder since few years and have tried taking treatment using different SSRI/SNRI meds. but they all aggravate my RLS symptoms due to which i was not able to take treatment. NDRI med. such as bupropion have been tried as well but it did nothing on my anxiety but worked on RLS due to dopamine inhibition. I want to ask are there any medicines left that i can try to fix my anxiety without aggravating my rls symptoms excluding benzo drugs which are not daily solution and not good for long term?

Answered by Dr. Dr. Ashok Kumar Choudhary (59 days later)

Brief Answer:
Buspirone can be used

Detailed Answer:
Dear XXXXXXX
Thanks for using Healthcaremagic.

I read your query and understand your concerns.

From the available description it appears that following medication can be useful for you.
1. Buspirone
2. Tyneptine
3. Mirtazepine

All the three medications described above have novel mechanism of action and differ significantly from SSRI as well as SNRIs. They have their own merits and depending on the choice of your doctor and you it can be decided to choose one of these medications for treatment of generalised anxiety disorder or social anxiety disorder.

I hope this helps you.
Feel free to write back to me if you have more questions.
Thanks and regards.

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Dr. Ashok Kumar Choudhary (34 hours later)

Thanks for your reply doctor, have tried buspirone in past but it aggravated my rls symptoms so i had to stop the drug. The only drug that doesn't aggravate my rls symptoms are vortioxentine & bupropion but both these drugs doesn't do anything for anxiety. How effective can be sertraline for anxiety? doctor suggesting that drug but i am pretty sure it will also aggravate my rls as it's also serotonin acting drugs besides sexual side effects. I am like out of options to treat my anxiety because of my restless legs syndrome & side effects such as sexual ones.

Answered by Dr. Dr. Ashok Kumar Choudhary (13 hours later)

Brief Answer:
Follow up

Detailed Answer:
Dear XXXXXXX
Thanks for follow up.

Sertraline is very effective on anxiety symptoms and no doubt is there in this regard. At the same time sertraline is unique SSRI as it helps in the dopamine transmission which is often used for treatment of RLS. So it can be stated that Sertraline is very unlikely to cause RLS.
Regarding the sexual side effects I like to state that not everybody gets sexual side effects. Only one in four to one in ten develops sexual side effects witch means majority have no sexual side effects. In addition the sexual side effects are completely reversible on discontinuing medication.

Since vortioxetine does not cause RLS to you, I feel vilazodone can be tried for treatment of anxiety as the mechanism of action is quite similar in both of the medications.

I hope this helps you further.
Thanks again.

Note: For further follow up on related General & Family Physician Click here.

Above answer was peer-reviewed by : Dr. LAKSHMI