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Suggest Treatment For Anixety-panic Attacks
Question: I have been on tramadol in order to prevent taking harsher narcotics for degenerative disc disease in the C series of my neck. I was also on Paxil for anxiety attacks. I then started having seizures, tremors, rapid heart rate, and the list goes on. I am laying in bed now shaking all over. I can't stop. I had a seizure in my sleep last night and discontinued those meds a week ago. The only things I have taken are Zofran, Gabapentin, Zanaflex, Benedryl, and Trazadone. My heart won't stop racing and it has taken me forever to type this correctly with my hands constantly jerking. HELP!
Brief Answer:
Panic Attacks
Detailed Answer:
Hello.Delighted to be able to help.
The symptoms that you refer are characteristic of Anixety-Panic Attacks.
I recommend:
-Continue taking Paroxetine 20 mg per day at morning.
-Alprazolam 0.25 mg thrice a day.
If taking Alprazolam+Paroxetine,you have a panic attack, you must put a tablet of Alprazolam under tongue to abort the crisis. If a tablet is not enough,you can put 1 or 2 more to the improvement of your symptoms.
Please consult your doctor for a prescription.
I Hope I have answered your query. If you have any further questions, I will be happy to help.If you do not have any clarifications, please don’t forget to evaluate my answer.I wish you good health.
Panic Attacks
Detailed Answer:
Hello.Delighted to be able to help.
The symptoms that you refer are characteristic of Anixety-Panic Attacks.
I recommend:
-Continue taking Paroxetine 20 mg per day at morning.
-Alprazolam 0.25 mg thrice a day.
If taking Alprazolam+Paroxetine,you have a panic attack, you must put a tablet of Alprazolam under tongue to abort the crisis. If a tablet is not enough,you can put 1 or 2 more to the improvement of your symptoms.
Please consult your doctor for a prescription.
I Hope I have answered your query. If you have any further questions, I will be happy to help.If you do not have any clarifications, please don’t forget to evaluate my answer.I wish you good health.
Above answer was peer-reviewed by :
Dr. Yogesh D
I had to go to the ER because my insides began to spasm. They said it was Serotonin Toxicity from the Tramadol, Paxil, Zofran, and Trazadone. I have to discontinue all meds and take Valium. If it was anxiety, it was ready to kill me. I'm glad they gave me meds in order for me to temporarily stop producing serotonin. The Valium has helped a little but I still jerk around a bit. Thanks for trying from so far away.
Brief Answer:
Serotonin Toxicity
Detailed Answer:
Hello.Delighted to be able to help.
I agree with Emergency Physicians in the diagnosis of Serotonin Toxicity from the Tramadol, Paroxetine and Trazadone (Ondansetron has the opposite effect)
Is it right to suspend medication and prescribe Diazepam.
The symptoms that you have now (increased heart rate, tremor...) are common to Serotin Toxicity and a sudden interruption of anxiety-antidepressant medication(Trazodone and Paroxetine).Usually Serotonin Toxicity symptoms disappear 24 hours after stopping the intake of drugs,I think your current symptoms are due to sudden interruption of anxiety medication.
A week later is possible continue antidepressant intake.Of the three drugs that increase the concentration of serotonin, I recommend only taking Paroxetine.Paroxetine 20 mg per day (even 10 mg the first week and then 20 mg)will help to decrease anxiety.However it is advisable to make an analysis for measurement of Serotonin blood levels before of continue the intake of Paroxetine.
For now, continue with Diazepam (you can also use it under the tongue if you have panic attacks) and in a few weeks your doctor should consider replacing Diazepam by Alprazolam.
Please,go to your doctor to request measurement of blood levels of serotonin and
continue the intake of Paroxetine if he deems it appropiate.
I Hope I have answered your query. If you have any further questions, I will be happy to help.If you do not have any clarifications, please don’t forget to evaluate my answer.I wish you good health.
Serotonin Toxicity
Detailed Answer:
Hello.Delighted to be able to help.
I agree with Emergency Physicians in the diagnosis of Serotonin Toxicity from the Tramadol, Paroxetine and Trazadone (Ondansetron has the opposite effect)
Is it right to suspend medication and prescribe Diazepam.
The symptoms that you have now (increased heart rate, tremor...) are common to Serotin Toxicity and a sudden interruption of anxiety-antidepressant medication(Trazodone and Paroxetine).Usually Serotonin Toxicity symptoms disappear 24 hours after stopping the intake of drugs,I think your current symptoms are due to sudden interruption of anxiety medication.
A week later is possible continue antidepressant intake.Of the three drugs that increase the concentration of serotonin, I recommend only taking Paroxetine.Paroxetine 20 mg per day (even 10 mg the first week and then 20 mg)will help to decrease anxiety.However it is advisable to make an analysis for measurement of Serotonin blood levels before of continue the intake of Paroxetine.
For now, continue with Diazepam (you can also use it under the tongue if you have panic attacks) and in a few weeks your doctor should consider replacing Diazepam by Alprazolam.
Please,go to your doctor to request measurement of blood levels of serotonin and
continue the intake of Paroxetine if he deems it appropiate.
I Hope I have answered your query. If you have any further questions, I will be happy to help.If you do not have any clarifications, please don’t forget to evaluate my answer.I wish you good health.
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
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