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Suggest Treatment For Anxiety Disorder

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Posted on Wed, 26 Aug 2015
Question: During my mid thirties, I developed anxiety disorder. I met with a psychiatrist ,Dr. XXXXXXX Beatu swho was recommended by my family practioner.I met with him 3-4 times and was placed on Imipramine X1 daily, It took about 2months to notice n improvement. A short 10-14 days I noticed marked improvement. I no longer needed the Xanax as a rescue. I continued to take the imipramine, because no one (either of the two physicians I had who ever treated me. My family physician told me to start taking two Imipramine a day, which I have been doing for 6 weeks. I am currently 68 years old, with the anxiety as
bad as it was initally, I have difficlty functioning, particularly if it requires me to leave the house. I am wondering if there are any new drugs or other options that might provide me some relief so I can visit with friends, better manage my household and stop being told to just get over it. Lord knows I would love to do that.
doctor
Answered by Dr. Pankaj Borade (4 hours later)
Brief Answer:
need to consider following possibilities

Detailed Answer:
Dear,
welcome to HCM
From your complaints i could understand that currently you are suffering from ‘anxiety’.
In past you had been on imipramine.

I am considering following possibilities
A relapse of underlying anxiety condition.
Anxiety and withdrawal due to imipramine discontinuation.
emergent or progression of existing psychiatric condition.

In order to have a more specific clinical picture i would need to know
Have you discontinued imipramine in recent past or have you reduced its dose?
The anxiety symptoms have appeared gradually or the onset was abrupt and acute?
Can you recall of any stressor that could have triggered it?
what other medication are you on besides imipramine? or drug use, alcohol use?

I am also suspecting a component of depression to be present here.
persistent low mood, decreased work activities, sleep disturbances, social withdrawal,etc are suggestive of depression symptoms.

A baseline routine investigation of blood and ECG is advisable.

Our further line of management would depend upon knowing of the reason behind anxiety symptoms.
A change to other drug or addition of one more drug can be suggested and discussed then.

Kindly reply with the answer to above questions.
Note: For further guidance on mental health, Click here.

Above answer was peer-reviewed by : Dr. Yogesh D
doctor
Answered by
Dr.
Dr. Pankaj Borade

Psychiatrist

Practicing since :2011

Answered : 571 Questions

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Suggest Treatment For Anxiety Disorder

Brief Answer: need to consider following possibilities Detailed Answer: Dear, welcome to HCM From your complaints i could understand that currently you are suffering from ‘anxiety’. In past you had been on imipramine. I am considering following possibilities A relapse of underlying anxiety condition. Anxiety and withdrawal due to imipramine discontinuation. emergent or progression of existing psychiatric condition. In order to have a more specific clinical picture i would need to know Have you discontinued imipramine in recent past or have you reduced its dose? The anxiety symptoms have appeared gradually or the onset was abrupt and acute? Can you recall of any stressor that could have triggered it? what other medication are you on besides imipramine? or drug use, alcohol use? I am also suspecting a component of depression to be present here. persistent low mood, decreased work activities, sleep disturbances, social withdrawal,etc are suggestive of depression symptoms. A baseline routine investigation of blood and ECG is advisable. Our further line of management would depend upon knowing of the reason behind anxiety symptoms. A change to other drug or addition of one more drug can be suggested and discussed then. Kindly reply with the answer to above questions.