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Suggest treatment for extreme anxiety

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Practicing since : 2005
Answered : 947 Questions
There are times when I go to bed that I wake up and I know it's going to happen. I get a lot of anxiety about it because it really frightens me. I wake up and feel really cold. Then I start to like shiver uncontrollably but big scale.... It feels like my heart is trying to like start back up or something....there is no pain. But I cannot stop it from happening if it's going to happen. This has been happening for about 2 years...but not when it's warm outside....only in the cold months. I sort of dread going to bed. I do have insomnia and I take a sleeping pill plus I have sleep apnea and use a machine part of the time. It seems like a small seizure or something.. My grandmother died at 52 from a stroke. She had a fib. I've not been diagnosed with anything like that...i do take blood pressure and cholesterol meds....I'm 50. feel really cold
Posted Tue, 11 Feb 2014 in Mental Health
Answered by Dr. Manisha Gopal 49 minutes later
Brief Answer: Please read below Detailed Answer: Hello and welcome to HCM! I have read your question carefully and can see that you have hypertension, insomnia, sleep apnoea and are on treatment for the same along with cholesterol lowering drugs. there is a symptom of anxiety which happens every time in cold nights and you cannot control it, there is no pain associated. It never happens in warm season, and has been happening from about two years. From what you have mentioned, the symptoms in question are suggestive of extreme anxiety, and not cardiac or organic ( seizure) as- - there is no pain associated - it almost always happen in cold nights but only when you try to sleep, not otherwise - nothing much has happened physically to you ever even after having theses attacks form 2 years. - doesn't look like related to breathing issue as it gets better after some time - you have history of anxiety and insomnia - doesn't get better with treatment of sleep apnoea -many times you know that you are going to have one such attack, means that you may be anxious more on such days... From my clinical experience I can say that your sleeping problem ( lunesta is not working good here) and this anxiety ( more like a panic attack) are correlated. You have not mentioned any anti anxiety medicine in your drug list, so, I think that you have never been on any in past too. I would suggest that you should see a psychiatry & get your self evaluated. I think a good anti anxiety medicine like - ( paroxetine, or esciatlopram etc.) along with something to get good sleep like- zolpidem 5-10 mg or clonazepam, will help you a lot. lot of the patients have reduction/ complete stoppage in anxiety and panic attacks after few days only. After about a week or two, the sleep improves and there is no need to continue with sleep pill. # as you are hypertensive and have high cholesterol it would be good that you get an ECG and routine blood test before starting treatment. Hope the reply is useful please feel free to ask more questions for clarifictaion Dr. Manisha Gopal MD Psychaitry
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