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Suggest Treatment For Insomnia, Anxiety And Depression
Question: Hi, I'm a student who has the most important exams of my life around the corner. I've been busy with work before but took study leave. After a traumatic experience with heat stroke a few months back, I've been sleepless ever since. Although I recovered from it, I wake up every night 2am with a racing heart. I've had 3 full blown panic attacks in my entire life but my GP says I'm prone to panic attacks in future as my EKG reads short PR intervals. Since I cannot easily go back to sleep I choose to study. I find extreme satisfaction while studying after I wake up with a racing heart. Its going on for a month now and I'm getting very poor sleep. I follow diet of salads, shakes and soups and never had tea or coffee, smoking or drinking in my life. Visited my GP after the traumatic event, who put me on Szetalo plus for a month which reduced to szetalo 0.5 in 2nd month. As I was scared of dependency and depression being side effects, i discontinued szetalo 0.5 mid way and have been having a fluttering chest and insomnia also waking up wih a racing heart in the night. Insomnia did not go away while I was on szeatlo plus. i quit working out at gym due to fear of palpitations at night. My GP adviced to restart all medication from scartch. I want to know if szetalo's wihdrawal leads to depression or Generalized anxiety & can I have them again until my exams are over in a few months as I'm not on any medication now. Many thanks.
Brief Answer:
continue medicine regularly and later on stop gradullay
Detailed Answer:
Hello,
Thanks for writing to us.
Szetalo plus contains escitlaopram 10 mg and clonazepam 0.5 mg.
Escitalopram is an anti depressant drug from SSRI group while clonazepam is a drug for anxiety and sleep from benzodiazepine group.
If your problem is only insomnia (sleep disturbance) you need clonazepam only. Clonazepam has the least potential of addiction among all benzodiazepine. Even I also recommend in most of the patient.It helps in panic attack also.
Actually you need treatment by a psychiatrist. Anxiety disorder treatment includes both medicines and psychotherapy. For diagnosis detail history and mental status examination are required in person by a psychiatrist.
I want to brief you about treatment of anxiety problem and insomnia so you can discuss with psychiatrist and choose your treatment.
Insomnia (sleep disturbance) is of two types:
Primary: There is problem of only sleep disturbance and no other physical or psychological problem is there. In this case treatment for sleep problem is needed.
Secondary: There is some underlying physical or psychological problem which is responsible for sleep disturbance. In this, main treatment is done for underlying problem.
First of all try to follow some measures called 'sleep hygiene' which would help in sleep. You can find the same in below link.
sleepfoundation.org/ask-the-expert/sleep-hygiene
Drinking a cup of warm milk before going to bed helps in 30-40% of patients and they do not need medicines as per my clinical experience.
As such drugs from benzodiazepine group and Z group sedatives (ambien/zolpidem) are used in sleep disturbance. But all are prescription medicines and you need to consult doctor for prescription.
Specific treatment of anxiety disorder includes both medicines and cognitive behavior therapy (CBT).
In mild cases only CBT is sufficient. In moderate to severe cases initially medicines and then CBT is added. And later on medicines stopped gradually.
If medicines alone are used chances of relapse are more after stopping the medicines.
In medicines SSRI group of drugs(fluoxetine,paroxetine,sertraline, escitalopram) are main stay of the treatment. I prefer paroxetine. Benzodiazepines group of drugs(clonazeapm, lorazepam or etizolam) are used initially for short duration for fast symptomatic relief.
Hope I have answered your query, I will be happy to help further.
Regards,
Dr.Chintan Solanki.
continue medicine regularly and later on stop gradullay
Detailed Answer:
Hello,
Thanks for writing to us.
Szetalo plus contains escitlaopram 10 mg and clonazepam 0.5 mg.
Escitalopram is an anti depressant drug from SSRI group while clonazepam is a drug for anxiety and sleep from benzodiazepine group.
If your problem is only insomnia (sleep disturbance) you need clonazepam only. Clonazepam has the least potential of addiction among all benzodiazepine. Even I also recommend in most of the patient.It helps in panic attack also.
Actually you need treatment by a psychiatrist. Anxiety disorder treatment includes both medicines and psychotherapy. For diagnosis detail history and mental status examination are required in person by a psychiatrist.
I want to brief you about treatment of anxiety problem and insomnia so you can discuss with psychiatrist and choose your treatment.
Insomnia (sleep disturbance) is of two types:
Primary: There is problem of only sleep disturbance and no other physical or psychological problem is there. In this case treatment for sleep problem is needed.
Secondary: There is some underlying physical or psychological problem which is responsible for sleep disturbance. In this, main treatment is done for underlying problem.
First of all try to follow some measures called 'sleep hygiene' which would help in sleep. You can find the same in below link.
sleepfoundation.org/ask-the-expert/sleep-hygiene
Drinking a cup of warm milk before going to bed helps in 30-40% of patients and they do not need medicines as per my clinical experience.
As such drugs from benzodiazepine group and Z group sedatives (ambien/zolpidem) are used in sleep disturbance. But all are prescription medicines and you need to consult doctor for prescription.
Specific treatment of anxiety disorder includes both medicines and cognitive behavior therapy (CBT).
In mild cases only CBT is sufficient. In moderate to severe cases initially medicines and then CBT is added. And later on medicines stopped gradually.
If medicines alone are used chances of relapse are more after stopping the medicines.
In medicines SSRI group of drugs(fluoxetine,paroxetine,sertraline, escitalopram) are main stay of the treatment. I prefer paroxetine. Benzodiazepines group of drugs(clonazeapm, lorazepam or etizolam) are used initially for short duration for fast symptomatic relief.
Hope I have answered your query, I will be happy to help further.
Regards,
Dr.Chintan Solanki.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thanks you that's very informative.
I'm curious if any of the medications mentioned by you, if taken over a few months have side effects of short term memory loss?
I'm curious if any of the medications mentioned by you, if taken over a few months have side effects of short term memory loss?
Brief Answer:
No effects on memory
Detailed Answer:
Hi,
Thanks for follow up.
Niether of the drug causes effect on memory even if you take for few months.
Clonazepam causes sedation so avoid it before reading.
Take care.
No effects on memory
Detailed Answer:
Hi,
Thanks for follow up.
Niether of the drug causes effect on memory even if you take for few months.
Clonazepam causes sedation so avoid it before reading.
Take care.
Note: For further guidance on mental health, Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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