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Suggest Treatment For Severe OCD And GAD
Question: Hi,
My name is xxxxx and I am currently being treated for anxiety/panic disorder (GAD) and OCD. I was treated for this 2 years ago and was on Paxil 10 mg for 18 months. I was put on Paxil back then because I had a lot of anxiety/panic attacks related to school (I was an undergraduate in college at the time and had a difficult time accepting anything below an A). I went off of Paxil in May because I thought I didn't need it anymore. I had no anxiety at all during the 18 months I was on it. However, I started graduate school in August and my anxiety came back, but 100 times worse. I felt like I was living in a dream/like I was unreal. I was having a panic or anxiety attack almost everyday at work. I also developed new anxieties. I was scared my heart was going to stop beating, that I was having a heart attack, that I was going to stop breathing, etc. My psychiatrist, primary care physician, and therapist all suggested I start taking Paxil 10 mg and Xanax .5 mg as needed. I have been following this plan since September 2 when I started the Paxil again. My anxiety has definitely started to decrease, but it is not completely gone. I have no appetite and have been throwing up as a result of eating sometimes. I have also lost 12 pounds.
Like I said, I am less anxious than in August/September. However, I am very anxious in the mornings (I get a tingly feeling in my chest and have a little trouble breathing), so I am still taking a Xanax everyday. I met with my psychiatrist yesterday and he said the fact that I am taking a Xanax everyday shows the Paxil is not working 100%. He also said the reason why I may be anxious in the morning is because the "half life" of Paxil is 21 hours. He suggested I either start taking 12.5 mg of controlled release Paxil or a 10 mg of Paxil in the morning and a 5 mg of Paxil (cut the pill in half) before bed. I am nervous to increase my dose, but realize it is probably necessary.
My questions are: Will these symptoms I am experiencing go away? I am scared I will feel like this forever. Do you think the 12.5 mg of CR Paxil or the 10 mg coupled with the 5 mg at night is a better idea? Is it normal to not feel 100% better after taking Paxil for 5 weeks? Like I said, I never experienced any of these symptoms last time I took Paxil. I actually gained weight while I was on it, but never had any other side effects. I wish my appetite would come back and am scared it never will. Please let me know when you get a chance, thanks. I look forward to hearing from you.
My name is xxxxx and I am currently being treated for anxiety/panic disorder (GAD) and OCD. I was treated for this 2 years ago and was on Paxil 10 mg for 18 months. I was put on Paxil back then because I had a lot of anxiety/panic attacks related to school (I was an undergraduate in college at the time and had a difficult time accepting anything below an A). I went off of Paxil in May because I thought I didn't need it anymore. I had no anxiety at all during the 18 months I was on it. However, I started graduate school in August and my anxiety came back, but 100 times worse. I felt like I was living in a dream/like I was unreal. I was having a panic or anxiety attack almost everyday at work. I also developed new anxieties. I was scared my heart was going to stop beating, that I was having a heart attack, that I was going to stop breathing, etc. My psychiatrist, primary care physician, and therapist all suggested I start taking Paxil 10 mg and Xanax .5 mg as needed. I have been following this plan since September 2 when I started the Paxil again. My anxiety has definitely started to decrease, but it is not completely gone. I have no appetite and have been throwing up as a result of eating sometimes. I have also lost 12 pounds.
Like I said, I am less anxious than in August/September. However, I am very anxious in the mornings (I get a tingly feeling in my chest and have a little trouble breathing), so I am still taking a Xanax everyday. I met with my psychiatrist yesterday and he said the fact that I am taking a Xanax everyday shows the Paxil is not working 100%. He also said the reason why I may be anxious in the morning is because the "half life" of Paxil is 21 hours. He suggested I either start taking 12.5 mg of controlled release Paxil or a 10 mg of Paxil in the morning and a 5 mg of Paxil (cut the pill in half) before bed. I am nervous to increase my dose, but realize it is probably necessary.
My questions are: Will these symptoms I am experiencing go away? I am scared I will feel like this forever. Do you think the 12.5 mg of CR Paxil or the 10 mg coupled with the 5 mg at night is a better idea? Is it normal to not feel 100% better after taking Paxil for 5 weeks? Like I said, I never experienced any of these symptoms last time I took Paxil. I actually gained weight while I was on it, but never had any other side effects. I wish my appetite would come back and am scared it never will. Please let me know when you get a chance, thanks. I look forward to hearing from you.
Brief Answer:
I prefer 12.5 mg CR in my patients
Detailed Answer:
Dear XXXXXXX
Thanks for writing to us. I read your history and can understand your concern.
Answers of your questions:
Will these symptoms I am experiencing go away? I am scared I will feel like this forever.
Ans: Yes symptoms will definitely go away as you have responded well in past. However never stop paxil cold turkey and simultaneously CBT-cognitive behavior therapy is must. Many of the patients suffer recurrent episodes of anxiety disorder if they are treated only with medicines.
Do you think the 12.5 mg of CR Paxil or the 10 mg coupled with the 5 mg at night is a better idea?
Ans: I prefer 12.5 mg CR in almost all patients of mine with anxiety disorder. Advantages are sustained blood level of drug which gives good effects, single dose per day and fewer side effects.
Yes your appetite would come back as soon as you improve.
Xanax daily is not recommended. It is a very potent benzodiazepine and can cause tolerance and dependence easily. Klonopin is better alternative in my opinion. Increasing paxil dose will surely reduce your benzodiazepine need I guess. No need to be nervous at all. In many patients we have to go up to 37.5 mg daily dose of paxil and you are in need of still low dose relatively.
Hope I have answered your query, I will be happy to help further.
Regards,
Dr.Chintan Solanki.
I prefer 12.5 mg CR in my patients
Detailed Answer:
Dear XXXXXXX
Thanks for writing to us. I read your history and can understand your concern.
Answers of your questions:
Will these symptoms I am experiencing go away? I am scared I will feel like this forever.
Ans: Yes symptoms will definitely go away as you have responded well in past. However never stop paxil cold turkey and simultaneously CBT-cognitive behavior therapy is must. Many of the patients suffer recurrent episodes of anxiety disorder if they are treated only with medicines.
Do you think the 12.5 mg of CR Paxil or the 10 mg coupled with the 5 mg at night is a better idea?
Ans: I prefer 12.5 mg CR in almost all patients of mine with anxiety disorder. Advantages are sustained blood level of drug which gives good effects, single dose per day and fewer side effects.
Yes your appetite would come back as soon as you improve.
Xanax daily is not recommended. It is a very potent benzodiazepine and can cause tolerance and dependence easily. Klonopin is better alternative in my opinion. Increasing paxil dose will surely reduce your benzodiazepine need I guess. No need to be nervous at all. In many patients we have to go up to 37.5 mg daily dose of paxil and you are in need of still low dose relatively.
Hope I have answered your query, I will be happy to help further.
Regards,
Dr.Chintan Solanki.
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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