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Suggest Treatment For Symptoms Of Anxiety

Posted on Fri, 8 Jul 2016

Question: I feel shakey when I walk my head feels like im underwater. I feel a sense of intense fear for no reason anytime I try to talk to someone or focus on something my body gets light and I feel like I will fall over/ im 6ft 170 pounds I have had brain ct and mri chest ct calcium ct score of arteries, celaics disease test glucose check echocardiogram, carotid duplex several ekgs holter monitor and everything came back normal. I am always tired and hyperventilate and feel like im going to die and that im weak. complete white blood cell count was good. what could be wrong with me?

Answered by Dr. Chintan Solanki (1 hour later)

Brief Answer:
it is anxiety disorder

Detailed Answer:
Hello XXXXXXX

Thanks for writing to us. I can understand your concern.

From history and investigations it is confirmed that you are suffering from anxiety disorder likely panic disorder.

You are on zoloft and buspirone and these are the drugs for the same.

I want you to brief about treatment of anxiety disorder.

Best treatment of panic/anxiety disorder includes both medicines and psychotherapy. .

In psychotherapy I recommend 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 in panic disorder. Benzodiazepines group of drugs (clonazepam, lorazepam, alprazolam or etizolam) are used initially for short duration for fast symptomatic relief.

You can ask your doctor about CBT.

Do not hyperventilate when you feel fear do deep breathing exercise. Inhale for 3 seconds, keep breath in for 3 seconds and exhale for 3 seconds. Do it for 10 minutes. You will feel relax.

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

Follow up: Dr. Chintan Solanki (43 hours later)

hello dr. my doctor just up my dose of Zoloft to 150mg I took it three hours ago and I'm breathing deeply feel unfocused and have hot flashes and feel like I'm gonna die... is this a cause of concern?

Answered by Dr. Chintan Solanki (2 hours later)

Brief Answer:
no, it is panic attack

Detailed Answer:
Hi,

Thanks for follow up.

The symptoms you mentioned are symptoms of panic attack and you need not to be concerned as you are not going to die.
Just do deep breathing as I mentioned earlier.
And until you get this answer, your panic attack likely have been subsided.

Feel free to discuss further.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Chintan Solanki (45 hours later)

Thank you for your time doctor. I also wanted to ask what is the rate of remission in panic and generalized anxiety disorders. I sometimes feel like I will be traped like this forever.

Answered by Dr. Chintan Solanki (7 hours later)

Brief Answer:
not forever

Detailed Answer:
Hi,

Panic and generalized anxiety disorder have remission rate of more than 60%. Even in patients who cannot achieve complete remission they remain better on medications. Relapse is common but it is also treatable. patient who are treated with psychotherapy with medicines can achieve remission easily.

Wish you early remission.

Take care.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Chintan Solanki (9 hours later)

oops that was an accident I wanted to ask how well does Zoloft work. for management of anxiety is higher does better ? how about buspar? if not attachment don't know why it's there.

Answered by Dr. Chintan Solanki (9 hours later)

Brief Answer:
zoloft is good but paroxetine is better

Detailed Answer:
Hi,

Sorry for delayed response.

Maximum recommended dose of zoloft is 200 mg. It is good drug for anxiety disorder. However I prefer paroxetine due to its anti cholinergic properties it gives more relief in anxiety.

Buspar is also good anti anxiety drug. 5 mg three times a day is recommended when anxiety is high.

If your doctor has increased dose of Zoloft recently you should wait for 2 weeks to see optimum effects.

Take care.

Note: For further guidance on mental health, Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar