Get your Health question answered in 3 easy steps
A Doctor will be with you shortly
Ask a Doctor Now
144 Doctors are Online

Severe anxiety, frustration, Obsessive-Compulsive disorder, irrational fears, agoraphobia. Tried CBT therapy. Taking Xenax, Lexapro. Advise?

What are the best treatments for someone with really severe anxiety issues. I m talking about somebody with lot of obsessions, compulsions, ocd ! bizaree rituals out of irrational fears. Health anxiety, fears of dying, getting ill. This person dwells on anxiety thoughts a lot. Feels need to talk about anxiety a lot, and gets wound up, angry at times too frustrated. Is agoraphobic, does not leave the house. family does shopping for him. He gets down a lot, and angry annoyed at himself, sometimes a bit depressed. He had a check up around december 2011, and the doctor found nothing wrong. He went looking for things wrong after that, even when doctor checked him ( the doctor who checked him out actually said he would do that, as he knew by talking to him ) and anyway, hes improved on that, but still thinks something could be wrong with him, even though hes functioning fine, eats well, sleeps ok, good energy etc. But he seems to be in a habit of thinking negatively, dwelling on negative thoughts, scared of thoughts he had etc, he has a fear that imagining getting cancer etc and visuals of diseases, medical words, focusing on areas could cause disease like cancer, despite being told by experts such things are not possible. Hes tried CBT therapy, and liked it, but didnt stay at it long enough. He takes .25 mg xanax twice soemtimes three a day. a low dosage. and sometimes he takes Lexapro. but goes off it for a while and doesnt bother. Could you offer some advise ? Distraction works for him, he loves movies, books and internet... but he wants to improve a lot more on things liek getting out of the house, and stop being obsessed with health stuff etc. Someday s he is doing better, but he gets bad days too... Thanks
Asked On : Sun, 7 Apr 2013
Answers:  3 Views:  88
Report Abuse
Share on Facebook
Share on Twitter
Share on Google+
Question is related to
Psychiatrist 's  Response
Dec 2014
Welcome to HCM

The symptoms you have described in him are most likely due to Anxiety Disorder. He is also having Obsessive Compulsive Disorder and Agoraphobia. The anxiety is leading to negative thoughts, irritability, poor sociality etc issues. These are due to depression secondary to anxiety. He is also having hypochondrical ideas about getting some serious disease or cancer. All these disorders are part of Anxiety Spectrum disorder. Xanax or alprazolam is a nice drug that helps in relieving the symptoms of anxiety but it should not be taken for prolonged time as it may cause dependence and tolerance.
Other medicines like SSRI as Fluoxetine, Paroxetine, Sertaline etc can be given in consultation of psychiatrist. Apart from medicines behavior therapy is also needed in his case. The treatment will continue for long time most likely 6-12 months so good compliance to treatment is also needed. Visit a Psychiatrist for details.

Dr. Seikhoo Bishnoi, MD
Answered: Thu, 25 Apr 2013
I find this answer helpful

 1 user finds this helpful

Psychiatrist Dr. Ashish Mittal's  Response
welcome to Healthcare Magic.

From the query it appear that you have agoraphobia, generalized anxiety disorder and OCD. Your above mentioned most of the symptoms are related to these disorders. These are chronic problems which requires treatment for several years.

In drug treatment two types of medicine used. For immediate relief of anxiety benzodiazepines group of medicines (like xanax) are used for short term and for long term relief most commonly SSRI (selective serotonin reuptake inhibitors like lexapro) are used. SSRI takes around 3-4 weeks to show its effect. Non drug treatment like cognitive behaviour therapy (form of psychotherapy) also takes weeks to show its effect.

Your treatment appear to in right direction. In your case poor treatment response is due to poor compliance to treatment. So, be regular in treatment and you will improve significantly.

Wish you all the best.

Dr Ashish Kumar Mittal
Answered: Thu, 25 Apr 2013
I find this answer helpful

 1 user finds this helpful

1 Doctor agrees with this answer

Psychiatrist Dr. Sundar Gnanavel's  Response
Thanks for your query. The patient seems to have an admixture of various anxiety disorders including OCD, agoraphobia, hypochondriasis and also some depressive symptoms. Xanax/Alprazolam is a sedative medication that only temporarily alleviates anxiety symptoms and also has addictive potential.
The ideal treatment consists of:
1. Anti-anxiety medication including SSRIs
2. Psychotherapy techniques including CBT/Cognitive behavioural therapy
Yoga/meditation/breathing relaxation exercises are also beneficial. Wish you good health.
Dr Sundar
Answered: Sun, 28 Apr 2013
I find this answer helpful
Disclaimer: These answers are for your information only and not intended to replace your relationship with your treating physician.
This is a short, free answer. For a more detailed, immediate answer, try our premium service [Sample answer]


Loading Online Doctors....
© Ebix, Inc. All Rights Reserved.
All the information, content and live chat provided on the site is intended to be for informational purposes only, and not a substitute for professional or medical advice. You should always speak with your doctor before you follow anything that you read on this website. Any health question asked on this site will be visible to the people who browse this site. Hence, the user assumes the responsibility not to divulge any personally identifiable information in the question. Use of this site is subject to our Terms & Conditions
Already Rated.
Your rating:

Ask a Doctor