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Dr. Andrew Rynne

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Does an SSRI drug help alleviate GAD while on Cymbalta and Xanax?

Answered by
Dr.
Dr. Soujanya

Psychiatrist

Practicing since :2008

Answered : 611 Questions

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Posted on Fri, 24 Aug 2018 in Mental Health
Question: Hello, I suffer from GAD, Panic attacks and Agoraphobia. I'm on Cymbalta 60mg at the moment and have been on this for roughly 1 year maybe a bit longer, I'm also on Xanax 0.25mg.
Before Christmas, my GAD got very bad as I was weaning myself off the Cymbalta but I then spoke with my GP and even though I had told him that they weren't working or me he just told me to go back on the dose I was on.
From what I gather Cymbalta is used for depression and pain, I don't suffer from either!
I've been doing therapy for years now with the likes of CBT, NLP, all that relaxation stuff, you name it ive done it.
My question is is there another medication you can suggest for GAD and panic attacks, I know medication will not take away the panic attacks as that is something I have to work on myself but its just the GAD disorder is what I'm trying to get sorted, constantly feeling anxious is just such a horrendous feeling to have and with that it brings on fear of fear.
I was thinking of an SSRI called Zoloft Sertraline from the research and advice of others it seems to be quite good?

Many thanks

xxxxxxxxxxxxx
doctor
Answered by Dr. Soujanya 3 hours later
Brief Answer:
Yes, SSRI s are first line drugs in GAD.

Detailed Answer:

Hello,

I have gone through your query in detail and understand your symptoms and the medications you have tried along with the psychotherapy.

I can certainly understand your suffering towards partial response of these drugs, so I would like to suggest you can start on Sertraline in the first week, followed by its escalation of dosage after 2 weeks.

It is clear that you are on Xanax, which can be continued for anxiety and sleep problems.

I would suggest you to continue CBT, relaxation therapy, as which may take longer duration to work, but definitely when they are combined with medications, it would be helpful.

You can also discuss about ACT that is acceptance and committment therapy for this.

For agarophobia, exposure therapy works better.

Anyway, for panic attacks also sertraline works, but I would also suggest you to take PETRIL MD, that is clonazepam during the attack , and follow envelope breathing during your episode.

Envelope breathing helps in compensating carbon dioxide, which gets deficient during hyperventilating episode of panic attacks.

I can advise you to discuss about these therapies and medications with your doctor and follow accordingly.

Hope I have answered your query.
Let me know if I can assist you further.
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Soujanya 49 minutes later
Hi Dr XXXXXXX

Thank you very much indeed for your reply and information.
I shall discuss this with my doctor on Monday.
I will continue with the above mentioned therapies too.

Warmest Regards
xxxxxxxx
doctor
Answered by Dr. Soujanya 27 minutes later
Brief Answer:
Thank you for your reply

Detailed Answer:
Hi,

Its my pleasure to help people with my knowledge.
I'm very happy that my information helped you.

I will be always available to answer your queries.

Please provide your review.

Hope I have answered your query.
Let me know if I can assist you further.
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Soujanya 18 hours later
Hi Dr XXXXXXX

Many thanks for your message, sorry to bother you again but I'm just inquiring about side effects with regard to the sertraline?

I know all meds have to inform users of potential side effects but one of the side effects I get from the duloxetine Cymbalta is very hot flushes and they increase when anxious and or in panic in which triggers more panic.

A friend of mine is on Sertraline and says that they are a very mild SSRI with little or no side effects?

Have you heard of any side effects from your patients?

Many thanks and all the best.

Warmest Regards,

xxxxxxxxxx
doctor
Answered by Dr. Soujanya 1 hour later
Brief Answer:
Nothing to worry, very minimal side effects.

Detailed Answer:
Hi

I have gone through your query, and its my pleasure to answer.

It has minor side effects like dizziness, nausea, drowsiness, nervousness , but nothing to worry much as they occurs only in some people, depending on their response, which is known as pharmacokinetics.

Take Care!

Dr. Soujanya,
Psychiatrist
Above answer was peer-reviewed by : Dr. Yogesh D
doctor
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Follow up: Dr. Soujanya 5 hours later
Hi Dr XXXXXXX

Thank you so much for your reply, information and advice with all my questions.

Wishing you the very best and again many thanks.

All the best

xxxxxxx
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