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What Would Cause Bouts Of Anxiety, Weepiness And Headaches That Are Recurrent?

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Posted on Thu, 24 Jan 2019
Question: Hello: I started taking 50mg Sertraline XXXXXXX 2014 due to pregnancy anxiety (I had also taken it postpartum in 2012 then weaned off successfully). I felt good on it and never stopped taking it but am unsure if I really need it for an true anxiety disorder or if I just needed it to manage pregnancy/postpartum hormones. I am now 41 and have been experiencing random bouts of anxiety, weepiness and headaches since XXXXXXX 2017 that are sometimes monthly (there are some months I don't have trouble) that can last 3-7 days. These bouts have come before, during and after my period. I am on a monophasic birth control pill. Would you attribute this new issue to perimenopause/being a woman in my 40s or an underlying anxiety disorder that has worsend/tolerance to the 50mg of Setraline after nearly 4 years? At my doctor's instructions, I have just increased to 75mg. Although the medication solution is the same (an increase in Sertraline), I'd feel more comfortable if I knew what the acutal cause was. Thank you!
doctor
Answered by Dr. Seikhoo Bishnoi (28 minutes later)
Brief Answer:
Chronic course of anxiety disorders and pills are contributing to this.

Detailed Answer:

Hello,

Anxiety disorders follow a long chronic course and the symptoms relapse usually with time. You have been given Sertraline initially for anxiety during pregnancy then for postpartum anxiety, then for anxiety in the day to day activities.

In my opinion, the reason for worsening is a relapse of symptoms of anxiety. Monophasic oral pills though are considered as safe but can become a contributory factor for symptoms worsening.

The right decision for treatment is to increase the dose of Sertraline to 75mg and if needed up to 100mg. This will help to control the anxiety.

Hope I have answered your query. Let me know if I can assist you further.

Regards,
Dr. Seikhoo Bishnoi
Psychiatrist


Above answer was peer-reviewed by : Dr. Arnab Banerjee
doctor
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Follow up: Dr. Seikhoo Bishnoi (18 minutes later)
Thank you. My OB/GYN said birth control pills in general are protective factors against mood disorders and specifically monophasic pills since it’s a steady dose of hormones. Do you think monophasic pills can make mood disorders worse?
doctor
Answered by Dr. Seikhoo Bishnoi (3 hours later)
Brief Answer:
Yes, they can make mood worse.

Detailed Answer:

Hello,

Yes, newer pills are considered relatively safer in new studies but in all practicality, they could worsen the mood. This could be one of those factors for your worsening mood.

Hope I have answered your query. Please don't hesitate to clarify more doubts.

Regards,
Dr. Seikhoo Bishnoi
Psychiatrist
Above answer was peer-reviewed by : Dr. Yogesh D
doctor
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Follow up: Dr. Seikhoo Bishnoi (18 hours later)
Do you recommend any supplements? I am currently taking 400mg magnesium, 100mg B-6, 1200mg calcium plus D3. Is this even worth it?
doctor
Answered by Dr. Seikhoo Bishnoi (5 hours later)
Brief Answer:
Yes, the supplements will supplement the actions of the antidepressants.

Detailed Answer:

Hello,

Yes, these supplements will help in controlling your anxiety. Magnesium will help in relaxing you.

You should also include vitamin B12 supplements in your diet. Either you can increase animal food in your diet or start taking around 500 mcg Methylcobalamin supplements.

You can also try Omega-3-Fatty Acid supplements. These will help to stabilize your mood and reduce depression.

Hope I have answered your query. Let me know if I can assist you further.

Regards,
Dr. Seikhoo Bishnoi
Psychiatrist
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Seikhoo Bishnoi (40 minutes later)
How much Omega 3?
doctor
Answered by Dr. Seikhoo Bishnoi (5 hours later)
Brief Answer:
Take at least 500 mg OF EPA or DHA

Detailed Answer:

Hello,

The exact dosage varies in different brands. Take any good supplement containing at least 500 mg of any Omega-3-Fatty Acid (EPA or DHA).

Hope I have answered your query. Let me know if I can assist you further.

Regards,
Dr. Seikhoo Bishnoi
Psychiatrist
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Seikhoo Bishnoi (31 hours later)
How long should it take for the Sertraline increase to take effect? When should I increase to 100mg if 75mg isn’t working?
doctor
Answered by Dr. Seikhoo Bishnoi (14 minutes later)
Brief Answer:
You should wait at least a couple of weeks to see the effects.

Detailed Answer:

Hello,

The drug should start working in around a couple of weeks. You should wait for at least 2-3 weeks at 75 mg and see if the anxiety is fully controlled. If the symptoms persist then the dose can be increased to 100 mg.

So at around 3 weeks if need, the dose can be increased to 100 mg.

Hope I have answered your query.

Regards,
Dr. Seikhoo Bishnoi
Psychiatrist
Note: For further guidance on mental health, Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Seikhoo Bishnoi

Psychiatrist

Practicing since :2007

Answered : 5193 Questions

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What Would Cause Bouts Of Anxiety, Weepiness And Headaches That Are Recurrent?

Brief Answer: Chronic course of anxiety disorders and pills are contributing to this. Detailed Answer: Hello, Anxiety disorders follow a long chronic course and the symptoms relapse usually with time. You have been given Sertraline initially for anxiety during pregnancy then for postpartum anxiety, then for anxiety in the day to day activities. In my opinion, the reason for worsening is a relapse of symptoms of anxiety. Monophasic oral pills though are considered as safe but can become a contributory factor for symptoms worsening. The right decision for treatment is to increase the dose of Sertraline to 75mg and if needed up to 100mg. This will help to control the anxiety. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Seikhoo Bishnoi Psychiatrist