Get your health question answered instantly from our pool of 18000+ doctors from over 80 specialties
146 Doctors Online

By proceeding, I accept the Terms and Conditions

Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

HCM Blog Instant Access to Doctors
HCM BlogQuestions Answered
HCM Blog Satisfaction

Hi, I suffer from severe anxiety/panic attacks that can last

Answered by
Dr.
Dr. Ashok Kumar

Psychiatrist

Practicing since :2000

Answered : 3114 Questions

default
Posted on Mon, 11 Feb 2019 in Mental Health
Question: Hi, I suffer from severe anxiety/panic attacks that can last even up to 3 hours. I have the following symptoms: cold, bluish hands and feet, my head is covered with sweat, sweaty palms, fear of death, distorted reality. My stomach reacts immediately, and I have 2-3 bathroom visits during the attack. I also have a feeling that my body weight is greater than normal, (I feel that I am heavier than under normal conditions). These symptoms scare me a lot. Also, I experience fears that I will not be able to manage after my parents pass. Anything can trigger the attack. I was wondering if there is any strong medicine that could help me with these. I have had the attacks for 3 years now. The stress is tremendous. I also am sure that the fact that the attacks are so intense contributes to my panic/anxiety attacks even more. It is very difficult for me to get out of the attacks. I am asking for medications because therapy is not helping me, and also due to intensity of the attacks and their length.
default
Follow up: Dr. Ashok Kumar 0 minute later
Hi, I suffer from severe anxiety/panic attacks that can last even up to 3 hours. I have the following symptoms: cold, bluish hands and feet, my head is covered with sweat, sweaty palms, fear of death, distorted reality. My stomach reacts immediately, and I have 2-3 bathroom visits during the attack. I also have a feeling that my body weight is greater than normal, (I feel that I am heavier than under normal conditions). These symptoms scare me a lot. Also, I experience fears that I will not be able to manage after my parents pass. Anything can trigger the attack. I was wondering if there is any strong medicine that could help me with these. I have had the attacks for 3 years now. The stress is tremendous. I also am sure that the fact that the attacks are so intense contributes to my panic/anxiety attacks even more. It is very difficult for me to get out of the attacks. I am asking for medications because therapy is not helping me, and also due to intensity of the attacks and their length.
doctor
Answered by Dr. Ashok Kumar 3 hours later
Brief Answer:
I feel in addition to above diagnosis depersonalization and panic attacks

Detailed Answer:
Hello,
Thanks for using Healthcaremagic.

I request you to provide more details for decisive answer
1. Duration of problem
2. Current symptoms
3. Past symptoms with duration of each symptom
4. Past medications with dose and their response
5. Current medications and their dose and response
6. Family history, if any with possible details of medication.
7. Current or past medical condition with details

I look forward to answer you further.
Thanks and regards.
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
doctor
Answered by Dr. Ashok Kumar 0 minute later
Brief Answer:
I feel in addition to above diagnosis depersonalization and panic attacks

Detailed Answer:
Hello,
Thanks for using Healthcaremagic.

I request you to provide more details for decisive answer
1. Duration of problem
2. Current symptoms
3. Past symptoms with duration of each symptom
4. Past medications with dose and their response
5. Current medications and their dose and response
6. Family history, if any with possible details of medication.
7. Current or past medical condition with details

I look forward to answer you further.
Thanks and regards.
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
default
Follow up: Dr. Ashok Kumar 12 hours later
Hello Dr. XXXXXXX XXXXXXX In response to your questions, I provide the following:
1) Duration of the problem: the attacks have been happening for almost 4 years now, each attack lasts for about 3 hours
2) Current symptoms: cold, blueish hands, cold feet, visits to the bathroom, excessive sweating of the palms and head, feelings of hopelessness, fear of death, distorted reality. worries and fears (extreme)
3) Past symptoms: deprivation of sleep for many days in 2014, inability to close eyes, symptoms of electrical shocks in the brain, head covered with excessive sweat requiring a towel to wipe out. No anxiety prior to this
4) Past medications with dose: Klonopin 2mg; Trazodone 200 mg, Fluvoxamine 200 mg, Trileptal 1500 mg, hydroxizine 50 mg, Seroquel 300 mg. For anxiety did not try anything except Klonopin and Hydroxizine.
5) Current medications, dose and response: same as in answer No. 4. Klonopin 2mg helps very little, hydroxizine also very little. I feel I need higher dose or a different medications. So far, I have not experimented on the meds to find one that helps me most. Will contact my psychiatrist and ask for Xanax. Want to try also Inderal and Atarax and possibly others. All current medications except Klonopin and Hydroxizine work great and help a lot.
6)Family history: depression (mother); schizoaffective disorder with psychotic features (me) obsessive compulsive disroder (me)
7) Current or past medical conditions with details - please see No. 6
default
Follow up: Dr. Ashok Kumar 0 minute later
Hello Dr. XXXXXXX XXXXXXX In response to your questions, I provide the following:
1) Duration of the problem: the attacks have been happening for almost 4 years now, each attack lasts for about 3 hours
2) Current symptoms: cold, blueish hands, cold feet, visits to the bathroom, excessive sweating of the palms and head, feelings of hopelessness, fear of death, distorted reality. worries and fears (extreme)
3) Past symptoms: deprivation of sleep for many days in 2014, inability to close eyes, symptoms of electrical shocks in the brain, head covered with excessive sweat requiring a towel to wipe out. No anxiety prior to this
4) Past medications with dose: Klonopin 2mg; Trazodone 200 mg, Fluvoxamine 200 mg, Trileptal 1500 mg, hydroxizine 50 mg, Seroquel 300 mg. For anxiety did not try anything except Klonopin and Hydroxizine.
5) Current medications, dose and response: same as in answer No. 4. Klonopin 2mg helps very little, hydroxizine also very little. I feel I need higher dose or a different medications. So far, I have not experimented on the meds to find one that helps me most. Will contact my psychiatrist and ask for Xanax. Want to try also Inderal and Atarax and possibly others. All current medications except Klonopin and Hydroxizine work great and help a lot.
6)Family history: depression (mother); schizoaffective disorder with psychotic features (me) obsessive compulsive disroder (me)
7) Current or past medical conditions with details - please see No. 6
doctor
Answered by Dr. Ashok Kumar 1 hour later
Brief Answer:
Follow up

Detailed Answer:
Hello,
Thanks for follow up with required details.

First of all regarding diagnosis I feel the diagnosis should include Panic disorder with denationalization in addition to schizoaffective disorder and obsessive compulsive disorder.

Now regarding the treatment as the current treatment includes best option for obsessive compulsive disorder and Schizoaffective disorder I feel you need to discuss following changes with your psychiatrist.

1. Addition of Clomipramine- An TCA which not only helps in OCD but have significant anti anxiety properties. The dose for the purpose ranges between 25 mg to 300 mg per day.

2.Replacement of Xanax instead of current Klonopin. Since klonopin is not helping at the required level Xanax is next best option. The dose ranges from 0.25 mg to 2mg per day. It appears to me that you will require higher dose.

3. Removal of Hydroxizine. I understand that it is helping you to some extent but have no other role in current regimen. For the management of sleep I think larger dose of quetiapine at night and clomipramine must help you.

4. Addition of Inderal if the above options does not help you to the optimum level.

I hope this answers you.
Feel free to write back to me if you have more questions.
Thanks and regards.
Above answer was peer-reviewed by : Dr. Prasad
doctor
doctor
Answered by Dr. Ashok Kumar 0 minute later
Brief Answer:
Follow up

Detailed Answer:
Hello,
Thanks for follow up with required details.

First of all regarding diagnosis I feel the diagnosis should include Panic disorder with denationalization in addition to schizoaffective disorder and obsessive compulsive disorder.

Now regarding the treatment as the current treatment includes best option for obsessive compulsive disorder and Schizoaffective disorder I feel you need to discuss following changes with your psychiatrist.

1. Addition of Clomipramine- An TCA which not only helps in OCD but have significant anti anxiety properties. The dose for the purpose ranges between 25 mg to 300 mg per day.

2.Replacement of Xanax instead of current Klonopin. Since klonopin is not helping at the required level Xanax is next best option. The dose ranges from 0.25 mg to 2mg per day. It appears to me that you will require higher dose.

3. Removal of Hydroxizine. I understand that it is helping you to some extent but have no other role in current regimen. For the management of sleep I think larger dose of quetiapine at night and clomipramine must help you.

4. Addition of Inderal if the above options does not help you to the optimum level.

I hope this answers you.
Feel free to write back to me if you have more questions.
Thanks and regards.
Above answer was peer-reviewed by : Dr. Prasad
doctor
default
Follow up: Dr. Ashok Kumar 1 hour later
Dear Doctor:
Thank you for your reply. I have made notes of all the medication changes you propose. I will send an email today to my therapist who in turn will contact my psychiatrist and will ask him to make changes. I am not afraid to try new meds. They can only help me. I have read today that people with anxiety indeed appreciate more Xanax than Klonopin. Thank you very much for your priceless input! I must reiterate that my panic disroder is extremely serious in symptoms. I will try all the meds you advise.
Sincerely,
Dana Dzwonczyk
Your Grateful Patient
default
Follow up: Dr. Ashok Kumar 0 minute later
Dear Doctor:
Thank you for your reply. I have made notes of all the medication changes you propose. I will send an email today to my therapist who in turn will contact my psychiatrist and will ask him to make changes. I am not afraid to try new meds. They can only help me. I have read today that people with anxiety indeed appreciate more Xanax than Klonopin. Thank you very much for your priceless input! I must reiterate that my panic disroder is extremely serious in symptoms. I will try all the meds you advise.
Sincerely,
Dana Dzwonczyk
Your Grateful Patient
default
Follow up: Dr. Ashok Kumar 27 hours later
Dear Doctor,
My therapist has scheduled for me to see my psychiatrist on XXXXXXX 10, 2019. I must tell you, Sir, that my therapist has never heard "denationalization" diagnosis. I hope I will be able to work with my psychiatrist to add the two medications you mentioned in the previous answer. I have gone online and I have seen pictures depicting Panic Attack with Denationalization: I completely agree that that is what I suffer from considering extreme severity of my symptoms. I have made scrupulous notes of what you have told me. Will keep you posted about my psychiatrist decision on adding meds. I do hope that with the meds he will put me on, I will better manage my panic attacks. I know that they may not be curable, but at least treatable, and that they will last shorter time. Thank you, Doctor!
default
Follow up: Dr. Ashok Kumar 0 minute later
Dear Doctor,
My therapist has scheduled for me to see my psychiatrist on XXXXXXX 10, 2019. I must tell you, Sir, that my therapist has never heard "denationalization" diagnosis. I hope I will be able to work with my psychiatrist to add the two medications you mentioned in the previous answer. I have gone online and I have seen pictures depicting Panic Attack with Denationalization: I completely agree that that is what I suffer from considering extreme severity of my symptoms. I have made scrupulous notes of what you have told me. Will keep you posted about my psychiatrist decision on adding meds. I do hope that with the meds he will put me on, I will better manage my panic attacks. I know that they may not be curable, but at least treatable, and that they will last shorter time. Thank you, Doctor!
doctor
Answered by Dr. Ashok Kumar 5 hours later
Brief Answer:
Follow up

Detailed Answer:
Dear XXXXXXX
Thanks for follow up and feedback.

First of all I like to correct myself that there is no diagnosis called "denationalization" instead it is termed "depersonalisation" (sorry for typos).

In regard to depersonalisation I like to make it clear that it is fairly common with severe anxiety disorders such as panic attacks. I also like to add that with calculated decisions about use of medications.

Hope I am able to answer your concerns.
If you have any further query, I would be glad to help you.

In future if you wish to contact me directly, you can use the below mentioned link:
http://doctor.healthcaremagic.com/doctors/dr-ashok-kumar/67386

Thanks and regards.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
doctor
Answered by Dr. Ashok Kumar 0 minute later
Brief Answer:
Follow up

Detailed Answer:
Dear XXXXXXX
Thanks for follow up and feedback.

First of all I like to correct myself that there is no diagnosis called "denationalization" instead it is termed "depersonalisation" (sorry for typos).

In regard to depersonalisation I like to make it clear that it is fairly common with severe anxiety disorders such as panic attacks. I also like to add that with calculated decisions about use of medications.

Hope I am able to answer your concerns.
If you have any further query, I would be glad to help you.

In future if you wish to contact me directly, you can use the below mentioned link:
http://doctor.healthcaremagic.com/doctors/dr-ashok-kumar/67386

Thanks and regards.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
default
Follow up: Dr. Ashok Kumar 14 hours later
Got it!
I am not closing yet the discussion, though, In two days I will see my psychiatrist. I hope he will be willing to add the medications you suggested. I am willing to try anything as my attacks are extreme. I could see that you also work for the Virtual Hospital www.icliniq.com. There is a way there to speak over the phone with you or simply to make a query. I have noted everything you said. Thank you again. My previous psychiatrist was not to my satisfaction because I told her that my panic attacks were too strong to rely only on therapy. I will google "panic attack with depersonalisation". Thanks again. I will keep in touch either through the link you gave me, here or www.icliniq.com.
default
Follow up: Dr. Ashok Kumar 0 minute later
Got it!
I am not closing yet the discussion, though, In two days I will see my psychiatrist. I hope he will be willing to add the medications you suggested. I am willing to try anything as my attacks are extreme. I could see that you also work for the Virtual Hospital www.icliniq.com. There is a way there to speak over the phone with you or simply to make a query. I have noted everything you said. Thank you again. My previous psychiatrist was not to my satisfaction because I told her that my panic attacks were too strong to rely only on therapy. I will google "panic attack with depersonalisation". Thanks again. I will keep in touch either through the link you gave me, here or www.icliniq.com.
default
Follow up: Dr. Ashok Kumar 1 hour later
Dear Doctor,
For my condition of panic disorder with depersonalization, is it a good idea to ask my psychiatrist for one of the following:

SSRI- Paxil
SNRI - Pristiq
TCA - Clamipramine
BETA-BLOCKERS - Inderal
BENZODIAZEPINE - Xanax
Buspirone
All the above in addition to the meds I take now.
Can I take all the above to get significant relief from my panic attacks?
I will also look for CBT class as it is the one you suggested, and one that was most advised online. Thank you, Doctor!
default
Follow up: Dr. Ashok Kumar 0 minute later
Dear Doctor,
For my condition of panic disorder with depersonalization, is it a good idea to ask my psychiatrist for one of the following:

SSRI- Paxil
SNRI - Pristiq
TCA - Clamipramine
BETA-BLOCKERS - Inderal
BENZODIAZEPINE - Xanax
Buspirone
All the above in addition to the meds I take now.
Can I take all the above to get significant relief from my panic attacks?
I will also look for CBT class as it is the one you suggested, and one that was most advised online. Thank you, Doctor!
doctor
Answered by Dr. Ashok Kumar 7 hours later
Brief Answer:
Follow up

Detailed Answer:
Dear XXXXXXX
Thanks for follow up.

I do not think adding everything will more than rational changes in medications. Instead too many of medications may bring more side effects and we need to remain aware of them.

I do not see any space for Paxil and Prestiq at this level as Fluvoxamine is already part of treatment with appropriate dosage (200 mg per day).

As suggested above adding Clomipramine and Xanax can be the first step at this stage. In case we do not get desired results after appropriate dose and timing of new medications we can try further options.

To confirm I am available at Icliniq.com/ashok as well as above provided address (http://doctor.healthcaremagic.com/doctors/dr-ashok-kumar/67386). The Icliniq option also includes phone and video consultation if required.

Thanks and regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
doctor
Answered by Dr. Ashok Kumar 0 minute later
Brief Answer:
Follow up

Detailed Answer:
Dear XXXXXXX
Thanks for follow up.

I do not think adding everything will more than rational changes in medications. Instead too many of medications may bring more side effects and we need to remain aware of them.

I do not see any space for Paxil and Prestiq at this level as Fluvoxamine is already part of treatment with appropriate dosage (200 mg per day).

As suggested above adding Clomipramine and Xanax can be the first step at this stage. In case we do not get desired results after appropriate dose and timing of new medications we can try further options.

To confirm I am available at Icliniq.com/ashok as well as above provided address (http://doctor.healthcaremagic.com/doctors/dr-ashok-kumar/67386). The Icliniq option also includes phone and video consultation if required.

Thanks and regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
default
Follow up: Dr. Ashok Kumar 10 hours later
Okay. I will mention to my psychiatrist to put me on Clamipramine and Xanax for now. I also prefer less medications. Maybe they will do the job. Thanks, Doctor.
default
Follow up: Dr. Ashok Kumar 0 minute later
Okay. I will mention to my psychiatrist to put me on Clamipramine and Xanax for now. I also prefer less medications. Maybe they will do the job. Thanks, Doctor.
doctor
Answered by Dr. Ashok Kumar 12 hours later
Brief Answer:
Follow up

Detailed Answer:
Hello,
Thanks for updates.

I hope that your psychiatrist will consider the recommendations with utmost care for betterment of his patients.

I look forward to help you further if required.
Thanks and regards.
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
doctor
Answered by Dr. Ashok Kumar 0 minute later
Brief Answer:
Follow up

Detailed Answer:
Hello,
Thanks for updates.

I hope that your psychiatrist will consider the recommendations with utmost care for betterment of his patients.

I look forward to help you further if required.
Thanks and regards.
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
default
Follow up: Dr. Ashok Kumar 12 hours later
Hello Doctor,
Unfortunately my psychiatrist is not willing to add anything to my treatment. He says that Anafranil is a complicated medication that has a lot of side effects particularly in older patients. As to Xanax he says he prescribes it rarely due to its addictive nature. I told him that I wanted to see how Anafranil will affect me, but he said no. I do not have any other way to get the medication as I am on limited income and have "bad" and "cheap" state insurance. There is one way: but I do not know if it is legal: my sister in Poland could talk to the doctor there adn maybe he would be willing to put me on anafranil for a trial period. Any way, I want to try the medicine. My psychiatrist says that hydroxizine and Klonopin should be sufficient in treatment of my panic attacks. They are not. As I told you previously Hydroxizine does not do any good to me. What do you think, Dr. XXXXXXX I should do?
default
Follow up: Dr. Ashok Kumar 0 minute later
Hello Doctor,
Unfortunately my psychiatrist is not willing to add anything to my treatment. He says that Anafranil is a complicated medication that has a lot of side effects particularly in older patients. As to Xanax he says he prescribes it rarely due to its addictive nature. I told him that I wanted to see how Anafranil will affect me, but he said no. I do not have any other way to get the medication as I am on limited income and have "bad" and "cheap" state insurance. There is one way: but I do not know if it is legal: my sister in Poland could talk to the doctor there adn maybe he would be willing to put me on anafranil for a trial period. Any way, I want to try the medicine. My psychiatrist says that hydroxizine and Klonopin should be sufficient in treatment of my panic attacks. They are not. As I told you previously Hydroxizine does not do any good to me. What do you think, Dr. XXXXXXX I should do?
doctor
Answered by Dr. Ashok Kumar 9 minutes later
Brief Answer:
Follow up

Detailed Answer:
Dear XXXXXXX
Thanks for follow up.

I am sorry to know that your psychiatrist decided against adding the medication as he fears side effect of clomipramine. However I must add that 52 years of age is not old age and most of my patients upto 60 years of age tolerate it without any problem.

Regarding xanax it is completely true that it is most addictive among available benzodiazepines but it does not need that this fails to help the needy patients. Even I avoid xanax as far possible but when required I do not see any harm. I mean to say that keep the discussion open and convince your psychiatrist that you have tried the klonopin to the higher dose (2mg per day) and allow a fair trial with xanax.

I am not convinced with idea of getting the medication illegally on pretext of one or another thing as this is prescription only medication and there are valid reasons for the same. In case it is used without prescription I feel there are higher risk in compare to benefits.

I hope this helps you further.
Thanks and regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
doctor
Answered by Dr. Ashok Kumar 0 minute later
Brief Answer:
Follow up

Detailed Answer:
Dear XXXXXXX
Thanks for follow up.

I am sorry to know that your psychiatrist decided against adding the medication as he fears side effect of clomipramine. However I must add that 52 years of age is not old age and most of my patients upto 60 years of age tolerate it without any problem.

Regarding xanax it is completely true that it is most addictive among available benzodiazepines but it does not need that this fails to help the needy patients. Even I avoid xanax as far possible but when required I do not see any harm. I mean to say that keep the discussion open and convince your psychiatrist that you have tried the klonopin to the higher dose (2mg per day) and allow a fair trial with xanax.

I am not convinced with idea of getting the medication illegally on pretext of one or another thing as this is prescription only medication and there are valid reasons for the same. In case it is used without prescription I feel there are higher risk in compare to benefits.

I hope this helps you further.
Thanks and regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
default
Follow up: Dr. Ashok Kumar 1 hour later
Hello Doctor:
I contacted my therapist with a request to provide me the name and address (email address) of the Clinic Manager who assigns patients to doctors. I will try to change the doctor and I will explain to the new one that I expect him to address an aggressive treatment which will consist on trying other medications, such as the one you recommended for my panic attacks. I will keep you posted. Thank you for your help.
default
Follow up: Dr. Ashok Kumar 0 minute later
Hello Doctor:
I contacted my therapist with a request to provide me the name and address (email address) of the Clinic Manager who assigns patients to doctors. I will try to change the doctor and I will explain to the new one that I expect him to address an aggressive treatment which will consist on trying other medications, such as the one you recommended for my panic attacks. I will keep you posted. Thank you for your help.
default
Follow up: Dr. Ashok Kumar 5 hours later
My therapist emailed me and told me that we would talk about my psychiatrist dusring a therapy session. I promise I will not give up. The psychiatrist seems to be evil spirited as I myself do not see any problem in prescribing me Anafranil. He simply does not want to do it for his personal reasons. I have filed today a complaint to the State Medical Board against him also. I have a feeling that Anafranil could really help me.
default
Follow up: Dr. Ashok Kumar 0 minute later
My therapist emailed me and told me that we would talk about my psychiatrist dusring a therapy session. I promise I will not give up. The psychiatrist seems to be evil spirited as I myself do not see any problem in prescribing me Anafranil. He simply does not want to do it for his personal reasons. I have filed today a complaint to the State Medical Board against him also. I have a feeling that Anafranil could really help me.
doctor
Answered by Dr. Ashok Kumar 6 hours later
Brief Answer:
Follow up

Detailed Answer:
Dear XXXXXXX
Thanks for follow up and updates.

Although this is personal issue but I do not feel the complaint can have any impact on the practicing psychiatrist. This is because prescribing one or another medication is privilege to a doctor and nobody can deny it.

However I hope that your new psychiatrist will be more understanding and empathetic in compare to current one and will try to help in all possible manner. There is no doubt about potency of clomipramine in the management of various anxiety disorders including OCD and panic attacks.

I hope this helps you.
Thanks again.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
doctor
Answered by Dr. Ashok Kumar 0 minute later
Brief Answer:
Follow up

Detailed Answer:
Dear XXXXXXX
Thanks for follow up and updates.

Although this is personal issue but I do not feel the complaint can have any impact on the practicing psychiatrist. This is because prescribing one or another medication is privilege to a doctor and nobody can deny it.

However I hope that your new psychiatrist will be more understanding and empathetic in compare to current one and will try to help in all possible manner. There is no doubt about potency of clomipramine in the management of various anxiety disorders including OCD and panic attacks.

I hope this helps you.
Thanks again.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
default
Follow up: Dr. Ashok Kumar 17 hours later
Hello Doctor,
Today at my therapist's I have learned that my psychiatrist mentioned things that he did not tell me: possibility of mania if I take Anafranil. I am not sure if he is mean adn really does not care about my mental health or is he uneducated and he blames me for discovering that he does not what to do. In the USA things like that happen often particularly in the domain of psychiatry. For my treatment of schizoaffective disrorder and sleep disturbance I recommended the medications to my former psychiatrist myself (I knew what these medicnes targeted), and he gladly accepted my suggestions and today I feel great if not for panic attacks. I think my current psychiatrist does not know what it means pacnick attack with depersonalization. It is also possible that he never encountered a case like mine. If this is true he should listen to my suggestions that I get from you. In the clinic I am a patient there are 5-6 psychiatrist. Mine seems to neglect the treatment power in axiety that Anafranil presents. Therapist told me that psychaitrist told him that the way of trsring anxiety the way I presented is an old school. I must be careful not to create too much hostilities in the clinic. I will keep my psychiatrist for now as I am not sure if i have suffiecient grounds to change a doctor. I have been panic free 7 days now. I will also see my family doctor soon. maybe he will have some knowledge to compare with yours.
default
Follow up: Dr. Ashok Kumar 0 minute later
Hello Doctor,
Today at my therapist's I have learned that my psychiatrist mentioned things that he did not tell me: possibility of mania if I take Anafranil. I am not sure if he is mean adn really does not care about my mental health or is he uneducated and he blames me for discovering that he does not what to do. In the USA things like that happen often particularly in the domain of psychiatry. For my treatment of schizoaffective disrorder and sleep disturbance I recommended the medications to my former psychiatrist myself (I knew what these medicnes targeted), and he gladly accepted my suggestions and today I feel great if not for panic attacks. I think my current psychiatrist does not know what it means pacnick attack with depersonalization. It is also possible that he never encountered a case like mine. If this is true he should listen to my suggestions that I get from you. In the clinic I am a patient there are 5-6 psychiatrist. Mine seems to neglect the treatment power in axiety that Anafranil presents. Therapist told me that psychaitrist told him that the way of trsring anxiety the way I presented is an old school. I must be careful not to create too much hostilities in the clinic. I will keep my psychiatrist for now as I am not sure if i have suffiecient grounds to change a doctor. I have been panic free 7 days now. I will also see my family doctor soon. maybe he will have some knowledge to compare with yours.
doctor
Answered by Dr. Ashok Kumar 16 hours later
Brief Answer:
Follow up

Detailed Answer:
Dear XXXXXXX
Thanks for following up and the updates.

I am sorry to know that there is a lack of proper communication between you and your psychiatrist leading to distrust and denial of much-required treatment. However, I am glad to know that he cares much for you as a possibility of mania is real with Anafranil and his fears are not groundless.

However, I feel Xanax should not be denied as benzodiazepines are already prescribed (clonazepam 2mg) and enough to cause much more addiction than low dose Xanax.

I must also acknowledge that Anafranil is older medication and he may be convinced that using older medications is old fashioned despite the fact that older medications are much helpful when newer generation antidepressant fail to show effects.

I hope this helps you.
Thanks again.


Above answer was peer-reviewed by : Dr. Arnab Banerjee
doctor
doctor
Answered by Dr. Ashok Kumar 0 minute later
Brief Answer:
Follow up

Detailed Answer:
Dear XXXXXXX
Thanks for following up and the updates.

I am sorry to know that there is a lack of proper communication between you and your psychiatrist leading to distrust and denial of much-required treatment. However, I am glad to know that he cares much for you as a possibility of mania is real with Anafranil and his fears are not groundless.

However, I feel Xanax should not be denied as benzodiazepines are already prescribed (clonazepam 2mg) and enough to cause much more addiction than low dose Xanax.

I must also acknowledge that Anafranil is older medication and he may be convinced that using older medications is old fashioned despite the fact that older medications are much helpful when newer generation antidepressant fail to show effects.

I hope this helps you.
Thanks again.


Above answer was peer-reviewed by : Dr. Arnab Banerjee
doctor
default
Follow up: Dr. Ashok Kumar 3 days later
Dear Doctor,
I have good news it has been 11 days since my last panic attack. I keep a good work, keep my mind busy, getting good restful sleep, and keeping distracted. I would like to get a part time job that would allow me to concentrate on something positive such as work. I need a light, physical work where I can engage my mind thoroughly with something, like washing a table, for ex. I completely agree with what you said about anafranil. I will keep your recommendation in mind, and in the meantime, I will contact the Clinic Manager to see if I could change the psychiatrist. Being in state insurance makes me very cautious, but I will ask. There is a very good psychiatrist from XXXXXXX Dr. XXXXXXX She is very very good. There are very many excellent doctors from XXXXXXX in the US. My first psychiatrist Dr Viral Goradia put me on the exact medications that I asked him to put me on, and he did not object. If it were not for panic attacks, I feel very well otherwise. The meds are well adjusted. I hope that one day I will be able to benefit from the medicines you recommend. Thank you, Doctor!
default
Follow up: Dr. Ashok Kumar 0 minute later
Dear Doctor,
I have good news it has been 11 days since my last panic attack. I keep a good work, keep my mind busy, getting good restful sleep, and keeping distracted. I would like to get a part time job that would allow me to concentrate on something positive such as work. I need a light, physical work where I can engage my mind thoroughly with something, like washing a table, for ex. I completely agree with what you said about anafranil. I will keep your recommendation in mind, and in the meantime, I will contact the Clinic Manager to see if I could change the psychiatrist. Being in state insurance makes me very cautious, but I will ask. There is a very good psychiatrist from XXXXXXX Dr. XXXXXXX She is very very good. There are very many excellent doctors from XXXXXXX in the US. My first psychiatrist Dr Viral Goradia put me on the exact medications that I asked him to put me on, and he did not object. If it were not for panic attacks, I feel very well otherwise. The meds are well adjusted. I hope that one day I will be able to benefit from the medicines you recommend. Thank you, Doctor!
doctor
Answered by Dr. Ashok Kumar 4 hours later
Brief Answer:
Follow up

Detailed Answer:
Dear XXXXXXX
Thanks for follow up and a feedback beyond my imagination.

I am glad to know thats since our first interaction the panic attacks are under control and every possible thing is done on your part.

I must acknowledge that getting oneself engaged in one or another thing is most important when dealing with anxiety disorders and hope that you will find some form of work suitable for you as well as more understanding psychiatrist.

In case any help is required on my part feel free to write back to me.
Wish you great health ahead.
Regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
doctor
Answered by Dr. Ashok Kumar 0 minute later
Brief Answer:
Follow up

Detailed Answer:
Dear XXXXXXX
Thanks for follow up and a feedback beyond my imagination.

I am glad to know thats since our first interaction the panic attacks are under control and every possible thing is done on your part.

I must acknowledge that getting oneself engaged in one or another thing is most important when dealing with anxiety disorders and hope that you will find some form of work suitable for you as well as more understanding psychiatrist.

In case any help is required on my part feel free to write back to me.
Wish you great health ahead.
Regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
premium_optimized

The User accepted the expert's answer

Share on