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Suffering from anxiety disorder and taking xanax. Having tightness in chest, flushing and tongue is rolling.

Dec 2014
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Practicing since : 2007
Answered : 4770 Questions
I DESPERATELY need advice. I have severe anxiety, GAD. I also get intense anxiety attacks with the standard feelings of worry, despair, hopelessness. I have been taking 2mg of Xanax to control my attacks for years as well as Prozac and Cymbalta for depression and to help prevent the anxiety levels from areaching the attack phase. About 10 days ago, I had to go to the dentist to have a tooth pulled. I was starting to have a panic attack bec I have had a very bad experience with the dentist the previous two times I went. So on the way I took 2mgs of my Xanax. Now, I hadn't eaten nor slept in several days due to the pain from my tooth and infection in the gums. Only a few minutes after the Xanax started to work, it hit me way harder than usual. Not only was my speech slurred, but I was dozing off and my wife had to fill out all my paperwork. Afterward, I do not remember getting the tooth pulled, the ride home, during which we stopped at Dairy Queen and I ordered something totally out of character for me. I also don't remember the rest of the day or night. However, according to my wife, I continued to take more of my Xanax, either bec I couldn't remember or refused to believe that I had already had my daily dose. So in around 13 hours I had 11 bars of Xanax or 22mgs. I even drove my grandfather to work at 3:40 a.m. Luckily I wasn't killed. Nothing like this has ever happened before. After I returned from taking him to work, my wife and I got into an argument that quickly turned into a severe physical altercation, or so I'm told and the physical marks on both us corroborate. The police were called and I spent the next 4 1/2 days in jail on domestic violence charges. My court date is set for the first part of December of this year, 2013. I'm going to discuss all the legal aspects of this with my lawyer. Since then I have allowed my wife to control and dole out all my daily controlled substance medication including my pain meds that I take for complications due to Lupus. I had vowed to never take any Xanax again, due to the fact that besides the fact that it does help my anxiety, i do like it a little more than is healthy. However, of course, my anxiety and panic attacks have not disappeared. I have tried over the past 8 years Klonopin, Ativan, Valium, buspar, etc. Some of them helped minutely to prevent an attack, but whenever an attack ultimately did occur, it manifests itself in terms of severe chest tightness, hyperventilation, flushing, tics, stuttering, and even the sensation of my tongue rolling in on itself. The only options for relief are the Xanax, or a trip to the ER. The problems with the first is that although I'm rarely home alone, it does happen and I'm even more prone to attacks when I have no one to help me talk it through. And I vowed to my wife not to take Xanax anymore in order to prevent the events that occurred that hurt both the love of my life and our relationship from happening again. The issue with the second option, a trip to the ER is that I am unable to drive, if I happen to be home alone. I can't afford to pay for Ambulance rides several times a month. And if my wife IS home, it is so impractical to go to the ER every time I have a panic attack, especially considering their answer is to give me a shot of Ativan and most likely a small script of the same and refer me to my PCP to follow up with basically the same treatment, a new script of Ativan. I need advice. The only thing that seems to really help me, hurt my relationship that day. But if I keep going like this, it's gonna hurt more than just my marriage, but my mental and emotional health. Plus my children have no clue of what has been transpiring behind the scenes, nor would either me or their mother want them to.
Posted Sat, 26 Oct 2013 in Mental Health
Answered by Dr. Seikhoo Bishnoi 1 hour later
Brief Answer:

Detailed Answer:
Thanks for asking from Health Care Magic

I have read your query and I can understand your problem. You are a 28 years old male with no significant medical history. You have severe Generalized Anxiety Disorder with episodic panic attacks. You have taken ativan, clonazepam, diazepam, buspiron as your drug therapy and none of them provided full relief. You are currently on Prozac (fluoxetine) and Cymbalta (duloxetine). Xanex provides proper control over panic attacks but the drug caused severe sedation and abnormal behavior which landed you into legal trouble and problems with your wife. You have two options either to take xanex or to visit ER.

Now coming to management-

You took 11 tablets of xanex on single day which caused the symptoms with severe sedation, you fail to remember the things along with disorientation. This resulted in accidental intake of drug.

If you are not in opinion to take the xanex again you can think of other drugs which provide better control for short periods of time and are not much sedating. Drugs like Etizolam are very useful. The drug is comparatively less sedating and dont cause much dependence. Please keep the box of medicine with your family members and take the drug dose only on precipitation of attack.

Other drug like Flupentixole and melitracen combination is very useful in panic attacks. The drug is not at all sedating and is very useful in panic attacks. Consult your psychiatrist for detailed consultation.

Continue to take Prozac and Cymbalta as per prescription as they will help in reducing the frequency of attacks.

Apart from medicines non-medicinal treatment like Behavior Therapy is very useful in panic attacks. Relaxation Exercises like Breathing Exercises, Progressive Muscle Relaxation Exercises, Yoga will help to boost your confidence and will control the panic symptoms. If properly practiced with help of a Psychologist the technique even help in avoiding medicine completely.

Hope this helps you, if you have more questions you can ask again.

Above answer was peer-reviewed by
Follow-up: Suffering from anxiety disorder and taking xanax. Having tightness in chest, flushing and tongue is rolling. 3 days later
Flupentixol/melitracen are both BANNED in the US as well as many other countries.
Answered by Dr. Seikhoo Bishnoi 9 minutes later
Brief Answer:
Hello again

Detailed Answer:

Yeah it has been banned in a number of countries but after subsequent trials the ban has been lifted from some countries. If it is banned in US then you can't have access to that drug. In such case other fixed dose combination like Alprazolam and Propranolol combination can be used in panic attacks. The combination is not much sedating and is safe.

Low dose benzodiazepine especially Etizolam can be used without worry as this is comparatively non-sedating.

Thanks, if you have more questions you can ask again.
Above answer was peer-reviewed by
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