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Suggest remedies for persistent anxiety post a stroke

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Posted on Tue, 26 Jul 2016
Question: I had a stroke in XXXXXXX 2016 and 3 months post had develop anxiety . I saw my psychiatrist and he started me on pristiq in gradual doses up to 150 mg and valdaxone 50 mg Nolte - I start pristiq at 50 mg 29/4 and graduated to 150mg 20/ 5/ 16 and started valdaxone 50 mg 6 XXXXXXX . Since commencing , I have experience minimal change in mood and nausea, no appetite and have lost 5 kgs. I saw my psych today and after robust discussions have decided that I have given pristiq a fair go and we have decided to wean both and see what happens after a week. My anxiety is still a problem and I am taking clonazapan 3 mg daily . I am disappointed and frustrated and not sure where to from here ? WhAt are your thoughts ?
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Answered by Dr. Ashok Kumar (5 hours later)
Brief Answer:
I think SSRI medication better choice for you

Detailed Answer:
Dear XXXXXXX
Thanks for using Healthcaremagic.

I read your query and understand your concerns.

From the available description I think SSRI group of medication should be tried in your case rather than Pristq (SNRI). This is based on the fact that post stroke depression and anxiety respond best to SSRI group of medications. Among the SSRI escitalopram (lexapro) and sertraline (zoloft) have best evidence.

I request you to discuss these two molecules with your psychiatrist. I understand there may be risk of stroke so they should be used along with proton pump inhibitor and never alone.

Hope I am able to answer your concerns.
If you have any further query, I would be glad to help you.
If not, you may close the discussion and if possible you may rate the answer for my future patients.
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
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Answered by
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Dr. Ashok Kumar

Psychiatrist

Practicing since :2000

Answered : 3337 Questions

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Suggest remedies for persistent anxiety post a stroke

Brief Answer: I think SSRI medication better choice for you Detailed Answer: Dear XXXXXXX Thanks for using Healthcaremagic. I read your query and understand your concerns. From the available description I think SSRI group of medication should be tried in your case rather than Pristq (SNRI). This is based on the fact that post stroke depression and anxiety respond best to SSRI group of medications. Among the SSRI escitalopram (lexapro) and sertraline (zoloft) have best evidence. I request you to discuss these two molecules with your psychiatrist. I understand there may be risk of stroke so they should be used along with proton pump inhibitor and never alone. Hope I am able to answer your concerns. If you have any further query, I would be glad to help you. If not, you may close the discussion and if possible you may rate the answer for my future patients. 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.