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Suggest Treatment For Alcohol Induced Anxiety While On Vyvanse And Zoloft
Question: Good afternoon,
I am a 28 year old male, 5'10 and weigh 330-340. I drink casually, some weeks more than others, and I am a daily smoker, smoking about 8-12 cigs a day. I am diagnosed with GAD and ADHD. I was taking Zoloft for a while, 50mg dose, and stopped taking it abruptly a bout 4 months ago. I also take 60 mg Vyvanse every day, though I had stopped that 4 months ago as well and just start back about a week ago. I had been out of work so it was not needed.
So back in 2009 or 2010 before I was diagnosed with GAD, I had this pressure in my head that would not go away. After a few days, I went to my family doctor and told him what was going on and in conclusion, he said it was anxiety and it will go away, and prescribed me Xanax. I stopped taking it after it subsided, as I was young, had no responsibilities and no extra stress to flair up my underlying anxiety.
Fast forward to about two weeks ago. The same pressure I had felt back then came back, though it was different. This one I felt was more towards both my temples, it feels as if I pulled my jaw muscle and it is causing the tightening sensation. It was constant at first, but for the past few days it has been coming and going, more of a throbbing as well. Also, it has been going back and forth between my temples, to the back of my head more towards the sides, and on top of my head. When I was showering today, when I let the hot water hit my head the pressure which was not there at the time came in a strong throbbing, tightening sensation and went away. There also is slight, dull pain at times as well.
About 5 days ago, I had drank excessively at my friends house on an empty stomach, about 6-8 shots of whiskey. The next morning I had the typical sluggish hangover feeling with the dizziness when I looked down. The next day though, it was still slightly there. When I look around I sort of feel dizzy and have vertigo. Sometimes I feel I have to work at walking a straight line as if I am drunk. The dizziness and vertigo have slightly subsided, but just 2 days ago i started noticing that it seemed i had regressed dexterity and precise coordination with my hands. For example, I spin pens at time when I am concentrating on something, and I can barely do it any more. I feel clumsy and my hands feel a bit weak. I dont have trouble gripping anything, but when I try to get a nice strong grip I feel it is a bit weaker and my arms will start shaking. I also have slight tremor that comes and goes, nothing that affects me holding anything though it is more of an annoyance than anything. Also, I feel coldness in my finger tips, more in my left hand and slight, slight, very slight numbing in my middle finger. I can still feel everything but I do notice a change.
I do not know if all of this is due to poor circulation, my anxiety or an underlying issue. I don't get as anxious without the medication like I used to as it helped me learn to deal with things, but all of this happening has caused to be a bit worse than usual; not like impending doom, but that typical, worrying anxiety.
Any input would be greatly appreciated and I apologize for the lengthy question.
Thank you!
I am a 28 year old male, 5'10 and weigh 330-340. I drink casually, some weeks more than others, and I am a daily smoker, smoking about 8-12 cigs a day. I am diagnosed with GAD and ADHD. I was taking Zoloft for a while, 50mg dose, and stopped taking it abruptly a bout 4 months ago. I also take 60 mg Vyvanse every day, though I had stopped that 4 months ago as well and just start back about a week ago. I had been out of work so it was not needed.
So back in 2009 or 2010 before I was diagnosed with GAD, I had this pressure in my head that would not go away. After a few days, I went to my family doctor and told him what was going on and in conclusion, he said it was anxiety and it will go away, and prescribed me Xanax. I stopped taking it after it subsided, as I was young, had no responsibilities and no extra stress to flair up my underlying anxiety.
Fast forward to about two weeks ago. The same pressure I had felt back then came back, though it was different. This one I felt was more towards both my temples, it feels as if I pulled my jaw muscle and it is causing the tightening sensation. It was constant at first, but for the past few days it has been coming and going, more of a throbbing as well. Also, it has been going back and forth between my temples, to the back of my head more towards the sides, and on top of my head. When I was showering today, when I let the hot water hit my head the pressure which was not there at the time came in a strong throbbing, tightening sensation and went away. There also is slight, dull pain at times as well.
About 5 days ago, I had drank excessively at my friends house on an empty stomach, about 6-8 shots of whiskey. The next morning I had the typical sluggish hangover feeling with the dizziness when I looked down. The next day though, it was still slightly there. When I look around I sort of feel dizzy and have vertigo. Sometimes I feel I have to work at walking a straight line as if I am drunk. The dizziness and vertigo have slightly subsided, but just 2 days ago i started noticing that it seemed i had regressed dexterity and precise coordination with my hands. For example, I spin pens at time when I am concentrating on something, and I can barely do it any more. I feel clumsy and my hands feel a bit weak. I dont have trouble gripping anything, but when I try to get a nice strong grip I feel it is a bit weaker and my arms will start shaking. I also have slight tremor that comes and goes, nothing that affects me holding anything though it is more of an annoyance than anything. Also, I feel coldness in my finger tips, more in my left hand and slight, slight, very slight numbing in my middle finger. I can still feel everything but I do notice a change.
I do not know if all of this is due to poor circulation, my anxiety or an underlying issue. I don't get as anxious without the medication like I used to as it helped me learn to deal with things, but all of this happening has caused to be a bit worse than usual; not like impending doom, but that typical, worrying anxiety.
Any input would be greatly appreciated and I apologize for the lengthy question.
Thank you!
Brief Answer:
Mostly due to anxiety disorder, related with alcohol intake.
Detailed Answer:
Hello Dear,
Thanks for writing to us.
I have gone through your history. Followings are my comments:
1) In my point of view, above clinical features are MOSTLY due to anxiety disorder in relation with excessive alcohol intake and cigarette smoking. These will worsen the condition abruptly.
2) Some basic investigations are needed to carry out like thyroid profile, blood sugar, EEG, MRI scan, liver function test, Doppler ultrasound of arm or forearm for circulation etc to pinpoint the diagnosis following clinical examination.
3) I suggest you to consult with your treating physician or Neurologist for above mentioned investigations and proper guidance of treatment. It will be more worthwhile.
4) You have to LIMIT smoking and alcohol to improve quality of life. Weight should be reduced or controlled through moderate exercise or XXXXXXX Avoid stress or anxiety by regular meditation or yoga in the morning. Take balanced diet and vitamin B12 supplements to improve your condition.
Hope, it helps for your information. Wish your good health and take care.
For future query, you can directly approach me through
http://doctor.healthcaremagic.com/Funnel?page=askDoctorDirectly&docId=63326
Regards,
Mostly due to anxiety disorder, related with alcohol intake.
Detailed Answer:
Hello Dear,
Thanks for writing to us.
I have gone through your history. Followings are my comments:
1) In my point of view, above clinical features are MOSTLY due to anxiety disorder in relation with excessive alcohol intake and cigarette smoking. These will worsen the condition abruptly.
2) Some basic investigations are needed to carry out like thyroid profile, blood sugar, EEG, MRI scan, liver function test, Doppler ultrasound of arm or forearm for circulation etc to pinpoint the diagnosis following clinical examination.
3) I suggest you to consult with your treating physician or Neurologist for above mentioned investigations and proper guidance of treatment. It will be more worthwhile.
4) You have to LIMIT smoking and alcohol to improve quality of life. Weight should be reduced or controlled through moderate exercise or XXXXXXX Avoid stress or anxiety by regular meditation or yoga in the morning. Take balanced diet and vitamin B12 supplements to improve your condition.
Hope, it helps for your information. Wish your good health and take care.
For future query, you can directly approach me through
http://doctor.healthcaremagic.com/Funnel?page=askDoctorDirectly&docId=63326
Regards,
Above answer was peer-reviewed by :
Dr. Arnab Banerjee
Hello
Thanks for your input. A few more questions I'd like to ask. A few days ago I tasted blood in my mouth and when I spit, it was slightly red. A day or two before that my gum had swollen a bit on my left side and was tender. There has not been any blood since then. Could it be due to a tooth infection, possibly on the upper row? I have no pain in my teeth. Could anxiety be causing all if these issues with alcohol and smoking making it worse? Like the loss of coordination, feeling as if my fingers stiffen up and don't feel as flexible. Starting yesterday I would sometimes get a pain in my left leg that would go away, happened about twice yesterday and once today. Does stopping my medication have anything to do with it? Just want your input on what it may be aside from me going to get it checked out, I do have an appointment set next week. I don't feel anxious I used to without my medication nor do I worry as much, just started a bit when these symptoms started happening.
Thanks for your input. A few more questions I'd like to ask. A few days ago I tasted blood in my mouth and when I spit, it was slightly red. A day or two before that my gum had swollen a bit on my left side and was tender. There has not been any blood since then. Could it be due to a tooth infection, possibly on the upper row? I have no pain in my teeth. Could anxiety be causing all if these issues with alcohol and smoking making it worse? Like the loss of coordination, feeling as if my fingers stiffen up and don't feel as flexible. Starting yesterday I would sometimes get a pain in my left leg that would go away, happened about twice yesterday and once today. Does stopping my medication have anything to do with it? Just want your input on what it may be aside from me going to get it checked out, I do have an appointment set next week. I don't feel anxious I used to without my medication nor do I worry as much, just started a bit when these symptoms started happening.
Brief Answer:
Mostly Gingivitis. Take Vitamin B complex capsule.
Detailed Answer:
Hello Dear,
Thanks for follow up query.
1) Above clinical features may be related with gingivitis. You should consult with dental hygienist / dentist. You may require one dental X-ray film. Plaque should be removed with periodontal scaling and curettage.
Oral hygiene should be maintained by proper brushing and flossing 2 to 3 times daily. Chlorhexidine mouth wash can be used. Use toothpaste, contains triclosan.
2) Anxiety disorder with vitamin deficiency (particularly B1, B6 and B12) are the main reason of this type of clinical presentation. Alcohol intake and regular smoking will worsen your condition. You have to QUIT or LIMIT both to improve quality of life.
3) I suggest you to consult with your treating physician for thorough clinical and neurological examination before prescribing any medication. You may need to proceed above investigations to confirm the diagnosis.
Until then, you should take adequate rest and Vitamin B complex or multivitamin capsule daily to improve your condition to some extent.
Hope, it helps for your information. Good luck and take care.
Regards,
Mostly Gingivitis. Take Vitamin B complex capsule.
Detailed Answer:
Hello Dear,
Thanks for follow up query.
1) Above clinical features may be related with gingivitis. You should consult with dental hygienist / dentist. You may require one dental X-ray film. Plaque should be removed with periodontal scaling and curettage.
Oral hygiene should be maintained by proper brushing and flossing 2 to 3 times daily. Chlorhexidine mouth wash can be used. Use toothpaste, contains triclosan.
2) Anxiety disorder with vitamin deficiency (particularly B1, B6 and B12) are the main reason of this type of clinical presentation. Alcohol intake and regular smoking will worsen your condition. You have to QUIT or LIMIT both to improve quality of life.
3) I suggest you to consult with your treating physician for thorough clinical and neurological examination before prescribing any medication. You may need to proceed above investigations to confirm the diagnosis.
Until then, you should take adequate rest and Vitamin B complex or multivitamin capsule daily to improve your condition to some extent.
Hope, it helps for your information. Good luck and take care.
Regards,
Above answer was peer-reviewed by :
Dr. Prasad
Answered by
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