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Suggest treatment for anxiety and depression

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Posted on Thu, 17 Dec 2015
Question: I was diagnosed with anxiety/depression back in XXXXXXX of this year.I am a blessed man and I do not have any issues that I know of. my doctor has tried 3 different drugs.The first two wiped me out. one he put me on was 10 mg of paroxetine. this med did not help at all infact it was making me wacky feeling. I stoped taking it a week ago and now the only thing I am taking is alprazolam. I feel Anxiety a good chunk of the day now. and there is no reason for this. my doctor said to go see a therapist and I have. not helping. I am taking up to 1 1/2 alprazolam a day and one before bed. even with taking this stuff I feel like I am getting my butt kicked. I love to read... lost intrest. I guess I could go back to the doctor and we could keep trying different drugs till one sticks, I have NEVER taken drugs before. I miss that happy peaceful sprit that once lived in me. any suggestions would be much appreciated!
doctor
Answered by Dr. Chintan Solanki (1 hour later)
Brief Answer:
mirtazapine is an option

Detailed Answer:
Hello XXXX,

Thanks for writing to us.

Alparazolam is a benzodiazepine group drug. It is very potent and chances of tolerance and dependence are there if taken for more than 6 weeks and also when it is taken more than the prescribed dose. I recommend clonazepam instead for anxiety. You can ask your doctor for the same. Benzo is symptomatic treatment.

You are losing interest in reading and this suggests possibility of onset of depression In that specific drug for anxiety should be started. You have mentioned only paroxetine. Considering you are not able to tolerate SSRI I recommend starting mirtazapine. You can ask your doctor for the same.

If I were your treating doctor I would like to rule out thyroid and vitamin B12 deficiency. When these reports come normal I of course would like to start medicine which suits you.

Hope I have answered your query, I will be happy to help further.
Regards,
Dr.Chintan Solanki.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Chintan Solanki (13 hours later)
Thanks for getting back to me, my concern with theMirazapine is I finally have my cholesterol level to where it's supposed to be.my lab works have all been within the normal range The first med that I tried and didn't work was well Butran.do you have any other medication recommendations for treatment methods that you can think of? Thanks! XXXX
doctor
Answered by Dr. Chintan Solanki (5 hours later)
Brief Answer:
desvenlafaxine, escitalopram or vilazodone

Detailed Answer:
Hi,

You have tried mirtazapine, wellbutrin and paroxetine with xanax. In that case I recommend desvenlafaxine, escitalopram or vilazodone.

For more specific diagnosed I need some information.

- Which symptoms do you have right now?

- Until now what medicines have you tried and in which dose? What was the side effect with each medicine that made you stop the same?

- Do you have any physical problem?

Waiting for your response to help you further.



Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Chintan Solanki (22 hours later)
My physical health is very good. I am a runner so t run marathons. I started doing that this year. As far as the doses.
I was taking 10 mg 1 tablet a day. I was on it a month and it did not seem to help.
I found I was taking more alprazolam for anxiety.rhe other one I mentioned in my Pryor message was I believe 10 mg. and that made me crawl out do me skin. I now have anxiety most the day. I find myself taking more alprazolam witch I know can be addictive! I find I am loosing intrest in everything. I keep myself very bossy. But I am wearing down and feeling hopeless. The thing I do not understand is I have no issues to speak of. It's like it is just there. Went to my doctor and he did not seem very knowledgeable. I miss just being happy. Oh and I should say when I get home from work I drink a glass of wine or two. And I am not really a drinker! So at this point I am at a loss. The good news is I am a man of faith. And that helps. So I rambled on. Just reinforces to give you all the info I can!
Thanks, XXXX
doctor
Answered by Dr. Chintan Solanki (6 hours later)
Brief Answer:
consultation with psychiatrist will help

Detailed Answer:
Hi XXXX,

Thanks for more information.

It is good that you are physically fit. Your problem is anxiety, which was treated with xanax, and feeling unhappy which was not treated yet. In previous reply I mentioned medicines for depression which are with the least side effects.

Started drinking wine suggests that you need to calm down your mind with some medicine. Alcohol may help initially but later on it can be addictive and wrong cope up strategy to deal with anxiety. So do not take daily and more in amount.

To confirm diagnosis of depression detail history and mental status examination are required and these should be done by a psychiatrist. You can consult psychiatrist if you have not consulted yet and discuss the options I mentioned and start medicine any one of them.

All the best and take care.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Chintan Solanki

Psychiatrist

Practicing since :2007

Answered : 2406 Questions

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Suggest treatment for anxiety and depression

Brief Answer: mirtazapine is an option Detailed Answer: Hello XXXX, Thanks for writing to us. Alparazolam is a benzodiazepine group drug. It is very potent and chances of tolerance and dependence are there if taken for more than 6 weeks and also when it is taken more than the prescribed dose. I recommend clonazepam instead for anxiety. You can ask your doctor for the same. Benzo is symptomatic treatment. You are losing interest in reading and this suggests possibility of onset of depression In that specific drug for anxiety should be started. You have mentioned only paroxetine. Considering you are not able to tolerate SSRI I recommend starting mirtazapine. You can ask your doctor for the same. If I were your treating doctor I would like to rule out thyroid and vitamin B12 deficiency. When these reports come normal I of course would like to start medicine which suits you. Hope I have answered your query, I will be happy to help further. Regards, Dr.Chintan Solanki.