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Suggest Treatment For Anxiety

Posted on Mon, 11 May 2015

Question: I have a hard time with attention span and focusing, and anxiety. I'm going to psychotherapy and a depression support group but it doesn't seem to help. I don't know if I should try someone else or not. I've tried Clonazapem (Clonapin) for anxiety, which helps, but haven't used it for awhile. Remeron doesn't make my heart rate go up like other anti-depressants but it makes me real drowsy for two days.

Answered by Dr. Chintan Solanki (1 hour later)

Brief Answer:
What antidepressants have you used until now ?

Detailed Answer:
Hello,

Thanks for writing to us.

Rameron may cause sedation in many patients. Heart rate may go up with anxiety itself.

For your problem I am suggesting following approach.

-If you have taken medicines form GP , consult psychiatrist for better diagnosis and treatment.

- Continue psychotherapy. However it is not completely effective at present so there is need of proper medicines.

- Clonazepam is very good anti anxiety drug. It should be given in low dose under medical supervision to prevent sedation and dependance. It can be restarted.

- A group of medicines called SSRI are used in anxiety as well as in depression. Particularly paroxetine will be helpful when anxiety component is more. If you have tried any other drug than remeron, please let me know the details.

-If you have any other physical problem please let me know the same with details of the medicines for the same.

- Regular scheduled sleep,meals and exercise are important aspect to prevent and improve such anxiety issues.

- Meditation and yoga may help your problem. You can learn the same from professional or with help of internet.

Provide some more information:

-since when problem is there?

- Is there any stress(social,occupational, relationship or economical) in your life?

Hope I have answered your query, I will be happy to help further after your further response.

Regards,
Dr.Chintan Solanki.

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Chintan Solanki (8 hours later)

Thank you for the information, doctor. With the Clonazepam, I normally use 1/2 pill because of drowsiness. A full pill really helps but I feel a little drowsy within 30 minutes. After about five hours, I have to lie down and sleep some. As far as antidepressants, I've also tried Paxil, Zoloft, Effenol, Celexa, and Prozac. However, I got a fast heart rate from them then discontinued them. I used them in 2002. I cut out caffeine around 2002 - 2003. There may be some other antidepressants to use now that may be better for me to try. With prescription Ibuprofen, I get a fast heart rate and drowsiness. I use DayQuil at night since I get drowsy from it and NyQuil during the day since it keeps me awake, which is backwards. Codeine keeps me awake at night then I'm drowsy the next day. Remeron is a good pain killer for my right hand pain but I slept off and on for five hours. Hopefully, I can find something helpful that I can tolerate.

Answered by Dr. Chintan Solanki (9 hours later)

Brief Answer:
pregabalin or duloxetine or bupropion is the option

Detailed Answer:
Hello,

Thanks for information.

In your depression with somatic pain duloxetine will help in great manner. It is like remeron but without sedation.
If pain component is more pregabalin can help. It helps in anxiety also. But it may cause sedation.
And depression component is more bupropion is also good alternative.

Please discuss above options with treating doctor and you will probably get a solution.

Take care.

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

Follow up: Dr. Chintan Solanki (4 hours later)

Thank you, doctor, for your explanation. This will be my finally reply. I made a mistake on my last reply. I mentioned that Remeron was a good pain killer but it made me drowsy. I got mixed up. I meant that Naproxen was a great pain killer for my right hand but I slept most of the time over a five-hour period. The Remeron was a good anti-depressant but made me real drowsy. I've got a new doctor now since my other one had to leave and I can discuss this some more with him. Thank you for your time and patience. So long.

Answered by Dr. Chintan Solanki (6 hours later)

Brief Answer:
treatment depends on type of pain

Detailed Answer:
Hi ,

Thanks for clarification.

Naproxyn is a pain killer like ibuprofen. Niether of them should be taken daily for long until required in excessive pain. They can cause damage to kidney.

Treatment depends on type of pain. If pain is neuropathic pregabalin is helpful while in somatic pain duloxetine will work. If pain is totally related to muscles or bones, intervention by orthopedic doctor is required.

Hope with new doctor you will get good slolution soon.

All the best & take care.

Note: For further guidance on mental health, Click here.

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