Brief Answer:
Cognitive Behaviour Therapy- CBT is a good alternative

Detailed Answer:
Hello Mr. XXXXXXX

Thanks for writing to us.

GAD- Generalized Anxiety Disorder is one of the common anxiety disorders.

Treatment of the same is divided in two parts. With drugs and without drugs.

Medicines:
SSRI group of drugs like escitalopram,fluoxetine,paroxetine, sertraline are mainstay of therapy.
Benzodiazepines like clonazepam,lorazepam,etizolam are given for short duration.
You are on Felizs 20 - escitalopram 20 mg.Hope you have some improvement with this.

Without Medicines/psychotherapy:
CBT- Cognitive behaviour therapy sometime cures the problem.In this automatic thoughts of worries regarding daily life are replaced actively by person with correct appropriate thoughts according to situation. Simultaneously relaxation techniques are also taught.

When problem is severe and affecting daily life medicines are must.

In my patients I used to start paroxetine with etizolam or clonazepam. After some improvement I apply CBT. As patient feels CBT is helpful I used to stop benzo drugs. I continue with SSRI and CBT. As CBT treats the basic cause of problem gradually, less chances of relapse after stopping the medicine completely.

Discuss above aspect with your treating doctor, change medicines if needed and start CBT.

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

Regards,
Dr.Chintan Solanki.

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Brief Answer:
it is anxiety only nothing else, you are good candidate for psychotherapy

Detailed Answer:
Hello Mr. XXXXX,

Thanks for follow up and information.

The symptoms you mentioned are symptom of anxiety disorder. I mentioned that in many patients if treatment is done with only medicines without psychotherapy, chances of relapse are high. Same is happening in your case probably.You have improvement with feliz but after stopping the same symptoms reappear.
Only possibility to rule out is drug discontinuation symptoms.Many patients on SSRI for long if stop drug suddenly they may have some symptoms. These are actually not symptoms of illness but due to stopping of the drug suddenly. SSRI should be tapered off gradually in such cases.Please discuss this issue with your treating doctor.
As you are aware that these are worries about worries and you should be relaxed with your family, you can undergo psychotherapy easily and have significant improvement.

I am sorry that I am in XXXXXXX otherwise I would also like to help you more. But yes in XXXXXXX lots of psychiatrists are there.Even in Armed Forces Medical College has also good department of psychiatry(I have referred one patient there).I am not knowing personally any one there otherwise I would surely recommended.

You can ask your doctor to refer you to someone who is good at psychotherapy specifically in CBT. Deep breathing exercise, meditation, yoga can also help if you do the same regularly.


Feel free to discuss further if an more doubt.

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