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Suggest Treatment For Generalized Anxiety Disorder

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Posted on Wed, 19 Aug 2015
Question: I am 28yr old male. I hv been having poor sleep,excess worry and GI disorders(diagnosed with generalized anxiety disorder). last yr i was given paroxetine 20mg for 6wks, then 10mg for close to 6mths and then discontinued. My sleep improved for a while only to become poor again. I had to continue paroxetine 20mg for up to 9months now. each time I try to reduce the dose and stop, I get insomnia. how long shd I remain on the medication and how do I get off it?
doctor
Answered by Dr. Shubham Mehta (45 minutes later)
Brief Answer:
GAD is a relapsing illness.

Detailed Answer:
Hello
Welcome to HCM.
I can understand your concerns.

Generalized anxiety disorder (GAD) has the tendency to relapse when medication is stopped.

The method of reducing the drug is to discontinue it gradually, which you did last time. But unfortunately, your symptoms recurred.

Here, I would like to know that when you stop this drug, do you have problem of insomnia only or all of your symptoms (worries, GI symptoms) recur?

If all the symptoms recur, you may have to take the drug for long, may be around 2 years or so.

If its just insomnia, you can take drugs like zolpidem (prescription drug) on SOS basis. This is a safe drug when taken on SOS basis for short-term.

Other then this, psychological treatments like biofeedback therapy, deep breathing and meditation also help to great extent.

Avoid anxiety provoking substances like smoking, alcohol, tea and coffee.

Kindly discuss this with your treating doctor.
Hope this helps.

Feel free to ask further, if you have more doubts.
Thanks.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Shubham Mehta (3 hours later)
thank you
what's the meaning of SOS.

The last time i was off the drug my GI symptoms didn't stop(still hasn't stopped) but insomnia and worries got better. only to relapse later

currrently am on the drug 20mg and have tried not to exceed 6months but when i reduce the dose gradually and stop it, i wont be able to sleep till i resume the drug.
doctor
Answered by Dr. Shubham Mehta (2 hours later)
Brief Answer:
continue with the minimum possible dose

Detailed Answer:
You are welcome

SOS means 'as and when needed'.

Sinc your symptoms relapse when you stop the drug, I would suggest you to continue with the drug.

The best way out is to reduce the dose to minimum possible. Like if you do good on 10mg, then you must continue with this dose for long.

Apart from this, I would request you to consider the psychological treatments which I mentioned earlier.

Both drugs and these psychological treatments will work together for you.

Hope this helps.

Feel free to ask further.
Take care.
Thanks.
Note: For further guidance on mental health, Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Shubham Mehta

Psychiatrist

Practicing since :2008

Answered : 2145 Questions

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Suggest Treatment For Generalized Anxiety Disorder

Brief Answer: GAD is a relapsing illness. Detailed Answer: Hello Welcome to HCM. I can understand your concerns. Generalized anxiety disorder (GAD) has the tendency to relapse when medication is stopped. The method of reducing the drug is to discontinue it gradually, which you did last time. But unfortunately, your symptoms recurred. Here, I would like to know that when you stop this drug, do you have problem of insomnia only or all of your symptoms (worries, GI symptoms) recur? If all the symptoms recur, you may have to take the drug for long, may be around 2 years or so. If its just insomnia, you can take drugs like zolpidem (prescription drug) on SOS basis. This is a safe drug when taken on SOS basis for short-term. Other then this, psychological treatments like biofeedback therapy, deep breathing and meditation also help to great extent. Avoid anxiety provoking substances like smoking, alcohol, tea and coffee. Kindly discuss this with your treating doctor. Hope this helps. Feel free to ask further, if you have more doubts. Thanks.