Brief Answer:
Other anxiolytic medication

Detailed Answer:
Hi there.

Welcome to Healthcare Magic.

Thanks for the query.

According to the history you have provided you seem to be suffering from chronic arthritis of most of the joints of your body.

I can understand that you are going through a tough time because the anti-anxiety medication doesn't seem to be working as you are mostly stressed all the time and also have disturbed sleep.

Untreated Anxiety can also cause increased reaction to pain. Even though Venlafaxine had been used commonly to treated General Anxiety disorder, it is known to cause a possible life threatening disorder of the Serotonin syndrome. This can cause increased anxiety, hallucinations, irritability, racing pulse and breathing, fluctuating blood pressure, headaches etc. This Serotonin syndrome occurs with Venlafaxine alone and also when combined with Tramadol which can firm a deadly combination as this has increased risk for Serotonin syndrome.

I advise you to consult with your Doctor about this possible interaction and get the drugs changed. I would advise Escitalopram as quite a safer drug with less side effects compared to Venlafaxine.

The fault is not with Tramadol but with Venlalafaxine. Also you may require Valium or Diazepam which is very good to reduce anxiety and give your a sound night's sleep.

Tramadol usually does not cause any withdrawal symptoms though some dependence may exist.

I advise you to eat healthy. Keep well hydrated. Exercise daily. Avoid stress by performing Yoga, Pranayam and deep breathing exercises.

Avoid cross leg sitting, kneeling, squatting, climbing stairs as these can worsen arthritic conditions. Apply warm fomentation to the painful areas as these increase the blood supply and help in healing and providing relief. Avoid smoking, alcohol and much meat in the diet.

I hope I have answered your query.

I will be available for follow up queries.

Thanking you.

Regards,

Dr. Aashish Raghu

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Brief Answer:
Joint injections with steroid, PRP.

Detailed Answer:
Hi there.

Thanks for the follow up query.

Yes, You could consult your Doctor about introducing Chondroitin sulphate and Glucosamine tablets. They are helpful in regenerating damaged cartilage in an arthritic joint. Also if the arthritis is seen clinically and on Xray isn't severe, Joint injections of Hyaluronic acid, Steroid or Platelet rich plasma (PRP) can be efficacious.
Recent studies have shown that PRP can give relief upto 6 months as compared to steroid injection. Moreover PRP is available from the patient's own blood.

Arthritis is a progressive disorder. Unless you follow the precautions I listed earlier, no matter what medication you take it won't improve. Adequate rest to the joints are important for the joints to heal.

You can take muscle relaxants like Thicolchicoside which provide relief from the muscle spasm associated with an arthritic spine. Also Epidural steroids can help especially if mild nerve compression exists.

I hope I have answered your query.

I will be available for follow up queries.

Thanking you.

Regards,

Dr. Aashish Raghu

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Brief Answer:
Kindly make proper lifestyle adjustments as mentioned which is the mainstay

Detailed Answer:
Hi there.

I advise you to kindly follow the precautions that I have mentioned earlier and make good lifestyle changes as well which will be the mainstay in your road to you getting better.

Do follow up with me after consulting your Doctor.

Thanking you.

Regards,

Dr. Aashish Raghu

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