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Suggest Treatment For Severe Anxiety And Panic Disorder
Question: Hi Doctor , I'm a 22 year old male suffering from severe Anxiety and Panic Disorder .
when I was 20 I got diagnosed with benign PVCs ( irregular heartbeat 10 000 - 15 000 a day ) coming from my right ventricle , after going through all the heart tests possible the reason was never found withing the heart muscle, I then started getting panic attacks with my irregular heartbeat . I was reading and researching a lot about my condition online and in the end I got scared to death that my condition was going to kill me !
Doctors tried to convince me that I was going to be okay because my heart muscle was healthy but Of course I did not believe them and I did not trust them .
I had a cardiac ablation six months ago and the problems seems to be fixed for now but my Anxiety and Panic disorder is NOT . Yesterday I ended up in the ER again after having a chest pain , doctor though it was pectoral muscle trigger points responsible for the pain . I have been to the ER for 38 times in the past six months after the ablation and it always turns out to be Anxiety !?!? Bloods , chest x rays , ECGs always show up normal and this causes me more anxiety because My problem never gets diagnosed , the Doc says it's all in your head .! I have all kinds of symptoms , dizziness , headaches , hot flushes , muscle pains , chest tightness , irritated mood , and isolated PVCs and my cardiologist says that anxiety can cause them .
Last night when I got dischared from the hospital i wanted to kill myself and end this suffering , it seems like there is no hope , I have tried meditation , Yoga herbal teas for anxiety and some meds , Oxazepam , Diazepam but they only help for couple of hours ... I have spoke with a CBT therapist a few times but i dont think he helped my anxiety in any way . The problem is that i don't believe that it is all my anxiety , physical symptoms i get are so real I don't see how my anxiety can cause them .
I want to take some meds from Today because I feel like this can not go on anymore , My GP can prescribe Brnzos and Anti Depressants but I wanted to ask a specialist in this field , what are some of the most safest anti anxiety and anti depressants meds for the heart ? When I read the side effects I get scared cuz it can cause chest pains and irregular heartbeats and i really DONT need that to happen to me , so Can you Please help me out to get started with the meds that has less cardiac side effects ? Thanks .
when I was 20 I got diagnosed with benign PVCs ( irregular heartbeat 10 000 - 15 000 a day ) coming from my right ventricle , after going through all the heart tests possible the reason was never found withing the heart muscle, I then started getting panic attacks with my irregular heartbeat . I was reading and researching a lot about my condition online and in the end I got scared to death that my condition was going to kill me !
Doctors tried to convince me that I was going to be okay because my heart muscle was healthy but Of course I did not believe them and I did not trust them .
I had a cardiac ablation six months ago and the problems seems to be fixed for now but my Anxiety and Panic disorder is NOT . Yesterday I ended up in the ER again after having a chest pain , doctor though it was pectoral muscle trigger points responsible for the pain . I have been to the ER for 38 times in the past six months after the ablation and it always turns out to be Anxiety !?!? Bloods , chest x rays , ECGs always show up normal and this causes me more anxiety because My problem never gets diagnosed , the Doc says it's all in your head .! I have all kinds of symptoms , dizziness , headaches , hot flushes , muscle pains , chest tightness , irritated mood , and isolated PVCs and my cardiologist says that anxiety can cause them .
Last night when I got dischared from the hospital i wanted to kill myself and end this suffering , it seems like there is no hope , I have tried meditation , Yoga herbal teas for anxiety and some meds , Oxazepam , Diazepam but they only help for couple of hours ... I have spoke with a CBT therapist a few times but i dont think he helped my anxiety in any way . The problem is that i don't believe that it is all my anxiety , physical symptoms i get are so real I don't see how my anxiety can cause them .
I want to take some meds from Today because I feel like this can not go on anymore , My GP can prescribe Brnzos and Anti Depressants but I wanted to ask a specialist in this field , what are some of the most safest anti anxiety and anti depressants meds for the heart ? When I read the side effects I get scared cuz it can cause chest pains and irregular heartbeats and i really DONT need that to happen to me , so Can you Please help me out to get started with the meds that has less cardiac side effects ? Thanks .
Brief Answer:
sertraline.
Detailed Answer:
Hello
Welcome to HCM.
I can understand your concerns.
I have your details. I hope you are keeping a regular follow-up (as advised) with your cardiologists for your PVCs.
Your main query now is about the most cardiac safe anti-anxiety and anti-depressant drugs.
Your anxiety and panic seem to be severe as you have visited ER very frequently (38 times in 6 months..thats very frequent).
I can understand your desperation that you wanted to kill yourself.
Please DO NOT consider taking such extreme steps.
Anxiety and panic are like a vicious cycle. They more you think about getting rid of anxiety, the more anxious you get.
So, my first suggestion to you is to TRUST your doctors.
Its a good habit to search about your illness on net and get knowledge about it.
But, the information given on net is far different from what we practically see in our OPDs.
Now coming to your question, the anti-depressant and anti-anxiety agent which is considered to be most cardio-safe is SERTRALINE (prescription drug).
As nothing can be 100%, I would suggest you to keep a regular follow-up with your cardiologist while taking the drug so that your cardiac status remains under observation.
Also, the drug should be started with minimum dose (25 mg is the starting dose for sertraline) and gradual dose increment should be done.
The benzos (prescription drug) are usually cardio-safe. But, I suggest you to take them on SOS basis (I prefer clonazepam in my patients with cardiac disease).
I hope you find my suggestions to be of some help.
Feel free to discuss further.
I wish you good health.
Thanks.
Dr. Shubham Mehta, MD (Psychiatry).
sertraline.
Detailed Answer:
Hello
Welcome to HCM.
I can understand your concerns.
I have your details. I hope you are keeping a regular follow-up (as advised) with your cardiologists for your PVCs.
Your main query now is about the most cardiac safe anti-anxiety and anti-depressant drugs.
Your anxiety and panic seem to be severe as you have visited ER very frequently (38 times in 6 months..thats very frequent).
I can understand your desperation that you wanted to kill yourself.
Please DO NOT consider taking such extreme steps.
Anxiety and panic are like a vicious cycle. They more you think about getting rid of anxiety, the more anxious you get.
So, my first suggestion to you is to TRUST your doctors.
Its a good habit to search about your illness on net and get knowledge about it.
But, the information given on net is far different from what we practically see in our OPDs.
Now coming to your question, the anti-depressant and anti-anxiety agent which is considered to be most cardio-safe is SERTRALINE (prescription drug).
As nothing can be 100%, I would suggest you to keep a regular follow-up with your cardiologist while taking the drug so that your cardiac status remains under observation.
Also, the drug should be started with minimum dose (25 mg is the starting dose for sertraline) and gradual dose increment should be done.
The benzos (prescription drug) are usually cardio-safe. But, I suggest you to take them on SOS basis (I prefer clonazepam in my patients with cardiac disease).
I hope you find my suggestions to be of some help.
Feel free to discuss further.
I wish you good health.
Thanks.
Dr. Shubham Mehta, MD (Psychiatry).
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you so much Doctor !
I have Lexapro 5mg at home , is sertraline a better option for me than Lexapro or Cipralex ? Thank You
I have Lexapro 5mg at home , is sertraline a better option for me than Lexapro or Cipralex ? Thank You
Brief Answer:
sertraline is better.
Detailed Answer:
Your welcome.
In my opinion, sertraline is a better choice for you then lexapro or cipralex.
Sertraline has been more extensively studied and reviewed about its safety in cardiac cases.
Hope this helps.
Take care.
Thanks.
sertraline is better.
Detailed Answer:
Your welcome.
In my opinion, sertraline is a better choice for you then lexapro or cipralex.
Sertraline has been more extensively studied and reviewed about its safety in cardiac cases.
Hope this helps.
Take care.
Thanks.
Note: For further guidance on mental health, Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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