Get your health question answered instantly from our pool of 18000+ doctors from over 80 specialties

134 Doctors Online
Doctor Image
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

I will be looking into your question and guiding you through the process. Please write your question below.

Suggest treatment for social anxiety and agoraphobia

Answered by
Dr.
Dr. Ashok Kumar

Psychiatrist

Practicing since :2000

Answered : 2719 Questions

default
Posted on Thu, 23 Mar 2017 in Brain and Spine
Question: I have been suffering from agoraphobia and social phobia for many years since I was 20. I've had some psychotherapy sessions, they helped to some extent, but I have never been free from symptoms.Now I am 58, have type 2 diabetes and been in a menopause period now, so it has become worse. I saw a neurologist and he prescribed me citalopram, although I had never taken any medicine, only once when I was young, I took one amitriptyline and had a severe panic attack. Since that time I have always had a fear of taking any medicine for my condition. Now I decided to try it. I am always waiting for worsening of the symptoms as it is said in the instruction, feel sleepy, have difficulty to concentrate, been very slow and feel pressure in my eyes, have blurred vision, sometimes feel agitation. Well, I ┬┤ve always had these symptoms but in a different way, something has changed. And I've been taking citalopram only for 6 days, keep hesitating to continue it or not... When I go out I need to drink some wine otherwise, it is difficult for me to socialise with other people. I work as a teacher for adult people and it's so hard to work when you have these panic attacks when everybody is watching you. I try not to show that but it's like a nightmare. I really don't know if to continue, as yesterday I had a terrible panic attack, but the sensations on citalopram were different from the usual ones...
doctor
Answered by Dr. Ashok Kumar 2 hours later
Brief Answer:
I think you should continue

Detailed Answer:
Hello,
Thanks for using Healthcaremagic.

I read your query and understand your concerns.

Considering your suffering over the last four decades and nature of job I feel there is definite need to continue treatment. I understand you had panic attack but it does not mean it was due to medication. I have observed people with extremes fears and noticed that they have tendency of more side effects in initial two weeks before medications starts doing some work.

The extreme worries associated with medication intake probably driving you away from medicine but it does not mean they are harmful.f you compare risk and benefit analysis you will find that benefits clearly outweigh the risks with their use.

I hope this helps you.
If you have more questions I will be glad to assist you further.
If you do not have more questions, please close the discussion and if possible rate the answer for my future patients.

In future if you wish to contact me directly, you can use the below mentioned link:
http://doctor.healthcaremagic.com/doctors/dr-ashok-kumar/67386
Thanks and regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
default
Follow up: Dr. Ashok Kumar 2 days later
Dear Dr. XXXXXXX

Thank you very much for your reply! Well, I'll try to go through these side effects and see what happens in a couple of weeks, probably it will help me and I could lead a normal life and have no problems teaching.
Will it be necessary to increase the dose of the medication? I take Metformin and simvastatin for diabetes, how can it interact with citalopram? Can I drink some wine on this medication?

Thank you in advance and have a nice day!

doctor
Answered by Dr. Ashok Kumar 4 hours later
Brief Answer:
Follow up

Detailed Answer:
Hello,
Thanks for follow up.

First of all regarding dose increase it may be needed if the current dose fails to give desired results. I am not sure what dose your psychiatrist prescribed for you but most of my patients need citalopram in dose range of 20-40 mgh per day.


There are no significant interactions with simvastatin and metformin with citalopram. It is one of the safe medications when it comes to drug drug interactions.

I will recommend not more than two standard drinks while you are on medication.

I hope this helps you further.
If you have more questions I will be glad to assist you further.
If you do not have more questions, please close the discussion and if possible rate the answer for my future patients.

In future if you wish to contact me directly, you can use the below mentioned link:
http://doctor.healthcaremagic.com/doctors/dr-ashok-kumar/67386
Thanks and regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
default
Follow up: Dr. Ashok Kumar 17 hours later
Thank you for your answer! And the last question I wanted to ask you: I am on the lowest dose now 10 mg. As you advised, it may be necessary to increase the dose with time, but will it be necessary to take the medication always, I mean, during my whole life, or it will be possible to quit it in some time? Does it make you dependant on it?

Thank you!

Have a nice day!
doctor
Answered by Dr. Ashok Kumar 2 hours later
Brief Answer:
follow up

Detailed Answer:
Hello,
Thanks for follow up.

It neither makes you dependent nor addict.

At the same time it is not necessary to use the medicine for life long.

I hope this clarifies.
Thanks and regards.
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
premium_optimized

The User accepted the expert's answer

Share on
Question is related to
Diseases and Conditions ,   ,  
Drug/Medication ,   ,  
Treatment/Therapy

Recent questions on  Social phobia

doctor1 MD

My 13 years daughter was vaccinated with Gardasil 3 times : 26/9/2012 28/11/2012 30/04/2013 After 3 weeks of this Gardasil, she started complaining of heavy headache and stomach pains. She has now developed depressions,anxieties, tiredness,restless, luck of appetite , irregular menstruation She has developed ADHD, sort of Autism, mental retardation, social visual impairments, social phobia, She suffers in noisy surroundings with a lot of people. She is now isolated herself from her friends and brothers. She lucks sustained attention and impulses and learning at school. Dr. Edward KIizza 36 Gillette Street, Preston, Lancashire, PR1 5HX , UK........ Please what are the side effects of Gardasil and what are the treatments?

doctor1 MD

HI I am experiencing cramps in my calves. It just started about a week ago and getting worse. I have been doing stretches and doesn't seem to work. My doctor switched me from lexapro to zoloft , could the zoloft be doing this or is this a vitamin...

doctor1 MD

Dear doctor presently I am using venlift od 150 mg ( 2 capsules ) to overcome depression . It is not unknown. It is the problems which I am facing int he life. Secondly I am facing the problem of Generalised Anxiety Disorder for which I am taking...

doctor1 MD

HOMEOPATHIC TREATMENT Dear Homeopathic Doctor, I am male aged 45 years vegetarian. Height 175 cm, weight 78 kg doing Government job. Since childhood, I have been suffering from Depression along with problem of unknown fear. I don't know what type...

doctor1 MD

Hello! I have a big troubles. Everything started 10 years ago, when I was diagnosed with cancer, but lucky or unlucky, it was just a hernia. A year later, I started having problems like waking up in the middle of the night, cant breathe etc. Just an easy problems. After time, the things went wrong. I was affraid to go to a doctor, because I don't want to hear, that I am sick of Cancer. That is still the good part. Few Years later, I started having more serious problems. Currently, almost everyday at anytime I am in a different moods. Once I am happy, everything is fine, next minute I am depressed, and nothing is valuable to me. It happens after I lost one girlfriend though. But the problems are:
1. Cant focus on almost nothing
2. Brain Fatigue
3. Sleeping more then 8 hours and wake up tired.
4. Always thinking of something in the past, cant concentrate
on the present.
5. Social Phobia - recently I found , that I am having it
6. Hard time to organize my day. When I sleep less, like 4 hours
I am feeling more organized and easy going. But on the next day,
I need to sleep more , like 10 hours and when I wake up, I am confused, stressed, tired, and the day is just passing by me.
7. Sometimes, I am feeling, like I am out of my body and my life is just passing near myself.
8. Avoiding reading documents and doing work, where brain is involved more then normal. That 's a big problem, because the
quality of my life is getting worse and worse. Currently, I am 30 years old, finished my law school, but don't want to tell you how
hard I took my exams, because, when I read something, I do forget it very fast
9. It is hard for me to remember many things from my day. Everyday, I am not having many memories. For Example,
not sure what I ate, not sure what movie I watched, not sure with whom and when I have a meeting. Cant organize myself, and the biggest problem ever is, that when I have all those symphoms,
I start stearing in the mirrow and I see, that somehow, my eye
is changed. The way my eyes looks is a bit scary even for me. When I dont feel this pressure in my eye, they seems well, but often they skin where my eyelash is located is purple to red colour. this is only on one of my eye.
10. Tired during the day. Need a sleep often in the early afternoon for at least 30 mins.
11. Cant focus on many things, even if I want to.
I would like to ask you, please, give me a clue, because when I go to doctor, everyone says, that I am ok, and this is just a depression. It is not, I am sure. I read forums, about Bipoliar Disorder, Concentration Disorder, and almost every desiase, I have the sympthoms. I need to know, what I am seek of, so I can take the propper treatment and have at least more normal life.
Thank you very much , and hope to read from you!!!

doctor1 MD

I have had bad symptoms of indigestion reflux and constipation ever since I quit smoking weed. I also suffer from borderline personality disorder, psychosis and social phobia. Abilify seems to help a little bit with regulating my moods and psychosis but it makes my digestive problems worse. Will smoking weed help with my digestive problems, it seemed to help with mood regulation and weight loss in the past but I am worried about the marijuana aggrivating my psychosis.

doctor1 MD

i am suffering from social phobia and i told my this problem to psychologist and he suggest me to take medicines. 1 at day time and 2nd at both day and night. so do u think it is wise to take it as i have mental problem and he is suggesting me medicine at body level ? or it is lack of my knowledge ?