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Suggest Treatment For Stress And Anxiety

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Posted on Mon, 9 Feb 2015
Question: I am a 46 year old male healthy. very good shape. recent positive tilt test for neurocardiogenic syncope. as a business owner lots of stress. also stress from negative health thoughts from PE last year. looks like trigger is excitement or such. question is looking to have my GP prescribe xanax till I can lower stress level. no meds for anything else. thoughts
doctor
Answered by Dr. Olsi Taka (32 minutes later)
Brief Answer:
Only for short periods of time.

Detailed Answer:
I read your question carefully and I understand your concern. It was a good idea to ask before asking your GP for medication.

Regarding your question, it depends. Xanax is effective to control anxiety. The problem with it as with all benzodiazepines class of drugs is that with time they develop dependance and tolerance (meaning same dose won't be effective and you'll need an always bigger dosage for the same effect) as well as other side effects.
For this reason I prescribe Xanax only for short periods of time, 2-4 weeks, usually when anxiety is a new occurrence, related to particular life stressors and it is hoped for these stressors to be removed or better coped with, so anxiety will subside during these 2-4 weeks.

If I predict the possibility there will be need for a longer term treatment then I choose an antidepressant which have a very good effect for anxiety as well, without developing tolerance. These days SSRI (like citalopram) or SNRI (like venlafaxine) class of drugs are preferred. The catch with these drugs is that usually anti-anxiety effect needs a few weeks to kick in, can even become worse during the first week. For that reason I usually accompany their use with Xanax for the first couple of weeks.

Another option is an azapirone group anxiolytic like Buspirone which doesn't carry the risk of dependance and withdrawal symptoms like benzodiazepines, but also needs a couple of weeks for its effects to be felt.

They are prescription drugs though so you have to discuss their use with your physician. Also it would be good to exclude other possible reasons like for example hyperthyroidism which is a common cause of anxiety.

Psychotherapy and relaxation techniques are also important management alternatives and much safer than drugs, so it would make sense to try them before you start any medication.

I remain at your disposal for further questions.
Note: Consult an experienced Otolaryngologist / ENT Specialist online for further follow up on ear, nose, and throat issues - Book a Call now.

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
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Answered by
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Dr. Olsi Taka

Neurologist

Practicing since :2004

Answered : 3673 Questions

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Suggest Treatment For Stress And Anxiety

Brief Answer: Only for short periods of time. Detailed Answer: I read your question carefully and I understand your concern. It was a good idea to ask before asking your GP for medication. Regarding your question, it depends. Xanax is effective to control anxiety. The problem with it as with all benzodiazepines class of drugs is that with time they develop dependance and tolerance (meaning same dose won't be effective and you'll need an always bigger dosage for the same effect) as well as other side effects. For this reason I prescribe Xanax only for short periods of time, 2-4 weeks, usually when anxiety is a new occurrence, related to particular life stressors and it is hoped for these stressors to be removed or better coped with, so anxiety will subside during these 2-4 weeks. If I predict the possibility there will be need for a longer term treatment then I choose an antidepressant which have a very good effect for anxiety as well, without developing tolerance. These days SSRI (like citalopram) or SNRI (like venlafaxine) class of drugs are preferred. The catch with these drugs is that usually anti-anxiety effect needs a few weeks to kick in, can even become worse during the first week. For that reason I usually accompany their use with Xanax for the first couple of weeks. Another option is an azapirone group anxiolytic like Buspirone which doesn't carry the risk of dependance and withdrawal symptoms like benzodiazepines, but also needs a couple of weeks for its effects to be felt. They are prescription drugs though so you have to discuss their use with your physician. Also it would be good to exclude other possible reasons like for example hyperthyroidism which is a common cause of anxiety. Psychotherapy and relaxation techniques are also important management alternatives and much safer than drugs, so it would make sense to try them before you start any medication. I remain at your disposal for further questions.