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Suggest treatment for stress, anxiety and depression

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Posted on Wed, 20 May 2015
Question: Problems with stress & Anxiety
I need to find a Doctor that will prescribe ClonazePam for anxiety.
doctor
Answered by Dr. Ravi Soni (55 minutes later)
Brief Answer:
Benzodiazepine works for short duration

Detailed Answer:
Hi, thanks for writing through HCM.

I have read your query and understood that you are suffering from anxiety and depressive symptoms, to which you call as stress.

Benzodiazepines are not the treatment for long term management of anxiety, they give immediate benefit only and are not recommended for long term use. At your age, it can cause serious side effects. I feel that you need antidepressant drug which can manage the anxiety in long run without a need for benzodiazepine.

If you were my patient then I would have given you Lexapro 5 mg initially along with one benzodiazepine. After 15 days I would have increased lexapro to 10 mg and would have reduced the dose of benzodiazepine.

There are many psychiatrist available near kansas city. You can search a psychiatrist near your city on healthgrades.com. Follow the link for the healthgrades.com:
http://www.healthgrades.com/psychiatry-directory/mo-missouri/kansas-city

Benzodiazepines cause tolerance and dependence in long run. Since you are taking it for more than 10 years, you might have became dependent on it, that is why the doctor is not prescribing you the benzos. Ask the doctors for detoxification from benzos and treatment of anxiety. Avoid alcohol and other recreational drugs.

Hope I have answered your query. If you have any further query then I shall be happy to help.
Wish you good health.
Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
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Follow up: Dr. Ravi Soni (54 minutes later)
Dr. XXXXXXX XXXXXXX Thank you for answering my question. If your a Psychiatrist,& that's what you would do, why should I expect anything different from another Psychiatrist? At sixty-five years of age, I'm not concerned about the addictive properties of this type drug. My concern is being comfortable and capable of enjoying my children, & seven grandchildren for the rest of my life. I've concurred a liver disease, I don't drink, use recreational drugs, & have tried various anti-depressants for six months and still had continued panic attacks. Would these generalized practices still apply?
doctor
Answered by Dr. Ravi Soni (13 hours later)
Brief Answer:
You have not mentioned about antidepressants

Detailed Answer:
Hi, thanks for writing again.

You take benzodiazepines because you have panic attacks. At your age, doctor is also worried about your cognition and locomotion. Benzodiazepine drugs interfere with cognition and cause amnesia. They also cause sedation and confusion which can lead to urinary difficulties with increased chances of falls.

When I prescribe benzodiazepine to elderly patient, I take extra precaution because it can cause many complication. You might not have these side effects because you are taking it for long time, but in long run it can still cause you memory problems.

In my patient sometimes I do use benzodiazepines for long time but with regular follow ups. I give them antidepressant drugs which increases the level of serotonin, deficiency of which is the main culprit behind panic attacks. By taking SSRI drugs the level of serotonin will be increased and anxiety will improve, but the usual time period for significant improvement in panic attacks is 6 to 10 weeks. So, I usually give benzodiazepine initially with SSRI drug, when SSRI will start showing it's effects, the benzodiazepine will be withdrawn gradually. Stopping the SSRI drug within 15 to 20 days will not give any benefit. They need to be continued for at least 6 to 10 weeks before evaluating their efficacy.

The doctor is not prescribing the benzodiazepine because they feel that you might be addicted to it and they don't want any legal problems. When you shall explain the problems in detail, they may help. If you ask for benzodiazepine then they won't prescribe the drugs. They are doctors, they do what they feel right. They do not prescribe drugs, what patient asks. So you need to explain in detail to the psychiatrist so that he can come to a decision and do the needful.

Hope I have answered your query. If you do not have further query then close the discussion and rate the answer.
Wish you good health.
Above answer was peer-reviewed by : Dr. Pradeep Vitta
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Answered by
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Dr. Ravi Soni

Psychiatrist

Practicing since :2010

Answered : 538 Questions

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Suggest treatment for stress, anxiety and depression

Brief Answer: Benzodiazepine works for short duration Detailed Answer: Hi, thanks for writing through HCM. I have read your query and understood that you are suffering from anxiety and depressive symptoms, to which you call as stress. Benzodiazepines are not the treatment for long term management of anxiety, they give immediate benefit only and are not recommended for long term use. At your age, it can cause serious side effects. I feel that you need antidepressant drug which can manage the anxiety in long run without a need for benzodiazepine. If you were my patient then I would have given you Lexapro 5 mg initially along with one benzodiazepine. After 15 days I would have increased lexapro to 10 mg and would have reduced the dose of benzodiazepine. There are many psychiatrist available near kansas city. You can search a psychiatrist near your city on healthgrades.com. Follow the link for the healthgrades.com: http://www.healthgrades.com/psychiatry-directory/mo-missouri/kansas-city Benzodiazepines cause tolerance and dependence in long run. Since you are taking it for more than 10 years, you might have became dependent on it, that is why the doctor is not prescribing you the benzos. Ask the doctors for detoxification from benzos and treatment of anxiety. Avoid alcohol and other recreational drugs. Hope I have answered your query. If you have any further query then I shall be happy to help. Wish you good health.