Brief Answer: Diagnosis needs clarification... Detailed Answer: Hello and welcome to Healthcare Magic. Thanks for your query. I understand that you must be going through a difficult time due to your problems. From the brief description of your problems it appears that you are suffering from an anxiety with panic attacks and possibly agarophobia (fear / anxiety of going to public places or crowded places). Regarding the medication that you are on, Klonopin (Clonazepam) is an anti-anxiety / sedative medication, but Abilify (Aripiprazole) is an anti-psychotic medication which is used in the treatment of psychotic disorders. Trihexyphenidyl is a medication which is given to prevent certain side effects of anti-psychotic medication. I'm not sure why you are on an anti-psychotic medication and am wondering if you had been diagnosed to have a psychotic disorder. Can you clarify this issue for me, because treatment of your symptoms will depend mainly on the correct diagnosis... Regards, Dr. Jonas Sundarakumar Consultant Psychiatrist

---

Brief Answer: Medication and psychological therapy are effective Detailed Answer: Hello again and thanks for the clarification. Like I had mentioned earlier, it appear that you are suffering from a type of axniety disorder called Agarophobia with Panic Attacks. People with this problem become very anxious when going to public place or when they are in a crowd. Often they get intense anxiety attacks / panic attacks when exposed to these situations. Over a period of time, they start avoiding going out alone or going to crowded places because they develop a subconscious fear that they might get an anxiety attack. Now, the good news is that this is a treatable condition and with appropriate treatment, the anxiety can be overcome. The treatment of this anxiety disorder is with a combination of medication and psychological therapy. There are medication called SSRIs which can significantly reduce anxiety symptoms and prevent the occurence of panic attacks. There is also effective psychological therapies which can provide long-lasting results. A specific form of therapy called Cognitive Behaviour Therapy (CBT) which has been proven to be very effective in the management of this condition. So, I would advise you to see a psychiatrist in your place for further treatment. It is important that you seek help early because early treatment has a better outcome. Wish you all the best. Regards, Dr. Jonas Sundarakumar Consultant Psychiatrist

---

Brief Answer: Different SSRIs are available... Detailed Answer: Hello again, There are a number of other SSRIs available - such as Citalopram, Escitalopram, Sertraline, Fluoxetine, etc. and each one has different effect, dosage and side-effect profile. so, please discuss with your doctor as to which one will be most appropriate for you. Wish you all the best. Regards, Dr. Jonas Sundarakumar Consultant Psychiatrist

---

Brief Answer: SSRIs can be effective in treatment of agarophobia Detailed Answer: Hello again, All SSRIs are liscenced and effective for the treatment of agarophobia. But the specific choice of medication would depend on each individual. I'm not sure what dose of Paxil (Paroxetine) you are on. In case, the low dose is not able to control your symptoms, then an increase in dose or a switch to a different SSRI may be required . Best regards, Dr. Jonas Sundarakumar Consultant Psychiatrist

---

Brief Answer: Paxil would be a good choice... Detailed Answer: Hi again, Paxil is Paroxetine and is one of the SSRIs which has been proven to be effective in the management of anxiety disorders, including Agarophobia and Panic attacks. So, in your case, it would be a good choice. The medication is usually started at a minimal dose and then gradually increaded step-wise according to the person's response and tolerability. It is important to remember that these medication may take a few weeks to bring about their effects. So, you may have to wait patiently till that time. Best wishes, Dr. Jonas Sundarakumar Consultant Psychiatrist

---

Brief Answer: These are common symptoms of Agarophobia... Detailed Answer: Hi, This symptom of developing faint spells and dizziness when you are in big places is a common symptom of Agarophobia with panic attacks. It is important to know that anxiety can present itself with not only psychological symptoms but also physical symptoms. So, physical symptoms like light-headedness, faint spells, palpitations, breathing difficulty, etc. are well known symptoms of anxiety. I would suggest that in addition to the treatment, you should also learn and practice relaxation techniques to help you avoid these symptoms. Best wishes, Dr. Jonas Sundarakumar Consultant Psychiatrist

---

Brief Answer: Medication plus relaxation would be effective... Detailed Answer: Medication can be effective and is often necessary. What I meant was along with medication, relaxation techniques or other psychological therapy would be helpful. The SSRI medication like Paxil can be quite effective in controlling your symptoms. Klonopin (Clonazepam) is a benzodiazepine medication which is used for short-term symptomatic relief. There is also a risk of getting dependent on them. However, SSRI medication like Paxil can give long-term results and also don't have any risk of dependence. Best wishes, Dr. Jonas Sundarakumar Consultant Psychiatrist

---