Thanks for your query.
I appreciate your efforts for medical consultation in so much distress.
Anxiety , panic disorder, mild depression can occur in mixed anxiety and depressive disorder, which is a subtype of anxiety disorder.
Anxiety occur due to neurotransmitters
imbalance in brain most commonly involving serotonin neurotransmitter.
In drug treatment two types of medicine used:
1)For immediate relief of anxiety benzodiazepines group (zolipax) or antipsychotic
(oleanz) of medicines are used.
2)For long term relief most commonly SSRI (selective serotonin reuptake inhibitors) (like paxidep and serta) are used. SSRI takes around 3-4 weeks to show its effect. Non drug treatment like cognitive behaviour therapy
(form of psychotherapy
) also takes weeks to show its effect.
All these process is complex. I have just simplified it to make you understand it.
Most Common side effects of SSRI (like paxidep and serta):
-Nausea, dry mouth, acidity, loss of appetite, trouble sleeping, constipation
, tiredness, drowsiness, dizziness, or increased sweating may occur.
These side effects appear frequently at start of treatment and during increasing dose of medicine. Paxidep and serta belong to same class of medicine (SSRI). There is no much benefit to combine them, as chances of side effects will increase. Serta 25 mg is low dose, you can stop it without much difficulty.
So your current symptoms are the side effects of SSRI which is very common at start of treatment and during increasing dose of medicine. The common strategy to deal with this side effect is.........wait for few days and continue medicine, as these side effects are self limiting and stop after few days.
If any of these effects persist or worsen or affect your personal/social/occupational life, tell your doctor. Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects.
Apart from above advice following simple measures will help you:
-Diet monitoring to loose weight.
-Decrease worrying by keeping yourself busy and distracted from worrisome thoughts by talking to family members or watching T.V. or counting back (100 to 0).
-Healthy diet: Milk and fruits in diet.
-Daily morning walk
, yoga and meditation
(which you can learn from some expert in person)
I hope this information has been both informative and helpful for you. In case of any doubt, I will be available for follow ups.
Wish you good health.
Dr Ashish XXXXXXX Mittal