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What Causes Insomnia And Claustrphobia After Stopping Alprax Abruptly?

Posted on Tue, 1 Apr 2014

Question: Hi I am male 70yrs, 80kgs, happily retired, no worries at all on family or financial issues. Active lifestyle, Golf, walking etc. BP and Sugar under control with medication. I have a family history of anxiety, and have developed some claustrophobia over the past decade. Used to take Alprax 2.5 daily for years and was reasonably OK. Had side effects of anger and muscle tremors. Two weeks ago I stopped Alprax abruptly (admit mistake) and have now developed insomnia, and my claustrphobia has increased. Have to travel in a few weeks and need to tackle this potential problem. Should I return to Alprax? Change to Valium/Nexito, when, and can I taper down afterwards? I am a normal well balanced sociable gentleman, and this is my only psychological issue. Will be grateful for your help

Answered by Dr. Abhishek Kapoor (24 minutes later)

Brief Answer: Take both antidepressant and benzodiazepine Detailed Answer: HI Thanks for using healthcare magic. I, Dr Abhishek Kapoor, would help you in this query. Claustrophobia is a specific phobia and in this case, you would not get relief with benzodiazepine only. I would suggest you to take antidepressant and benzodiazepine together. In anxiety disorder, paroxetine has very good response as compared to other antidepressant and belief me, you would also get good response with it. It is a very nice antidepressant with less side effects. In benzodiazepine, better to go for clonazepam rather than diazepam or alprazolam. Diazepam has longer duration of action, so it could effect your daily schedule due to its sedative effect and alprax due to its shorter action, would easy cause withdrawal effect. Clonazepam would better control anxiety symptoms due to its intermediate action. You would not get these drugs over the counter, so better to consult a psychiatrist for proper dose management. Rest, you can discuss with your psychiatrist In case, you need further help, you can ask. Regards Dr. Abhishek Kapoor Psychiatrist

Above answer was peer-reviewed by : Dr. Shanthi.E

Follow up: Dr. Abhishek Kapoor (5 hours later)

Thank you. I am away from my home base and will return in a couple of weeks. In the meantime, till I can fix up an appointment with a Psychiatrist (through my GP), can I take Alprax 2.5mg plus Nexito 2.5mg for a few days. I have these medicines from earlier prescriptions of my GP. This would be the anti depressant plus the anti anxiety as advised by you. Would Zolfresh 10mg be useful at night instead of the two mentioned above? Grateful for your help! XXXX

Answered by Dr. Abhishek Kapoor (26 minutes later)

Brief Answer: You can take 10 mg Nexito Detailed Answer: Hi Minimum effective dose of Nexito is 10mg, so take at least 10 mg in a day. You can take alprax 0.25mg on sos basis and there is nothing harm in taking zolfresh 10 mg at night. Rest, you can consult with your psychiatrist when ever you will come. Regards Dr. Abhishek Kapoor Psychiatrist

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Above answer was peer-reviewed by : Dr. Vaishalee Punj