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What Causes Regular Panic Attacks, Sinus Infection, High BP And Cholesterol?

Posted on Wed, 5 Aug 2015

Question: I have had panic attacks my entire adult life. I take Welbutrin ,that was just increased from 150 to 300, and Xanax .5 three times a day, as a prophylactic. Most times I take only two a day and sometimes up to four if I know I will be in a trigger situation. I was ,also, taking Celexa until recently, but weaned myself off them as I did not like taking so many drugs for the same thing as I am also taking medication for High blood pressure, high cholesterol, bad sinuses and post prostate cancer. Seven medications in all, including the anti anxiety meds. The Psychiatrist that originally prescribed the anxiety meds, over twenty years ago, told me to get used to the idea I would probably be taking these drugs the rest of my life. For at least ten years my PCP has been prescribing these medications. All of a sudden my PCP has decided I should not be taking the Xanax as I have been for years and wants me to wean myself down. He even suggested he add an additional drug to make up the difference. All these drugs( Xanax, Celexa, Webutrin, and whatever anti depressant he wants to add) are drugs that can not be quit cold turkey. My question is this. What difference does it make that I should wean myself down from the Xanax, that I take as prescribed and will have to keep in my arsenal, and add a third drug just because the doctor is skittish about me taking the Xanax? Particularly when I will have to continue to keep the Xanax as part of my treatment.

Answered by Dr. Chintan Solanki (2 hours later)

Brief Answer:
in my opinion xanax should be stopped gradually

Detailed Answer:
Hello XXXXXXX

Thanks for writing to us.

I read your query and understood your concern.

Xanax (Alprazolam) is benzodiazepine group of drug. It must be used under strict medical supervision otherwise it can cause tolerance, severe dependence and chances of abuse become higher.

You are taking since many years and under medical supervision. That is good. But in long run benzodiazepine causes dementia. You are already at age of 61 so chances of developing dementia is very high. If I were our treating doctor I would also like to stop xanax.
Stopping xanax suddenly is not a good idea particularly after this much long duration.
Dropping 0.25 mg every 10 days will be good option to stop xanax. Paroxetine or mirtazapine is good alternative for your anxiety disorder in my opinion.

So in conclusion whatever your doctor is thinking is right. In fact in my 10 years career I have never prescribed xanax to my new patients. And in whom already xanax was going on I used to stop/replace.

Hope I have answered your query, I will be happy to help further.

Regards,

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Chintan Solanki (39 minutes later)

I understand your concern but I looked up the two drugs you mentioned and they are just more anti depressants. What about a rescue drug for when I am in a trigger situation that requires immediate relief. I don't know if you have ever had a severe panic attack. They are not fun. You think you are going to die and going crazy. The more you try to calm down the worse it gets. Rationally you know what's going on but when you are hyper ventilating and cannot breath that is of little comfort.

Answered by Dr. Chintan Solanki (3 hours later)

Brief Answer:
they are also anti anxiety drugs, I prefer clonazepam in stead of xanax

Detailed Answer:
Hi,

Thanks for follow up.

I can really understand that what is panic attack and how crazy you feel during the same.
Drugs I mentioned are used to treat panic disorder. Most of the anti-depressants are anti-anxiety drugs also. They are specifically used when anxiety is more. They can prevent panic attacks.
In severe attack I prefer mouth dissolving clonazepam instead of xanax as it has lower dependence and tolerance potential than xanax.. If you are comfortable with xanax and can control use of it as per doctor's prescription, you can use on required basis but not daily.

Considering your history I also would like to suggest psychotherapy to treat panic attack. I recommend cognitive behavior therapy (CBT).
Regular Meditation can help you. Use of Deep breathing technique (slowly inhale for 3 seconds deep in lungs with open mouth, keep breath in lungs for 3 seconds and then exhale slowly for 3 seconds) while panic attack can reduce stop severity of symptoms.

Hope this answers your concern. Feel free to discuss further.

Note: For further guidance on mental health, Click here.

Above answer was peer-reviewed by : Dr. Neel Kudchadkar