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Steve -- a.k.a. Oreport
Steve -- a.k.a. Oreport, Voc Rehab Counselor, M. Ed.
Category: Health
Satisfied Customers: 1079
Experience:  Disability/Rehab Consultant. Broad knowledge of many chronic and acute health problems.
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Why do you get an uncontrollable urge to swallow and have ...

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Why do you get an uncontrollable urge to swallow and have excessive saliva which also results in throat spasms during sleep and wakes me up into a panic attack? Is this all due to stress? How can I control it and will it become a habit if not taken care of? I am taking Xanax right now but the my throat hurts all the time and I must swallow constantly to speak or sometime uncontrollably the throat shifts into spasms if I try to keep from swallowing. Please help as I have not gotten a real answer from my psychologist or psychiatrist. They just keep saying it is due to stress. It is driving me crazy and putting me into panic all day. The xanax takes the edge off, but I still am experiencing these problems.

Please help!
Submitted: 7 years ago.
Category: Health
Expert:  Steve -- a.k.a. Oreport replied 7 years ago.
The ubiquitous 'lump in the throat' is a classic symptom of anxiety and stress -- as is excessive salvation. Although, ironically (as I am sure you know) anxiety can also cause dry mouth.

If you are really concerned that there may be something else going on to cause the excess salvation -- you can always do a search and see what you find. However, in the absence of other symptoms, I think the chances are very good that what you are experiencing is a part of your anxiety.

Having dealt with anxiety and depression for most of my life, I can tell you that concentrating directly on the symptoms seems to be the least effective approach. For example, telling an anxious person to 'relax' -- will, more often than not, have the exact opposite effect.

I do think you may want to talk to your doctor about taking an antihistamine medication at night in order to dry up your mouth a little and reduce the chances of over--salivation causing choking and subsequent panic -- that, you do not need.

Other than that, my advice is pretty standard stuff that I am sure you have heard before:

  • exercise
  • breathing exercises/meditation
  • progressive relaxation routines
  • focus on the needs of others
  • do not dwell on negative thoughts
Give yourself six weeks. Start out slow. Do a little more each day. I am betting that you will be pleasantly surprised.

Click above Link(s) (if any) for additional information.

Let me know if you need more input. If not, thanks for the opportunity to assist you... Please honor my efforts by Clicking the green 'Accept' button (located within this post -- above-right). Adding a bonus -- should you wish to do so -- would be warmly welcomed.

I would also appreciate your Feedback comments regarding your experience with me.

Good Luck!

Steve
Steve -- a.k.a. Oreport, Voc Rehab Counselor, M. Ed.
Category: Health
Satisfied Customers: 1079
Experience: Disability/Rehab Consultant. Broad knowledge of many chronic and acute health problems.
Steve -- a.k.a. Oreport and 2 other Health Specialists are ready to help you
Customer: replied 7 years ago.
An antihistamine may excel the anxiety so I don't think this will help. Do you think this involuntary swallowing spasm will go away eventually? I don't want it to become a habit. I also have been clearing my throat lately. I have obsessive/compulsive disorder and obsessive over physical ailments that bother me. What kind of doctor can I see that would handle Obsessive Compulsive disorder?
Expert:  Steve -- a.k.a. Oreport replied 7 years ago.
I believe that decongestant medications are more likely to exacerbate your anxiety symptoms than antihistamines are -- although, your doctor would be the best ones to advise you on this.

With regard to treaty OCD -- psychiatrists are the physicians of choice.

Of course, you can always explore alternative medical disciplines -- such as homeopathy and naturopathy. Personally, I have had very good results with homeopathic treatment -- regarding my own anxiety/panic/depression symptoms.

Click above Link(s) (if any) for additional information.

Let me know if you need more input. If not, thanks for the opportunity to assist you... Please honor my efforts by Clicking the green 'Accept' button (located within this post -- above-right). Adding a bonus -- should you wish to do so -- would be warmly welcomed.

I would also appreciate your Feedback comments regarding your experience with me.

Good Luck!

Steve
Customer: replied 7 years ago.
What is homeopathy therapy? Have you heard of other people having these swallowing expisodes with panic attacks? Is this common with stress? Does it disapate?
Expert:  Steve -- a.k.a. Oreport replied 7 years ago.
Yes, I have heard of (and experienced) symptoms similar to this associated with anxiety and panic symptoms. I cannot tell you how common these symptoms are -- however, my observation is that they are fairly common. Same story with regard to whether and/or when these symptoms dissipate. I can tell you that, overall, anxiety and panic symptoms dissipate with age.

Homeopathy is a very interesting (now alternative) treatment modality -- which was extremely popular in nearly 1900s. There were even several homeopathic medical schools in the US at the time. It is based on the theory that if a substance causes a a symptom in a well person -- that same substance will cause that symptom to abate in a person who is ill. The other very interesting part is that homeopathic remedies are diluted to the point where there is no measurable amount of the substance left. The theory is that homeopathic remedies act a lot like vaccines -- causing the body's own systems to come back into balance.

Of course, homeopathy has its distractors -- to consider it anywhere from outright fakery -- to the placebo effect.

Read more about homeopathy here.

Click above Link(s) (if any) for additional information.

Let me know if you need more input. If not, thanks for the opportunity to assist you... Please honor my efforts by Clicking the green 'Accept' button (located within this post -- above-right). Adding a bonus -- should you wish to do so -- would be warmly welcomed.

I would also appreciate your Feedback comments regarding your experience with me.

Good Luck!

Steve
Customer: replied 7 years ago.
Should I go see an ENT specialist for the throat? I know I have had this in the past with stress, but it seems not to disappate right now? In the past, it would happen sometimes, but go away. I hope this is not a chronic condition that I have to live with. I can't handle this. I was having chest pains for months now and that has stopped. Instead, it went from the chest pains into this. I seem to obsessive over physical ailments turning my problems inward upon myself (I am myself's worse enemy) and turning my mind in what is physically bothering me which extends into a vicious cycle of obsessiving over the physical symptom to only again cause another panic attack. What do I do with this? I have not eaten in a week and although I want to lose weight this is thoroughly not the way. I also have had no sleep and have to try to function at work. I am a single mom with a 12 year old daughter and no help from anyone. It frightens me that my job may be on the line as they have begun laying off discretely (at least one person per week is gone). I have been handed a great deal of responsibility (I am an Administrative Assistant) and have not gotten an increase or raise this year. They claim here at this company that nobody got anything. I spoke to one other person and they claim they got an increase. So are they lying or are they feeling me out to see if it is worth keeping me? I lost my job three years ago and it took me over 1 year and 9 months to find work again. This job I am in right now started out as a temp-to-perm situation and I work with a "bitch" of a boss. She went through six Administrative Assistants before I came on board. She tells me when she gets upset that things are not going "her way" (she is very controlling) - that "I can do anything right!"   The management; however, does not believe her. My fear is losing my job again and having to start all over and with no job security ANYWHERE and no jobs out there, at the age of 49, I don't think I will make it! So you can see my stress situation. They started increasing my workload back in December and told me that things would get worse in February.   That is when I started experiencing chest pains, shortness of breath, panic attacks and going to emergency for heart attacks a few times only to find out after a stress test and numerous test that we can all chalk this up to anxiety. I just started Xanax and I don't know how effective this will be. However, I do like to drink and can drink on the weekend at least 6 to 8 beers in one night out in an evening with friends. I was told to be careful with Xanax. I have a CA trip plan at the end of June which I paid a great deal of money for to go with my daughter. I want to enjoy myself and be able to drink. Do you know if I don't take the Xanax the day I think I will be drinking that I will be o.k.? I don't know if you have to take Xanax everyday or is it more like Vallium where you can take it only when you are uptight or stress?   If I drink, it seems to help me cope better and I feel alittle more at ease. I want to go out this Friday and I would like to drink. I also would like to drink while I am away on my trip in CA. Do you know anything about how the interaction of Xanax and drinking may effect me? The internet tells me very scary stories and I don't know what to believe. A few years ago, I had a nervous breakdown while going through my divorce process with my husband. I was taking Klonopin which really did not help all that much. However, to ease the pain, I also accompanied the drug with alcohol more times than not. I am alittle nervous taken Xanax. Can you tell me the implications of using alcohol and Xanax and being I do like to drink and enjoy myself especially on weekends and on my trip, I would like to substain from taking this drug. Can I skip it those days I think I am out for a drinking night? Or do you suggest I speak to the psychiatrist and ask for something else? I don't want to go on SSRI's that put on weight. I took Paxil after losing my job three years ago and blew up 70 pounds in 9 months. I just took off 50 pounds after three years and am not about to let that happen again. Any suggestions to all of this?
Expert:  Steve -- a.k.a. Oreport replied 7 years ago.
Take a minute and read over your last reply as if it was sent to you by someone else asking you for help. What conclusions do you come to?

Is a visit to an ENT likely to give you any information about your throat symptoms -- that you do not already have?

All other things being equal, does drinking alcohol while taking Xanax (even skipping Xanax on drinking days) sound like a good, rational plan?

Is the possibility of weight gain a good enough reason to avoid taking antidepressant medication (which may manage your OCD and related symptoms well)?

Is drinking heavily on weekends -- and planning a vacation where the main activity being looked forward to is drinking -- role modeling good coping skills for your daughter?

I have to be gone for a few hours. I will check back when I return.

Thanks in advance.

Steve
Customer: replied 7 years ago.
You really have not answered any of my questions. I do not want to take any medication that will induce putting on weight as I have enough problems and it took me nearly three years to get 2/3rds of the weight off. As far as going to a ENT specialist, he may be able to give me more insite if there is a physical problem along with the anxiety. I don't think I should give up trying to enjoy myself when I am so down lately. It is a trumph enough to go to work these days. I do so look forward to going away and hope I will stop having these throat spasms to feel comfortable. I wanted to know the effect of drinking say two or three beers if I am out on a Friday night (not eight) or if I am away and anticipate going out for a drink at the pool or out to eat and have two drinks with dinner with my daughter, I should be entitled to. My question is of more concern of the effect the drink and Xanax will take. I am on .5 mg taking two pills a day. If worse comes to worse, I will skip the dosage for the day knowing I may go out that night and have a few. I am meeting up with an old friend of 35 years who I haven't seen in 25 years and we will probably go out to have dinner and drinks. I will not tell him I am on Xanax. My daughter will also be with me though. Please tell me the effect of alcohol and Xanax. Again, I used Klonopin with alcohol and it did nothing. My psychiatrist told me it would only enhance the drowiness and effect of the drug. I just don't want to pass out or go into convulsions. I want to make sure I should stop drinking say after "four drinks" at the most without any worry. I would prefer to skip taking it that day so I don't have to worry about drinking and not sticking to what I originally planned to do. Many times I go out saying I am going to have only two or three drinks and end up having at least six (if there is a happy hour (2 for 1 drinks, etc...) So you can't count on that. I have been really anxious and not feeling well these days and hopefully at the time of the trip I will be in better spirits. I would like to leave the job behind and let some of the stresses go so I can "recharge" my batteries as I am overstressed and overwhelmed these days. Another doctor told me they thought I should take the trip regardless how I feel even if it is an effort to do so. I put insurance money on the trip in case I could not make it which is good in case I decide I am too anxious at the time to go. I wanted to a straight answer as I don't want to end up in the hospital in CA or anytime before that. The best bet is to skip the dosage that day. Please advise instead of answering me with questions. I would not be asking if I was not sure.

Thanks.
Expert:  A. Schuyler, NP replied 7 years ago.

Hi,

Steve asked me to take a look at your question. As for alcohol and Xanax - it's not a good idea. Xanax greatly increases the effects of the alcohol in an unpredictable fashion; i.e. 2 drinks may make you feel/act as if you had 4, or 6, or more. You lose your inhibitions, judgement, self-control, and physical control easier. If you are going to self-medicate with alcohol, then it is definitely best to avoid the Xanax that day.

It won't hurt to have an ENT or a medical doctor take a look at your throat, and perhaps check you for gastroesophageal reflux (GERD), just to make sure there is nothing physical that is causing the excessive swallowing.

As for OCD/anxiety drugs, there are other drugs besides Paxil. This is something to discuss with your psychiatrist, letting him or her know emphatically that you don't want to gain weight. You may also find that a brisk 30 minute walk or bike ride each day will help you cope with your stress levels, and help you lose a little weight. It would be something neat that you and your daughter could do together after work and school. In addition, I like to get outside each day at lunch or break if it's just a 10 minute stroll around the building. It picks me up, clears out the cobwebs, and I think my patients get a better provider because of it. You might want to try this on your lunch break to help prepare you for the afternoon with the witch of a boss. Good luck.

 

Customer: replied 7 years ago.
Has anyone heard of the symptom with the throat spasms, swallowing and excessive saliva before? It also wakes me up in a sleep at night and puts me into a panic attack. Is this something that will pass? I tend to rumanate thoughts in my head and I obsess when something physical is bothering me. I wish I could just turn off my mind "focusing" on such things, but don't know how to do this. Please let me know if you ever heard of anyone having these symptoms. I am afraid to take Xanax knowing it is highly addictive and I tend to like to drink. I don't want to end up in seizures or passed out somewhere. What can I do to turn off the thoughts of swallowing and focusing on my physical ailments? I have GERD, but I take protonix for that. This is not what is causing this. It is definitely due to stress, however, I hope it does not turn into a cronic condition. I would like to know if you have heard these symptoms from others and how they dealt with it. Were they ever able to rid them of this repeating itself again and how. I have lost 22 pounds since January when my panic attacks started. It all started with chest pains and panic. Now it seems to be the focus in the throat. I rather have the chest pains as I know now that it is not heart related. I had many test (stress test, EKG's, chest x-rays and echogram, etc...) and it is unrelated. I also visited my GI who did an endoscopy and check for anything. I have a history of GERD and take medication for that, but this is not related to GERD at all. The chest pains could also be from acid reflux and heartburn but I think they were a combination of stress and acid. They have subsided and now I have this annoying habit in the throat that I wish will go away. It sends me in a talespin of panic when it happens and that is perhaps one of the reasons I am not eating lately. It also is effecting my sleep where I have a throat spasm and swallow which wakes me up and sends me into a panic attack. I then try to "breath deeply" and try to calm down only to have another spasm happen and panic attack. It is a vicious cycle. Can someone give me a suggestion or help me? Can someone let me know that they have heard this from others and how they might have handle it?

Thanks.
Expert:  A. Schuyler, NP replied 7 years ago.

Hello,

In cases like yours, it is most likely the mixed up neurotransmitters in the brain that are responsible for the throat sensation and the panic attack. Technically/medically, it is more likely the increased epinephrine released when you sleep that causes the "fight or flight" response that leads to the excess salivation and swallowing. You wake up and experience the panic attack. It isn't the swallowing that causes the panic/anxiety, it is the other way around. If ever I have heard of a case where regular medication is warranted, then yours is it.

I completely agree that Xanax is not the best drug for your situation. It has all the side effects you mentioned, and is really only intended for short-term use. You need a long-acting drug that you take every day to keep your neurotransmitters on an even keel.

 

Customer: replied 7 years ago.
What medication would you suggest would be best for me?
Expert:  A. Schuyler, NP replied 7 years ago.

It is difficult to recommend drugs for someone whose complete medical history is not known to you. Some of the possibilities are low-dose Zoloft, a selective serotonin reuptake inhibitor (SSRI) that is not associated with weight gain, Lexapro (a newer SSRI), Buspar, or one of the newer SSRI plus norepinephrine inhibitors (Cymbalta). Your psychiatrist is the best one to help you with this.

 

Customer: replied 7 years ago.
Thank you. You were the best informative person on this. I will submit all this information to my doctor. I believe I should also be on a SSRI (along with the Xanax as backup). How long does Xanax stay in your system if I take a whole pill of 5 mg.? Is it only five hours?
Expert:  A. Schuyler, NP replied 7 years ago.

For Xanax peak concentration is 1-2 hours after you take it with a half-life ranging from about 6-11 hours. Half life is the length of time it takes for 1/2 of the drug concentration to be totally out of your system, so 1/2 is out in the first 6-11 hours, 1/2 of the remaining half is out in the next 6-12 hours, etc. For someone taking it on a regular basis (like 3 times a day every day), small (but not therapeutic) amounts of it could be detectable in the blood for up to about 10 days. This latter is only important for people who are subject to drug testing for abuse problems. If you are taking it only when you have symptoms, most of the therapeutic effectiveness of Xanax that you would notice is gone in about 5 hours.

 

Customer: replied 7 years ago.
I have been taking 1/2 tablet at 5 mg. during the day and whole tablet when I sleep. So I don't really see the benefit for this. If it only last 5 hours, especially when I sleep, this will not help the panic attack. I will wake up at least 8 hours later with panic if it only last 5 hours. I will have to pop another pill during the course of the night to have a full night's sleep. As for work, this will only keep me calm from 8 a.m. when I take it until lunch time. I will have to take more if I feel the need to. I don't think it is worth taking the Xanax. I want something that stays in your system and put the serotonin back to the brain. I will run this by the doctor. This Xanax is good for quick fixes and it is not worthy of taking with the fact that you can become addictive.
Expert:  A. Schuyler, NP replied 7 years ago.
I totally agree with you.
Customer: replied 7 years ago.
How long does Xanax take to kick in while having a panic attack? Will the panic attack subside right away or will I have to wait 15 minutes? I think I will ask my doctor to put me on Zoloft or Buspar. I tried Klonopin and it did nothing for me in the past. Paxil works; however, it puts tons of weight on.
Expert:  A. Schuyler, NP replied 7 years ago.
It should take more than 15 minutes, since it has to get into your blood stream, but less than an hour.
Customer: replied 7 years ago.
I am also getting a sore throat now along with a feeling of phylem in the back of my throat. For three days now, I keep trying to clear my throat and it does not seem to disappear. It is not enough that I have the excessive salivation and swallowing. Now I feel like I have something in back of my sore throat and the phylem does not want to go away. Could I possibly have a throat infection because my throat muscles are in overdrive? I don't want to get in the habit of clearing my throat (as another nervous tic). What do you think?
Expert:  A. Schuyler, NP replied 7 years ago.

Overworking the muscles of your throat doesn't cause an infection. Only bacteria, viruses, etc. can cause infection. This could be a completely other problem related to allergies or post-nasal drip. Try gargling with some hot salt water, or some nice hot tea with lemon and honey (my own favorite remedy).

 

Customer: replied 7 years ago.
I will see a ENT specialist next week if the sore throat don't go away.

Thanks for all your help. I am going to the psychiatrist now and I will print this out and show him and see what he comes up.
Expert:  A. Schuyler, NP replied 7 years ago.
Good luck!
Customer: replied 7 years ago.
Reply to Schuyler_ANP's Post: I have been researching medication all weekend and it seems that all the meds out there put on weight. My doctor gave me a trial box of Cymbalta to take for a week; however, I was reluctant to try it. There was no paper accompanying it saying what the side effects are or if there is weight gain. I went on the internet and all the medications (Zoloft, Lexapro, Paxil, Cymbalta, etc... all put on weight). Many people on the forum complained that they put on 10 pounds a month. I was on paxil four years ago and put on 70 pounds in 9 months. I have been fighting to get this weight off and finally am back to the size I was when I started the paxil. At that time, I was overweight. I am now 180 lbs. (use to be 125 lbs) and went up to 233 lbs after the paxil in no time. I have about another 40 pounds to go or so to get back in my size 12 pants. I don't want to be fat all my life because of medication. For anxiety, what is the best medication out there to take? I took Klonopin but it did not work in the past. The paxil worked; howver, put a large amount of pounds on. Cymbalta is for depression. I am having panic attacks and feel very edgy and keyed up. Why would the doctor give me Cymbalta? Does Cymbalta put weight on? Should I ask for Buspar? I wanted to try Wellbutrin as I been told by many that THIS IS THE ONLY DRUG that won't put weight on. My doctor felt that may enhance the anxiety. I thought WEllbutrin was the same type of medication as Cymbalta? Go figure??? Please also inform me how long does these meds take to kick in? I have a CA trip coming up the end of June and paid an awful lot of money ($1800) to go away with my daughter. I don't want to lose this money and not take the trip. I want to fee sane to take this trip. What do you suggest I do? I am barely making it to work these days. What medication would you suggest would be the best for NOT GAINING WEIGHT and for anxiety that may kick in within a week so I will start to function better? Is there a psychiatrist on? As far as my mental history, I was involved in 9-11, I had a breakdown in 1999 when I was going through a divorce and another breakdown in 2004 when I lost my job (when I went on the Paxil). I took the Klonopin in 1999 which really did not do much, but I really don't remember gaining too much weight on that one. When I lost my job, I was already divorced raising my daughter alone. I am currently experiencing the fear of losing my job once again as there have been cutbacks and they have me logging in my workload everyday to see if I am worth keeping. I think they may want to get rid of my boss eventually so I am unsure if my job is on the line. I also don't do well with be alone. I broke up a six-year relationship with a boyfriend last September and may be feeling the reprocusions of that along with the fear or losing my job once again. I have been having panic attack for three months now (started the end of February) with chest pains and full symptoms of panic. I must have been to every doctor on earth and my health is 100% good. My chlorestoral is 211 and everything else checks out fine. My blood pressure is high because of the panic I must be incurring. It is usually ranges around 140/100, but can fluctuate higher or lower. I have lost 23 pounds since January (was 200 pounds - now 178 pounds). I really fear gaing more weight back and I also don't want to lose out on the trip. I want to be able to focus at work as well so I don't in turn lose the job. Please give me advice on the medication. The doctor gave me Xanax also, but I don't want to take it as it is highly addictive. I tried it one day and it really did not help all that much. He gave .5 mg and I took 1/2 pill at work and a whole pill at bedtime. At work, I still had a hard time functioning. I was able to sleep but that was because I think I was so exhausted - I hadn't sleep in days. Another thing, is excessive saliva another symptom of anxiety?
Expert:  A. Schuyler, NP replied 7 years ago.

That's great, now you have some Cymbalta to start with. Since the "little paper" didn't come with it, I am including a link below to information on it. One of its side effects is decrease in appetite, so you should not gain weight on it. No, Cymbalta is not just for depression; it is also for anxiety and used for other things as well. Be careful where you do your "research." Remember that every single thing that happens in clincial trials is reported as a side effect - including dumb things like colds that have no bearing on Cymbalta at all. Controlled studies have consistently shown slight weight loss with the drug.

http://pi.lilly.com/us/cymbalta-pi.pdf

Did you ever stop and think about what people who have been miserable for months or years feel when they are finally put on a good antidepressant or anxiolytic? It feels GOOD! All of a sudden you aren't miserable. You feel like being more social, you feel like eating again for the first time in ages....and you do. Sometimes people don't realize until waaaay later that they can't make up for all the eating they didn't do when they were anxious. Calories "in" still have to equal calories "out", or the weight starts piling on. So, don't lose sight of your diet and exercise goals. You've done a terrific job of losing 23 pounds since the first of the year.

My advice is to start the medication now. It will take it a week or more to get into your system and you will probably not feel the entire benefit of it for a month, but you can't start any sooner than the present. It sounds like you and your daughter have a great trip to look forward to.

 

Customer: replied 7 years ago.
Can you tell me why my doctor felt Wellbutrin was not right for me? I was told from many that Wellbutrin does not put on weight? He told me it may enhance my anxiety? What do you think of this? Can you tell me the side effects to Cymbalta? Once I want to weed off of it, will have many withdrawal symptoms? How will it be weeding off it? Will if go back into the anxiety?
Expert:  A. Schuyler, NP replied 7 years ago.

Wellbutrin is an atypical antidepressant. It doesn't work exactly like the SSRIs or the benzodiazepines. What it does do is increase anxiety, agitation and insomia, and it doesn't do well with Xanax or any alcohol. It wouldn't be my choice (or even make my list of possibilities) for someone with anxiety/panic attacks either.

Here are the side effects of Cymbalta directly from its wensite.

"5. What are the possible side effects of Cymbalta?
Like all medicines, Cymbalta can cause side effects. In clinical studies, the most common side effect was nausea. For most people, the nausea was mild to moderate and usually went away within 1-2 weeks. Other common side effects included: dry mouth, constipation, decreased appetite, fatigue, sleepiness, and increased sweating. Most people were not bothered enough to stop taking Cymbalta. In clinical studies, some people taking Cymbalta experienced an increase in blood pressure. Your doctor or healthcare professional may periodically check your blood pressure."

When you want to stop Cymbalta, you will need to taper off it slowly just as you do with every other anti-anxiolytic.

 

Customer: replied 7 years ago.
I have high blood pressure. I don't know if this would be good for me. My blood pressure varies but is usually around 135 or 140/100. What do you think?
Expert:  A. Schuyler, NP replied 7 years ago.
I think it would be just fine to try. Your blood pressure isn't at a dangerous level, and increase in blood pressure with Cymbalta occurs in a small minority of patients.
Customer: replied 7 years ago.
What would help the panic attacks that wake me up every night.   I have been having anywhere from two to five panic attacks a night waking me out of a sleep. If I take the Cymbalta at 30 mg., how long will it take to be effective in my system? Will I get immediate relief? Or will I have to wait a week or so to see any change? Does Xanax stop panic attacks in the sleep? Perhaps, I should take a whole pill of Xanax (.5 mg) at bedtime and take the Cymbalta for a week before stopping the Xanax altogether. What do you suggest? Why would anyone have panic attacks in there sleep? Is this common? And in the future, how can I keep from these things reoccurring? I can't live on medication all my life. What would you suggest?
Expert:  A. Schuyler, NP replied 7 years ago.

Hello,

Yes, you can take the Xanax at bedtime to start off with while you begin the Cymbalta. The rate that Cymbalta begins to help will vary from person to person, but at least you won't feel any worse for the first week than you did before you began taking it. Many people wake up from sleep having a panic attack. It has to do with the neurotransmitters in the brain, so someone is not exempt from problems just because they are sleeping. It is possible to take a drug for the rest of your life if it is necessary. Many people have to take insulin, blood pressure medications, and thyroid replacement from the time they are children until they die at age 80. Popping a pill isn't a huge price to pay for good health.

 

Customer: replied 7 years ago.
Why would you take insulin, blood pressure pills and thyroid medication for anxiety? I was on thyroid medication for a lazy thyroid but because I am so anxious these days, my thyroid doctor told me I no longer need it for a while. If I go on Cymbalta, I may require it again if I put more weight on. Does Cymbalta stop OCD and rumnating thoughts? I want to stop focusing on swallowing and the throat spasms. Do you think this will stop my thought process of obsessing on these things and only take in the focus of what I am perceiving at the given time? Can I also take Cymbalta with Klonopin? Klonopin may help me sleep through the night as I would prefer an alternative to Xanax. Xanax only lasts about 2 hours in the system. I need something to let me rest and stop the panic attacks altogether while I sleep. I don't want to lose my job! Will Cymbalta stop the panic attacks in the sleep or will I also need Klonopin?
Expert:  A. Schuyler, NP replied 7 years ago.

No, no, no. YOU don't have to take insulin etc. for anxiety. My point was that many people take medications all their lives (myself included) - some in order just to live, so don't be afraid of having to take one Cymbalta pill, even if it does turn out that you would need it forever.

Cymbalta is prescribed for OCD as well as generalized anxiety disorder, panic attacks, and depression.

I wouldn't be thinking about adding Klonopin or anything else to the mixture right now. The first thing you learn in pharmacology class is "start low and go slow." Right now you are beginning Cymbalta. Let's see what that will do over the next month or so. You may find that you don't even need the Xanax, or anything else. This is especially true if you are working with a counselor at the same time, doing talk therapy to help you understand your anxiety disorder and how to control it on your own. This will help in requiring less medication to accomplish the same goal.

 

 

 

Customer: replied 7 years ago.
Will the Cymbalta put on weight? I went on the forum and alot of people claim they put on weight? Will it stop the panic attacks in my sleep? When I come off the Cymbalta, will I revert back to old behaviors and anxiety again?
Expert:  A. Schuyler, NP replied 7 years ago.

I think I've answered all these questions before. Cymbalta is known for decreasing appetite. In controlled studies, people lost weight on it. Of course, everyone will put on weight if they start to overeat.

Once the drug is in your system, you should not have panic attacks in your sleep.

It isn't known what will happen when you stop it. Some people will be on anti-anxiety medication all their lives in order to avoid the symptoms. For them, it works similar to high blood pressure medication. If they don't take their pills, they have hypertension.

 

Customer: replied 7 years ago.
Is 30 mg. the lowest dosage there is for Cymbalta or is there a lower dosage? Also, can I open the capsules and take them that way? I have a hard time getting pills down my throat. I always feel like I may choke on the pill. Should this be a problem if I take the pill on a spoon with food? Or do I have to swallow it whole?
Expert:  A. Schuyler, NP replied 7 years ago.
The capsule MUST be swallowed whole. That way the pellets dissolve at the right time to provide you proper anxiety relief. Removing the pellets from the capsule negates the entire design of the drug which is to be dissolved slowly. The lowest dosage is a 20 mg capsule, but it also has to be swallowed whole and isn't a great deal smaller.
Customer: replied 7 years ago.
I guess I will try to swallow the tablet. If I can't, what do you suggest I do? I have an appt. with my Psy. tomorrow. I have not begun to take the medication and am still contemplating doing so. Lately, I feel better during the day and can function; however, I have still have panic attacks in my sleep so I am not getting good sleep. I usually go to sleep and sleep for two to three hours and after about five hours break out in a panic attack. I have been avoiding the xanax. I have been taking Nyquil to put me asleep and so far if it has not gotten to be too much of a problem, I would rather take the Nyquil than the xanax. I am going to California in two and 1/2 weeks. I am hoping I will destress myself before than. So far I seem to be concentrating at work. It is the sleep deprecation that is killing me these days. Last week; however, I could not concentrate and thought I needed the Cymbalta. My friends tell me I should take it a short time as I may relapse and I may have good days and bad. I am still comtemplating this in my head. I keep thinking that this is only a "bandade effect" and that if I can tolerate everything and keep my head about me, it is better not to take the drug. What do you suggest?
Expert:  A. Schuyler, NP replied 7 years ago.
If you can't swallow the capsule, I really don't know what to suggest. There is little call for liquid anxiety medication. Nyquil contains acetaminophen, a sedating antihistamine, a cough suppressant, and about 50% alcohol. If this is giving you the sleep you need, you may try taking the antihistamine diphenhydramine (Benadryl®) before bedtime. Melatonin is a well-established sleep aid as well. Either or both of these would eliminate the dangerous combination of long-term use of acetaminophen and alcohol.
Customer: replied 7 years ago.
If I should take the Cymbalta, can I drink alcohol on the weekends? I am reluctant to drink with Xanax, but I think you can drink with Cymbalta. I took Klonopin years ago and drink when I was out (sometimes as much as six or eight drinks) for the evening.

I think if only sedates your more, but is not fatal. What do you know about this? I don't intend to stop drinking on my weekends and I am taking a trip to CA at the end of the month and want to enjoy myself without restricting myself if I can destress at all.
Expert:  A. Schuyler, NP replied 7 years ago.

The problem with drinking with Cymbalta and other drugs of this kind is that it increases the effects of the alcohol. Where you might be able to have 2 drinks over the course of an evening and drive without Cymbalta, you might be considered drunk while taking the Cymbalta. Not that your alcohol level would be that much higher on a drug screen, but it intensifies the effects of the alcohol - loss of judgement, poor motor control, poor impulse control, etc. I would never advise any woman to drink 6-8 drinks over the course of an evening whether she were taking medication or not. Two is the limit for healthy indulgence.

 

 

Customer: replied 7 years ago.
I most likely won't drink that much; however, if I feel the effect of the alcohol after two drinks - it will save me significant money as I will feel like I had 5 drinks already. I will not continue to drink if I feel "very high" right away. I just wondered if it was dangerous. I will take precautions and not drink and drive. I will moderate my drinking if I am on this drug.
Expert:  A. Schuyler, NP replied 7 years ago.
Good idea to watch it very carefully...and save a few bucks :-)
Customer: replied 7 years ago.
I won't have a heart attack or OD if I drink,right? I drank with Klonopin and although it intensified the "high" I managed. I just want to make sure it is o.k. to drink.
Expert:  A. Schuyler, NP replied 7 years ago.
Cymbalta carries a warning to "avoid substantial alcohol use." It does not indicate what quantity it means by "substantial." Most drugs carry the warning "avoid alcohol." No equivocation whatsoever with those; it means don't drink - period. Cymbalta seems to allow for 1 or 2, but caution against over-indulgence.
Customer: replied 7 years ago.
I feel a bit better the last two days and am able to concentrate at work. I did not have a panic attack in my sleep last night as I was totally exhausted. However, I am still have the excessive salivation which has to cause me to swallow every few minutes. I am going away to CA at the end of June. Do you suggest I try the pills or see if I can handle it without them? I was going to see my psychiatrist today to ask him what he thinks. He may push the pills on me. Again, I fear gaining weight and a dependency on these if they help at all. I also fear that once I finish with them, I will be back to square one (in the anxiety mode once again). This is a "bandade effect". However, I just hope I will be o.k. in CA as I paid $1800 for this trip and want to make the most of it with my daughter. I was going to ask the psychiatrist if he could give me a perscription just in case and take the Xanax as a backup on me. I wish the excessive salivation would subside. If this subsided, I would not focus on my throat and I will feel fine. Why is my throat increasing salivation when I am anxious? I have been reading on the forums that most people with anxiety have "dry mouth". Why am I having the opposite effect? I think this is the main cause to the anxiety I have when I sleep because I don't want to be awaken by having to swallow. I want to get my focus off the physical ailments of the anxiety. Once I can do this, I should be fine. Any suggestions? What could be the cause of that? I think it would dessipate if I could stop thinking about it, but because if is uncomfortable, I keep obsessing over it. Please advise.
Customer: replied 7 years ago.
Relist: I prefer a second opinion.
I really am trying to steer away from antidepressants. I tried accupunture yesterday. Do you think this will stop the constant need to swallow and the panic attacks in my sleep? Will this become a lifelong habit? What can I do without medication to make this stop? Do you think accupunture can help? I would like another person to review all I wrote and give me an answer please. Is this common with alot of people that have had OCD or anxiety disorder? What do they do to make it stop? It is very uncomfortable and I am not getting any sleep. Sometimes I feel like it consumes me. I need to focus at work and not obscess over the uncomfortable feeling of this swallowing.

Please help.

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