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Dr. Vikas
Dr. Vikas, Doctor (MD)
Category: Health
Satisfied Customers: 2239
Experience:  M.B.B.S ; M.D (Psychiatry and Deaddiction), MS. Health Informatics
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I have been diagnosed with an anxiety disorder a number of

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I have been diagnosed with an anxiety disorder a number of years ago and have been taking 20mg of lexapro since. everything seemed to be ok but more often now I will get an episode where it's hard to breathe and my heart races. about a year ago I've started to get chest pains so I went to the doctor and saw a cardiologist and through just an interview she said that it doesn't look like I have any problems but the pain was never diagnosed. so a few weeks ago I was getting sharp pains in the middle/left side of my chest but no where else so I went to the er. the did an ekg and an x Ray of my chest and said they didn't see anything wrong and it all looked good. I was told it was probably GERDs and was given a script for it. I still get the pains. I'm 29 year old male 245 pound 5'6'' heart disease is in my family so I'm always worried

Dr Vikas :

Hello

Customer:

hi

Dr Vikas :

Hi, are you online right now?

Customer:

yes

Dr Vikas :

If all of your heart related investigations are alright, the most likely cause could be GERD and I agree with your doctor in this.

Dr Vikas :

SSRI antidepressant like Lexapro also cause gastrointestinal side effects and this could be also add to GERD problem

Customer:

huh

Customer:

and the breathing is probably my anxiety then

Dr Vikas :

In such cases, we usually add a low dose of Mirtazapine which is also an antidepressant but with different mechanism of action and it can counteract the gastrointestinal side effect of Lexapro.

Dr Vikas :

yes, the breathing problem is frequently reported by patients suffering from anxiety

Customer:

Ok I'll ask my doctorabout that medicine

Dr Vikas :

yes, it will also augment the antianxiety and antidepressant effect of Lexapro which will again help in controlling your anxiety symptoms

Dr Vikas :

initially a low dose of 7.5 mg or 15 mg at night is sufficient in most cases.

Dr Vikas :

it is very sedative so should be taken at night

Customer:

Ok and its script only I assume

Dr Vikas :

you can also ask your doctor to prescribe PPI medicines such as Pantoprazole or Omeprazole which can effectively control your GERD symptoms

Dr Vikas :

In my view, simply adding a low dose of Mirtazapine should be helpful

Dr Vikas :

which medicine you are currently taking for GERD?

Customer:

nothing

Dr Vikas :

chest pain and breathing problem can also be because of anxiety other than GERD

Dr Vikas :

again in that case, adding another antidpressant like Mirtazapine can be useful

Customer:

any side effects from it

Customer:

other then tiredness

Dr Vikas :

Mirtazapine is sedative and can cause weight gain, these are two most common side effects

Customer:

Ok

Dr Vikas :

but since you will be taking it at night, so will not cause tiredness in morning

Dr Vikas :

and also discuss with your doctor about trying Pantoprazole for few days.

Dr Vikas :

if chest pain is because of GERD it should respond to Pantoprazole or any other PPI medicine

Dr Vikas :

do you have any other question to ask?

Customer:

ok great that's allvery helpand reassuring

Dr Vikas :

you are most welcome

Customer:

No Ithink I'm ok

Dr Vikas :

So may I discontinue that chat?

Customer:

yes that's fine thanks for the information

Dr Vikas :

discontinue the chat :)

Dr Vikas :

O.K

Dr Vikas :

Bye

Dr Vikas :

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