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Dr. Vikas
Dr. Vikas, Doctor (MD)
Category: Health
Satisfied Customers: 2207
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

Resolved Question:

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
Submitted: 1 year ago.
Category: Health
Expert:  Dr. Vikas replied 1 year ago.

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 :

If you are satisfied with my answer please rate one of the positive ratings (3,4,5) as this is the only way how we are compensated for our time and expertise.

Dr. Vikas, Doctor (MD)
Category: Health
Satisfied Customers: 2207
Experience: M.B.B.S ; M.D (Psychiatry and Deaddiction), MS. Health Informatics
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