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Vakul Aren
Vakul Aren, Doctor
Category: Medical
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Experience:  MBBS,DTM&H,34 years of experience
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Hi there I am going to see a GP tomorrow for anxiety. In

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Hi there

I am going to see a GP tomorrow for anxiety. In 2010 I was diagnosed with an anxiety disorder - well not formally diagnosed but I suffered a massive break down and had non stop panic attacks and even ended up in hospital. For the better part of six months I was in a terrible anxious state - since then because of the many physical symptoms I have been hypochondriac. I saw a counsellor who helped teach me how to manage my symptoms.

The anxiety has happened on and off since 2010 but to a much lesser degree. However, my hypochondria started when I was 13 as I remember clearly being obsessed with my health and being anxious to the point I thought was surely dying of some disease as young as 30.

I have had a really stressful year this year and have given myself what seems to be gastritis which won't heal even on medication. I had similar in 2010. This has started my hypochondria and it's affecting my daily life. I constantly obsess about it and I am nervous and anxious all day long, constantly checking constantly looking for answers and even when I get some I keep on going. I just can't seem to stop myself. I have had one or two panic attacks recently.

My question is, do you think medication is helpful at this stage. I have been told by a friend that I may be OCD - I remember severely anxious period in 2006 when I was travelling and I was gripped by fear that I would hurt someone ... irrational crazy fears that paralysed me and this would come on and off. But hasn't been my major concern of late. I am just unable to function properly and be focused, I cry easily and stress out all the time. I am totally depressed by this and can't seem to keep a clear head and get a grip on things. I have moments where I feel ok but they don't last.

I was told by my friend who is a psychologist that I might want to think about getting on an SSRI but I have some questions.

1) Is it appropriate in my case (I don't want to think that I have to come to depend on drugs)
2) Are there any side effects (I am concerned especially with my stomach problems)
3) Will I ever be able to get off them or will i become dependent on them
4) I have read some horror stories of people having such a difficult time getting of SSRIs
5) What is the likely impact on libido because this is something I do not want to lose, though my anxiety is already having an impact on this.

I would like some recommendations on whether it is appropriate to go on meds and what else can I do. I can't seem to control my over reactions to things.
Submitted: 1 year ago.
Category: Medical
Expert:  Vakul Aren replied 1 year ago.
Welcome to Just Answer. I will try and help you with the query.Use of antidepressants ,specifically SSRIs and SNRIs,in Generalised Anxiety Disorder is usually successful.This along with counselling ,including Cognitive Behavioural Therapy(CBT) and other similar techniques like biofeedback may help the most.I would suggest that it would help if you are assessed for GAD and panic disorder and a trial of SSRIs like Desvenlafaxine or Paroxetine done.You may in addition need benzodiazepines like Clonazepam or lorazepam till such time the full thereupeutic effect of the SSRI is evident.This initial phase may last upto 3-4 weeks,if a side effect causes a major problem with a SSRI drug,another compound may be tried.Atypical antidepressants have also been used in such cases with success.Once the drug has been successful along with stress reduction techniques in normalising matters,a very gradual reduction in the dose is started. This will help in tapering off the SSRI with minimal problems.Libido is definitely affected but not to the extent which is seen while affected by the anxiety and stress.Rare cases of horror stories do occur,but they are more due to a rapid withdrawal rather than any other problem.Stress reduction methods like regular exercise,spending time with family and friends,listening to music and pursuing ones hobbies help .
Customer: replied 1 year ago.

Thank you for your answer. Can you please advise if:


 


1) I have lexotan 3MG (I usually break it into half and take 1.5mg) - I feel very sleepy on it and cannot work or function. The last time I took it a few days ago, my anxiety was severe and it over-rode the effect of lexotan I suppose because I felt like maybe it was going to give me a panic attack? I assume lextoan is a benzodizepine.


 


2) Is Desvenlafaxine similar to prozac? and will these SSRIs be tough of my stomach I am very very worried about it aggravating my stomach condition (assumed gastritis based on symptoms only and on nexium 40mg 1 x day - no improvement = hypochondria). I don't want to start on a medication for it to make my sotmach worse.


 


3) I am worried about a reaction to an anti-depressant because my ex partner was on it and she turned blue and had to stop it immediately. I don't remember what it was called.


 


4) I understand the stress reduction techniques but when I'm anxious I have no motivation to pursue hobbies or even do anything because I feel like there's something physically wrong wtih me and then mentally and then physically. I am hoping going on meds will help this.


 


Thank you for your reply.

Expert:  Vakul Aren replied 1 year ago.
Lexotan is a benzodiazepine which helps in anxiety,its use is limited to short term use,2-3 weeks after which it may not be of much use.Gastritis is rarely reported by patients but may be seen in the occasional patient.Reactions to the Desvenlafaxine are rarely serious and should not be a problem.The drugs will help in clearing up the anxiety and stress along with life style changes may reignite your passion for your hobbies in due course of time.
Vakul Aren, Doctor
Category: Medical
Satisfied Customers: 3403
Experience: MBBS,DTM&H,34 years of experience
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MBBS,DTM&H,34 years of experience