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Dr Basu
Dr Basu, Experienced Specialist
Category: Medical
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Experience:  MD
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I have moderate to severe panic attacks, sometime 3-4 times

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I have moderate to severe panic attacks, sometime 3-4 times a week. I was diagnosed with dysthymia and anxiety disorder earlier this year; even though I have been dealing with it since I was 17 (now 32). I also have trouble sleeping. I have tried many different medications but nothing has worked. I have tried zoloft, wellbutrin, paxil, effexor, prozac, lexapro, klonopin, buspar, and vistaril. Right now I take prozac and buspar for my depression and anxiety and trazodone for my sleep. I continue to take the medicines even though they are not working. I have tried nonpharmaceutical things as well, like deep breathing, exercise, journaling, and therapy. Nothing is working. Many years ago when I was in college, my doctor at the student health center prescribed me xanax. I took it as prescribed, PRN 1mg. It worked! I couldn't believe something worked. After college I moved to SC and my doctor took me off of it and started prescribing klonopin instead. I took it as prescribed, 10mg daily. Not the same effect. Now buspar, I actually continue to have panic attacks while taking it. I have a doctor's appt in about 10 days. My question is: how do I discuss with my doctor that my meds aren't working, but I know what works? I have researched xanax and its addictive qualities. But I have also researched how much it helps other people like me.
Submitted: 1 year ago.
Category: Medical
Expert:  Dr Basu replied 1 year ago.
Hi there,
This is Dr Basu, Experienced Specialist.
I am here to address your concerns and provide great service.
Pretty much what you wrote here should be discussed with your doctor as well.
If we go by the step therapy protocol, you failed the SSRIs, buspar, vistaril, even klonopin.
So the next option will be xanax since it is stronger.
But the addictive property and the fear of stopping working make many clinicians cringe.
Hence, a psychiatrist experienced in managing panic disorders should be better to take care of your issues.
Nowadays, Gabapentin is another option worth exploring for persistent anxiety attacks.
It does work as good as benzos with less addictive potential and tolerance.
Atypical medications like Abilify or seroquel are other options if your doctor wants to try something other than xanax.
Best wishes

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