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Ask Dr. Kaushik Your Own Question

Dr. Kaushik
Dr. Kaushik, Psychiatrist
Category: Mental Health
Satisfied Customers: 3936
Experience:  MD Psychiatry
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Hello, I have Panic Disorder. I was diagnosed 10 years ago.

Customer Question

Hello,

I have Panic Disorder. I was diagnosed 10 years ago. I was on medication until the fall of 2009. For two years I experienced no symptoms and not single panic attack. In september 2011 I had a very severe panic attack where I was taken to the ER by ambulance. I have been battling everyday since then with my anxiety and panic. It has gotten to the point where it is effecting my everyday life. Three days ago I went to a psychiatrist. Two days ago I started taking 75mg of Effoxor in the morning 50mg of Seroquel at night and 1mg of Ativan to combat panic attacks. I feel my anxiety has gotten worse since starting the meds. I have taken these meds before in the past with no issue and they were very helpful. Will the medications increase anxiety while my body adjusts to take them. I want to give the meds a chance but the last two days have been very difficult. Any thoughts?
Submitted: 1 year ago via Patientsville.
Category: Mental Health
Expert:  Dr. Kaushik replied 1 year ago.

Dr. Kaushik :

Hi there,

Dr. Kaushik :

Welcome to Just answer !

Customer:

Hello

Dr. Kaushik :

Well, it has just been two days that you have been on this drug regime , which is too early to expect a miracle recovery to happen , since this drug regime should be given it's due time period to reach steady state plasma levels so as to produce the desired effects ..

Dr. Kaushik :

so give this drug regime another 3-5 days to let your body adjust and respond to the drug regime..

Dr. Kaushik :

and please do not compare the last time when you were on these drugs as everytime it is different response from the body , so it is quite normal to see this varied response this time around..

Customer:

Could the introduction of the medication to my body increase anxiety

Dr. Kaushik :

oh..

Dr. Kaushik :

yes ..

Dr. Kaushik :

it many times happens ..

Dr. Kaushik :

since effexor is an activating drug

Dr. Kaushik :

which sometimes causes anxiety initially but later in a few days satrts to allay the same anxiety..and panic attacks

Dr. Kaushik :

and please note that whenever you get a panic attack you need to try to breath in and out from a paper bag or else do an exercise where in you need to intentionally breath deeply in and out for 2-3 minutes and then your breathin problem will subside ..

Dr. Kaushik :

along with panic feeling..

Dr. Kaushik :

and if this do not work ..

Dr. Kaushik :

then you need to take 0.5- 1 mg dose of ativan

Dr. Kaushik :

at the time of panic attack ..

Customer:

thank you that is very helpful to hear. I have been hesitant to take the 1mg of Ativan because I do not want to over do it to where I can not function

Dr. Kaushik :

No you can take ativan as PRN that is

Dr. Kaushik :

as and when required basis ..

Dr. Kaushik :

so do not worry , as you can take as much as 4 mg / day ..

Dr. Kaushik :

but make sure that you inform about this PRN use of ativan to your doctor ..

Dr. Kaushik :

I hope this helps and allays your doubts..

Dr. Kaushik :

and gives you some assurance..

Dr. Kaushik :

so hang in there , this will be over soon ..

Customer:

it does thank you for your time

Dr. Kaushik :

Wish you all the best..

Dr. Kaushik, Psychiatrist
Category: Mental Health
Satisfied Customers: 3936
Experience: MD Psychiatry
Dr. Kaushik and other Mental Health Specialists are ready to help you
Customer: replied 1 year ago.
Hello Again,

It has now been on day 5. Things are slightly better but I still have very intense anxiety. I am having a very difficult time completing the simplest task. I am completely on edge. I know it is only anxiety but I cannot get it to stop.

Expert:  Dr. Kaushik replied 1 year ago.

Wwll, i can see that you are struggling with anxiety, but having said that you are also getting there albeit slowly as expected, which happens at times..

 

However , as of now you what you can do is that you shall inform your doctor that you need to take an additional 1 mg of ativan other than the already continuing 1 mg dose of ativan. But this additional 1 mg you need to take at a different timing say after 8-10 hrs of first 1 mg dose pf ativan..

 

So, kindly adopt this ploy of using another dose of ativan to see you throught this troubled and distressing phase while your symptoms subside in due time as the drug gets settled in your system.

 

I am positive and hopeful that soon your symptoms of anxiety will start to go away , but until that happens do as mentioned above and do inform your doctor about this and take his approval as this seem to be the most plausible remedy for your problem at this point when you need some more time for the drug effexor to produce it's desired effects ..

 

I hope this helps..

 

Wish you all the best and God bless..

 

Regards..

Customer: replied 1 year ago.
Thank You for your response. I will try your suggestion and I hope the panic will subside a bit.
Expert:  Dr. Kaushik replied 1 year ago.

yes you do that..

 

Regards..

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