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Dr. Vikas
Dr. Vikas, Psychiatrist
Category: Mental Health
Satisfied Customers: 2219
Experience:  MBBS ; M.D Psychiatry, MS. Health Informatics
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Living overseas, had a panic attack, was given xanax at local

Resolved Question:

Living overseas, had a panic attack, was given xanax at local hospital, no mental illness docs where I live, have effexor and wellbutrin as a safe guard from former doc. not sure what to take, depressed and anxious, 3 panic attacks in 1 year, counseling would be helpful, but not an option here. Any advice?
Submitted: 1 year ago.
Category: Mental Health
Expert:  Dr. Vikas replied 1 year ago.

Dr Vikas :

Hello

Dr Vikas :

For controlling occasional panic attacks / acute anxiety attacks, you can see a local doctor and ask him or her to prescribe you a mouth dissolving preparation of Clonazepam in a dose strength of .25 or .5 mg to be taken on as and when needed basis.

Dr Vikas :

This tablet dissolves rapidly in mouth and bypass gastric metabolism thus providing quick relief in panic attacks.

Dr Vikas :

It can be a very good option for controlling occasional panic attacks.

Dr Vikas :

If these attack increase in frequency, in that case, any GP near you can prescribe a SSRI antidepressant like Sertraline or Escitalopram which are sufficient for controlling anxiety / panic attacks. Clonazepam can be taken on as and when needed in combination. Antidepressant once started should be taken for at least 6-8 months.

Dr Vikas :

Even Effexor can also be helpful in controlling panic attacks but as you are having only occasional panic attack so as and when needed clonazepam is a much better option in my view.

Dr Vikas :

Wellbutrin will not help in controlling panic attacks.

Dr Vikas :

are you currently online?

Dr Vikas :

I hope this helps, if you have any doubt or query, please feel free to discuss further.

Customer: I am currently living in Kuwait, which has little to no psych. meds. I have to travel to another country to get any of these types of meds. Do you think restarting Effexor 75mg daily would help?
Dr Vikas :

these are not special psychiatric medicine specially Clonazepam. Xanax is Alprazolam and is just like Clonazepam. The advantage of Clonazepam is that it is longer acting and mouth dissolving preparation act rapidly.

Dr Vikas :

if a doctor can prescribe you Xanax (Alprazolam), he or she can also prescribe you Clonazepam. Both of these medicines are benzodiazepines.

Customer: I generally take this as needed when my hormones get out of control due to my PCOS, not daily. I have a limited supply of Xanax, but I don't want to get addicted to this. I have tried Topamax before and still have some, but I didn't like the side effects.
Dr Vikas :

As I mentioned before, Effexor can help in anxiety and panic attacks but you need to take it daily for few months once you start it. If you intend to take it occasionally, it will not be useful

Dr Vikas :

also, 75 mg is the starting dose and most patients respond to at least 150 mg per day.

Dr Vikas :

You will not get addicted to Xanax if you are taking it occasionally.

Customer: Unfortunately these Meds are reserved for ER patients and local nationals only. Expats can't get any unless its in the ER. Joys of living internationally.
Dr Vikas :

sorry to hear that.

Dr Vikas :

Can't you see a GP or Physician there as he or she can also easily prescribe you these medicines.

Dr Vikas :

?

Dr Vikas :

are you there?

Expert:  Dr. Vikas replied 1 year ago.

Jennifer,

I am waiting for your reply.

Kind regards

Vikas
Customer: replied 1 year ago.
I was previously being treated in Hong Kong while I was living there and she gave me enough to get me started here, but there are no local doctors who can prescribe or pharmacies that can sell these meds to foreigners. I will start the Effexor daily and see how that goes. Will have to travel to get resupplied though. Previous doctor put me on Effexor and Wellbutrin in order fir Wellbutrin to offset the overeating that Effexor can cause as I also have weight problems. Do you think this is necessary to add Well itrin into the mix as well?
Expert:  Dr. Vikas replied 1 year ago.
Jennifer, I don't think that adding Wellbutrin to Effexor is of any help for controlling over eating. Wellbutrin itself does not cause weight gain but can't control overeating due to other medicine.

Also, it will not help in controlling panic attacks.
Dr. Vikas, Psychiatrist
Category: Mental Health
Satisfied Customers: 2219
Experience: MBBS ; M.D Psychiatry, MS. Health Informatics
Dr. Vikas and other Mental Health Specialists are ready to help you
Customer: replied 1 year ago.
Thank you for your help! I will begin the Effexor today and see how that goes for the next month or so. Have a great day!
Expert:  Dr. Vikas replied 1 year ago.
You are most welcome Jennifer.

You too have a great day.

Kind regards

Vikas

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Dr. Vikas
Dr. Vikas
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MBBS ; M.D Psychiatry, MS. Health Informatics