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Dr. Vikas
Dr. Vikas, Psychiatrist
Category: Mental Health
Satisfied Customers: 2253
Experience:  MBBS ; M.D Psychiatry, MS. Health Informatics
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This a question for dr v.I was given lustral together with

Customer Question

hello this a question for dr v.I was given lustral together with stealzine 2mg for any intail panic side effects way back in 1996 it worked well.About a year ago i was put on ativan for 2months and aafter being on ativan for a month they tried remeron for anxiety the remeron didnt work even though i was on ativan 1mg i still got at panic induced by remeron at 30mg.could you tell me why that might be and if i stared a new ssri like prozac or celexa with klonipin cca i be sure the klonipin will stop any intail panic because atian didnt but that was after being on it 2months?.
Submitted: 8 years ago.
Category: Mental Health
Expert:  Dr. Vikas replied 8 years ago.
Hello Carlos,

Thanks for your question, and apologies for the delay.

The dose range of Ativan is from 2 to 6 mg per day, but some patients who are on Ativan and have Panic disorder may require higher doses from 6 to 10 mg per day.

Could you kindly mention your diagnosis correctly as told by your doctor. Was this panic attack induced by Remeron ?/???? or are you also suffering from Panic disorder?

Please see the links below for more information.

Panic Disorder

More about Panic disorders.

Customer: replied 8 years ago.
Hi i was diagnozied with gad and i was ativan 1mg a day for gad and after being on ativan a mointh they put me on remeron i was on 15mg ofremeron but it didnt improve the anxiety then at 30mg it gave me a panic attack first time.Like i said ive been on lustral in the past with 2mg of stealzine in the intail 2months and i had no sid effects also paxil a few yewars after and had no intail sideeffects thats why iam wondering if i started prozac or celexa at a low dose would klonapin stop any intail panic side effects just like stealazine did or maybe i just tolerated lustral and paxil well.
Expert:  Dr. Vikas replied 8 years ago.
Hi Carlos,

Panic attack are common with Anxiety disorders and it is not appropriate to say that Remeron caused this Panic attacks. It is possible that Remeron was not effective in controlling the anxiety symptoms in you and could be increased further to 45 mg if tolerated well.

As you must be knowing that Lustral, Paxil, Celexa,and Lexapro all belongs to same SSRIs class of drugs and If Lustral was effective for you earlier, in my view this should be the drug to be tried in your case.

SSRIs may cause initial anxiety and Jitteriness in some patients and Benzodiazepines such as Klonopin are usually given at initiation of treatment and I don't see any reason why it will not be able to control initial anxiety symptoms in you.

So if you are very much concern about the initial anxiety related symptoms at the start of therapy, you should discuss with your treating doctor about the use of Klonopin in your case.

Best wishes.
Dr. Vikas and other Mental Health Specialists are ready to help you
Customer: replied 8 years ago.

Hi dr vikas i have been on 4ssris over many years they worked perfectly in controlling the anxiety which was chronic.With lustral i started at 50mg along with 2mg of stealazine i had no side effects from it no panic 2 years later i came off lustral and tried to go back on it a month later but had a very bad panic attack as a lustral side effect the stealzine wasnt effective by that time but when i started paxil furst time at minimal dose

i felt great and slowley increased it it worked perfectly in controlling the anxiety and no intaial side effects but i came off that after a year and tried to go back on it and i got a very bad panic attack going back on it but i stasyed on it and in 2weeks felt great again.

Still now iam not any meds and i cant convince myself that i wont get a very bad intail panic attack if i start prozac with klnopin i seem to have lost trust and dont know how to convince myself of taking meds can you state that stealzine and klonopin are as powerful as each other at stopping intail anxiety on ssris.

Expert:  Dr. Vikas replied 8 years ago.
Hello Carlos,

I guess, you are thinking over it too much.

It is very much likely that you will not experience Panic attacks or anxiety symptoms while taking Prozac and Klonopin together in appropriate dosing. Just tell your treating doctor about your concerns and he will take proper care of your fears.

As I have mentioned earlier, we usually don't use stealzine for this purpose, but we do have a very good experience with Benzodiazepines . Benozdiazepines such as Klonopin are very effective in controlling anxiety symptoms, and you should not worry about it.

Just go for the treatment, and everything will be allright.

Best wishes

Dr. Vikas and other Mental Health Specialists are ready to help you
Customer: replied 8 years ago.
Well in fact my dr is disencourging the prozac he isnt offering a benzo because he said it will complicate it and he offered me an antiepleptic for the anxiety disorder iam not happy with my dr at all.