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Anxiety and Stress Disorders

Guidance fo Anxiety Disorder

04/11/2005

Question:

Repected sir, I am Male aged 45 years having HBP.Hieght 181 cms Weight 104 kg. Regular brisk walk for 1 hour. No diabetes :Non-smoker : Non-alchoholic:Non-chewer: All reports like Thyroid Renal function/Liver function tests are normal : No diabetes. I am on Amlodipine-10 Atenolol-100 Losartan 100. As I am a senior executive having lot of responsibilites, I have a stress and anxiety copuled with disturbed sleep. I consulted one neurophysician who after examining me diagnoised as Anxiety and panic orders and prescribed medicines as follows : 1. Paroxetine controlled release 12.5 2. Clonazepam 0.5 3 flupentixol-0.5 mg + Melitracen-10 mg ) I have collected generic names from my chemist who was kind enough to provide me the details so as to have a correct guidance from me. I have as yet not started the medicines since I wanted to take advice from your web who render selfless service and I have high regards for Netwellness. My query to you sir is as follows : 1. Are the above medicines having any potential sideeffects like drowsiness or impaired alertness or those which disturb my routine assignment as I have a freuent touring also.? 2. For how long the above medicines need to be taken ? 3. What is your advice whether I should start the drug regimen ? I have a vague feeling that the drugs are antidepressents whereas I am most successful execuitve yet I have been dubbed as psychic patient ( this is my loud thinking ) . My relative who is primary healthcare provider suggested to take Escitolopram-10 in place of above. Please tell me which one is more effective ? Kindly clear my misgivings. Of course, once the superspeciality to whom I have approached suggested medicines, I have no business to sit over his judgement yet I have a feeling that I must consult Netwellness since they are the best and beloved friend philosopher and guide for me because on several occasions, they have provided me the best guidance. Thanks and regardsĀ 

Answer:

It sounds like you have been doing an excellent job getting several opinions about your health.  That is always a good idea.  Depression and anxiety are closely linked, and both involve a chemical imbalance of neurotransmitters in the brain.  Anyone can get these diseases, including poor, struggling, ignorant people and well educated, successful, rich people.

Treatment for depression and anxiety usually takes 9 - 18 months at a minimum - some people need treatment longer.  SSRI medications (selective serotonin reuptake inhibitors) are often first line medications -- both paroxetine and escatrolopram are both SSRIs and are used for both depression and anxiety.  There is no clear evidence that one SSRI is better than another for these diseases.  Clonazepam is an anti-anxiety drug that treats the symptoms of anxiety, unlike the SSRIs which treat the underlying cause.  Some people need both medications initially, but can stop their anti-anxiety drugs like Clonazepam later.  Unlike the SSRI which have NO addictive potential, Clonazepam can become addictive.  The other drugs recommended to you are not available in the USA and I have no experience with them.  All medications have side effects, and I encourage you to talk to your physician and pharmacist about these specific medications.  Drowsiness can certainly occur with the Clonazepam, but is less likely with the SSRIs.

 

Good Luck.

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Response by:

Nancy   Elder, MD Nancy Elder, MD
Associate Professor
College of Medicine
University of Cincinnati