Are There Any Medicine Left That Can Fix My Anxiety?

Posted on Mon, 9 Sep 2024

Question: Hello doctor, i suffer from anxiety disorder since many years and have tried taking treatment multiple times using different SSRI & SNRI meds. however all serotonin acting drugs aggravates my RLS symptoms so another doctor prescribed me bupropion 150 XL , its been like 2 weeks but i don't feel anything except that my RLS is disappeared, on top of that this medicine cost a lost so just to control rls symptoms this is not an good long term option for me. I have RLS due to low dopamine, no other cause got ascertained after several tests, there are also mild neuropathy symptoms as well.

So my major ques, is are there any medicine left that can fix my anxiety?? I have mixed general & social anxiety, my life is crippled as just any thought gives me internal XXXXXXX heart attack like feeling, heartbeats increase , also hands and feets gets cold. I am so tired looking for relief but this RLS have caused an hindrance to my treatment. I also get frequent mood swings such as sometimes i feel sad inside for days while sometimes i feel normal but i am not depressed, i am just struggling with anxiety which is not letting me move forward in my life.

Answered by Dr. Shubham Mehta (49 days later)

Brief Answer:
Increase dose of bupropion.

Detailed Answer:
Hello,
I have gone through your query and understand your situation.

I have few suggestions for you:
1. Consider increasing the dose of bupropion to 300mg.
2. Consider adding buspirone or tofisopam to bupropion.
3. Consider using tianeptine. It has a different mechanism of action than SSRIs.

Please discuss this with your treating doctor and proceed accordingly.

Also please note that these medications are prescription drugs and should be taken as per advice of your treating doctor.

Hope this helps.
Thanks.

Above answer was peer-reviewed by : Dr. Saisudha Kotla

Follow up: Dr. Shubham Mehta (2 hours later)

Thanks for your reply doctor, i am No longer on bupropion as doctor made me switched to another drug which was vortioxentine, took it for 3 week starting from 5 mg to 10 mg but again no significant relief on anxiety but again RLS was not aggravated. So i had to again stop that considering it's way too high cost . I am being told to take sertraline for a start as i have frequent mood swings issues, which have not tried it yet but i am sure it will work on my anxiety but it will aggravate my rls symptoms including giving me sexual side effects. I am so confused what to do at this point of time, i don't want sexual side effects and rls symptoms aggravation but also want anxiety to get controlled . On top of all of this, most of the drugs are costly.

Answered by Dr. Shubham Mehta (1 hour later)

Brief Answer:
lithium plus buspirone

Detailed Answer:
Hello again.

Sertraline is another SSRI which can have sexual side effects.

Vortioxetine is a costly molecule. In my experience, it is not that effective anti-anxiety drug as SSRIs.

I would again suggest that consider increasing the dose of Bupropion.

Or,
Another option could be starting with a mood stabilizer like Lithium or Lamotrigine and adding drug like buspirone (All are prescription drugs) to it. This will control your mood swings as well as anxiety. This would be cost-effective also as both lithium and buspirone are very cheap and easily available.

Please discuss this with your doctor and proceed accordingly.

Wish you good health.

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Shubham Mehta (3 hours later)

Isn't those drugs for bipolar? I mean i am not bipolar but yes i suffer from frequent mood swings ranging from sad to even normal for many days but nothing like that of bipolar extremes. As for buspirone, i have taken that in past too, took it for 8 days & everyday was a struggle with nausea symptoms which even anti- nausea drug failed to help with it, & even buspirone too aggravated my rls symptoms. As a matter of fact, the issue is that all serotonin acting drugs are enemy of restless legs syndrome. This is the same reason,why i am asking for help everytime as i just want my anxiety struggle to be treated without causing me restless legs.

Answered by Dr. Shubham Mehta (18 hours later)

Brief Answer:
Clobazam sos

Detailed Answer:
Hello again.
Sorry for delay in response.

I understand your situation. You are having tough time.
I think increase in dose of bupropion should be the best possible solution in the given scenario.

If the anxiety is disabling, you can take clobazam (prescription drug) on sos basis.
Kindly discuss this with your doctor.

Thanks.

Note: For further follow up on related General & Family Physician Click here.

Above answer was peer-reviewed by : Dr. Saisudha Kotla