Diagnosed With Anxiety And Taking Zoloft. Developed Panic Disorder, Heart Palpitations, Swollen Ribs. Should I Live In Constant Fear?

Posted on Thu, 24 Oct 2013

Question: I have been diagnosed with anxiety and have started a New medicine 2 weeks ago. Zoloft 50mg. I have been having bad panic attacks on and off for two months. I have developed panic disorder constantly worrying about another panic attack. When I'm having a panic attack I get heart palpatations, rapid heartbeat, severe chest pain, shakes, hot flushes, feeling out of my body, thoughts of having a heart attack. I have been to the hospital 3 times with these symptoms and they have done an ecg every time which has been normal. Could I still be having cardiac problems with a normal ecg reading?? I'm worried about the chest pains but doctors have told me its anxiety or inflammation of my ribs and because I'm tense with anxiety it causes the chest pain. Will these panic attacks stop or will I be able to manage them better on the zoloft as I have only been taking it for two weeks and xanax short term for a month while the zoloft is building up. I don't want to be living in constant fear help.

Answered by Dr. Susanta Padhy (23 minutes later)

Brief Answer:
Unlikely to be cardiac problem

Detailed Answer:
Anxiety particularly panic disorder have such symptoms, you are referring to, classically.

Zoloft does work for panic disorder very well.

However, to my mind, the dose should be increased at least to more than 100- 150 mg / day. This you can discuss with your doctor

Because anxiety disorder needs higher dose of SSRI drugs (zoloft for example in your case)

Seems unlikely to have cardiac problem. In fact, this is typical of panic disorder that in spite of ECG and cardiology opinion normal, they would keep on harboring the fear

With continuation of regular treatment, I do not see any reason for you spend your live in fear. You should be off fear.

Hope this helps

Wish you a fear-free life

Above answer was peer-reviewed by : Dr. Shanthi.E

Follow up: Dr. Susanta Padhy (36 minutes later)

Thanks you, its a relief to know u don't think its cardiac related. I feel the pain in my chest is intensified when I'm anxious or having a panic attack. Are there other strategies I can do when extremely anxious or having a panic attack. I feel I'm forever monitoring my body for symptoms and panic when I feel something. My anxiety is mainly related to my health.

Answered by Dr. Susanta Padhy (8 hours later)

Brief Answer:
No need to do other strategies

Detailed Answer:
To my mind no need to follow any additional strategy except for considering to increase the dose of ZOLOFT to 100-150 mg/day

Kindly do not monitor your symptoms, because this itself is a typical symptom of panic disorder. And as a treatment strategy, we usually recommend not to monitor or analyse symptoms, as this will worsen the symptoms of panic attacks

Good luck

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

Follow up: Dr. Susanta Padhy (13 hours later)

My anxiety has been really bad today. I have been getting the same chest and shoulder pain I have had for the past week really bad today as well. I have taken .25mg xanax 4 hours ago which helped for about 2 hours. I have also taken 5mg oxycodone for pain which helped up until I started feeling bad anxiety again then the pain started aching again. I feel really on edge and unsettled and am finding it difficult to relax today. I can't help thinking that there is something more serious going on with me that both my doctor and the hospital doctor have not picked up on. My doctor is going to increase my Zoloft to 100mg after I have been on it a month. I can't wait to overcome this anxiety instead of letting it rule my life. I feel I'm going crazy and my doctor is probably sick of me coming to him with the same problems even though he has sauteed me it will all get better in time. I'm just worried about my chest and shoulder pain and increased anxiety

Answered by Dr. Susanta Padhy (11 hours later)

Brief Answer:
Xanax dose can be increased

Detailed Answer:
Xanax dose can be increased and can be taken regularly thrice daily, to cover for 24 hrs, till you see your doctor

This increase in xanxax should be temporary (till 2 weeks after Zoloft increase)

Overall, not to be worried so much. Anxiety will not take your life

Good luck

Note: For further guidance on mental health, Click here.

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