Question: Hi, I am a 27yo female, 5'7" and 250lbs. Hx of hypothyroidism, panic disorder, mild depression, cervical cancer, venous thrombosis in lt arm due to iv infiltration. Sx cholecystectomy, t&a, and appendectomy. Smoke 1ppdx10yrs. I am currently on Ativan 1mg tid, synthroid 50mcg qd, lexapro 20mg qd, and weaning off topamax 50mg qd (I'm just taking it every other day). I also take Benadryl daily, and aspirin 250. I had a bout with bronchitis, acute otits media, and slight dehydration about a month ago. During that time I took 10d of levaquin, and a lincomycin/steroid shot combo. I began having severe right leg pain after the levaquin. Did an ultrasound of leg and was negative for any blood clots/etc. Now the bronchitis is trying to return along with a UTI. Doctor rx'd omnicef, and after one pill my mouth became raw and had a facial rash. So meds were changed to Bactrim DS, and a medrol dose pack. I began both yesterday, and was so nervous tht I was only able to take 4 of the 6 pills for first day dose. My heart was pounding out of my chest with force, but no tachy, and I was basically like a cat on crack. Today I did three pills and I will continue to taper down this week. Tonight I began to be so hot and flushed. My left shoulder/arm is very warm to the touch. I guess my question is, is this due to the medrol pack? And I'm also concerned with the topamax taper because I also take Benadryl most every day and I know it produces anticholinergic effects. (In my case no sweating and holding the heat in). Also should I be concerned with potassium depletion due to the steroids since I do have a tendency to let myself get dehydrated easily. Thank you very much!aybe I just worry too much, but I would like to know.

Thank you very much! I hate taking all these meds and only being 27yo. The Ativan I have taken for 10 years. I was actually at 2mg five times a day at one point. A psychiatrist I was seeing put me on that dosage and when she discontinued her treatment with me (because I refused to take adderall with GAD). My GP lowered that dose to 1mg tid, which is what I'm still on. When I was 17yrs old my panic began out of no where and a wide variety of specialists all evaluated me and told me there was absolutely nothing medically wrong with me. The panic has slowed down a great deal over the past few years, and I honestly think I am having rebounding from the lexapro and Ativan both. Everyone treating me were just looking for a quick fix to give me some answers, because like I said I was a completely normal teen and panic blind sided me. I'm going to dc the medrol, as I can't allow myself to be in such a jittery/anxiety filled state all the time. The flushing has went down some, but my shoulder/arm is still very warm to the touch.

Thank you so much for your help! I completely agree with your suggested treatment route, but it is so hard to find a decent/dedicated therapist here in my rural community. My main concern with coming off the Ativan is seizures. I've never had one before in my life, but they are a huge fear of mine (stemming from my panic). That's what I'm so concerned with right now in coming off the topamax. I was never on topamax for psychiatric reasons, the dr rx'd it for weightloss therapy. I gained 60lbs in 4months from PCOS and the medicine did zero for it. So I told him I wanted off the 50mg and he said to just quit taking it. I won't do that for fear of having a seizure lol. I'm just doing it every other day for right now. I also visited GP this morning because my cold symptoms have not improved and I am just so tense and jittery. He said to dc the medrol, continue the Bactrim, and rx'd diflucan 150 qd x 5 days due to white patches in my mouth. (I do not believe it is oral candida, but we shall see).