HealthCareMagic is now Ask A Doctor - 24x7 | https://www.askadoctor24x7.com

Have Neck And Shoulder Pain. Pins And Needles Feeling. Take Xanax For Anxiety. What Is The Cause?

Posted on Fri, 6 Dec 2013

Question: Neck pain Shoulder pain Pins and needles feeling I have anxiety and i take xanax .but i dont improve . I need your help to change medication .

Answered by Dr. Preeti Parakh (3 hours later)

Brief Answer: Explained below. Detailed Answer: Hi, Welcome to Healthcare Magic! The pain in neck and shoulder and the pins and needle like sensation are most probably due to cervical spondylosis, and I hope that your doctor has advised an X-ray of the neck. If not, please get it done. In this there are degenerative changes in the vertebral column in the neck area, because of which the nerves from the spinal cord get compressed. This results in pain and abnormal sensations in the areas supplied by the nerve. If there is cervical spondylosis, you will have to do neck muscle strengthening exercises which will provide relief. In addition, there are some medicines like pregabalin and gabapentin which help in both neuropathic pain and also relieve anxiety. Pregabalin 75 mg at bedtime is a good starting dose and can be hiked up later as needed. Regarding your anxiety, Xanax can only reduce anxiety as long as the medicine is in your body but it cannot prevent the anxiety from coming again. For better results, you should start a medicine of the SSRI class (Zoloft, Lexapro, Paxil etc) or the SNRI class (Effexor, Cymbalta etc). These would have a long term effect on anxiety. You may also find a benefit in muscle aches as well from these. I shall be able to help you better if you can describe your symptoms in more detail, especially the duration of anxiety and if you feel that your neck pain is related to anxiety or not. I would also also like to know if the pins and needle sensation occurs only in the neck and shoulder area or all over the body and whether this too is related to anxiety or not. Best wishes. Dr Preeti Parakh MD Psychiatry

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Preeti Parakh (13 hours later)

Ok i will be more detailed . Some days i wake up with shoulder pain , but some days i am normal . Sometimes i get pins and needles behind my ears , under my chin . Its not a constant feeling . Sometimes i feel that there are insects walking on the sides of my neck ( there are no insects of course ) The pins and needles are concentrated up in the neck . I can describe the shoulder pain as just pain to be accurate . This also goes for the pelvic pain , i cant say it is constant . I dont get pins and needles at other parts of my body . I do get itchness under my armpits ( sometimes ) not every day even . I feel that i raise my shoulders a lot ( this is related to anxiety ) . At some point my neck was so stiff like a rock , looking left or right would cause a sound that i can hear at the base of my skull, a sound like ( glass being crushed ) . When i started Xanax that neck stiffness improved a lot . I am not sure if the pelvic pain is related to anxiety or not , cause i suffer from chronic prostatitis . Can prostatitis cause pelvic pain and lower back pain and knee pain ? I know i am very stressful and my heart rate can be a 100 in the morning when i wake up . Also i am depressed in the morning . Depression fades through the day but the anxiety persists . I am not afraid of something in particular , its general . The depression does not annoy me a lot or affect my life a lot , i know we all can have some degree of depression . But the anxiety i know it is hurting my body organs , specially my stomach, i clench my stomach and my rectum muscles and urinary tract muscles badly . I also raise my shoulders all the time nearly , and i noticed that i push my head into the bed so this might be causing the neck strange feelings . I cant be sure cause the symptoms can be very intense that i wanna scream from pain . Its also worth saying that i have nightmares nearly every day . I dont sleep well cause of the night mares . I grind my teeth too . The dentist told me my teeth are worn out and designed a guard for me . I have been on seroxat for 2 years in the past , but i wanted to stop it cause i heard it is a XXXXXXX medication . I had bad withdrawal symptoms like electric shocks in my brain for sometime . I heard that there are new medications in the market for panic disorder like Caitalopram , but i dont know if that is good for my condition or not . I heard citalopram has less side effects than other medications . I dont want to make the wrong choice again . I dont know what is the difference between Effexor , Zoloft , Prozac , Seroxat , Citalopram . I need you to tell me whats the difference . What is the difference between SSRI and SNRI also ? What if i tried an antidepressant and i felt bad with it , will i be addicted to it from the first few days ? Is it easy to change to another brand if i dont get well with some medicine if i only took it for a few days ? Also will i need to be on those meds for life or i can decrease gradually at some point and then stop ? I hope you can help me make the right choice , and i want to start with a low dosage and then increase gradually . I hope i can take the medication near bed time so i dont have to live with side effects at first .

Answered by Dr. Preeti Parakh (54 minutes later)

Brief Answer: Escitalopram would be a good option. Detailed Answer: Hi, Thanks for the detailed description. The medicine Seroxat that you had been on previously is paroxetine, which is also an SSRI. Both SSRIs and SNRIs are antidepressants but have differing mechanisms of action. Both are very safe and effective. There is no risk of becoming dependent or addicted on these medicines and you also do not have to take these lifelong. Once you get well, you should continue the medicine for one more year and then taper it off. You should not stop these abruptly as there may be some discontinuation symptoms for a few days, but reduce the dosage gradually and taper these off. If you do not feel comfortable with one medicine, you can very easily be shifted to another agent without any problems. Whoever told you that Seroxat is a XXXXXXX medicine, misguided you. It is in fact far safer than Xanax which you are currently on. Citalopram is a good option but better will be the newer version of citalopram, which is called escitalopram. It has lesser side effects than citalopram and needs lesser dose as well. It works very well in both anxiety and depression and should suit you well. Escitalopram is started at a low dose of 5 mg per day. After two days, the dose is hiked to 10 mg per day, which is the minimum therapeutic dose. It takes around four to six weeks for the SSRI or SNRI to show its full response. So you should wait for around six weeks on 10 mg escitalopram per day to decide whether a hike in the dose is needed or not. If required, the dose can gradually be built up to 20 mg per day. Escitalopram is taken once a day, usually after breakfast but you can take it near bedtime if you wish. If your neck pain and pins and needle sensation are anxiety related, then they can also be expected to improve with escitalopram. It may also bring some relief in pain at other sites. However I do feel that your pelvic pain is likely to be due to prostatitis. Best wishes. Dr Preeti Parakh MD Psychiatry

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Preeti Parakh (2 days later)

Hello Dr Preety I purchased Cipralex 10 today . I took half pill . This was like 4 hours ago . Is it normal that this medication can increase anxiety at first ? Cause i felt my heart faster a bit after i took it . The 2 side effects i can notice easily now is the dry mouth and the ( Laziness / sleepiness ) I also notice my body is more relaxed , i feel my muscles more relaxed specially in the pelvic area . Another thing , this medication has less withdrawal symptoms then Seroxat ? I did suffer a lot with seroxat withdrawal symptoms .

Answered by Dr. Preeti Parakh (12 minutes later)

Brief Answer: Explained below Detailed Answer: Hi, Welcome back! All antidepressants can increase anxiety in the first few days of use. Please do not worry about it as it will improve in a few days. If Cipralex is making you feel sleepy, you should shift the dose to the night and take it at bedtime or a little before that. SSRIs like Cipralex cause insomnia in some people and sleepiness in some. Cipralex has very less discontinuation symptoms. Amongst all SSRIs, Seroxat is the worst in this respect. Please do not worry and continue with Cipralex and hike up the dose to 10 mg after one more day. If you feel that the increase in anxiety is too much then you can continue on 5 mg for a few more days before going on to 10 mg per day. It is good that you are already feeling a relaxation and I expect that with time you'll notice even better results. Best wishes. Dr Preeti Parakh MD Psychiatry

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Preeti Parakh (23 hours later)

Hello Dr Thank you for your answers . I felt extreme anxiety today , i had to take Xanax 0.5 today so i can live through the day . Did i mess up with this ? I am very scared , feel afraid of all day . Afraid i will not get better , after of the anxiety . I try to comfort my self and tell myself every thing will be ok . I did have insomnia last night , and i woke up very early and was feeling bad . My heart was moving my body ( very strong beats ) I took 2 inderal 10 pills to reduce the heart beats . It was 100 .They improved me a lot . I will take my second half pill of Cipralex before sleeping when i feel sleepy . I think that could work . I also find that i pee a lot , is that common side effect ? I am not sure any more what is illness and what is side effect and what is anxiety. I feel very sad and miserable . Does the side effects remain for 4 weeks ? or it will be better after few days ?

Answered by Dr. Preeti Parakh (15 minutes later)

Brief Answer: Only a few days. Detailed Answer: Hi, Please do not worry and hike up the dose of escitalopram to 10 mg after two days as scheduled. The initial discomfort wears off in a few days, most likely within a week. During this period, you should continue with Xanax. I had understood from your query that you were on Xanax and you should not stop it abruptly as this can cause withdrawal symptoms. For the next few days, take Xanax daily in the same dose as you were taking earlier. If by any chance, you were not taking Xanax regularly then for the next one week, take 0.25 mg twice a day. This will help you tide over the time it takes escitalopram to start its anxiolytic action. You can take Inderal when required as before. Please do not worry. Things will soon be better. Take care. Best wishes. DR Preeti Parakh MD Psychiatry

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Preeti Parakh (2 minutes later)

ok i will go on with that . I dont have to close the question soon right ? Cause i will need you in this critical time . Sorry to bother you with many questions , but i am really having a difficult time of my life . Thank you ...

Answered by Dr. Preeti Parakh (13 minutes later)

Brief Answer: You can ask as many questions as you like. Detailed Answer: Hi, Please do not feel apologetic about the questions. You do not need to close the question before you are ready to do so. Even if the query is closed, you can ask me a question directly on this link ( WWW.WWWW.WW . I understand that this is a very difficult time for you. Please try to live this one day at a time and don't worry about the future. Things will be much better in a few days. I forgot to mention in the previous answer that frequency of urination is a symptom of anxiety and not specifically related to escitalopram. You have not messed up or made any mistake. This medicine has worked for millions of people all over the world. There is no reason why it will not help you. Take care. Best wishes. Dr Preeti Parakh MD Psychiatry

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

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar