Brief Answer:
Do not stop medicine suddenly.
Detailed Answer:
Hello,
Thanks for your query.
I appreciate your efforts for medical consultation in so much distress.
Important aspects of your query are:
• 39 year old male
• Known case of anxiety and
depression, on treatment for 6 years
• Complaints of: difficulty in stopping medicines and anger/anxiety on stopping medicines for 1 day
Anxiety and depression are chronic illness like diabetes and
hypertension which require long term treatment. Anxiety and depression occur due to
neurotransmitters imbalance in brain most commonly involving serotonin neurotransmitter. In some cases where symptoms recur frequently, treatment may require for life long.
Both drug and non drug treatment like cognitive
behaviour therapy (form of
psychotherapy) are used for treatment.
In drug treatment of anxiety two types of medicine used. For immediate relief of anxiety benzodiazepines group of medicines (like lobazam in your case) are used for short duration (due to risk of dependence). For long term relief most commonly SSRI (selective serotonin reuptake inhibitors like paxidep in your case) are used. SSRI takes around 3-4 weeks to show its effect, till that time benzodiazepines control the anxiety symptoms. SSRI (Paxidep) do not produce dependance like benzodiazepines(lobazam) and can be continued as long as required.
With this back ground following steps will be helpful:
-Try to stop lobazam gradually. Reducing 2.5 mg lobazam per week will not cause much discomfort and you can stop it 4-5 weeks.
-After that reduce respidone 0.25 mg per week and stop in 2 week.
-Start non drug treatment like cognitive behaviour therapy (form of psychotherapy) from nearby
psychologist to control anxiety and depression. It will help reducing medicine doses also.
-Also check your thyroid hormone profile as its imbalance lead to increase anxiety.
-Stopping paxidep decision differ patient to patient according to their condition in OPD visit. Some patient may require it for years.
-All these medicines are prescription medicine and doses should be change under
psychiatrist supervision.
I hope this information has been both informative and helpful for you. In case of any doubt, I will be available for follow ups.
Wish you good health.
Regards,
http://bit.ly/Dr-Ashish-Mittal