I Am A 70 Female Who Runs 3 Miles Daily

Posted on Tue, 28 May 2019

Question: I am a 70 female who runs 3 miles daily eats healthy is in good physical health. I have been taking effexor xr 75 mg for twenty years to address sleep anxiety. It has worked beautifully until about a year ago when breakthrough anxiety started ocurring and fear of not sleeping then insomnia. Recently I take .5 xanax every other day.
Should I still be taking effexor or should I increase the dose to 110 mg .?

Answered by Dr. Dr. Ashok Kumar Choudhary (1 hour later)

Brief Answer:
Increase of effexor dose is warranted

Detailed Answer:
Hello,
Thanks for using Healthcaremagic.

I read your query and understand your concerns.

First of all I like to communicate that this is common condition where the previous effective dose becomes ineffective among individuals with anxiety and depressive disorder. Considering the fact that you are perfect in regard to physical health the relapse of sleep anxiety is probably related with same feature of antidepressant as explained above.

In regard to management of problem it is best strategy to increase the dose to higher level in compare to previous effective dose. Since 75 mg worked for you over the last 20 years adding a smallest dose (37.5 mg) to previous dose is well warranted.

After the few weeks of this addition it is recommended to take off the xanax as continuation of xanax is never recommended unless it is absolutely necessary.

I hope this answers you.
Feel free to write back to me if you have more questions.
Thanks and regards.

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Dr. Ashok Kumar Choudhary (40 minutes later)

would it be helpful to have a thyroid check? I ask this because my sleep anxiety started 4 months after the birth of my first child and subsequently with two more births. It then re appeared when I was menopausal?

Answered by Dr. Dr. Ashok Kumar Choudhary (9 hours later)

Brief Answer:
Thyroid check is recommended

Detailed Answer:
Hello,
Thanks for reverting back to me.

Thyroid disorders are very common among individuals with depression and anxiety disorders and it is recommended to check before starting treatment or when something unusual happens such as failure of medication to act without any explainable cause as in your case.

The thyroid check is not only helpful in diagnosing the condition but also helpful when managing the person with sleep anxiety.

Considering these two facts I feel thyroid check should be done provided it was not done in last three to six months.

I hope this answers you further.
If you have any further query, I would be glad to help you.

In future if you wish to contact me directly, you can use the below mentioned link:
http://doctor.healthcaremagic.com/doctors/dr-ashok-kumar/67386
Thanks and regards.

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

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