
On Medicine For Anxiety And Panic Disorder. Any Risk For Heart Related Problem?

Thanks for your query.
I appreciate your efforts for medical consultation in so much distress.
From your history it is apparent that you have anxiety and panic disorder. Anxiety and panic disorder occur due to neurotransmitters imbalance in brain most commonly involving serotonin neurotransmitter. These disorders are chronic (long term) illness like Hypertension and Diabetes. Treatment control symptoms of illness and in most of the cases symptoms reemerge after stoppage of treatment. So, these medicines need to be continued for years like you have received.
Paxil contain paroxetine and cipralex contain escitalopram. Both medicines belong to same class of medicines, that is SSRI (selective serotonin reuptake inhibitors). Both are very good medicines for anxiety and panic.
Although there is long list of side effects (like each medicine) but clinically these medicine are very safe. There is no causal relationship between cardiac illness and these medicines.
Anxiety itself can cause palpitation and twitching in chest due to muscle spasm. So, there is no need for worry. If you have doubt, you can have electrocardiogram to rule out any cardiac problem.
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,


Out of curiousity, if I were to decrease to 10mg, what is the best method of doing so? I have a pill cutter, but do I suddenly cut the 20mg in half and take 10mg a day, or should I take 10mg one day and 20mg the next for a couple weeks, then to 10mg a day? What are the common withdrawl symptoms when reducing this drug dosage?
Thanks for follow up.
I can understand your concern. When anxiety symptoms controlled for years, in such cases medicines doses can be reduced, like your doctor is planning currently.
But same time we should monitor symptoms of anxiety/panic due to risk of recurrence of anxiety symptoms during drug tapering. If they reemerge then we have to give previous dose of medicine on which patient was well (20mg cipralex).
While tapering doses we need to be slow and watchful. In my view, first take 15 mg (10+5 mg) for 1 month, then if you are well, medicine can be reduced further to 10mg per day. There is no difference taking half of 20mg or 10mg tablets, but i would favor single 10mg tablet due to convenience. There will be no withdrawal on slow tapering as mentioned above.
Please accept my answer in case there are no further queries and recommend our services to your friends too if you have found it helpful.
Wish you good health.
Regards.

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