Brief Answer:
SSRI medicines and psychotherapy would help

Detailed Answer:
Hello,

Thanks for writing to us.

I can understand your concern. You seem to have some anxiety disorder probably panic disorder.

For diagnosis and treatment , detail history and mental status examination required by a psychiatrist.

For treatment SSRI group of medicines is the main stay in phramcotherpay. Low dose benzodiazepine medicines can be given for short period. Benzo can work fast and relieve your physical symptoms immediately.

In psychotherapy, specifically CBT- Cognitive Behaviour Therapy is beneficial.

Pharmacotherapy and Psychotherapy both can be applied simultaneously or alone depending upon choice of patient and doctor.

You should consult with all reports to a psychiatrist for solution of your problem.

Hope I have answered your query,

Regards,
Dr.Chintan Solanki.

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Brief Answer:
Yes propranolol is helpful medicine for anxiety

Detailed Answer:
Hello,

Thanks for follow up.

It is good that you are trying for CBT therapy.Keep it up.

Propranolol is good drug for anxiety. Particularly for chest and heart related symptoms of anxiety it is very good.But it is just symptomatic treatment. Ultimate treatment is SSRI or psychotherapy.

During anxiety body reacts in specific manner.There is secretion of adrenaline and steroid hormones.It leads to more blood supply and energy to muscles which in turn causes involuntary twitching/spasm of the muscles.
Simultaneously nerves supplying muscles also get activated and make muscle stimulated which is also responsible for twitching.


During anxiety heart has to pump at somewhat fast rate to provide blood flow to peripheral muscles.This is possible when only blood supply to heart muscles increases and frequency of heart muscles contraction increases. Simultaneously respiration also increases which occur due do fast functioning of lungs.Lungs as well as chest muscles have to work fast for more breathing.Heart and lungs are the main organs of chest. Both organs work fast during anxiety and twitches felt in chest.

Hope you will find this answer helpful.

Regards,
Dr.Chintan Solanki.

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Brief Answer:
In your case, propranolol is less likely causing night trouble.

Detailed Answer:
Hello dear,

Thanks for query.

Propranolol can cause sleep disturbance as well as change in heart rhythm. But it causes mostly slowing or irregular heart rhythm not racing heart suddenly. It may cause difficulty in sleeping, if it is taken after evening due to reduction in blood pressure. But it does not cause nightmare.

What have you mentioned is likely anxiety symptoms which is part of your anxiety problem currently going on. It calms down in a minute or so is in favor of anxiety. If it is due to propranolol it can last long.

For confirmation, we need to check whether it is there before starting propranolol or started after taking propranolol. As well as it can be checked by stopping porpanolol. You need to discuss with your treating doctor for that.

Wish you healthy life and best of luck for early stability and effects of CBT.

In future you can contact me directly if you wish with this link:
http://bit.ly/drchintansolanki

take care.

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Brief Answer:
If your blood pressrue is normal and no sinusitis,these are anxiety related

Detailed Answer:
Hi,

Thanks for writing back. No need to be sorry.I am here to answer your queries.

Head and nose pressure and numbness in forehead can be caused by anxiety symptoms.But basic primary causes for these symptoms must be checked.

Your blood pressures should be checked. High blood pressure more than 150/90 can cause such types of symptoms.

Other cause may be sinusitis. Your ENT examination and if needed
x-ray PNS (paranasal sinus) to be done to check for this cause.

So you need to be examined by a doctor for confirmation of your symptoms' cause.

Regards,
Dr.Chintan Solanki.

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Brief Answer:
you should go to doctor for check up

Detailed Answer:
Hi,

Thanks for follow up.

Your blood pressure is normal. So nothing serious related to brain likely. It may be due to stress/anxiety or else some ENT(ear,nose,throat) related problem.
You should consult doctor for check up.

Until that you can take over the counter pain killer medicines.

I will be glad to answer if more queries.

Dr.Chintan Solanki.

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Brief Answer:
You are good candidate for CBT

Detailed Answer:
Hi,

Thanks for appreciation.

It is good that you have been checked up by GP and nothing is serious there.

During our discussion you have asked queries without hesitation and asked your all doubts.Hope I have clear your doubts satisfactorily.

Same way in CBT , you have to correct your automatic thoughts and behavior. Hope CBT will work for you in very helpful manner.

All the best & regards,
Dr.Chintan Solanki.

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