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Suggest Treatment For Anxiety Disorder And Heart Palpitations
Question: Hello! I am 22 years old 5 foot 6, 170 lbs with general anxiety disorder and consistent rapid heart rate being treated with metoprolol tartrate. For the past few days I have been having strange pains in my left shoulder. It seems to start in the front of my shoulder and then spread to my chest. The pain I would describe it as like a sharp chip going down your throat and it happens with every heart beat. It doesn't stay long, but it's very uncomfortable and then I become worried about a heart attack even though I'm young. I have had heart monitoring done and I have a holster on for 2 weeks and they said everything looked normal except for the fact my heart rate was fast. I also tend to have low blood pressure. What could this be?
Brief Answer:
Iit is episode of anxiety likely, you need treatment for anxiety disorder
Detailed Answer:
Hi XXXXXXX
Thanks for writing to us.
You are young lady with generalized anxiety disorder(GAD). The pain you described suggests possibility of pain related to heart(Angina). However it can occur in patient with anxiety disorder also.
Already heart monitoring with holter have been done and it was normal.This rules out possibility of heart pain.Fast heart rate can occur in anxiety disorder due to high sympathetic tone. Anxiety also can cause low blood pressure.
Metoprolol can control fast heart rate but I prefer propranolol.Xanax as and when required for anxiety episode is useful but I do not prefer this strategy. Sometime patient gets addicted with xanax in such cases.
If you have not consulted psychiatrist yet, I recommend to consult psychiatrist once.
Best treatment of generalized anxiety disorder(GAD) includes both medicines and cognitive behavior therapy(CBT).
In mild cases only CBT is sufficient. In moderate to severe cases initially medicines and then CBT is added. And later on medicines stopped gradually.
If medicines alone are used chances of relapse are more after stopping the medicines.
In medicines SSRI group of drugs(fluoxetine,paroxetine,sertraline, escitalopram) are main stay of the treatment.I prefer paroxetine. Benzodiazepines group of drugs(clonazeapm, lorazepam or etizolam) are used initially for short duration for fast symptomatic relief.
Hope I have answered your query, I will be happy to help further.
Regards,
Dr.Chintan Solanki.
Iit is episode of anxiety likely, you need treatment for anxiety disorder
Detailed Answer:
Hi XXXXXXX
Thanks for writing to us.
You are young lady with generalized anxiety disorder(GAD). The pain you described suggests possibility of pain related to heart(Angina). However it can occur in patient with anxiety disorder also.
Already heart monitoring with holter have been done and it was normal.This rules out possibility of heart pain.Fast heart rate can occur in anxiety disorder due to high sympathetic tone. Anxiety also can cause low blood pressure.
Metoprolol can control fast heart rate but I prefer propranolol.Xanax as and when required for anxiety episode is useful but I do not prefer this strategy. Sometime patient gets addicted with xanax in such cases.
If you have not consulted psychiatrist yet, I recommend to consult psychiatrist once.
Best treatment of generalized anxiety disorder(GAD) includes both medicines and cognitive behavior therapy(CBT).
In mild cases only CBT is sufficient. In moderate to severe cases initially medicines and then CBT is added. And later on medicines stopped gradually.
If medicines alone are used chances of relapse are more after stopping the medicines.
In medicines SSRI group of drugs(fluoxetine,paroxetine,sertraline, escitalopram) are main stay of the treatment.I prefer paroxetine. Benzodiazepines group of drugs(clonazeapm, lorazepam or etizolam) are used initially for short duration for fast symptomatic relief.
Hope I have answered your query, I will be happy to help further.
Regards,
Dr.Chintan Solanki.
Note: For further guidance on mental health, Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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