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Suggest Treatment For Anxiety While On Buspar And Cymbalta

Posted on Thu, 12 Jan 2017

Question: I have been taking buspar and cymbalta for over 3 months for severe combat related PTSD. I also take trazasone and ropinirole for sleep. I still have severe anxiety and suicidal thoughts. My doctor at the VA told me it's normal to have suicidal thoughts but to me it feels very scary. My hands sweat constantly and I still can't sleep after taking 200mg of trazadone. Is this normal? I can't get into the VA to be seen for another month and that is the only place I can receive care as I can't afford to pay a civilian doctor. Is there anything I can do to get this all to stop? I am desperate for answers right now. Thank you!

Answered by Dr. Dr. Ashok Kumar Choudhary (20 minutes later)

Brief Answer:
I do not think it can be considered normal

Detailed Answer:
Hello,
Thanks for using Healthcaremagic.

I read your query band understand your concerns.

First of all I do not think suicidal ideation is normal thing. I understand it can be part of severe combat related PTSD but we need to understand that it is indicative of inadequate treatment.

Presence of constant hand sweats difficulty in sleep again points toward the inadequate response to medication.

Having said this I feel SSRI should be the part of treatment considering the current symptoms. Although there are six SSRI medications available in the market but I feel Prozac is better option. This could be discussed on your next VA visit.

For time being I request you to increase the dose of trazodone to 300 mg at night. Although it is off the recommended dosage range but considering severity of symptoms I think this need to be done. Please report same to your regular doctor.

I hope this helps you.
If you have any further query, I would be glad to help you.
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Thanks and regards.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. Ashok Kumar Choudhary (5 minutes later)

I really appreciate your help. I will try the 300mg rather than the 200mg and see how that works. Also, is there anything I can do for the constant anxiety that just never seems to go away? I do remember taking Prozac and Xanax a few years ago and I was productive and had a successful business. I stopped taking it due to being stubborn thinking I could live without medication and my life fell apart. My kids are with their dad 1100 miles away and I no longer have my business and haven't been able to successfully keep a job. It is the most frustrating thing in the world to tell my doc that I knew what helped in the past and having it ignored for whatever reason. Thank you again and I hope that I'm not taking up too much of your time.

Answered by Dr. Dr. Ashok Kumar Choudhary (24 minutes later)

Brief Answer:
Thanks for your feedback

Detailed Answer:
Hello,
Thanks for reverting back top me with positive feedback.

I think deep breathing is the one which can help you immensely in anxiety symptoms. For doing this slow down your inhalation and stop for few seconds and than exhale slowly. Target 12-15 seconds per breath.

I am happy to know that prozac helped in past and it will be helpful for your doctor to go back with prozac. I understand it is difficult to explain but please understand that he/she is there to help you and will not mind your input and will take necessary action.

I hope this helps you further.
Wish you great health ahead and advance XXXXXXX Christmas.

Thanks again.

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

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar