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Suggest Ways To Manage Severe Anxiety
Question: Doctor,
I have been experiencing some pretty severe anxiety all day today, along with a SHARP headache around and behind my right eye-the pain also extends to the right side of my head and it is quite piercing. As I mentioned in one my earlier correspondences, I stopped drinking six and 1/2 months ago-I had allot of anxiety symptoms when I first stopped drinking, and then the symptoms subsided after about 4 months, and I as said they have since returned. Is it a fairly normal thing for those anxiety symptoms(which are both physical as well as mental) to resurface-someone told that I might have what's called protracted, or post acute withdrawal symptoms. With regards to the headaches-could they also be a symptom of anxiety, as I have an overgrowth of candida issue as well, which has caused these type of cluster headaches in the past. As I mentioned also in an earlier note-I have had a brain MRI about 3 weeks ago, and it appeared to be OK(see results above)-so I would hope that the normal MRI result would hopefully rule out a neurological issue for the reason for the headaches. Both conditions are quit debilitating right now, and so I would appreciate your feedback as soon as you can.
I have been experiencing some pretty severe anxiety all day today, along with a SHARP headache around and behind my right eye-the pain also extends to the right side of my head and it is quite piercing. As I mentioned in one my earlier correspondences, I stopped drinking six and 1/2 months ago-I had allot of anxiety symptoms when I first stopped drinking, and then the symptoms subsided after about 4 months, and I as said they have since returned. Is it a fairly normal thing for those anxiety symptoms(which are both physical as well as mental) to resurface-someone told that I might have what's called protracted, or post acute withdrawal symptoms. With regards to the headaches-could they also be a symptom of anxiety, as I have an overgrowth of candida issue as well, which has caused these type of cluster headaches in the past. As I mentioned also in an earlier note-I have had a brain MRI about 3 weeks ago, and it appeared to be OK(see results above)-so I would hope that the normal MRI result would hopefully rule out a neurological issue for the reason for the headaches. Both conditions are quit debilitating right now, and so I would appreciate your feedback as soon as you can.
Brief Answer:
venalafaxine can also be a good choice
Detailed Answer:
Hello,
I have read your query and according to this you have been maintaining abstinence from alcohol from past 6 1/2 months and had early withdrawal anxiety symptoms. Later these subsided to come back again in full strength...and that you are considering these to be protracted withdrawal symptoms.
Your doctor is planning to put you on seroquel for the same.
The headache you are having presently is more on the right side extending from eye to head on same right side. This looks more like migraine to me. Very common during various withrawal stages.
Now medicine- your doctor is right in giving you seroquel for anxiety, as it will help you sleep as well. But this will not take care of your headache... In cases similar or more serious than yours, I use venalafaxine or dothiapine. These help in managing amxiety effectively and also treat strong headaches like migraine . The good point is that the venalafaxine is non sedative so, can be taken easily without any work compromise & can be built to a well desired dosage.
There are also effective meds which can be tried during acute attacks of headaches and can abort them in 10-15minutes.
You should take care of not using librium frequently as it is habit forming. Take care to start a proper anti anxiety medicine and get well.
Diet is very important as well. Avoid tea coffee chocolates ice creams and citrus fruits/ drinks...take a diet which is balanced...and has less sugary stuff. Eat small frequent meals to avoid empty stomach triggering the headaches.
Walk of 20-30min always help anxiety and headaches!
Wish you good health.
Please feel free to ask more queries for further clarification.
Dr. Manisha Gopal
MD Neuropsychiatry
venalafaxine can also be a good choice
Detailed Answer:
Hello,
I have read your query and according to this you have been maintaining abstinence from alcohol from past 6 1/2 months and had early withdrawal anxiety symptoms. Later these subsided to come back again in full strength...and that you are considering these to be protracted withdrawal symptoms.
Your doctor is planning to put you on seroquel for the same.
The headache you are having presently is more on the right side extending from eye to head on same right side. This looks more like migraine to me. Very common during various withrawal stages.
Now medicine- your doctor is right in giving you seroquel for anxiety, as it will help you sleep as well. But this will not take care of your headache... In cases similar or more serious than yours, I use venalafaxine or dothiapine. These help in managing amxiety effectively and also treat strong headaches like migraine . The good point is that the venalafaxine is non sedative so, can be taken easily without any work compromise & can be built to a well desired dosage.
There are also effective meds which can be tried during acute attacks of headaches and can abort them in 10-15minutes.
You should take care of not using librium frequently as it is habit forming. Take care to start a proper anti anxiety medicine and get well.
Diet is very important as well. Avoid tea coffee chocolates ice creams and citrus fruits/ drinks...take a diet which is balanced...and has less sugary stuff. Eat small frequent meals to avoid empty stomach triggering the headaches.
Walk of 20-30min always help anxiety and headaches!
Wish you good health.
Please feel free to ask more queries for further clarification.
Dr. Manisha Gopal
MD Neuropsychiatry
Above answer was peer-reviewed by :
Dr. Neel Kudchadkar
Since I just had a Brain MRI done on 03/18/15(and the results were basically normal)-that would have detected any possible type of stroke or brain aneurysm on the Radiology Report, and thus if it didn't detect any type of bleeding that would cause a stroke or aneurysm-I should be OK as that those fronts.
Brief Answer:
yes, migraine & anxiety needs no MRI abnormality
Detailed Answer:
Hello,
You are right that there is no neurological abnormality in you ..but migarine headaches dont need them. Migraine headaches can happen in anyone with or without neurologicak issues and are usually diagnosed clinically. They are strong, rapidly building up headaches...severe enough to disrupt normal functioning ..can be associated with nausea or photo phono phobia and can be pulsatile in nature.
You headache presently donot look like clusture headaches.
Venalafaxine can be a good choice according to my clinical experience in your case. It will help both headches and protacted withdrawal anxiety...
Its good that you are aware of your condition and have a learning attitude. This is a must in recovery!
Wish you good health.
Dr. Manisha Gopal
MD Neuropsychiatry
yes, migraine & anxiety needs no MRI abnormality
Detailed Answer:
Hello,
You are right that there is no neurological abnormality in you ..but migarine headaches dont need them. Migraine headaches can happen in anyone with or without neurologicak issues and are usually diagnosed clinically. They are strong, rapidly building up headaches...severe enough to disrupt normal functioning ..can be associated with nausea or photo phono phobia and can be pulsatile in nature.
You headache presently donot look like clusture headaches.
Venalafaxine can be a good choice according to my clinical experience in your case. It will help both headches and protacted withdrawal anxiety...
Its good that you are aware of your condition and have a learning attitude. This is a must in recovery!
Wish you good health.
Dr. Manisha Gopal
MD Neuropsychiatry
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you for your response. My doctor has me currently taking clonidine for the physical symptoms of anxiety, and she has recently gotten me back on Seroquel for the overall anxiety(which has been rough the last couple of days). My neurologist prescribed venlafaxine(37.5 mg to start and the after a month go to 75 mg), but I have yet to take it, as we were seeing how I do on these current meds first. If I go on the Effexor, is it a drug that can interact well with what I am currently taking, and are there any significant side effects.
Brief Answer:
no bad interaction seen generally; take effexor
Detailed Answer:
Hello,
So you are presently on two drugs for anxiety - clonidine and quiteapine.
Had I been treating you, I would have simply reduced and stopped clonidine. I could have guided you on this but you havent mentioned the dosage...
clonidine should be stopped as it is not giving any desired result (else there would not be any need for quiteapine). And clonidine is prone to give hypotension and may lead to dizziness...so, we avoid day time dosing and high doses..
We should try to use only one molecule to treat the symptom as far as possible.
secondly, I think we can add venalafaxine 37.5mg in a day and increase to 75mg or upto 150mg.. monitor the response and later once there is good response..we can start reducing quiteapine.
There is no significant interaction between quiteapine or clonidine or venalafaxine. In certain clients we have to use them together to treat different symptoms.
So,please dont worry so much.
You should get blood pressure monitored and see if there is any concern. As even low BP can give rise to headaches...so, clonidine must be watched out!
Venalafaxine is better choice as quiteapine gives lot of sedation in pateints but venalafaxine dosent..so, is more work friendly!
It will be wise if you get your thyroid level , Vit. B 12 level and liver function tests. See if these are ok or need any correction.
Wish you good health and speedy recovery.
Dr. Manisha Gopal
MD Neuropsychiatry
no bad interaction seen generally; take effexor
Detailed Answer:
Hello,
So you are presently on two drugs for anxiety - clonidine and quiteapine.
Had I been treating you, I would have simply reduced and stopped clonidine. I could have guided you on this but you havent mentioned the dosage...
clonidine should be stopped as it is not giving any desired result (else there would not be any need for quiteapine). And clonidine is prone to give hypotension and may lead to dizziness...so, we avoid day time dosing and high doses..
We should try to use only one molecule to treat the symptom as far as possible.
secondly, I think we can add venalafaxine 37.5mg in a day and increase to 75mg or upto 150mg.. monitor the response and later once there is good response..we can start reducing quiteapine.
There is no significant interaction between quiteapine or clonidine or venalafaxine. In certain clients we have to use them together to treat different symptoms.
So,please dont worry so much.
You should get blood pressure monitored and see if there is any concern. As even low BP can give rise to headaches...so, clonidine must be watched out!
Venalafaxine is better choice as quiteapine gives lot of sedation in pateints but venalafaxine dosent..so, is more work friendly!
It will be wise if you get your thyroid level , Vit. B 12 level and liver function tests. See if these are ok or need any correction.
Wish you good health and speedy recovery.
Dr. Manisha Gopal
MD Neuropsychiatry
Note: For further guidance on mental health, Click here.
Above answer was peer-reviewed by :
Dr. Shanthi.E
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