Brief Answer:
Hi

Detailed Answer:
Hello,
Thanks for your query.
I appreciate your efforts for medical consultation in so much distress.

Important aspects of your query are:
•     65 year old female
•     Known case of anxiety disorder
•     Already on serotonin medication.
•     Complaints of: Severe anxiety, shakes and shivers.

It is common to have shakes and shivers with anxiety. But shakes and shivers reduce after after improvement in anxiety. Control in anxiety also reduces acid secretion.

Both drug and non drug treatment like cognitive behaviour therapy (form of psychotherapy) are used for treatment. Choice of treatment depends on severity of symptoms, personal preference and availability of treatment.

In drug treatment of anxiety two types of medicine used. For immediate relief of anxiety benzodiazepines group of medicines (like clonazepam) are used for short duration (due to risk of dependence). For long term relief most commonly SSRI (serotonin medications) are used. SSRI takes around 3-4 weeks to show its effect, till that time benzodiazepines control the anxiety symptoms.

If you have started treatment recently and having only serotonin medications, then you can request your psychiatrist to start some benzodiazepines group of medicines (like clonazepam) for brief duration, for immediate control of anxiety.

Along with medications following simple measures will help you:
-Healthy diet: Milk and fruits in diet.
-Daily morning brisk walk for 20-30 minutes.
-Follow structured daily routine. Fix sleep and wake up time.
-Do not use excessive caffeine (tea, coffee and cold drink). (If present in your case)
-Stop substance use like alcohol (If present in your case)
-Breathing exercise, yoga and meditation (which you can learn from some nearby expert)

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,

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