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What Causes Severe Anxiety And Panic Disorder While On Zoloft?
Question: Hi, I am suffering from panic disorder, obsessive worrying over health anxieties/irrational fears. My doc recently did a GNA test which indicates that I am an "intermediate" for enzyme CPY2d6 and all the SSRIs are indicated to be used with "caution" and start at a low dose.
I have tried Zoloft in the past with much success but it has pooped out. He wants me to try Luvox at 25mg to start, but I'm really worried about the side effects considering this test. Plus, my Pharmacist said it's not readily prescribed nowadays bc of drug interactions and increased side effects. Should I try Pristiq instead which the DNA test indicated was a better choice for my DNA - is Pristine good for panic and obsessive worry?
I'm just worried about what I should do! I know there are no sure answers but I value feedback.
Thanks
xxxxxx
I have tried Zoloft in the past with much success but it has pooped out. He wants me to try Luvox at 25mg to start, but I'm really worried about the side effects considering this test. Plus, my Pharmacist said it's not readily prescribed nowadays bc of drug interactions and increased side effects. Should I try Pristiq instead which the DNA test indicated was a better choice for my DNA - is Pristine good for panic and obsessive worry?
I'm just worried about what I should do! I know there are no sure answers but I value feedback.
Thanks
xxxxxx
Brief Answer:
Pristiq is a good choice considering your status.
Detailed Answer:
Hi, thanks for asking from HCM for your health related queries
I can understand your concern. CYP2D6 is a microsomal enzyme system and its testing has gained importance recently. About 30% of population is IM for this enzyme and response of the drug depends upon type of drug. No particular guidelines are there for use of SSRIs in CYP2D6 IM individuals. But as SSRIs themselves inhibit CYP2D6 and at the same time they are metabolised by the CYP2D6. Thus in IM higher than normal concentration is expected for SSRIs. Though in low doses there is not much risk of side effects but at high doses risk of side effects increase significantly. So in my opinion LUVOX 25 mg is relatively safer but high doses of this drug might increase the risk of side effects.
Pristiq is Desvenlafaxine and the drug is free of CYP2D6 metaboliser status. The drug is a good option for anxiety and panic attacks in case of IM status. So you can go for this drug also without any worries. The drug is good for Panic and obsessive worries. High doses would be needed to get good effects.
Thanks, Hope this helps you. Please don't hesitate to ask again for more doubts.
Take care
Pristiq is a good choice considering your status.
Detailed Answer:
Hi, thanks for asking from HCM for your health related queries
I can understand your concern. CYP2D6 is a microsomal enzyme system and its testing has gained importance recently. About 30% of population is IM for this enzyme and response of the drug depends upon type of drug. No particular guidelines are there for use of SSRIs in CYP2D6 IM individuals. But as SSRIs themselves inhibit CYP2D6 and at the same time they are metabolised by the CYP2D6. Thus in IM higher than normal concentration is expected for SSRIs. Though in low doses there is not much risk of side effects but at high doses risk of side effects increase significantly. So in my opinion LUVOX 25 mg is relatively safer but high doses of this drug might increase the risk of side effects.
Pristiq is Desvenlafaxine and the drug is free of CYP2D6 metaboliser status. The drug is a good option for anxiety and panic attacks in case of IM status. So you can go for this drug also without any worries. The drug is good for Panic and obsessive worries. High doses would be needed to get good effects.
Thanks, Hope this helps you. Please don't hesitate to ask again for more doubts.
Take care
Note: For further guidance on mental health, Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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