What Medication Can Be Taken For Worsening Anxiety And Panic Attacks Which Started After A Traumatizing Accident 15 Years Ago?

Posted on Fri, 15 Sep 2023

Question: I was in a car accident that nearly killed me 15 years ago, and I've been on different pain medications over probably the last 10. I am currently on a Fentanyl patch of 25mcg changed every 48 hours. now here's my issue- before the accident and after I've had lots of problems with anxiety and panic attacks. I have been able over the years to sorta keep the mental part "reinged" in and was able to come off all of the psychiatric medications, but over the last 2 years or so the anxiety has gotten worse and worse. I don't know if it's age related ( I'm 36 now) or what, but the aniexty used to be predominantly "mental" such as insomnia, OCD tendencies for calming down, repetitive thoughts etc. But as I've gotten older it's shifted to more "physical" manifestations like panic attacks, and I can no longer hide or suppress it like I was once able to, so I need to know what is safe to take for my anxiety, but I also HAVE to keep taking the pain medicine also-any advice would be greatly appreciated, thank you

Answered by Dr. Dr. Soujanya (1 hour later)

Brief Answer:
My suggestion.

Detailed Answer:

Hi,

I certainly understand your concern towards your anxiety symptoms. I would like to know some details regarding the psychiatrist medications that you have taken earlier, and please elaborate more about your repetitive thoughts.

I understood that you are on pain medications currently, there is nothing to worry to take psychiatric medications along with pain ones.

Anyway, I can advise you to start on antidepressants which also has anti-anxiety action, along with benzodiazepines if required.

Please provide clear details about your symptoms to prescribe specific antidepressant.

Hope this information would help you. Let me know if I can assist you further.

Thank you.

Regards,
Dr. Soujanya
Psychiatrist

Above answer was peer-reviewed by : Dr. Nagamani Ng

Follow up: Dr. Dr. Soujanya (30 minutes later)

over the years I've been on a variety of antidepressants, mood stabilizers, and antianxiety meds plus therapy on and off, medications taken would include celexa, Lexapro, depakote, prozac, paxil. anxiety medications I've tried before have been kolonopin and diazepam (Valium). but haven't taken the anti anxiety meds while on the patch, the Valium and kolonopin didn't seem to help at all when I was taking them, so I stopped right around the time I started the Fentanyl patch, for fear that I'd have to many sedatives in my system, and since they weren't helping I stopped taking them. but now it's to the point that the anxiety has taken on much more physical manifestations, basically full blown panic attacks that when I was a little younger I could "will" my way through, but it's gotten worse and now I'll come close to hyperventilating, during the simplest times and conversations.

Answered by Dr. Dr. Soujanya (9 hours later)

Brief Answer:
My suggestion.

Detailed Answer:

Hi,

It was clear that you have already taken many psychiatric medications. Hope those have been continued for the prescribed duration of period.

Now, it was evident that you are suffering from panic attacks, so it is advisable to take Clonazepam mouth dissolving medications during the attack.

It is also advisable to follow envelope breathing techniques and deep breathing techniques.

Along with that, you can start on Paroxetine, which deals with your anxiety better.

If you have any sleep disturbances along with this, you can take Clonazepam in the night on daily basis.

If you feel that clonazepam does not work, you can take Etizolam, instead of this.

Please discuss with your treating doctor regarding this and follow accordingly.

Hope this information would help you.

Thank you.

Regards,
Dr. Soujanya
Psychiatrist

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Above answer was peer-reviewed by : Dr. Remy Koshy