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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest Treatment For Long Term Anxiety And Panic Disorder

Long term panic/anxiety disorder. On 1-4 mg Klonopin PRN per day. Had a pretty good year overall (2014), but last month, and ESPECIALLY last 3 days, almost continuous symptoms. Mainly fright, some chest pain (feels like what would be described like a pulled muscle), mild, but disconcerting. Sweaty feet/palms tonight only. Have not done any heavy physical work. VERY scared. Had this before, but not consecutive like this for maybe 10 years. Took walks, worked out last week, no cardio issues. Freaking out! Do not have insurance nor ample funds! Addendum- I can't afford to get an answer here. Sorry. No funds now.
Thu, 18 Dec 2014
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Psychiatrist 's  Response
Hello thanks for choosing HCM for your health related queries

You are suffering from Panic and Anxiety disorder and are on Clonazepam 1-4 mg on SOS basis. Since last one month you have again started feeling anxious, you have symptoms like chest pains, sweating, poor concentration etc. These symptoms are persistent since last 3 days. As per my opinion you should consider to consult a doctor for that. Clonazepam can help to reduce the symptoms on SOS basis but the drug is not a definitive treatment of anxiety or panic disorder. Medicines like SSRIs as Fluoxetine, Paroxetine, Sertraline etc are commonly used in panic and anxiety disorder. These medicines help to reduce the intensity of panic attacks. For immediate relief of symptoms you can use propranolol. The drug helps to reduce the symptoms of anxiety and is not having abuse potential. Consult a psychiatrist for prescription of drugs.

Apart from medicines try relaxation exercises, yoga, meditation for better results and relief.

Thanks, hope this helps you.
I find this answer helpful
Psychiatrist Dr. S. Ashok Kumar's  Response
Hello,
Thanks for using healthcaremagic.

As you might be knowing panic attacks are anxiety spectrum disorder hat can be treated both by medication and psychotherapy.

In the acute stage medications are necessary and for the long term management both options are suitable.

The SSRIs are most commonly used medication in panic attacks but unlike benzodiazepines it does not offer any immediate relief.

For the immediate relief the effective drugs are clonazepam and alprazolam can be used as per the requirement.

Once you are able to feel under control the SSRI group of medications can be tried which includes lexapro, proxetine and fluoxetine. They are generally effective by one month and if you do not see any improvement by that time the other option from same class can be explored. Till these medicine show effect alprazolam or clonazepam need to be continued.


I hope this answers your query.
Thanks and regards
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Suggest Treatment For Long Term Anxiety And Panic Disorder

Hello thanks for choosing HCM for your health related queries You are suffering from Panic and Anxiety disorder and are on Clonazepam 1-4 mg on SOS basis. Since last one month you have again started feeling anxious, you have symptoms like chest pains, sweating, poor concentration etc. These symptoms are persistent since last 3 days. As per my opinion you should consider to consult a doctor for that. Clonazepam can help to reduce the symptoms on SOS basis but the drug is not a definitive treatment of anxiety or panic disorder. Medicines like SSRIs as Fluoxetine, Paroxetine, Sertraline etc are commonly used in panic and anxiety disorder. These medicines help to reduce the intensity of panic attacks. For immediate relief of symptoms you can use propranolol. The drug helps to reduce the symptoms of anxiety and is not having abuse potential. Consult a psychiatrist for prescription of drugs. Apart from medicines try relaxation exercises, yoga, meditation for better results and relief. Thanks, hope this helps you.