Dr. Bharat Udey
Geriatrics
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
Answered by
Education:
MD Psychiatry
Professional Bio:
Dr.Bharat Udey is an expert in the field of Geriatrics, Psychiatry, Sexology, Sleep Medicine. Heis experienced and well-versed in all the treatment modalities in Geriatrics, Psychiatry, Sexology, Sleep Medicine.
This doctor is not available for online consultations on the platform anymore.
Dr. Bharat Udey
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Patient's Query
Hello doctor,
My brother who is 25 years old has been suffering from anxiety for the past four years. His doctor put him on Effexor and Elavil. Both the medicine has to be taken daily in addition to Xanax. Lately, the anxiety has developed into full blown panic attacks, two of which resulted in a seizure and passing out briefly. In addition, we just discovered through a DNA test that he has two MTHFR mutated genes. He seems to be rely more on the Xanax now as a safety net or crutch when he feels a spell coming on. I am very concerned that he has become too dependent on the Xanax and now that he is taking a prescribed vitamin supplement to counter the MTHFR. It is likely making all the drugs on board more potent than before. I have read that the cause of anxiety for some people is the MTHFR gene mutation. Therefore, I wonder if he even needs any of the drugs he is on, but I realize that he cannot just quit cold turkey. He needs opinion. He is in a real tough cycle right now where he can hardly function, which is not good as he is in final semester of law school. Please help.
Hello,
Welcome to icliniq.com.
I can understand your concerns. From your description, it seems that your brother might have become dependent on Xanax (Alprazolam). Xanax belongs to Benzodiazepine group of drugs and is quite notorious for causing dependence if used for a longer period. Hence when not taken, it leads to anxiety like symptoms which can mimic a panic attack. These are actually the withdrawal symptoms of Xanax. Hence, I would suggest you to stop your brother from taking Xanax as soon as possible. Substitute Xanax with some other drug with less abusive profile like Clonazepam and then gradually taper and stop it. Besides this, Effexor (Venlafaxine) is an effective drug for anxiety disorder. But, we need to adjust the dosage to increase the efficacy. You need not give him Elavil (Amitriptyline) with Effexor. However, he can continue with the supplements. I would also suggest you to take a neurology opinion in view of seizure like episodes that happened previously. Thank you.
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Dr. Bharat Udey
Geriatrics
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