HomeAnswersPsychiatryanxiety disorderAfter being diagnosed with panic disorder 19 years ago, I stopped my prescribed medication recently. This led to a severe relapse. Why?

Why did I experience a severe relapse of panic disorder after recently discontinuing the medications prescribed to me?

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Published At November 25, 2023
Reviewed AtNovember 25, 2023

Patient's Query

Hi doctor,

I have a history of anxiety or panic disorder which was first diagnosed 19 years back and I was in in-patient psychiatric care for two months. I was prescribed the medicines Celexa 20 mg (once daily), and Clonazepam 0.25 mg (thrice a day- PRN) 50 pills with a repeat of 50 upon discharge. I was on tablet Celexa for 19 years and took Clonazepam when needed. For 19 years, though I had Clonazepam in hand, I took it sporadically. I have no addiction issues.

I weaned off from the tablet Celexa two years back and I am not taking the tablet Clonazepam either. I take the tablet Ativan rarely depending on the situational need. I have no previous or family history of drug or alcohol abuse. Currently, I am experiencing a severe relapse of anxiety or panic disorder. I feel anxious upon awakening, and it lasts as long as I stay awake. My symptoms are as severe as what I experienced 19 years ago. Please help.

Hello,

Welcome to icliniq.com.

I welcome you to icliniq with a loving heart and with confidence that I will be able to help you with your medical issues better.

Did you quit taking medicines very gradually? Since you have been on medicines for the past 19 years, you need to reduce the dosage very gradually. If not, there could be a relapse. Before experiencing a relapse, did you face any anxiety-provoking situations? I suggest you start taking the same medicines in the same dosage. Take the tablet Clonazepam three times a day initially for two weeks. Also, start doing some physical exercise. Avoid smoking and drinking habits (if any).

I hope this helps. Do get back if you have any further queries.

Thank you.

Patient's Query

Hello doctor,

Thank you for your reply.

Yes, I stopped taking the tablet Celexa 20 mg very gradually and stopped it two years back. I experienced no drastic or upsetting changes in my life in the past two years. I will start doing exercise. I do not drink or smoke. I appreciate your suggestion to continue taking the tablet Celexa 20 mg (never had bad side effects) and I understand your suggestion on taking the tablet Celexa rather than trying a different SSRI at this point.

I also understand from your response that returning to Clonazepam (rather than the occasional Ativan) would be the correct short-term treatment plan at this point.

Thank you.

Hi,

Welcome back to icliniq.com.

Glad to have you back.

Yes, returning to the same molecule will work well in a short period of time. Also, you never experienced any bad side effects and that is another added factor. As you mentioned that you stopped taking the medications two years back, I would like to know during which period you quit taking the medications and for how many months you stopped it. If we stop taking any anti-depressant or anti-anxiety medicine, then we need to start doing some physical exercise to maintain the serotonin balance.

All depression and anxiety problems occur secondary to neurochemical imbalance and if we stop taking the medications after so many years, then over a period of time, the serotonin levels will go down and you will experience the same symptoms again. So, better start doing some physical exercise and also get involved in your routine daily lifestyle. Vent out your feelings if any such thoughts disturb you. Also, start doing some activities that make you happy.

I wish you good health.

Thank you.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Vipul Chelabhai Prajapati
Dr. Vipul Chelabhai Prajapati

Psychiatry

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