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Q. Taking Clonazepam, Mirtazapine for anxiety and depression, Can you suggest any solution?

Answered by
Dr. Ananth S
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on May 19, 2018 and last reviewed on: Oct 25, 2019

Dear Doctor,

I am suffering from anxiety, restlessness and taking Clonazepam 0.75mg & Mirtazapine 30mg daily. I had depression and panic attacks for the last 7 years relieved by Ativan 1mg and with open angle glaucoma.

Need a second opinion.

Dr. Ananth S

Andrology Psychiatry Psychologist/ Counsellor Psychotherapy
#

Hi,

Welcome to icliniq.com.

Depression, anxiety, restlessness and panic attacks are best respond to a combination of a Selective Serotonin Reuptake Inhibitors (SSRIs) and Benzodiazepines.

Mirtazapine is not the most efficient ant depressant and it is not a true SSRI as fluoxetine, paroxetine, citalopram and sertraline are.

I recommend 20 to 40mg of Paroxetine (slowly titrated up from 10mg) and 1mg of either clonazepam or ativan (lorazepam) every 8 hours as needed for anxiety.

Glaucoma precludes use of any anticholinergics such as hydroxyzine or benadryl (diphenhydramine).

SSRIs are also at times likely to make glaucoma worse but a preliminary trial is always worth it.

Revert back to a psychiatrist online for further help --> https://www.icliniq.com/ask-a-doctor-online/psychiatrist


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