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Q. What are the ways to manage generalized anxiety with DPDR and muscle stiffness?

Answered by
Dr. Seikhoo Bishnoi
and medically reviewed by Dr. Divya Banu M
This is a premium question & answer published on Jun 29, 2019 and last reviewed on: Jul 02, 2019

Hello doctor,

I have severe generalized anxiety that started 10 years ago and it has become very severe now. I have anxiety attacks, DPDR everyday, muscle stiffness, shaking hands and legs. I had changed four medicines, first on Sertraline no effect, then on Fluoxetine, it works only on specific region. It cures my DPDR, nothing else, then Venlafaxine for six months. It relieved my half GAD and now on Nexito 10 for 18 weeks. It works but not full. I am already having moderate anxiety.

Dr. Seikhoo Bishnoi

Psychiatry Psychotherapy Sexology


Welcome to

I can understand your problem. Anxiety in day to day situations, even without any cause is seen in generalised anxiety disorder. Nexito, Sertraline and Fluoxetine all are SSRI drugs and have great efficacy in anxiety. I personally prefer Escitalopram or Nexito for my patients. You are on 10 mg dose and are seeing some improvement but still not complete relief.

One option for your persisting symptoms is to increase the dose of Escitalopram to 15 mg. This should provide more relief to your anxiety. Apart from this, addition of Buspirone is one another option. Buspirone if taken twice a day along with Escitalopram will help to reduce the residual anxiety and will also augment the actions of Escitalopram. You can talk with your doctor for this. Anxiety takes time to go and you should understand this. With proper medicines you will be alright.

Do you have any unwanted thoughts which produce anxiety? Is there any ongoing stress that is aggravating anxiety? Any symptoms like low mood, bad thoughts, negative thoughts, poor motivation, etc.?

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