How to manage my health anxiety?

Question

Hello doctor,

I was put on Remeron for depression, extreme insomnia, and extreme anxiety constantly throughout the day. The first day I took it, I slept for 15 hours and hoped it would work. I started experiencing double vision, shaky movements, and falling by the fifth day. I consulted my psychiatrist, who put me on Prozac 10 mg and Klonopin 1 mg thrice daily. I was also taking Xanax for my anxiety, and he upped my dose to 1 mg for my anxiety. I ended up taking more to get the same relief from the Xanax for my panic attacks, and he also put me on Lunesta for my insomnia. Since then, I believe Klonopin is not helping my ongoing anxiety. What are my other options for anxiety medicines? I want to save Xanax for my panic attacks and do not want to build tolerance. Seven years back, before I started having these problems, I had a baby and had my gallbladder removed two weeks after having my third cesarean section. I had to have my gallstone removed through an ERCP (endoscopic retrograde cholangiopancreatography), which caused severe pancreatitis. I was in the ICU (intensive care unit) for three weeks. After a week, I was hospitalized again for an ileus, for which I was in hospital for a week. I received treatment for kidney stones in a larger hospital a few weeks later via ambulance. It has triggered my anxiety, and I have this intense fear of death, whether being killed or dying for my health. It also affects my children, as I am worried about them. I was a healthy person before the onset of these health problems. Please help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I have read the query, and I can understand your concern.

The benzos like Klonopin (Clonazepam) are for short-term use only. Therefore, in my opinion, you should discuss with your treating psychiatrist regarding tapering it off. Our main goal is to prevent a panic attack from occuring. You can discuss with your treating psychiatrist regarding increasing the dose of Prozac (Fluoxetine) or augmenting them. Regarding other anxiolytic options, you can discuss with your treating psychiatrist a short-term course of Etizolam or Buspar (Buspirone). Nonpharmacological techniques are equally beneficial and should be used in conjunction. Some simple steps can help:

When having a panic attack, modify your breathing. Breathe at a rate of around 15 times per minute. You can imagine a relaxing place or imagery and try to focus on it.
To get a good night's sleep, adhere to the sleep hygiene rules.
You may calm down, focus, and reduce anxiety by practicing meditation daily for at least 30 minutes in the morning.
CBT (cognitive behavior therapy) is another option.

I hope this will help you. Feel free to ask if you have any further queries.

Thank you.