Hi doctor,
I have a panic disorder and severe insomnia worsened by my anxiety. My doctor prescribed me Ambien 5 mg or Zolfresh 5 mg at night, Paxil-CR 12.5 mg at night, Etizolam 0.5 mg twice a day and Divalproex 500 mg once in a day. I also have suicidal ideations when I do not sleep well and gets panicked. Out of all, I did not take Zolfresh, but was able to sleep well in the last two days by the combination of others. I have a period of panic attacks, but they are a few. I really want to ask if the prescribed drugs might be overdose as the main problem with me is major depressive disorder and panic attack brought out by not sleeping well. I am skeptical regarding the drugs prescribed and I want to know the side effects due to a combination of those.
Hi,
Welcome to icliniq.com.
I have gone through the query and understand your concerns.
- If your diagnosis is panic disorder, anxiety and major depressive disorder, then the prescription of Paxil CR (Paroxetine) and Etizolam is completely on the line of treatment and I do not feel anybody should raise any doubt.
- Regarding Divalproex 500 mg, it is not a medication used to treat the above mentioned disorders. It can be used for conditions such as aggression, mood swings, irritability, suicidal thoughts and others.
- Considering that you have the suicidal thoughts, it can be said that it was indicated when you last met your psychiatrist. I request you to discuss the reason for prescription of Divalproex 500 mg on your next visit. I also state that it is not something unusual when you have suicidal thoughts.
- Regarding the Ambien or Zolfresh (Zolpidem), the only use of this medicine is induction of sleep. Since you are able to sleep with other medications, I feel it can be stopped without further questioning.
- In case you have difficulty with sleep, then it can be taken on need basis. So, it can be said that there is no need to take Zolfresh on a regular basis.
- My advice about future courses, if you have good control with your symptoms, then please discuss with your doctor to reduce the dose of Divalproex in near future.
- If you still have symptoms and crossed more than four weeks with current medications, then there is need to up the dose of Paxil-CR. We can take up to 60 mg of Paxil in a day when necessary.
- Since Etizolam is Benzodiazepine a call should be taken to decrease the dose of Etizolam when your condition is stabilized.
For further doubts consult a psychiatrist online --> https://www.icliniq.com/ask-a-doctor-online/psychiatrist
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