Hi doctor,
I am 48 years old. I was an active person before COVID-19. During the lockdown, I did not go out of the house. Recently, I have developed panic and anxiety disorder within these two months. Sometimes, I have depression. My symptoms are typical. I have a high pulse rate during swimming with high blood pressure. I have shortness of breath with restlessness, fear of death, fear of losing control, and sleeplessness. I have never taken medicine without knowing its side effects whatever I prescribed.
I do not want to develop any dependency on the drug. I have consulted two psychiatrists. The first doctor prescribed me Alprax 1 mg and I took one tablet at night. I took Prozac 20 mg along with Agotin 25 mg and Lexotanil 3 mg at late night. The second doctor prescribed me Zoloft 50 mg for six days and Clonazepam 0.5 mg. I planned to have a second one after reading a lot. But I had a severe reaction and got two severe panic attacks after taking Zoloft 50 mg. I was not able to sleep at night after taking Clonazepam.
The next day, I stopped taking Zoloft and tried to follow the first doctor's medication at a low dosage. I took Prozac 20 mg one tablet in the morning and Clonazepam 0.5 mg at night. I consulted the second doctor to know the reaction behind the medication. He insisted me to take Zoloft 25 mg one tablet in the morning for ten days.
I did not follow the instruction and I took Prozac 20 mg on the third time. I felt much better and I had slight restlessness. My blood pressure and pulse rate were normal. I do not had any panic attacks. After few days, I started to have panic attacks again with sleeping problems now. Which tablet can be taken now? Can I take Zoloft or Prozac? How long it should be taken and how to taper it off?
Hi,
Welcome to icliniq.com.
Prozac and Zoloft belong to the same group of drugs called SSRI (selective serotonin inhibitor). They are taken for depression or anxiety or panic attacks. Sometimes, it depends on the patient. Some patients respond well to Zoloft (Sertraline) and some people respond well to Prozac. If you are feeling well on Prozac (Fluoxetine), then you can take it. You do not need to take Zoloft. You can take tablet Clonazepam 25 mg mouth dissolving when you have a panic attack in the daytime and you should not take it regularly.
You can take Clonazepam 0.5 mg at night when you have a sleep disturbance. You need to take medication for at least six months. After six months, you can taper off it gradually. It will take time to taper off it. Mostly it depends on the dose. If you get stable on the high dose, then you need more time to taper off. You should follow some lifestyle changes and it is non-pharmacological management. It will help you. You need to do exercise for 30 to 45 minutes daily and have a walking daily. If you cannot go outside, do some physical activity inside your home. Try to have sun exposure or fresh air daily through your window.
You should do meditation for twenty minutes daily and sit in a comfortable position. Try to concentrate on having normal breathing. Do not stop or force yourself to stop your thoughts and leave them. You should eat healthy home-cooked foods and avoid taking junk foods. You should drink enough water. You should spend quality time with friends and family.
You should spend time on creative hobbies like reading books, writing journals, painting, drawing, learning new skills or language or musical instruments. You should have enough sleep for seven to eight hours daily. You must avoid taking tobacco or any substance abuse. Live your life peacefully and do not waste it. Be bold and confident.
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