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Q. Will Fluanxol with Lithium help in my panic disorder?

Answered by
Dr. Ramchandra Lamba
and medically reviewed by Dr. Vinodhini. J
This is a premium question & answer published on Jul 18, 2020 and last reviewed on: Aug 06, 2020

Hello doctor,

I am a 31-year-old guy who has been living with panic disorder for 10 years now. Panic has taken over my body and last year was pure hell in my life. I was finally admitted in December and after that the anxiety has only returned. I wake up with streaks in my arms and legs and I feel pressure over my chest. I end up crying every day now. I do not feel sorry for myself and I train and go to work.

The anxiety has taken over so much that I am thinking hard about taking my life now. I have received medication in the form of Cymbalta 120 mg, Lamictal 200 mg, Mirtazapine, Fluanxol, and now the doctor also wants to use Lithium. I am scared of all these medications now and I am wondering if anyone has tried Lithium with any other medication. Has it helped and what are your experiences?

I received 0.5 mg of Fluanxol and I felt better for two weeks. Then everything came back. We increased the dose to 1 mg and I felt better for two weeks. Now I am on 2.5 mg and the doctor wants to increase to 3 mg. What do you think about all this? Can I add Lithium? It helps a little when I take Soboril but is afraid of becoming addicted to it so only dares to take it two times a week.

Dr. Ramchandra Lamba

Psychiatry Psychologist/ Counsellor Sexology


Welcome to

I have gone through your concern and I think that probably Quetiapine can help you to some extent. Adding Lithium is unlikely to helpful unless you have comorbid depression or bipolar disorder.

If SSRI (selective serotonin reuptake inhibitor) group of drug have not been tried, then discuss with your psychiatrist for adding this group of drugs. If tried in the past with no response then it is fine. Also adding Buspirone is quite helpful. In place of Sobril this drug can be tried. Fluanxol can be increased to the mentioned doses. Mirtazapine doses can be increased to 45 mg if you are taking less.

Along with these medicines you need to do regular exercise like morning walk, at least 45 minutes five times a week. Meditation or breathing exercises or Jacobson's progressive muscle relaxation exercises will be quite helpful and effect of these complementary to drug treatment.

I hope this helps.

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