HomeAnswersPsychiatrypmddI am a postpartum mother dealing with severe anxiety and PMDD. Kindly help.

How can PMDD and anxiety be treated in a postpartum mother?

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The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.

Answered by

Dr. S. Adithya

Medically reviewed by

iCliniq medical review team

Published At February 23, 2023
Reviewed AtFebruary 27, 2023

Patient's Query

Hello doctor,

I am a postpartum mother of a 6-month-old baby who is dealing with terrible anxiety symptoms now my cycle has returned. After the birth of our daughter, I have been experiencing postpartum anxiety regularly. I have been prescribed Clonazepam 0.25 mg to manage my anxiety while dealing with an infant and working from home. I weaned off this medication by taking 0.125 mg and then down to nothing at all eventually. However, when my cycle returned for the first time in three months, I began experiencing PMDD like I had before the birth of my child and needed to take the Clonazepam again, so my doctor suggested increasing my SSRI.

I took 10 mg of Escitalopram for the past six years and had relief from my anxiety entirely. However, since the birth of my daughter, it has changed. I then increased the dose from 10 mg to 15 mg and the Clonazepam to 0.125 mg daily, and I have done this for eight weeks. This cycle for 14 days has been extremely difficult with severe anxiety and I have had to take 0.25 doses now and again when the anxiety is at an extreme point.

Kindly help.

Answered by Dr. S. Adithya

Hello,

Welcome to icliniq. com.

Thank you for your query.

I understand how distressing it is for you. Moreover, you are in a postpartum period which causes you more distress since there will be a lot of hormonal fluctuations during this period. However, I would say you are doing better with Escitalopram and Clonazepam. You can take the tablet Clonazepam whenever required. It does not cause you any harm and will not lead to addiction with such short durations. I would also suggest tablet Propranolol 20 mg in the morning daily to relieve your anxiety along with Escitalopram.

I hope this has helped you. Thank you.

Patient's Query

Hello doctor,

Thank you for your reply.

It seems Escitalopram works for me on a usual basis. Do you suggest increasing the dose of Escitalopram from 15 mg to 20 mg during my 14-day cycle to avoid PMDD severity? You also mentioned that Clonazepam would not harm when taken for short durations. But since I have taken it daily for three months and now have weaned, will this harm me? Or is this still considered a short duration? I do not know where to go with the dose from here. I am down to 0.125 mg. How to use this medication properly to avoid any form of addiction?

Answered by Dr. S. Adithya

Hello,

Welcome back to icliniq.com.

Need not increase the dose of Escitalopram to 20 mg during your cycle. That does not make any difference. You can increase it to 20 mg and take it regularly, irrespective of your menstrual cycle. Since you have tapered it properly to 0.125 mg, you need not worry. You can take Clonazepam 0.25 mg as SOS only. That does not cause you any addiction. Apart from medications, try to do regular physical activities, deep breathing exercises, and listen to music.

I hope this has helped you. Thank you.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. S. Adithya
Dr. S. Adithya

Psychiatry

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