Is 20mg Of Escitalopram The Right Medicine For Anxiety And Depression?

Brief Answer:
relaxation therapy; bupropion or propranolol.

Detailed Answer:
Hello
Welcome to HCM.

You have been taking escitalopram for anxiety and depression. Even 20mg is not working now and you still have the symptoms.

You are right that alprazolam has habit-forming potential.

I have some suggestions for you which you may find helpful:

1. I will not recommend addition of prozac to escitalopram (both belong to same class of selective serotonin reuptake inhibitors). There is no use of adding a drug from same class.

2. The better option would be adding bupropion. This is a norepinephrine dopamine reuptake inhibitor. This will broaden the spectrum of action.

3. Another option is adding propranolol. This is available in extended-release formulation. This reduces the sympathetic activation caused by stress, thus controlling blood pressure and reducing your anxiety.

4. Occasional use of alprazolam, in case of intense anxiety not controlled by other drugs does not carries the risk of addiction. The of addiction is more when alprazolam is taken regularly for more than around 4 weeks.

5. Other than drugs, you can also go for behavior therapy and formal relaxation therapies like progressive muscle relaxation and biofeedback, if feasible for you. These work very well in combination with medications.
You can also practice simple relaxation exercises like slow and deep breathing and mediation on your own. These are excellent stress-busters.

To sum up,
First consider relaxation therapies.
If not feasible, go for propranolol.
The next choice would be bupropion, if propranolol does not help.

Kindly discuss these issues and doses with your local psychiatrist.

Hope you find these suggestions helpful.

Feel free to ask further.

Kindly close the discussion if you are satisfied with the responses and give your valuable feedback.

I wish you good health.

Thanks.
Dr. Shubham Mehta, MD (Psychiatry)

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