Suggest Treatment For Recurring Anxiety

Posted on Thu, 5 Mar 2015

Question: I have been taking Propranalol 80mg MR capsules for 3 days now. At first they worked very well and controlled my anxiety symptoms fantastically. However, this afternoon I noticed some of the symptoms coming back very slightly and now I'm worried that the tablets have stopped working, which is making the symptoms worse! Please advise. Thank you.

Answered by Dr. Seikhoo Bishnoi (22 minutes later)

Brief Answer:
If propranolol is not working then need to add proper anti anxiety drugs

Detailed Answer:
Hello thanks for asking from HCM

I can understand your concern. Propranolol belongs to beta-blocker drugs and the drug result in reduction of symptoms of anxiety. You has been advised to take the drug in 80 mg doses and it resulted in improvement in symptoms but with in 3 days you are having the symptoms again.

As Propranolol cause improvement in symptoms alone and will not treat anxiety. Other medicines like anti anxiety drugs as SSRIs should be prescribed commonly for your condition. Sertraline, Escitalopram etc will help to reduce the symptoms of anxiety and will reduce the frequency of anxiety also. If taken regularly these medicines are very effective. Continue to take Diazepam for insomnia as per your prescription. Visit a psychiatrist for prescription.

Apart from change in medicines try Relaxation Exercises, Yoga, Progressive muscle relaxation exercises (PMR) to keep yourself relaxed and for decrease in severe anxiety episodes.

Thanks, hope this helps you. Ask again for more doubts.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Seikhoo Bishnoi (36 minutes later)

Thanks. I did try Citalopram but it didn't agree with me.

Could it be that I just need a higher dose of Propranalol? I start some CBT counselling tomorrow which I hope is going to teach me how to manage my symptoms.

Answered by Dr. Seikhoo Bishnoi (4 hours later)

Brief Answer:
Further dose increase of Propranolol may result in side effects

Detailed Answer:
Hello again

If Citalopram didn't work other medicines of SSRI group like Sertraline can be tried. Sertraline is relatively better tolerated and is not much associated with increased restlessness during start of therapy. You can discuss for this drug with your doctor.

You are already taking 80 mg of propranolol and this may result in side effects if doses would be increased further. Hypotension, bradycardia may develop in high doses of the drug so should be avoided.

Please attend sessions of CBT and this will help in remaining relaxed.

Thanks

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar