Suggest Treatment For Severe Depression And Anxiety

Posted on Mon, 20 Mar 2017

Medically reviewed by Ask A Doctor - 24x7 Medical Review Team

Mon, 20 Mar 2017 Answered on

Thu, 13 Apr 2017 Last reviewed on

Question : I had a what you may describe as a trauma swallowing food . It felt stuck due to Gerd I absolutely panicked and finally throat relaxed. Went through all medical checks and even an endoscopy all checked out well except for Gerd. At any rate I became fearful to eat with out burpin with each spoonful. I have a long term history with Major Depessive Illness and anxiety All very well managed on Prozac50 mags and ativan2 ml needed a day. Doc increased anxiety med Ativan to 4mls a day and 60 mg of Prozac. I'm scared of the higher doses of Prozac but will be a goo patient if I can again feel normal. Also in Am I feel jittery not noted defore the increase of Prozac. Will this increase help and when can I see result. Also how would you recommend I take the Ativan during the day

When this all occurred I was not clinically depressed I was taking Prozac which has been a very good drug for me for many years The Gerd was the culprit here and panic it caused.im still not clinically depressed just freaked out by spasm.

Answered by Dr. Alexander H. Sheppe (1 hour later)

Brief Answer:
Consultation

Detailed Answer:
Hello, and thanks for your question.

What you are describing is classic panic disorder related to swallowing. This is an anxiety disorder. The best treatment for this is an SSRI medication such as Prozac, which you are taking. Doses as high as 80mg daily may be needed. You are currently taking 60mg daily, which is a very safe and effective dose. Give it a few weeks for your body to adjust to it, and it will begin helping you. I would not use Ativan because it is addictive and makes anxiety worse over time.

Dr Sheppe
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Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Alexander H. Sheppe (2 hours later)

I was taking Prozac before this 50 milgrams But had the flu the week before and missed doses. At times I am sloppy on taking medication. Could this have dropped blood levels enough to get vulnerable. And since their is some in my system could recovery time be shorter than if I began from start. Will the anxiousness I have to eat clear up as drug takes affect.

Io an taking Ativan to get over the hump and to help with anxiety for me it will be a short fix until I canbe sack to normal function them it t is used for sleep

Answered by Dr. Alexander H. Sheppe (7 minutes later)

Brief Answer:
Followup

Detailed Answer:
If you miss medication, it will take much longer for the medication to start working. You should continue taking 50mg daily. After 3-4 weeks your anxiety should decrease. I would avoid using Ativan because it rarely acts as a short fix, often requiring higher and higher doses which can lead to addiction and withdrawal.

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My name is Dr. Sheppe, and I am an XXXXXXX doctor working in New York City at NewYork-Presbyterian Hospital, ranked #1 for Psychiatry in the United States (tinyurl.com/psyrank). For a personalized comprehensive evaluation, treatment recommendations, and individual therapy, ask me at HealthCareMagic at this private web address: tinyurl.com/DrSheppeAnswers

Above answer was peer-reviewed by : Dr. Yogesh D

Follow up: Dr. Alexander H. Sheppe (20 minutes later)

Dr please one more question. If I have some Prozac in my system and add more in this case 50 to 60 mgs does this act quicker than if we were just beginning the process?

Answered by Dr. Alexander H. Sheppe (1 minute later)

Brief Answer:
Followup

Detailed Answer:
No, this does not act more quickly. Continue taking 50mg.

Please remember to rate and close this question thread when you are finished and satisfied.

My name is Dr. Sheppe, and I am an XXXXXXX doctor working in New York City at NewYork-Presbyterian Hospital, ranked #1 for Psychiatry in the United States (tinyurl.com/psyrank). For a personalized comprehensive evaluation, treatment recommendations, and individual therapy, ask me at HealthCareMagic at this private web address: tinyurl.com/DrSheppeAnswers

Above answer was peer-reviewed by : Dr. Yogesh D

Follow up: Dr. Alexander H. Sheppe (30 minutes later)

The doctor upped my dosage to 60 from 50 and I had hoped recovery time be less. Also you understand the new dose is now 60 which u stated was a safe and effective dosage and will help the anxiety disorder . Pjust wondering about the science of recovery duration may be shorter since I have some in my system already
Your answers were good thank you it was somewhat reassuring .

Answered by Dr. Alexander H. Sheppe (38 hours later)

Brief Answer:
Followup

Detailed Answer:
You are very welcome!

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In the future, for continuity of care, I encourage you to contact me directly at my private web address below. After you ask a direct question, it would be my pleasure to be your dedicated personal physician on this website. My name is Dr. Sheppe, and I am an XXXXXXX doctor working in New York City at NewYork-Presbyterian Hospital, ranked #1 for Psychiatry in the United States (tinyurl.com/psyrank). For a personalized comprehensive evaluation, treatment recommendations, and individual therapy, ask me at HealthCareMagic at this private web address: tinyurl.com/DrSheppeAnswers

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Above answer was peer-reviewed by : Dr. Prasad