What Could Cause Behaviors Like Anxiety, Frequent Anger And Irritation, Displeasure, Disappointment, Over-meticulous And Helplessness After Treating Cervical Spondylitis?

Posted on Tue, 29 May 2018

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

Tue, 29 May 2018 Answered on

Tue, 12 Mar 2024 Last reviewed on

Question : Hi,

This is regarding my father. He is 70 year old (Ht:5.5, Wt: 62kgs). He has been operated for cervical spondylitis in January 2017. In spite of the surgery, he still has numbness and pain in his right hand. The doctors told it will be like that as the nerves are compressed beyond repair. I think he is under depression (not exactly because of the surgery but even before he has some of the following symptoms).

Some of the symptoms I observe: Anxiety, being extra careful with everything, over planning, being very careful with money (he has more than enough cash flows), frequent anger, irritation, displeasure, disappointment, expressing helplessness. He has slight hypertension (hovers around 130-140) for past 4 years.

Current medication: Olmark A, Tegrital CR 200, Neurobion.

I would appreciate if you suggest any advice or medication.

Answered by Dr. Seikhoo Bishnoi (33 minutes later)

Brief Answer:
These symptoms can occur in anxiety too

Detailed Answer:

Hello,

Thanks for asking your health related doubts.

I can understand your concern. He is 70 and at this age cervical spine surgeries are rarely successful. If even after the surgery his symptoms are there then that could be due to nerve damage.

The symptoms like anxiety, extra cautiousness about everything, overplaying, frequent anger, irritability, disappointment, helplessness etc could be part of his personality. If he has never taken treatment for anxiety till now and he has done good in his life then I don't think these symptoms are part of anxiety disorder. With age and with associated problems like numbers in limbs in his case, a lot of individuals develop anxiety symptoms.

Low dose Escitalopram can be added to his prescription. This will help to control the anxiety symptoms and he will feel better. You can talk with his doctor for prescription. Please get his Serum B12 levels done. Low B12 levels are one of most common causes of numbness and other neuropathic complaints. If the levels are low then vitamin b12 supplements should be started.

Thanks and Take care

Please let me know if you need more help.

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

Follow up: Dr. Seikhoo Bishnoi (3 hours later)

Many thanks for the quick response. 3 questions:

1. He is currently taking Neurobion. I guess that would take care of B12 deficiency, if at all it's there. Or you think he should get his Serum B12 levels tested?

2. He is currently taking Tegrital CR 200. Is it okay to take Escitalopram along with Tegrital CR 200?

3. When you say low dose, can he take Nexito 5mg (morning and night)? Is that the correct dose for his age?

Thanks in advance for your response.

Answered by Dr. Seikhoo Bishnoi (34 minutes later)

Brief Answer:
No need to get B12 levels done.

Detailed Answer:
Hello again

Thanks for asking a follow up question.

1) Neurobion will take care of vitamin B12 levels. Make sure he drinks plenty of water. No need to get B12 levels done as of now.

2) Yes its okay to take Escitalopram while taking Tagretol CR 200. Escitalopram is a SSRI drug and is a safe to use drug.

3) 5 mg dose is fine for his age. Avoid increasing dose considering his age. If he has any cardiac issues then instead of Escitalopram, Sertraline can be used.

Thanks.

Note: For further guidance on mental health, Click here.

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