Managing Anxiety: Medication Insights and Treatment Options

Q: Managing Anxiety: Medication Insights and Treatment Options

Hello, online friend： You now understand that "panic" and "worrying about panic leading to anxiety" are two different things. <br>In fact, "panic" is not very common and primarily requires prevention. <br>On the other hand, "anxiety" is a persistent adversary that you need to ove

Supplementary question?

Hello Dr.
Liao, I apologize for missing a few questions and wasting an online resource.
I would like to ask you about my anxiety and panic due to missing doses.
Currently, I am taking 40 mg of Prozac (Fluoxetine) and 0.5 mg of Xanax (Alprazolam) once before bed.
I find myself wanting to take the medication earlier each day; it used to be at 11:00 PM, but now it has shifted to 9:00 PM.
When I feel uncomfortable in the morning, I take half a Xanax, and if I feel unwell in the afternoon, I might take another half, with a maximum of 2 Xanax per day.

I would like to ask you, Dr.
Liao, if taking 10 mg of Buspirone HCL during the day would have a longer effect than Xanax, or would you recommend taking half a Xanax when feeling uncomfortable? I understand that Xanax works quickly but wears off in about 2-3 hours.
What about Buspirone? If I still experience some anxiety in the morning, should I start with half a Xanax for relief or take Buspirone instead?
Additionally, I would like to know if your clinic is located at the Taoyuan Rehabilitation Hospital.
Can rTMS and TBS be helpful? Is there someone at the Taoyuan Rehabilitation Hospital I can consult with? Thank you very much, and I wish you well!

Drowning in the Sea of Anxiety, 20~29 year old female. Ask Date: 2021/07/28

Dr. Liao Dinglie reply Psychiatry

Hello, online friend: You now understand that "panic" and "worrying about panic leading to anxiety" are two different things.
In fact, "panic" is not very common and primarily requires prevention.
On the other hand, "anxiety" is a persistent adversary that you need to overcome.
Medications like "Xibin" are mainly used to manage "panic." If you haven't experienced frequent episodes recently, it indicates that there is no issue with the medication itself, and there is no need to change it.
As for "anxiety," you are experiencing symptoms such as heart discomfort, dizziness, feelings of heaviness, and difficulty getting out of bed in the morning, which may also affect your interpersonal relationships.
These symptoms should be discussed with your physician, and arranging for psychological counseling could also be beneficial.
"Buspirone" is a medication used to treat anxiety, and you can discuss it with your doctor as part of a comprehensive strategy to address these symptoms.
Additionally, rTMS and TBS have the advantage of relatively fewer side effects, so you can consult at an outpatient clinic.
If you go to the Taoyuan Rehabilitation Hospital, you can make an appointment for the "rTMS Special Outpatient Clinic." Wishing you success in maintaining a calm mindset to manage your anxiety.
Dr.
Liao Ding-Lie.

Reply Date: 2021/07/28

More Info

Managing anxiety can be a complex process that often involves a combination of medication, therapy, and lifestyle changes. It’s important to understand the different types of medications available, their effects, and how they can be used effectively in your treatment plan.

Understanding Your Medications
From your message, it appears you are currently taking Prozac (Fluoxetine) at 40 mg and Xanax (Alprazolam) at 0.5 mg. Prozac is a selective serotonin reuptake inhibitor (SSRI) that is commonly prescribed for anxiety and depression. It works by increasing the levels of serotonin in the brain, which can help improve mood and reduce anxiety over time. It typically takes several weeks to feel the full effects of Prozac, so patience is key.

On the other hand, Xanax is a benzodiazepine that provides quick relief from anxiety symptoms. It works by depressing the central nervous system, leading to a calming effect. However, it is important to use Xanax cautiously due to the potential for dependence and tolerance, which can lead to needing higher doses over time to achieve the same effect.

Medication Timing and Dosage
You mentioned that you have been taking Xanax more frequently, sometimes as much as two doses a day. While it’s understandable to seek relief from anxiety, it’s crucial to adhere to the prescribed dosage and timing. Taking Xanax too frequently can lead to increased tolerance and dependence. If you find yourself needing to take Xanax more often, it may be a sign that your anxiety is not adequately managed, and it would be wise to discuss this with your prescribing physician.

Regarding Buspirone, it is another medication used to treat anxiety. Unlike Xanax, Buspirone is not a sedative and does not have the same potential for dependence. It can take several weeks to feel its full effects, similar to Prozac. Buspirone is often used as a long-term treatment for anxiety and can be taken alongside SSRIs for enhanced effect. If you are considering adding Buspirone to your regimen, it’s best to consult with your doctor to determine the appropriate dosage and timing.

Managing Anxiety Symptoms
If you experience anxiety during the day, it might be beneficial to discuss with your doctor whether to take Xanax as needed or to start Buspirone. Some patients find that a combination of medications works best for them, while others may prefer to stick with one medication. Your doctor can help you find the right balance.

In addition to medication, consider incorporating non-pharmacological strategies to manage anxiety. Techniques such as cognitive-behavioral therapy (CBT), mindfulness meditation, and regular physical activity can significantly reduce anxiety symptoms. These approaches can be effective in conjunction with medication and may help you feel more in control of your anxiety.

Exploring Other Treatment Options
You also inquired about rTMS (repetitive Transcranial Magnetic Stimulation) and TBS (Theta Burst Stimulation). Both are non-invasive brain stimulation techniques that have shown promise in treating depression and anxiety. They work by stimulating specific areas of the brain associated with mood regulation. If you are considering these treatments, it would be beneficial to discuss them with a mental health professional who can provide guidance based on your specific situation.

Conclusion
Managing anxiety is a journey that requires a comprehensive approach. It’s essential to work closely with your healthcare provider to monitor your symptoms, adjust medications as needed, and explore additional treatment options. Open communication about your experiences with medication and any side effects you may encounter is crucial for effective treatment. Remember, you are not alone in this process, and there are many resources available to help you navigate your anxiety.
If you have further questions or need clarification on any points, don't hesitate to reach out to your healthcare provider. They are there to support you in your journey toward better mental health.

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