Questions in the Mental Health Forum have been answered by Roger L. Gould, M.D., affiliated with U.C.L.A. and by doctors from Henry Ford Health System.

Question Title: Meds

Forum: The Mental Health Forum
Topic: Anxiety

Posted by Nancy on August 09, 1999 at 10:52:35

I have talked to people who have started new meds and then had to have the dosage increased. However, I have been taking Xanax for about 8 months now and all of a sudden, I'm having heart palpitations and just feel like I'm going to jump out of my stin sometimes.

I've been checked out by a cardiologist so it's OK from that standpoint. Plus they started when my father became ill at the same time my son was ill-my dad lived in another state and I'm an only child so I was very torn. I stayed by his bedside for 3 weeks as he lay dying with my heart going beserk and not knowing if I would drop over at any moment. However, once he died and I got back home, they stopped. That was a month ago and now they've started again. My son is starting high school and he suffers from anxiety so I really dread this.

I only take .50mg per day of Xanax and I think my doc thinks I should taper off, but things are getting worse instead of better. Is it common for your need for such medication to change like that?

Posted by HFHS.MD-AJ on August 12, 1999 at 17:52:10

Nancy,

Your symptoms of palpitations and fear of dying may be due to panic attacks, which are commonly associated with stressful life events such as you describe. It is important to have a medical evaluation of your symptoms, as you have done. A problem with Xanax is that patients may need to increase the dosage in order to achieve a desired effect. This is called tolerance. Your doctor may have been trying to taper you off Xanax, to reduce your risk of dependence.

Selective Serotonin Reuptake Inhibitors (SSRIs) may be preferred to benzodiazepines such as Xanax for long term treatment of anxiety symptoms such as panic attacks, because the SSRIs have little or no potential for addiction. Best clinical outcomes for treatment of panic attacks have been observed when anxiolytic medications such as the SSRIs are used in combination with cognitive-behavioral therapy (CBT). If you are not already under the care of a psychiatrist, I would recommend that you consult one, for thorough evaluation and treatment.

This response is provided for general educational purposes only. Always consult your physician for any health concerns.

Keywords: panic attacks, SSRIs, CBT, Xanax, tolerance, dependence




 

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