Success shown with drugs and psychotherapy People plagued by panic attacks need not fear one thing: Treatment works. Panic disorders respond well to psychotherapy, drug treatment and a combination of the two, according to one of the largest studies of the condition. Panic disorder affects several million Americans, crippling them with recurrent bouts of profound anxiety and physical symptoms that can include chest pain and pounding, as well as rapid heartbeats and shortness ... Read More

A recent study adds to the body of evidence suggesting that the drug Paxil (paroxetine HCl) is effective in treating social anxiety disorder / social phobia. * note: social anxiety disorder is characterized by the fear of being observed or evaluated by others; sufferers report an overwhelming fear of embarrassment in social and performance situations. * researchers at the University of Southampton conducted a 12-week, multi-centre, double-blind, placebo-controlled clinical trial to compare ... Read More

Question. My patient is in the second trimester of her pregnancy. She has panic disorder and depression. In the past, she responded well to Zoloft and Klonopin. What are the safest medications for the next few months? Answer. The short, no-frills answer to your question is that any of the major antidepressants or anxiolytics are probably safe, now that the most vulnerable period of organ-formation (the first trimester) has passed. I ... Read More

Question. Do you have a list of drugs for depression, and non-addictive medications for anxiety? Tricyclics of the older vintage would be helpful. Answer. I am providing you with a list of commonly used antidepressants, as well as their usual doses: Maintenance Dosage and Tablet Size for Non-MAOI Antidepressants Antidepressant Tablet/capsule sizes Usual daily adult dose Amitriptyline (Elavil, Endep) 10, 25, 50, 75, 100, 150 mg 75-250 mg Amoxapine (Asendin) 25,50, 100, 150 mg 200-300 mg Bupropion (Wellbutrin) 75, 100 ... Read More

Question. After using alcohol and amphetamines to dull my "bad feelings" for many years, I was diagnosed with clinical depression and put on antidepressants in 1999. I went through several before finding success with Paxil and Ritalin. Then I moved away. I now don't have insurance and the medications are not working. I feel totally immobilized, and literally cannot work on a regular basis, even though I know I will ... Read More

Question. I have been taking 30 mg of Paxil daily for nearly two years. I have gained about 15 pounds that I can't drop even though I've increased my activity level and decreased my food intake. All the literature mentions weight loss but nothing is said about weight gain. A friend taking Paxil also experienced weight gain, as have my husband and three friends who are on Prozac. How can ... Read More

Question. Can you please give me your opinion on the P450 inhibitory effects of SSRIs, namely, fluoxetine, paroxetine, citalopram, sertraline and fluvoxamine? Which appears to have the least clinically significant effects on this and other liver enzymes? How do these effects demonstrate themselves to patients? How clinically significant are the effects? Answer. I'll give you the bottom line first, then fill in some of the details: if you are only worried ... Read More

Question. I have an 80-year-old relative with Parkinson's disease and depression who was started on Prozac with good initial effects on mood and energy levels. Unfortunately, he complained of worsening tremor. A pharmaceutical representative for Zoloft has suggested that this antidepressant would be a better choice for use in patients with parkinsonian symptoms because it has some dopaminergic effects. Have there been any studies of patients with Parkinson's disease suggesting ... Read More

Depression Meds and Side Effects Q. I am 19 and have experienced depression for over two years. My doctor recently prescribed Serzone, which caused severe headache, nausea and strangely hot skin. Then he switched me to Paxil, which caused severe nausea and vomiting. I have not returned to my doctor because he assured me the Paxil would not cause me to become ill. I am very nervous about trying further treatment, ... Read More

Depression and Inhalant Abuse Q. I have a friend who inhaled gas three times in his youth. He is very smart and has a great memory, but has severe depression. Is there a drug or specific combination of drugs that would help? He has tried Luvox, Zoloft and Paxil. A. Inhalation of cleaning solvents, paint, glue, gasoline, etc. is a significant public health problem and may be a stepping stone to other ... Read More