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Ask Dr. D. Love Your Own Question

Dr. D. Love
Dr. D. Love, Doctor
Category: Medical
Satisfied Customers: 17536
Experience:  Family Physician for 10 years; Hospital Medical Director for 10 years.
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I have anxiety and havent had my tablets 2 weeks,

Customer Question

i have anxiety and havent had my tablets for about 2 weeks, and im struggling to find a way to get my prescription. also over the past few months i am unable to maintain food and i have fairly loose bowel of about T4, i cannot stand the texture of food in my mouth so i avoid it because it makes me feel sick, my periods are irreguular and i have only had 2 so far this year, sometimes i have rectal bleeding. i have a weird pulsing thrououht my body, im angry and my mood swings are uncontrolable and so arratic
Submitted: 1 year ago.
Category: Medical
Expert:  Dr. D. Love replied 1 year ago.
Hello from JustAnswer.
I will be glad to assist you with information today.
Through this web site, we cannot assist you with obtaining the prescription for the medicine, but we can discuss the possible causes and management of your symptoms.
What evaluation has been done this far for these symptoms?
What medicine were you previously taking?
Was the medicine stopped because of a decision of your doctor? Or have you been unable to return for an appointment?
Customer: replied 1 year ago.

i havent been assessed or evaluated for any of my symptoms except the typical ones for my anxiety which were itching myself to the point of opening skin, over active thoughts, mood swings, clammy hands, tiredness, panic attacks, cannot stand massive crowds or one to one confrontation.

at the moment i have been taking paroxitine 30mg and i have been unable to return to doctors because i dont want to phone and also because of work etc. but its the other symptoms i am concerned about like my eating, the throbbing through my body sometimes, my stools and my mood swings are awful, i am making decisions which i would say are stupid and not thought about first.

Expert:  Dr. D. Love replied 1 year ago.
Thank you for the additional information.

It is true that many of these symptoms could be related to anxiety, but there are several other conditions that should be considered.

When there are significant mood swings associated with the anxiety, then it would be appropriate to consider mood disorders. If the mood swings are alternating between normal and feeling low, the concern would be that clinical depression is present. However, if the mood swings alternate between normal, feeling low and feeling excessively up, the concern would be bipolar disease.

However, there are also several other medical conditions that should be considered. In particular, the symptoms are worrisome for thyroid disease. The thyroid hormone is a general metabolic hormone, so altered levels of thyroid hormone can potentially cause symptoms throughout all the various organ systems. Specifically, it can affect the GI tract, menstruation, and cause this weird pulsing sensation by its effect on muscles and the cardiovascular system. There are some other metabolic problems that also can be present, including adrenal disease, electrolyte abnormalities, and certain nutrient deficiencies, such as vitamin B12 or folic acid, but thyroid disease would be more likely.

Rectal bleeding can be related to anal irritation from diarrhea or constipation, but the specific site of bleeding also should be considered. The most common would be from hemorrhoids, but a small tear, also called an anal fissure, is also a common cause. Inflammatory bowel disease or infection are also possible causes, but would be much less likely.

The paroxetine is a good antidepressant that also has been shown to be very effective for anxiety. It does not do as well for bipolar disease, which would usually involve the use of a mood stabilizer, such as lithium or valproic acid.

So, at this point, it would be appropriate to pursue evaluation for metabolic conditions that can cause your symptoms, particularly thyroid disease. Whether it would be reasonable to resume the paroxetine or consider a mood stabilizer would depend upon whether there are any episodes where the mood swings in the upwards direction.

If I can provide any further information, please let me know.
Customer: replied 1 year ago.

okay, what would you suggest i should do at this point?

Expert:  Dr. D. Love replied 1 year ago.
At this point, it would be appropriate to pursue the further evaluation noted above. This evaluation can be done by any doctor that you see, but would more often be done by your primary care physician. The doctor that has been prescribing the paroxetine would probably be the physician with whom it would be easiest to obtain an appointment.

The doctor that has been prescribing the paroxetine can also address the issue of whether the mood swings would warrant resumption of the paroxetine or the use of a mood stabilizer.

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