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DrRussMD, Board Certified MD
Category: Medical
Satisfied Customers: 65671
Experience:  Board certified Internal medicine and Integrative medicine. Many years of experience all areas.
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I have had heart ppalpitations for 4 months.A consultant cardiologist

Customer Question

I have had heart ppalpitations for 4 months.A consultant cardiologist has told me these are caused by anxiety.Despite this, I continue to live in dread of these.Every one sets me into near panic.My anxiety is through the roof and I can think of nothing else.Every day has become very difficult to the extent that my anxiety is making me non-functional.Just to complicate matters, my GP of 33 years has recently retired so that I have been seeing a young inexperienced locum whom the practice has taken on as a temporary replacement.I was already taking propranolol 40 mg twice daily and his advice was to increase this to 40mg three times daily.This has, however, achieved little.The only other treatment appears to be anti-depressants plus CBT which may or may not help at some time in in the future.He is very reluctant to prescribe valium.While appreciating the ethical issues, I feel these should not completely deny any relief of very unpleasant symptoms and the ability to continue soms sort of independent living.
I am a 66 years old retired male living alone.
I would be very greatful if you could let me know whether there are there any other medications or treatments available for anxiety and your views generally on my situation.


Alex Carroll.
Submitted: 4 years ago.
Category: Medical
Expert:  DrRussMD replied 4 years ago.

I am Dr. Thomas, double board certified physician with over 20 years of clinical experience. I will help you with your question and any follow up questions you have.

The indicated medications for anxiety disorder and panic are SSRIs and SNRIs as first line medications. Zoloft for example, celexa, lexapro, and many others , in fact over a dozen choices.

CBT is very useful and should be considered first line.

Valium is not indicated other than for very short term use, and is not a first line choice in this drug class, something like xanax being more often prescribed
Use reply to let me know if you have further questions.
Please do not forget a positive rating.