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Dr. David
Dr. David, Board Certified MD
Category: Medical
Satisfied Customers: 49197
Experience:  Board Certified Physician
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I am suffering anxiety and depression, nanxiety is worse. On

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I am suffering anxiety and depression, nanxiety is worse. On and off I've suffered for years the latest session has now lasted 6.5 months. I am taking 4 Duloxetene 60 mg per day although prescribed two, plus one Clonazepam 500mg and one Zaluron XL 300mg per day
I am a female 61 years of age, my questions are am I on the correct tablets, can they cause anxiety rather than relieve it. I also smoke 40-60 cigaretes a day, what effect will they have? and I have also recently taken to drinkiing Vodka during the day to ease my feelings. I awake with what I can only describe as tight belt around my stomach and afraid to get up.
I'm trying very hard to do things to distract from my horrible feelings, but seem to have no real inclination to do anything. I am awaiting further assessment and to hopefully to see a psychiatrist, but this won't happen until end of September. Incidentally when i have had this before and have recovered I have recovered completely, I have never been sure exactly what sets it of. My previous bouts have ranged from a couple of weeks to 3 years. As you can imagine I am getting extremely fed up with life and the apparent lack of help out there. Can you please assist.
My usband is typing this as I doubt I would be able to

This is Dr. David

I am sorry you are having such bad anxiety and depression symptoms.

many patients over time can become tolerized to treatments for their anxiety

and they often will need higher doses of medications to help treat their symptoms.

you should not be resorting to drinking alcohol and smoking to try to decrease anxiety symptoms

you should talk to your doctor about increasing the dose and frequency you can take your clonazepam to help

you should ask about other medications like hydroxyzine and buspirone which can help decrease anxiety symptoms.

it may be time to taper off of the duloxetine and try another medication like paroxetine or sertraline to help decrease anxiety symptoms.

you should be seeing a psychotherapist regularly as well to learn cognitive behavioral therapy to help decrease anxiety symptoms.

you should be on a regular exercise schedule to help decrease anxiety.

you may need beta blockers to help decrease your heart rate and stomach acid reducers as well

you should ask your doctor about help with cutting down your smoking and alcohol use.

let me know if you have questions.

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