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Dr. K.
Dr. K., Board Certified MD
Category: Medical
Satisfied Customers: 7563
Experience:  Board certified with experience in primary care.
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Mental health expert please Would could you recommend

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Mental health expert pleaseWould could you recommend patients who have not been able to starts anti anxiety meds such as citalopram and sertraline due the worsening of symptoms when starting. Would escitalopram have less side effects on onset ?
Hello and welcome to Just Answer, and online question and answer service. I look forward to answering your question. Please be aware that this is not a site that provides medical care, just answers and advice. We communicate through the platform via text or email. It is not an instant chat so please be patient.Each of these medications works in different ways so yes, you may notice different effects.
It is also important to start at a very low dose and increase weekly. Sertraline for example, can be started at 12.5 mg daily, which is a half pill at bedtime.Please respond to me with any followup questions you may have. I would appreciate your feedback on the answer I have provided.
Customer: replied 8 days ago.
Had started with a low dose but the effects of sertraline half a pill but couldn’t tolerate it would you say escitalopram might be better tolerated ? Anxiety is caused by hormone fluctuations (perimenopause )
It could be better tolerated. A better choice for perimenopausal issues would be a low dose combination birth control pill or a progesterone only pill.
Customer: replied 8 days ago.
Would that help with anxiety ? Panic attacks happen just before a cycle and completely disappear once cycle begins. I’m 42 dr’s seem reluctant to prescribed contraceptive pills at this age citing risks etc I have an appointment on Tuesday I’m going to be more firm in explaining just how bad my symptoms are drs seem to think that all I need to do I avoid stresses and eat more greens. The anxiety is debilitating I picked up my daughter from school and had to rush into the car to self talk myself down from a panic attack was mortified as parents left wondering why I didn’t give the usually smiley hellos and felt awful for being dismissive towards the children whilst trying to self calm
it helps with all the symptoms as your hormonal issues are causing. It. There is no reason for a Dr not to prescribe it unless you smoke. Progesterone only pills are also effective, and less risk.
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Customer: replied 8 days ago.
Great thanks a million