QUESTION:

Dear Doctor,

Now that I'm diagnosed, medicated, and working your program in "Biological Unhappiness", I'm finding I'm getting anxious daily, despite Tegretol, Haloperidol and Prozac. This isn't a new feeling, but one I used to calm with codeine when I could get it. Can I add yet another drug to my arsenal or switch to Paxi?. BuSpar will feel worse at first and I'm leery but willing. Also, just quit smoking but using nicotine inhalers.

Thanks.

ANSWER:

The screening test I use for my patients is crucial here. The generalized anxiety disorder, obsessive compulsive disorders, and panic disorder are all possibilities, and need to be evaluated. If the generalized anxiety disorder is present, Paxil will make you worse, not better. If you’re using the nicotine inhalers, it’s unlikely the smoking cessation is causing the anxiety. Just make certain you’re using the inhaler frequently enough.