QUESTION:
Dear Dr. Heller,
I've been lead to believe SSRI's are the one stop solution to this problem. I've suffered from panic since I was 5 years old, and social anxiety has been around in a less severe way. When I was 35 my hormones began to change and Panic Disorder came back full blown and I finally decided living with it was too exhausting and ruining my life. Well, I take Zoloft, but find I still need Klonopin for twitching, buzzing and other CNS complaints.
Is it ok to use both? I'd like to use Klonopin as needed and Zoloft only when I have hormonal depression, as it works well for that, but I've yet to find a doctor who isn't afraid of prescribing a benzodiazepine long term. I hope you can respond.
ANSWER:
Panic disorder is likely a lifetime disorder. SSRI's can help dramatically, and
reduce the need for benzodiazepines like Klonopin, lorazepam (Ativan) or alprazolam
(Xanax). The medical climate regarding treating pain and anxiety disorders is slowly
changing, allowing physicians to treat patients more aggressively. Physicians are fearful
of the DEA and state medical boards regarding using these medications long term. The most
important thing physicians can do is document why the patient is on these medications, why
they need them, and how many are being prescribed.
Treating all the anxiety disorders can be particularly helpful, such as the generalized
anxiety disorder and PTSD. My
screening test
may be of use to
you.
