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How Should I Treat My Anxiety?

Tuesday, 18 Feb 2014 05:17 PM

By Peter Hibberd, M.D.

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Question: I am 65 years old and have anxiety (sometimes panic attacks). Sometimes I take Ativan. But can you suggest something safe and not addictive?

Dr. Hibberd's answer:
 
Panic disorder does not need to be always treated with medication. Anxiety disorders are definitely over treated with medications, especially when non-medicine approaches are often best in the long term.
 
While Ativan is a very effective agent, frequent use of this will produce tolerance, and of course addiction may be seen with this medication, especially when doses are escalated or used too frequently. People with frequent episodes of panic or chronic anxiety are advised to avoid using medications such as Ativan (called benzodiazepines) because of drug tolerance, side effects, and addiction risks.
 
You should return to your physician, or ask for a referral to a specialist in panic disorder (a psychiatrist may be the best choice), so that a more appropriate long-term treatment plan can be established. The treatment of panic may involve some CBT (cognitive behavioral therapy), environmental adjustment (decreased stressors, sleep management, biofeedback and/or meditation and relaxation therapies such as massage or yoga). Surprisingly, antidepressant medication can also help.
 
Anxiety without panic is usually treated differently, so a specialty consultation is a good idea. Low-dose benzodiazepines are often prescribed temporarily, but if they are still needed after two to three weeks, you should work with your doctor to explore other treatment options.
 
Some patients who struggle with panic attacks do well with a low dose of a sedating antihistamine such as Atarax, but you should alcohol and stimulants, including caffeinated drinks. Ask your doctor about non-medication approaches to your condition, and you may be pleasantly surprised by the numerous options you have.

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