Psychiatry & Psychology--General/Panic Attacks/ Medication

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Question
I am 32 years old and have suffered from severe anxiety and panic attacks since I was 12. I have been on and off of medication for them for that long too. This last episode has lasted for 5 years, the first years I was home bound they kicked back in so bad. I have been taking xanax .5mg 3x a day, and paxil 10mg 3x a day for the five years. Im wanting to get off of them and let my brain and body "refresh", and see how I will do without them. I have never had to increase my dosages, but for the last year have really felt the dependency kicking in. The question: Is there anything I can do or take to help curb the withdrawals, as they are the same feelings as the reason Im taking the medications? (Anxiety, Nervousness, Tension, etc...) I dont want to mistake my symptoms coming back for the withdrawal symptoms.

Answer
You will not get withdrawals by reducing the Xanax by 0.25mg every other week, or the Paxil by 10mg monthly.

HOWEVER, my bet is that you will have terrible anxiety, nervousness and tension from a return of the underlying illness -- you have had this for 20 years.  Diabetics are dependent on insulin, people with panic and depression frequently need medications.

However, if you want to get off the medications without true withdrawal problems, like seizures, then there is the schedule to do so.  Anxiety and nervousness and tension are NOT withdrawal signs, but a sign of return of the illness.

Psychiatry & Psychology--General

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Daniel S. Harrop, M.D.

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Dr. Daniel S. Harrop received his B.A. and his M.D., both from Brown, and his M.B.A. from the Edinburgh Business School, Scotland. Board-certified in adult and geriatric psychiatry, he is a past president of the R.I. Psychiatric Society and a member of the Committee on Medical Quality of the American Psychiatric Association and the Committee on Continuing Medical Education of the R.I Medical Society. He serves as a consultant to four of the top five major medical management companies, including OptumHealth/United Healthcare, Magellan Behavioral Health Services, ValueOptions and APS Healthcare, and maintains a private practice in Providence, R.I. He also serves as chief psychiatric consultant on the Medical Advisory Board at the R.I. Workers Compensation Court. He was formerly on the faculty at the medical schools at both Brown University and Harvard University.

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