? Case of Anxiety

A female patient aged 45 years had been complaining of sudden onset palpitations from last one month. She even adds that when she visit me her pulse increases and it was the same too when i checked by pulse oximeter. History She is very anxious about coronavirus, and goes for excessive number of times handwashing and is generally very over concerned about COVID 19. On first visit, she had visited with complaints of pain in multiple areas of the body, which resolved when I had put her on etizolam 0.5 twice daily She says until she is on medications she is fine, when she stops all things recur. She is very happy, smiling when she visits, but somewhere in her mind she has fear of Covid 19 Investigations I had handed her a HAD scale to fill up which she refused as she thought I will put her on anxiolytics, antidepressants or so. Management how to tackle such case? Put her on escitalopram or sertraline or lorazepam ? Kindly give your valuable opinion for this case

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As far as I understood the case, U can keep the diagnosis as Somatoform Disorder (C/O Pain in multiple sites of the body) with Panic attacks due to Corona Phobia. She will respond best with Low dose Amitriptyline (Tryptomer 10), with Sertraline (25mg to start with, then after 6 days, increase it to 50mg) & Tab Clonazepam 0.25mg (1--------1-------0). Also add Mouth Dissolving Clonazepam (0.25mg) on SOS Basis. Nice case though!!!

@Gunjesh Kumar Sir, how long to give sertraline and amitriptyline?? Sertraline 6months?

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Absolutely a c/o Anxiety neurosis Rxtab escitaloram+tab etizolam one tab at bedtime for one month Counseling For her psychological satisfaction adv covid test to tell her she is negative and healthy and need not to worry

Thanx dr Kute Ankush

Need of counseling, and family support . In my opinion ask for CBC ESR Blood SUGAR LFT RFT RE URINE T3T4TSH Chest X-RAY PA view, CRP LDH and RT-PCR to ruled out her fearness, and continue your treatment

Recurrent panic attack due to specific anxiety... it how do mange with preoccupied thoughts...with multiple somatic complains... In this will be preferred hypochodriasis. Start paroxtine Escitalopram...Trifluphenazine. Benzodiazepines devided with CBT.


Tnx Dr Shivraj Agarwal sir

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GAD White collar tachycardia Councelling Nexito 10 mg morning + Buspirone 10 mg at bed time .

pitta dushti. treat with virechana to clear the excess pitta. then shirodhara should be followed

Psychological counselling with escitalopam with propanol

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