Am suffering from anxiety disorder and taking paroxetine 12.5 plus tab. And opipramol 50 mg once daily from last 3-4 years. Is it safe for long term use.

Question

No psychotropic drugs are ideal for long term use. But given the choice of struggling with the anxiety and taking medication for he same, the option is quite clear. If you are keen about getting off of the medication it is important to combine some therapy along with the medicines. Anxiety has all to do with fear and your inability (or so you would tend to think) to handle the same. Fear is based on looking too much into the future and imagining things that usually do not tend to happen (usually 90% of your fears will not happen). You need to change your perception of the fearful stimulus then you can change your response to the fear. The first one is the best and will preempt the need for the second. If you are already far gone into the reaction mode, then you need both responses to counter the attack. The way we see things in life (like half empty or half full glass) is very dependent on our attitude. Attitude may have developed over many years but fortunately can change in a matter of sustained choices made and acted up on now. Accordingly you choose to see things as either threatening or as an opportunity. The opportunist will be positive and work with the situation to make good out of it. The individual who sees it as threatening, will, out of fear, try to avoid/run away from the situation or react with anxiety. Yes, self-belief does impact it too, but you can see that prior to that, perception will tarnish the belief system too. Here, you can see that all the resolution lies in just changing your perception/attitude, even if it is against odds. Changing your response, despite the perception, is building up of your reserves and resources to handle any contingency that life throws up at you. And life throws up situations quite regularly and heavily. For this you need to develop a fit mind and body: the former, by meditation and mind exercises; and the later, by exercises and proper diet. You need good sleep too. Take care of the following: mental stability can be achieved by learning a few skills in handling emotions in an appropriate manner. Stress management skills, which have a lot to do with expressing emotions, will need to be a major part of your recovery program. Emotionally you need the help of a counselor and that will help you tremendously to move from anxiety to normal fear. Please persevere and cooperate through all the support you need and you will come through successfully. Develop your body?s health by physical fitness through exercise, good rest (sleep), and a proper diet. Any way what you need to focus on is to do vigorous exercise of the aerobic kind for the heart?s fitness; meditation for the brain?s fitness; sleep for a well rested mind and body; a sound spiritual well being for good confidence and stability; and a diet with lots of vegetables, fruits, and whole grains. Vigorous exercise, especially of the calisthenic kind, will make your heart, which is a muscle, grow larger; and then your heart will need to beat less often and you will respond to the anxiety with a calmer disposition. If your mind, constitution, and your emotions are in check and fit, you will never be disturbed again. The earlier you tackle this, the easier it is going to be. These changes will give you a handle on life and your perceptions and responses. Prayer is really powerful, if you are a spiritual person. Repeat some personally framed affirmations that are geared to calming you down and building confidence. Do a personality development course too. Anything that develops you personally will be of great assistance in building resilience.

Saul Pereira · Accepted Answer

No psychotropic drugs are ideal for long term use. But given the choice of struggling with the anxiety and taking medication for he same, the option is quite clear. If you are keen about getting off of the medication it is important to combine some therapy along with the medicines. Anxiety has all to do with fear and your inability (or so you would tend to think) to handle the same. Fear is based on looking too much into the future and imagining things that usually do not tend to happen (usually 90% of your fears will not happen). You need to change your perception of the fearful stimulus then you can change your response to the fear. The first one is the best and will preempt the need for the second. If you are already far gone into the reaction mode, then you need both responses to counter the attack. The way we see things in life (like half empty or half full glass) is very dependent on our attitude. Attitude may have developed over many years but fortunately can change in a matter of sustained choices made and acted up on now. Accordingly you choose to see things as either threatening or as an opportunity. The opportunist will be positive and work with the situation to make good out of it. The individual who sees it as threatening, will, out of fear, try to avoid/run away from the situation or react with anxiety. Yes, self-belief does impact it too, but you can see that prior to that, perception will tarnish the belief system too. Here, you can see that all the resolution lies in just changing your perception/attitude, even if it is against odds. Changing your response, despite the perception, is building up of your reserves and resources to handle any contingency that life throws up at you. And life throws up situations quite regularly and heavily. For this you need to develop a fit mind and body: the former, by meditation and mind exercises; and the later, by exercises and proper diet. You need good sleep too. Take care of the following: mental stability can be achieved by learning a few skills in handling emotions in an appropriate manner. Stress management skills, which have a lot to do with expressing emotions, will need to be a major part of your recovery program. Emotionally you need the help of a counselor and that will help you tremendously to move from anxiety to normal fear. Please persevere and cooperate through all the support you need and you will come through successfully. Develop your body?s health by physical fitness through exercise, good rest (sleep), and a proper diet. Any way what you need to focus on is to do vigorous exercise of the aerobic kind for the heart?s fitness; meditation for the brain?s fitness; sleep for a well rested mind and body; a sound spiritual well being for good confidence and stability; and a diet with lots of vegetables, fruits, and whole grains. Vigorous exercise, especially of the calisthenic kind, will make your heart, which is a muscle, grow larger; and then your heart will need to beat less often and you will respond to the anxiety with a calmer disposition. If your mind, constitution, and your emotions are in check and fit, you will never be disturbed again. The earlier you tackle this, the easier it is going to be. These changes will give you a handle on life and your perceptions and responses. Prayer is really powerful, if you are a spiritual person. Repeat some personally framed affirmations that are geared to calming you down and building confidence. Do a personality development course too. Anything that develops you personally will be of great assistance in building resilience.

Prof. Jagadeesan M.S. · Answer

It is safe for long term use, provided you don't self medicate and get yourself monitored, regularly by a psychiatrist. Once in three months is usually enough if all goes well. Regular blood tests and observation by psychiatrist is needed. Else you might land in some irreversible problems. Good luck.