Dear doctor, I am male aged 49 years working in the central govt office in new delhi. Since childhood I have been suffering from anxiety, panic attack and depression. For the last two decades I went different psychologists, psychotherapists (cbt), counseling, rtms, homeo and ayurveda. Still I am on medication since more than 2 decades depending on clonazepam 2 mg. It became highly addicted for me. Since 2 decades I have been using this. Under supervision of doctors every time I tried to taper to 1 mg. But after than I am unable to. Kindly tell me one thing doctor. First thing I have problem and anxiety with panic attack, sad mood. Secondly I have stomach disorders third thing I cannot retain urine. Fourth thing my cartilage damaged in both legs but right leg creating lot of pain fifth thing I have varicose veins due to this varicose eczema formed. Doctor one famous psychologist said do not go to each and every doctor for all these problems. Instead try to come out of problem of anxiety automatically reduce rest of the problems. Kindly said is it ok or shall I go holistic therapy for all these problems. Because since last four months, I have been taking holistic treatment of homeopathy and ayurveda. But no respite. Finally kindly tell me shall I concentrate on anxiety or go for holistic therapy for all these problems or going to individual doctors for respective problems.

Dr. Saranya DevanathanPsychiatrist51yrs exp

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Dear kameswara lybrate-user, I am an allopathic doctor. Holistic treatment will be done by your primary care doctor (family mbbs qualified). He/she will refer you to psychiatrist for anxiety issue, to a physician or gastroenterologist or urologist or orthopedic or general surgeon for other complaints, only if necessary. Most of these things he knows to manage to a large extent by him/herself. He/she knows all you problems and get the specialist opinion and incorporate them in your total treatment. You will send a referral letter to the specialist and get their feedback at different stages. If referred to a psychiatrist for anxiety, panic and depression, he/she will give you an antidepressant as mainstay of treatment. Clonazepam is given temporarily till antidepressant take action. It would have been stopped after 3-6 weeks, if you would have gone for follow up with the psychiatrist. Antidepressant would have been continued for 6 months or longer depending on the diagnosis. Dysthymia may be a possible diagnosis for you since you have these problems from childhood. In that case antidepressant will be prescribed for longer time till complementary treatment takes over. They are therapy, yoga, pranayama, supplements, rtms, etc. Most of the time, persons with anxiety don't persist with the complimentary treatment, needing long term antidepressant. Clonazepam is not and antidepressant.  

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Rakesh MohantyPsychiatristyrs exp

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Dear Lybrate user, it is clear from your words that you are suffering from the problem for a very long time. You have been tried both with medications and talk therapy. But you should visit to a psychiatrist and narrate your problem. Other medications which are not tried upon you can be tried. It is always advisable to stick to your medications and not to stop without your doctor's advice.  

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