[20F] Experiencing lightheadedness, upset stomach, and severe panic

Patient Description

A 20-year-old female has been experiencing unsteadiness and lightheadedness for the past two days, which worsens in the evenings while at work. She has also been dealing with an upset stomach for two weeks, preferring bland food but finding it difficult to eat due to stomach discomfort. Additionally, she has been suffering from severe panic described as solid fear for the same duration. She has a history of depression, diagnosed last year but present for about seven years. She recently stopped taking Pristiq (75 mg) abruptly four days ago and has noticed some weight loss, but no other new symptoms have been reported. Her bowel movements are a few hours apart with yellowish stools, and she has not observed any blood or black, tarry stools. She does not have any known allergies or adverse reactions to medications and is not currently taking any other medications.

Arora's Assessment

What might be happening

Based on the information you have provided, possible conditions include:

Gastroenteritis: This is an inflammation of the stomach and intestines, usually due to a viral or bacterial infection. It can cause symptoms such as an upset stomach, loss of appetite, and diarrhea. The lightheadedness could be due to dehydration from not eating and drinking enough.
- Treatment usually involves rest, hydration, and eating bland foods until the infection clears.
Anxiety Disorder: You mentioned experiencing severe panic and a history of depression. Anxiety can cause a variety of physical symptoms, including stomach upset and lightheadedness. It can also cause changes in appetite and eating habits.
- Treatment often involves a combination of therapy, medication, and self-care strategies.
Discontinuation Syndrome: Abruptly stopping certain medications, including Pristiq (an antidepressant), can cause a variety of symptoms, including lightheadedness and gastrointestinal problems. This is known as discontinuation syndrome.
- Treatment typically involves restarting the medication and then gradually reducing the dose under the supervision of a healthcare provider.

Please note that this is not an exhaustive list of possibilities, and these conditions may coexist.

What you can do

Try to stay hydrated and eat small, frequent meals. Bland foods like rice, bananas, and toast may be easier on your stomach.
Reach out to a healthcare provider to discuss your symptoms and the fact that you stopped taking Pristiq abruptly. They may want to restart the medication and taper it more slowly to minimize withdrawal symptoms.
Seek help for your panic symptoms. This could involve reaching out to a mental health professional, such as a psychologist or psychiatrist, or a primary care provider. They can provide treatment options and resources.

What you should look out for

Seek immediate medical attention if you experience:

Severe abdominal pain
Blood in your stool or vomit
Signs of severe dehydration, such as dark urine, dry mouth, and feeling extremely thirsty
Symptoms of a severe allergic reaction, such as difficulty breathing, swelling of your face or throat, or a new rash
Thoughts of harming yourself or others

Remember, this advice is intended to be general in nature, and specific causes may not apply to your situation. Always consult with a healthcare provider for appropriate examination, testing, and care recommendations.

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1 yr ago

Top picked over-the-counter products for Irritable Bowel Syndrome: American College of Gastroenterology Guidelines