[51M] Experiencing extreme anxiety with associated symptoms

Patient Description

A 51-year-old male is reporting extreme anxiety with associated symptoms of sweating, chills, fear, and dread. The anxiety is persistent throughout the day, peaking with nervousness and subsiding at night. The patient experiences a loss of appetite when anxious but maintains weight by forcing food intake. These symptoms began in November, following the discontinuation of Crestor in the same month. The patient has a history of adverse reactions to medications, including dizziness with Wellbutrin and a correlation between nervousness and Crestor use. Past blood tests have revealed very high levels of vitamin B6, calcium at the upper limit of normal, and low-normal vitamin D and testosterone levels. The patient is currently only on Effexor, which has been associated with similar symptoms during previous changes in dosage. No other medications are being taken, and no known drug allergies have been reported.

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Arora's Assessment

What might be happening

Based on the information you've provided, the following conditions might be contributing to your symptoms:

  • Generalized Anxiety Disorder (GAD): This is a common condition characterized by persistent and excessive worry about different aspects of life. Symptoms can include restlessness, feeling on edge, and physical symptoms such as sweating and chills.

    • Treatment typically involves a combination of psychotherapy, behavioral therapy, and medication. Effexor, which you are currently taking, is one of the medications commonly used to treat GAD.
  • Side effects from medication: Both Effexor and Crestor can have side effects that include anxiety, nervousness, and sweating. It's possible that your symptoms are related to these medications.

    • If your symptoms are due to medication side effects, they may improve with a change in medication or dosage. This should be done under the supervision of a healthcare provider.
  • Hyperthyroidism: This is a condition where the thyroid gland produces too much thyroid hormone, leading to symptoms such as anxiety, sweating, and weight loss. However, this is less likely given your normal weight and lack of other typical symptoms like rapid heart rate or heat intolerance.

    • Treatment typically involves medication to slow down the production of thyroid hormones, or in some cases, surgery or radioactive iodine.

What you can do

  1. Continue taking your Effexor as prescribed, unless advised otherwise by your healthcare provider.
  2. Try relaxation techniques such as deep breathing, meditation, or yoga to help manage your anxiety.
  3. Maintain a healthy lifestyle with regular exercise, a balanced diet, and adequate sleep. These can all help reduce anxiety and improve your overall well-being.
  4. Consider seeking help from a mental health professional. They can provide you with strategies to manage your anxiety and can help determine if your symptoms might be related to your medication.

What you should look out for

If your symptoms worsen or you develop new symptoms, you should seek medical attention. Specifically, look out for:

  • Rapid or unexplained weight loss
  • Rapid heart rate or palpitations
  • Severe anxiety or panic attacks
  • Thoughts of self-harm or suicide

Remember, this advice is intended to be general in nature, and specific causes may not apply to your personal circumstances. Always consult with a healthcare provider for accurate information.

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11 mo ago

People Also Ask


Can Effexor cause anxiety and other side effects?

Yes, Effexor can cause side effects such as anxiety, nervousness, sweating, and other symptoms, especially during changes in dosage. It's important to discuss any side effects with your healthcare provider.


What are the symptoms of Generalized Anxiety Disorder (GAD)?

Generalized Anxiety Disorder (GAD) is characterized by persistent and excessive worry about various aspects of life. Symptoms can include restlessness, feeling on edge, difficulty concentrating, irritability, muscle tension, and sleep disturbances.


How can high levels of vitamin B6 affect my health?

High levels of vitamin B6 can lead to nerve damage, causing symptoms like numbness or tingling in the hands and feet. It's important to monitor and manage vitamin B6 levels with the guidance of a healthcare provider.


What lifestyle changes can help manage anxiety?

Lifestyle changes that can help manage anxiety include regular exercise, a balanced diet, adequate sleep, and relaxation techniques such as deep breathing, meditation, or yoga. These practices can help reduce anxiety and improve overall well-being.


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