[51M] Experiencing extreme nervousness and related symptoms

Patient Description

A 51-year-old male reports experiencing extreme nervousness, inability to concentrate, loss of interest in hobbies, and a sensation akin to being 'plugged into an electrical outlet.' These symptoms have been present since November and are affecting all aspects of daily life, making it difficult to relax or perform routine activities. The patient describes additional symptoms including sweating, fear, anxiety, pacing, and dread, with pacing being more prominent in the morning till afternoon. The patient has a history of adverse reactions to medications, specifically Effexor XR and Crestor, with a notable episode of similar nervousness following the discontinuation of Effexor XR in 2010 and during a tapering off period in 2014. The patient also experienced a cessation of nervousness for a 3-week period upon discontinuing Crestor, which was then followed by a return of symptoms upon reinstatement of the medication. Currently, the patient is only taking Effexor XR and has stopped taking Crestor since January 7th. There is no other significant medical history, known drug allergies, or other medications reported.

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Arora's Assessment

What might be happening

Based on the information you've provided, you may be experiencing:

  • Generalized Anxiety Disorder (GAD): This is a common condition characterized by excessive and persistent worry about a number of different things. Symptoms can include restlessness or feeling on edge, being easily fatigued, difficulty concentrating, irritability, muscle tension, and sleep disturbance. Your symptoms of extreme nervousness, inability to relax, pacing, and sweating could be indicative of GAD.

    • Treatment for GAD often includes a combination of cognitive-behavioral therapy (CBT) and medication, such as selective serotonin reuptake inhibitors (SSRIs) or benzodiazepines.
  • Panic Disorder: This is a type of anxiety disorder characterized by recurring unexpected panic attacks. Panic attacks are sudden periods of intense fear that come on quickly and reach their peak within minutes. Symptoms can include palpitations, sweating, trembling or shaking, sensations of shortness of breath, feelings of impending doom, and fear of losing control or dying. Your symptoms of extreme nervousness, fear, and anxiety could be indicative of panic disorder.

    • Treatment for panic disorder often includes a combination of psychotherapy and medication.
  • Medication-Related Side Effects: Both Effexor XR and Crestor have been associated with side effects that could potentially explain your symptoms. Effexor XR, an antidepressant, can cause nervousness, sweating, and anxiety. Crestor, a cholesterol-lowering medication, has been associated with nervous system side effects such as dizziness, insomnia, and depression.

    • If you suspect your symptoms are related to your medication, it's important to discuss this with your healthcare provider. They may be able to adjust your dosage or switch you to a different medication.

What you can do

  1. Seek professional help: If you're not currently seeing a mental health professional, consider making an appointment. They can provide a formal diagnosis and treatment plan.
  2. Practice self-care: Regular exercise, a healthy diet, adequate sleep, and avoiding caffeine and alcohol can all help manage symptoms of anxiety.
  3. Mindfulness and relaxation techniques: Techniques such as deep breathing, meditation, and yoga can help reduce symptoms of anxiety.

What you should look out for

  • If your symptoms worsen or if you start to have thoughts of harming yourself or others, seek immediate medical attention.
  • If you experience any new or worsening physical symptoms, such as chest pain, shortness of breath, or severe headache, seek immediate medical attention.

Remember, it's important to consult with a healthcare provider for a formal diagnosis and treatment plan.

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11 mo ago

People Also Ask


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

Common symptoms of Generalized Anxiety Disorder (GAD) include excessive worry, restlessness, fatigue, difficulty concentrating, irritability, muscle tension, and sleep disturbances.


How can medication like Effexor XR affect anxiety symptoms?

Effexor XR, an antidepressant, can sometimes cause side effects such as nervousness, sweating, and increased anxiety, which may exacerbate anxiety symptoms in some individuals.


What are some non-medication strategies to manage anxiety?

Non-medication strategies to manage anxiety include regular exercise, a healthy diet, adequate sleep, mindfulness practices like meditation and yoga, and avoiding caffeine and alcohol.


When should someone seek immediate medical attention for anxiety symptoms?

Immediate medical attention should be sought if anxiety symptoms worsen significantly, if there are thoughts of self-harm or harm to others, or if new severe physical symptoms like chest pain or shortness of breath occur.


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