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Agoraphobia Symptoms and Treatments: Must know Information

Agoraphobia Symptoms and Treatment Overview:

The symptoms of agoraphobia may be the most prevalent of all of the anxiety disorders with as many as 5% of the general population or one in 20 people experiencing varying degrees of agoraphobic symptoms. In the United States, the only mental health disorder that experiences a higher level of prevalence may be alcoholism. Therefore, an understanding of agoraphobia symptoms, diagnosis and treatment is imperative to a well rounded understanding of panic and mental health disorders.

Agoraphobia symptoms:

From a practical perspective, agoraphobia is experienced as a fear of having panic attacks although the term actually refers to a fear of open spaces. An individual experiencing agoraphobia usually has an intense fear of having a panic attack and being in a circumstance in which escape is impossible. An individual may avoid such things as driving on highways for fear of having a panic attack, and being unable to escape the circumstances. Most people experiencing agoraphobia symptoms fear not only the panic attack , but being observed by others while having panic symptoms. Some of the more common circumstances avoided by agoraphobics are:

• Being trapped home alone.
• Being in areas where they feel enclosed such as while getting an MRI, tunnels etc.
• Being on public transportation and unable to leave if necessary such as on a bus or train.
• Being in places such as grocery stores or restaurants and other crowded places.

Agoraphobics frequently feel comforted when a “safe person” is present, which seems to help alleviate the agoraphobia symptoms. One of the more common features of this panic related disorder is a fear of being away from home and/or away from this “safe person”. A “safe person” may be a spouse, parent or anyone whom you have a significant relationship with who provides some comfort in these anxiety provoking situations. You may have an intense fear of driving or walking alone or experiencing any other circumstance without this “safe person”.

Most people who are agoraphobic have a relatively high level of anxiety most of the time. Much of this anxiety seems to be anticipatory, fearing future circumstances and situations which may provoke a panic attack, such as a fear of being left alone at home in the future. The severe restrictions on your life related to future panic attacks may also result in depression. Some people experience depression when they are in adverse circumstances that they have no control over which seem unescapable.

Agoraphobia Symptoms and Panic Disorder:

Agoraphobia develops as a result of having panic attacks or panic disorder. At the very beginning you may have panic attacks that occur for no reason, eventually resulting in a panic disorder. Later you begin to recognize that these panic attacks are occurring in specific situations and you begin to avoid those circumstances for fear of having continued panic attacks. These panic symptoms may be mild at the beginning resulting in uncomfortable feelings but not necessarily avoiding these specific circumstances. When experienced at a more moderate level the panic symptoms begin to result in avoidance of these panic inducing circumstances such as avoiding public transportation or shopping on your own. In these moderate anxiety circumstances, you may avoid some panic inducing situations but still continue on without serious restrictions on other aspects of your life. The restriction is usually only partial. When experiencing severe agoraphobic symptoms, you may experience restrictions which seem to affect every aspect of your life, resulting in being unable to leave home unaccompanied.

It is not really known why some people develop agoraphobia from their panic attacks and why others do not, or why agoraphobia is more severe for some rather than others. Some clinicians and researchers believe that the development of agoraphobia may have some environmental and hereditary components. It has been observed to run in families and twin studies have found that identical twins have a higher risk for both to develop agoraphobia. When looking at environmental factors, there may be some childhood experiences that predispose a child to agoraphobia. Some of these experiences may include growing up with parents who (1) are overprotective and/or (2) are overly anxious and communicate that the world is a “dangerous place” and/or (3) overly critical and perfectionistic.

People experience agoraphobia symptoms from all walks of life and all socioeconomic levels, At the present time, approximately 80% of agoraphobics are women. It is unclear what environmental issues factor into the gender difference, although it has been noticed recently that the level of agoraphobic women relative to men with the disorder seems to be leveling off somewhat. That would probably indicate more of a environmental than a genetic influence.

Agoraphobia Symptoms and Treatment:

There are various treatments available to help alleviate the symptoms of agoraphobia. Since agoraphobia is basically a disorder developed in relation to panic disorder and panic attacks, the same treatments are utilized for both including psychosocial treatments and the management of panic attack symptoms utilizing anxiety medications and antidepressant medications. An overall analysis of the medication management of panic disorder and panic attacks as well as an overview of the psychosocial treatments of panic disorder follow on separate pages.

Some of the main psychosocial treatments include relaxation training, panic control therapy and interoceptive desensitization. Once again, the same treatments that are utilized for panic disorder and panic attacks are also used for patients with agoraphobia. Also, additional assistance or treatment for agoraphobia symptoms may also include assertiveness training since agoraphobics frequently have difficulty standing up for themselves. Finally, as mentioned previously, some of the main treatments for agoraphobia include medication, graded exposure, cognitive therapy and group therapy.

Agoraphobia Treatments with Medication:

Some of the main treatments for agoraphobia as well as panic attacks and panic disorder include treatment with medication such as selective serotonin reuptake inhibitors (SSRI’s) such as, Zoloft and Paxil and tranquilizers such as Xanax, Ativan or Klonopin. The SSRI’s are more likely to be used in very severe cases where a person is homebound and otherwise very restricted in their activities of daily living. Low doses of tranquilizers such as Xanax may also be used to assist people who are going through the early stages of exposure treatment as well as being used by many doctors as a mainline treatment for anxiety and panic.

Graded exposure treatment for Agoraphobia:

When the treatment or intervention is referred to as “exposure” therapy it usually means that the person is exposed to the stimuli that seems to provoke the anxiety or panic reaction. Situations or circumstances that have been feared and/or avoided are exposed to the individual in incremental steps to gradually increase the amount of time and exposure without having a full-blown panic attack. A good example of graded exposure may be if a person has a severe fear of driving long distances or on the highway. They may initially drive short distances or at slower speeds and build up to greater distances or greater speeds. Sometimes a support person is used to accompany the agoraphobic. Finally, they may then eventually be able to drive alone. If a person is fearful of staying home alone, they may be at home by themselves for short periods of time building up to longer times alone.

Cognitive Treatment to Alleviate Agoraphobia Symptoms:

The goal of cognitive therapy is to help the individual recognize and eliminate exaggerated, fearful thinking which result in phobias and panic attacks in a more realistic way. You will then learn to identify, challenge and ultimately replace counterproductive thoughts with ones that are more helpful and realistic to the stimuli or environment.

Group therapy:

Agoraphobia symptoms can be effectively treated in a group setting with other individuals experiencing similar symptoms and disorders. Group therapy provides an opportunity for an individual to share their experiences with others and recognize that they are not alone and that there are many others who experience agoraphobic related panic attacks.

Agoraphobia Symptoms and Treatment: Some Final Words

Agoraphobia symptoms are successfully treated through the use of several psychosocial interventions and medications to alleviate the symptoms. Additional information is also available on this website related to panic disorder, psychosocial interventions and medication management. Do not allow yourself to continue to suffer agoraphobia symptoms when treatment is so readily available.

Some information adapted by Paul Susic Ph.D. Licensed Psychologist from The Anxiety and Phobia Workbook by Edmund J. Bourne Ph.D.

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Librium medication: Your choice for anxiety disorders?

Brand Name: Librium

Generic Name: Chlordiazepoxide

Why is Librium prescribed?

Librium is most frequently prescribed for anxiety disorders. It is often prescribed for short-term relief of anxiety symptoms, withdrawal from acute alcoholism as well as for anxiety and apprehension prior to surgery. This medication belongs to the family of anxiety medications commonly referred to as benzodiazepines.

Important facts related to this drug:

This medication is habit-forming and you can become dependent upon it. You should make sure not to quit taking Librium abruptly as you may experience withdrawal symptoms. You should always be careful not to discontinue this medication or change your dosage without the approval of your physician.

When should Librium not be prescribed?

This drug should not be prescribed if you are sensitive to or have ever had an allergic reaction to this medication or similar tranquilizers. If you’re experiencing everyday stress or anxiety you should probably not take these types of medications. You should always discuss your symptoms with your doctor.

If I am pregnant or breast-feeding what do I need to know?

You should not take Librium if you’re pregnant or planning to become pregnant as there may be an increased risk of birth defects. This drug may appear in breast milk and could affect a nursing infant. If the medication is essential to your health, your physician may advise you to discontinue breast-feeding until your treatment with Librium and has finished.

Librium Dosage:

Librium dosage: How do you take this anti-anxiety medication?

You should take Librium exactly as prescribed.

What if I miss my Librium dosage?

You should take your dosage of Librium as soon as you remember. If it is within an hour or so of when you’re scheduled to take your next dose, you should skip the missed dose and get back to your normal schedule as soon as possible. You should never double up on your dosage of Librium.

Storage instructions:

You should always store your medications away from heat, moisture and light.

Recommended Librium dosages:

Librium Dosages : Adults

Mild or moderate anxiety- The usual dosage of Librium is 5 – 10 mg, three to four times per day.

Severe anxiety– The usual dose is 20 – 25 mg three or four times per day.

Anxiety and apprehension before surgery- On days before surgery, the usual dosage is 5 – 10 mg three or four times per day.

Acute symptoms of alcohol withdrawal- The usual starting Librium dosage is 50 – 100 mg. The physician will usually repeat this dose up to 300 mg per day, until the level of agitation has been adequately controlled.
The doctor may then reduce the dosage as much as possible.

Children- Librium dosage :

The usual Librium dosage for children six years of age or older is 5 mg, anywhere from two to four times per day. Some children may need to take as much as 10 mg two or three times per day. Librium is not usually recommended for children under the age of six.

Dosage for older adults

Your doctor will usually limit or minimize your Librium dosage in order to avoid sedating elderly individuals too much, or otherwise negatively effecting their level of coordination. For senior adults, the usual Librium dosage is 5 mg two to four times per day

Librium overdosage:

Any medication taken in excess of the prescribed dosage may have serious negative effects. If you suspect an overdosage of this medication you should seek medical attention immediately. Some of the symptoms of overdosage include coma, confusion, sleepiness and slow reflexes.

What Librium side effects may possibly be expected?

Specific Librium side effects cannot realistically be anticipated, but if any develop or change in intensity you should contact your doctor immediately. Only your physician can determine if you need to continue taking this medication in spite of your side effects.

Additional Librium side effects may include:

Confusion, constipation, drowsiness, fainting, increased or decreased sex drive, liver problems, lack of muscle coordination, minor menstrual irregularities, nausea, skin rash or eruptions, swelling due to fluid retention, yellow eyes and skin

Side effects of Librium that may be due to rapid decrease or abrupt withdrawal include:
Abdominal muscle cramps, convulsions, exaggerated feeling of depression, sleeplessness, sweating, tremors and vomiting

Special warnings and concerns:

Librium can possibly make you drowsy or less alert, therefore you should not drive or operate heavy machinery until you are well aware of how you are effected by the side effects of Librium. If you are depressed or have a history of depression, you should contact your doctor prior to taking this anxiety medication. Also, this drug may cause children to be less alert as well. If you have a hyperactive or aggressive child taking this medication, you should talk to your physician immediately if you notice negative reactions such as excitement, stimulation or acute rage. Also, you should contact your physician immediately before taking Librium if you’re being treated for porphyria, (a rare metabolic disorder), or liver or kidney disease.

Food and drug interactions possible in addition to Librium side effects:

This medication will intensify or cause an additive effect when taken while drinking alcohol as it is a central nervous system depressant. You should never drink alcohol when taking this drug. If Librium is taken with other medications, the effects of the medications can be increased, decreased or in other ways possibly altered. You should always talk with your physician prior to taking or combining Librium with the following:

• Antacids such as Maalox and Mylanta
• Antidepressant drugs known as MAO inhibitors including Nardil and Parnate
• Antipsychotic medications such as chlorpromazine and trifluoperazine
• Barbiturates such as Phenobarbital
• Blood thinning drugs such as Coumadin
• Cimetidine (Tagamet)
• Disulfiram (Antabuse)
• Levodopa (Larodopa)
• Narcotic pain medicines such as Demerol and Percocet
• Oral contraceptives

Librium side effects should always be noted and reported to your doctor immediately. Never disregard the negative interactions with other medications or any specific Librium side effects.

Some information adapted from The PDR Pocket Guide to Prescription Drugs – Sixth Edition

Additional Information and webpage by Paul Susic Ph.D. Licensed Psychologist (Health and Geriatric Psychologist)

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Ativan Medication: Everything You Need to Know

Generic Name: Lorazepam.

What is Ativan prescribed for?

Ativan is an anxiety medication which is used for the treatment of anxiety disorders for the short-term relief of anxiety symptoms. This anxiety medication belongs to the class of drugs known as benzodiazepines.
What do I need to know about this anxiety medication?
When using Ativan you should always be aware of the fact that tolerance and dependence can develop with its use. You should also be very concerned about withdrawal symptoms which you may experience if you stop using this medicine abruptly. You should follow your doctor’s recommendations if you decide to discontinue or change your dosage.

How should you take this anxiety medication?

You should always take Ativan exactly as it is prescribed by your physician.

What if you miss a dose of this anxiety medication?

If it is within an hour or so of your usual scheduled time you should take the missed dose as soon as you remember. If not, you should skip the dose and go back your regular schedule. You should never take two doses at once.

How is it stored?

You should store this and similar anxiety medications at room temperature in a tightly closed container away from the light.

When should Ativan not be prescribed?

This anxiety medication should not be prescribed if you are sensitive to or have ever had an allergic reaction to this or similar antianxiety medications such as Valium. You should also avoid Ativan if you have had the eye disease acute narrow-angle glaucoma. Do not take Ativan to relieve the symptoms of normal everyday tension or anxiety. Everyday stress and worry does not require treatment with Ativan. You should discuss your anxiety symptoms thoroughly with your physician before trying Ativan or similar anxiety medications.

Ativan side effects:

What Ativan side effects may be expected?

Ativan side effects cannot really be anticipated, but if any develop or a change in intensity you should notify your doctor immediately. Only your physician can determine if it is safe to continue taking this anxiety medication.

If you experience any side effects to Ativan, they will usually appear at the beginning of your medication treatment. They will usually disappear as you continue to take this drug or if you reduce the dosage.

Ativan side effects may also include:

Dizziness, memory problems, sedation, transient amnesia, unsteadiness, weakness
Side effects of Ativan due to a rapid decrease in dosage or abrupt withdrawal:
Abdominal muscle cramps, convulsions, depressed mood, inability to fall or stay asleep, sweating, tremors, vomiting

What are some of the other special concerns related to Ativan?

Ativan and similar medications may cause you to become drowsy or less alert. You should never drive or operate dangerous machinery or participate in hazardous activities which require full mental attention when taking this medication. Also, if you suffer from depression you should consult your doctor before taking Ativan. If you have decreased kidney or liver function the use of this antianxiety drug should be discussed with your physician. If you’re an elderly individual, or if you have been using Ativan for a prolonged period of time, your physician may want to monitor you closely for stomach and upper intestinal problems.

What are some the possible food and drug interactions when taking this drug?

This and other similar anxiety medications are known to increase the effects of alcohol. You should always avoid alcohol when taking these anti-anxiety medications. When taken along with some other drugs, the effects of either could be increased, decreased or otherwise altered. It is very important to consult your doctor before combining Ativan with barbiturates (Phenobarbital, Seconal, and Amytal) or sedative-type medications such as Valium and Halcion.

Can you take this medication if you’re pregnant or breast-feeding?

You should not take Ativan if you’re pregnant or planning to become pregnant. Clinical experience and research has identified an increased risk of birth effects. Also, is not known if Ativan shows up in breast milk. If this medication is essential to your health, your doctor may advise you to discontinue breast-feeding until your medication treatment is finished.

Ativan dosages recommended for adults and children:

Ativan dosage for adults:

The common Ativan dosage recommended for adults is a total of 2mg to 6 mg per day divided into smaller doses. Usually, the largest dose is taken around bedtime. The total daily Ativan dosage may vary from 1mg to 10 mg per day.

Dosage for Insomnia due to anxiety:

Ativan is usually taken at bedtime in doses of 2mg to 4 mg.

For anxiety:

The usual starting Ativan dosage is a total to 3 mg per day taken in two or three smaller doses.

Ativan dosage for children:

The safety and effectiveness has not been established for using Ativan for children under the age of 12 years of age.

For older adults:

The usual starting Ativan dosage for the elderly and for those in a weakened condition should not exceed a total of 1mg to 2 mg per day, evenly divided into smaller doses to avoid oversedation. This dose can be adjusted by your doctor as necessary.

Ativan overdosage:

All medications taken in excess of the recommended amounts may have very serious consequences. An overdose of Ativan can be fatal, although this is relatively rare. If you suspect an overdose, you should seek medical attention immediately.

Symptoms of an overdose may include:

Coma, confusion, drowsiness, hypnotic state, lack of coordination, low blood pressure, sluggishness.

Information adapted from The PDR Pocket Guide to Prescription Drugs – Sixth Edition

Additional Information and webpage by Paul Susic  Ph.D. Licensed Psychologist  (Health and Geriatric Psychologist)

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Xanax : Anti Anxiety Medication of Choice?

Xanax or Alprazolam is an anti anxiety medication from the group of drugs known as benzodiazepines. These anxiety medications are known to directly affect the brain and may cause you to be more relaxed, make you more tranquil, sleep better, or they can slow down the nervous system transmissions in such a way as to act as an anticonvulsant. Many doctors prefer benzodiazepines to other anti anxiety medications that can be used with a similar effect, because they tend to be safer, have fewer side effects, and are usually as effective if not more so than these other medications. Xanax comes in the regular form as well as an extended-release form referred to as Xanax XR

What is Xanax usually prescribed for?

This anti anxiety medication is usually prescribed for anxiety, tension, fatigue, and agitation. It is also sometimes prescribed for irritable bowel syndrome, panic attacks, depression, and premenstrual syndrome (PMS).

Xanax precautions and warnings:

You should not take Xanax (Alprazolam) if you know that you are sensitive to or allergic to any other benzodiazepine medication including clonazepam. Xanax is also known to aggravate narrow-angle glaucoma, but is still sometimes prescribed if you have open-angle glaucoma.

Some other conditions where Xanax should probably be avoided are severe depression, severe lung disease, sleep apnea (intermittent cessation of breathing during sleep), liver disease, drunkenness, and kidney disease. In each of these conditions, the depressive effects of Xanax or similar antianxiety medications may be enhanced or could be detrimental to your overall condition.

Xanax should not be taken by psychotic patients as it is not effective for them and can trigger unusual stimulation, excitement or rage.

Xanax and other benzodiazepines are not meant to be used for more than three or four months in a row. Your condition should continue to be reassessed before continuing this anti anxiety medication beyond that period of time.

Xanax and similar anti anxiety medications may be addictive. Drug withdrawal may develop if you stop taking it after only four weeks of regular use, but is more likely after a longer period of use. These withdrawal symptoms may start with anxiety and progress to tingling in the hands or feet, sensitivity to light, sleep disturbances, cramps, tremors, muscle tension or twitching, poor concentration, flu-like symptoms, fatigue, appetite loss, sweating, and changes in your overall mental state.

Xanax Side Effects:

Xanax side effects cannot be anticipated, but if you experience an increase in symptoms or sensitivity to this or any medication you should contact your physician immediately. Possible Xanax side effect should be considered any time you’re anticipating doing any activity which requires your full attention or alertness.
Most common Xanax side effects:

The most common side effects of this anti anxiety medication include mild drowsiness during the first few days of therapy. Weakness and confusion may occur, especially for seniors and others who may be sickly or otherwise physically compromised. If these effects persist, you should contact your doctor immediately.

Less common Xanax side effects:

Some of the side effects experienced to a lesser degree among individuals taking this anti anxiety medication include depression, lethargy, disorientation, headache, inactivity, slurred speech, stupor, dizziness, tremors, constipation, dry mouth, nausea, inability to control urination, sexual difficulties, irregular menstrual cycle, changes in heart rhythm, low blood pressure, fluid retention, blurred or double vision, itching, rash, hiccups, nervousness, inability to fall asleep, and occasional liver dysfunction. If you experience any of these Xanax side effects, you should stop taking the medication immediately and contact your doctor.

Rare Xanax side effects:

Medical experts report that rare side effects can occur in almost any part of the body when taking this anti anxiety medication. You should contact your doctor immediately if you experience any side effects not listed above.

Drug interactions:

Xanax is a central nervous system depressant. You should avoid alcohol and other tranquilizers, narcotics, barbiturates, monoamine oxidase inhibitors (MAOI’s), antihistamines and antidepressants while taking this medication. If you’re taking Xanax with these other medications, you may experience an excessive amount of depression, tiredness, sleepiness, breathing difficulties and related symptoms.

Smoking is believed to reduce the effectiveness of Xanax by increasing the rate at which it is broken down by the body.

The effects of Xanax may be prolonged when taken together with cimetidine, oral contraceptives, disulfiram, fluoxetine, itraconazole, ketoconazole, metoprolol, probenecid, propoxyphene, propranolol, rifampin, and valproic acid.Theophylline may reduce Xanax’s sedative effects.

If you take any antacids, you should separate them from your Xanax dose by at least one hour to keep them from interfering with the absorption of this anti anxiety medication into the bloodstream.Xanax may raise digoxin blood levels and the chances of digoxin toxicity.The effect of levodopa may be decreased if it is taken along with this anti anxiety medication.Combining Xanax with phenytoin may increase its blood concentrations in the chances of phenytoin toxicity.

Xanax Dosages and Recommendations:

The usual adult Xanax dosage is 0.5-6 mg per day. The Xanax dosage should be tailored to meet your individual needs. Xanax is not recommended for children under the age of 18. This antianxiety medication should be taken on an empty stomach, but may be taken with food if it upsets your stomach.

Xanax overdosage:

The symptoms of Xanax overdosage are confusion, sleepiness, for coordination, lack of response to pain such as pinprick, loss of reflexes, shallow breathing, low blood pressure, and coma. You should take any individual’s you suspect to be experiencing an overdose to a hospital emergency room immediately. Also, you should always bring the Xanax prescription bottle or container.

Special information related to this and key anxiety medication:

Xanax can cost tiredness, drowsiness, inability to concentrate, or related symptoms. You should always be very careful driving or operating machinery, or perform any to these require concentration have high level of alertness.

Anyone taking Xanax or similar antianxiety medications (benzodiazepines) for more than three or four months at a time may be at risk for a drug withdrawal reaction if the medicine is stop suddenly.

If you forget to your latest Xanax dosage, you should take it is Senator member. It is almost time for your next dose, skip the one you forgot a return to your regular Xanax dosage schedule. Do not take a double dose. He takes Xanax XOR, you should take your full daily dose once a day in the morning. Tonight she were crushed Xanax XOR tablets.

Xanax and special populations:


Saks may cause birth effects of taken during the first three months of pregnancy. You should avoid Xanax while you are pregnant. Also, Xanax may pass into breast milk. Nursing mothers who must take Xanax should bottle -feed.


Seniors, should be especially careful when taking Xanax, especially those with liver or kidney disease, those are more sensitive to the effects of Xanax or similar benzodiazepines and generally require smaller doses to achieve the same effect.

Some information from The PDR Pocket Guide to Prescription Drugs

Additional information and webpage by Paul Susic Ph.D Licensed Psychologist (Health and Geriatric Psychologist)

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