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Feeling slow, foggy on ESCITALOPRAM, RITALIN. Cause?

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Hi, Doctor. Well, i have a lot of problems: I use Escitalopram - 10mg in the morning and 10mg before sleep - to treat panic disorder and agoraphobia (psychiatrist diagnosis), which is characterized to sudden high heart rate (130-140bpm). In the most of days, I feel OK. However, I also use Ritalin (10-15mg each 3-4 hours to study lots of books). I also use Zolpidem to sleep everyday (5-10mg). Anyway, according to my psychiatrist, theres no problem to use Escitalopram 10mg with Ritalin 10mg (which, in my non-technic opinion, does make sense, because, as far I know, Ritalin and Escitalopram works in different neurotransmitters; Ritalin, dopamine; Escitalopram, by other hand, serotonin). Those statements are correct? But my principal problem is the fact that Ritalin probably - probably - SOMETIMES leads to the high heart rate mentioned in the first lines of this text, i mean, Ritalin probably leads to the panic attack. Is it possible? What can I do to fix it? I discovered in several webforums the use of betablockers to negate this (probably) high-heart-rate-which-leads-to-panic-attack. Now Im on effect of Clonazepam (I used one 2mg tablet) and feel "slow", "foggy", with no energy at all -- and I really need to study, but, to study, I need Ritalin... Should I wait the Clonazepam's effect go away or I can use 5-10mg Ritalin? Besides taking clonazepam (and felt completely awful), what can I do when in panic? I mean, ehat I should do about each of these problems? Please, I really would like detailed answers. Thank you very much in advance.

Category: Psychiatrist

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 25 Doctors Online

Thanks for using for posting your query.
I have gone through your question in detail and I can understand what you are going through.
I agree with you that Panic attack is very troublesome and its good that you have achieved a good control with escitalopram. Now coming to your questions one after the other:
1) Other than clonazepam, you may use tofisopam which is a non-sedating benzodiazepine. It reduces the panic attack with out much sedation. Other options are oxazepam which is a very short acting benzodiazepine and will not lead to day long sedation as in clonazepam.
2) Regarding ritalin, it should be used only if you have an ADHD (diagnosed by a psychiatrist). I guess you have been using it since long and hence I guess it is prescribed. If it is prescribed, do use it regularly and it will not lead to increase in panic.
3) As of now, wait for the clonazepam effet to wean off and then opt for other options mentioned above instead of clonazepam.
Hope this helps,
In case if you have any further query, do let me know.
Kind regards
Dr. Srikanth Reddy

Dr. Srikanth Reddy
Category: Sexologist
Doctor of Medicine (MD), Psychiatry Residency Program,2001 – 2012
M.B.B.S,Mahatma Gandhi Institute Of Medical Sciences, Sevagram

Certificate Course in sex Therapy and Counselling, Sexology and Counselling, A
Sexology,Medikon Sexual Sciences, Mumbai

Training in Advanced Neurology at a leading corporate hospital (CARE hospital) in Hyderabad

Child Psychiatry Training in National Institute of Mental Health and Neuro-Sciences, Bangalore

Sex Therapy and Counsellingat MEDIKON Sexual Sciences, Mumbai.
Dr. Srikanth Reddy and 4 other Medical Specialists are ready to help you

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