instruction: hello doctor I was diagnosed with an anxiety disorder and was given trintellix 10 my I took it for two weeks it helped with anxiety attacks but made me nervous about every emotion or feeling I felt my mother has bipolar disorder and health anxiety and I think I have health anxiety too I am worried that I might get bipolar disorder so I was constantly checking when on trintellix for any signs of mania even though I have never had any manic episodes I also would shake and have a racing heart so I would get so scared which was causing me nervousness I could not even judge if the drug was working my doctor switched me to cipralex but I am afraid to take it and the same thing happens to me I also have intrusive thoughts sometimes and I feel stuck not sure what to do or what medication would be my best bet I am also on clonazepam 5 at night to help me sleep
output: hello it looks like you are experiencing significant anxiety I note that you are weaning off trintellix 10 my and are you are in a dilemma about starting cipralex escitalopram due to concerns about side effects like developing mania since your anxiety appears quite significant it is best managed by a combination of medication and psychological therapy like cut cognitive behavioral therapy cipralex is an effective medication in this situation remember that it will take at least two weeks for your body to get used to the medication and in this period some may experience nervousness agitation etc it generally settles down and you will see full therapeutic benefit from around four to six weeks so medication is worth a try and have regular follow up reviews with your psychiatrist as advised you can take cipralex long term till anxiety is better clonazepam 5 my is meant to be taken for the short term only ideally less than four weeks to prevent developing dependence in addition to medication consider cut to develop psychological strategies to manage anxiety regular exercise also helps maintain a good sleep schedule avoid alcohol and caffeinated drinks I hope this helps