instruction: hello I am looking and would like to discuss my treatment options for my conditions I have bipolar disorder I social and generalized anxiety disorders panic attacks and agoraphobia due to it in past I used escitalopram venlafaxine fluoxetine sertraline lithium depakote quetiapine risperidone anxiolytics venlafaxine was effective but had to discontinue it due to high blood pressure it caused other treatments mentioned did not work for me anxiolytics worked but now I do not have such options to continue this treatment because I am getting used to tranxene currently I am taking lamictal 200 my and 10 my olanzapine I am afraid to go out from my flat I am constantly alarmed nervous anxious cannot eat because of constant lump in my throat anxiety is debilitating I cannot work outside my home at work I get so anxious that I have to take some free days from work if I do not do that I vomit from this anxiety can duloxetine be effective is it common that it can increase pulse and blood pressure as venlafaxine did how long does it take for escitalopram to take effect can prozac decrease anxiety is paroxetine an good option for me
output: thank you for taking help from psychiatrist you should continue medications on which you are stable at present duloxetine may be good option for you it does not increases blood pressure tablet escitalopram takes around weeks for full effect after starting medications yup prozac can decrease anxiety but it belongs to same group as tablet escitalopram yup paroxetine is good anti anxiety but tablet escitalopram is better than tablet paroxetine you should follow below advice which can help your anxiety hope you get your answer thank you