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Mental Anguish
Oct 2, 2003

Hi, When initially diagnosed + I had a CD4 count of 275 and VL of 23,000. After 2 years of Kaletra/Combivir I am at 356 and Undetected. Is this good? My mental anxiety is thru the roof. 20mg of Paxil a day isn't working. Dr. not willing to increase. Should I switch meds or doctors?

Response from Dr. Horwath

Medically you're doing great. An undetectable viral load is exactly what you want. And a CD4 T-cell count >350 protects you from the risk of most opportunistic infections.

Your high level of anxiety, however, needs to be evaluated. A good evaluation would include checking for other medical problems. For example, do you have any signs of thyroid disease or other medical conditions that are sometimes associated with anxiety symptoms? Also, what's going on in your life? Are there some stressful events occuring now? Moreover, some anxiety disorders, such as panic disorder, can occur spontaneously, independent of stressful events.

Paxil 20 mg is an excellent treatment for some anxiety disorders, but you may need an adjustment of dosage or trial of another medication. Consult your psychiatrist about this.



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