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Medical Author:

Bettina E Bernstein, DO

Medical Editor:

Jerry R. Balentine, DO, FACEP

Jerry R. Balentine, DO, FACEP

Dr. Balentine received his undergraduate degree from McDaniel College in Westminster, Maryland. He attended medical school at the Philadelphia College of Osteopathic Medicine graduating in1983. He completed his internship at St. Joseph's Hospital in Philadelphia and his Emergency Medicine residency at Lincoln Medical and Mental Health Center in the Bronx, where he served as chief resident.

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Psychopharmacologic interventions (medicines that affect the mind and behavior) may be required for underlying depression, anxiety, or social phobias.

• Serotonin reuptake inhibitors (SSRIs), such as fluoxetine (Prozac), may be useful for underlying depression. Caution should be used when using such agents because in children and adolescents SSRIs may increase the risk of worsening depression, induce manic episodes with bipolar disorder (manic depression), and are currently being evaluated for their association with new-onset suicidal ideation or behavior. Sudden discontinuation of Prozac can cause withdrawal-like symptoms that include agitation, anxiety, confusion, dizziness, headache, and insomnia.
• Drugs that mask anxiety symptoms (racing heart, sweaty palms), such as propranolol, can significantly reduce anxiety. Propranolol may also induce depression in vulnerable individuals, and it should not be used in the presence of asthma. Propranolol should also not be suddenly stopped because hypertensive crisis (a severe, sudden increase in blood pressure that could lead to stroke) could ensue.

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