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1. What New Orleans Saints receiver crashed METOPROLOL PRESCRIPTION FOR
helmet-first into a sideline TV camera PALPITATIONS EXACERBATES ANXIETY
during a 1971 win over the Dallas Cowboys? DEAR DR. ROACH: I just discontinued us-
2. What three events make up horse racing’s ing metoprolol succinate extended release (ER)
Canadian Triple Crown?
3. What women’s pro tennis tournament was at a dosage of 6.25 mg. My heart rate is normally
first played in 2021 in Cluj-Napoca, Roma- in the 70-80s, and my blood pressure is normal.
nia? My doctor prescribed it for palpitations, but it
4. At the 2000 Sydney Paralympic Games, seems totally unnecessary. My issue is that I am
what country’s basketball team forfeited experiencing tachycardia of over 100 beats ev-
their gold medals after it was revealed that ery single night as well as dry mouth.
most of their players had no mental or phys-
ical handicap? Could this be anxiety? And do you think an
5. What Major League Baseball team owner antidepressant like Zoloft or Paxil would help?
claimed to have engaged in a fistfight with I had a Holter monitor, which showed nothing
two fans in a hotel elevator during the 1981 wrong with my heart. The palpitations were spo- The first is that antibiotics are effective against
World Series? radic only when I was anxious.
6. According to NBA rules, what is the maxi- I stopped metoprolol because it exacerbated
mum pressure (in pounds per square inch)
of an official basketball? my anxiety and caused me depression as well as
7. What starting pitcher for the Kansas City panic attacks. My doctor prescribed me 1 mg of
Royals won two AL Cy Young Awards Ativan to take at bedtime, but I am very scared
(1985, 1989) and was named MVP of the of getting addicted to it. So, I thought maybe an
1985 World Series? antidepressant would help instead. My doctor
prescribed 25 mg of Zoloft, but I want another
Answers:
opinion. -- S.S.
ANSWER: Generalized anxiety disorder is a
mum is 7.5 PSI). 7. Bret Saberhagen.
owner George Steinbrenner. 6. 8.5 PSI (the mini-
common problem and may be associated with
Transylvania Open. 4. Spain. 5. New York Yankees
panic attacks (sometimes depression as well).
Prince of Wales Stakes and Breeders’ Stakes. 3. The
The most common and highly effective medica-
the Pro Football Hall of Fame). 2. The King’s Plate,
1. Danny Abramowicz (his cracked helmet is in
tion treatment for generalized anxiety disorder,
with or without panic attacks, is an SSRI-type
drug like sertraline (Zoloft). Therapy is another
option, and the two together are more effective
than they are separately.
Metoprolol is an effective treatment for the
fast heart rate that some people get when they
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have anxiety, and metoprolol by itself is helpful
for many people who have anxiety. (The high
heart rate can make people feel even more anx-
ious.) However, it sounds like metoprolol did
not work for you. There is a small increased
risk of depression among people who take beta
blockers like metoprolol.
In my opinion, lorazepam (Ativan) is not a
good long-term choice for an anxiety disorder,
but it can still be helpful in some people while
they’re waiting for another treatment to start
working (such as therapy or a medicine like
Zoloft). It takes six to eight weeks to reach max-
imum effectiveness.
Addiction is not an issue when both the
patient and prescriber agree that it will be only
used as a short-term treatment. For Zoloft, 25
mg is a low dose, and some people need higher
doses (sometimes much higher) to control their
symptoms.
***
DEAR DR. ROACH: Why shouldn’t you use
antibiotics for a cold? -- T.Y.A.
ANSWER: There are two main reasons.
bacteria; they’re not effective against the virus-
es, which are the cause of colds. It is true that
a person (or their doctor) cannot be 100% sure
whether they have a virus, but people are gener-
ally pretty good about knowing when they have
a cold.
The second is that resistance to antibiotics
has become a major issue in medicine. There are
now strains of bacteria that are resistant to all
antibiotics, and I have seen patients die because
their bacteria were resistant to all the antibiot-
ics we have. Using antibiotics less often and for
shorter durations is a major goal to reduce the
rate of antibiotic resistance. (Antibiotic use in
animals that are raised for food is a major issue
as well.)
Patients can help by not asking for (or de-
manding) antibiotics for what are almost cer-
tainly viral infections.