Q. I feel fearful and anxious all the time. Is it due to patulous eustachian tube condition?

Answered by
Guruvamsee Krishna. Avvaru
and medically reviewed by Dr. Vinodhini. J
This is a premium question & answer published on Dec 05, 2020

Hello doctor,

I am 26 years old. I remain very fearful and anxious 24 hours a day and always feel that something very bad is going on. I have a habit of try listening to even very faint sounds and when outside the house. On-road, I always fear every approaching vehicle, no matter how far it is. Focusing on anything like studying or doing any task feels very hard to do, and I always feel frustration, fear, and doom. When sitting, I cannot stop shaking my legs. I am facing these problems for the past five years. And I am not under any medications.



Welcome to

How is your mood, concentration on studies, daily activities, biological function, and appetite? Is there any family history? Do you have any thyroid disorder? How is your interaction with others? Do you have any suspicious? Are you interested in staying aloof? How many friends do you have and how is your sleep?

Investigations to be done:

Complete blood count. Thyroid function test. Lipid profile test. Liver function test.

Treatment plan:

Please take tablet Paroxetine 12.5 mg
for one week, then after Paroxetine 25 mg to be continued, and tablet Clonazepam 0.25 mg for one week.

Thank you doctor,

I do not feel depressive. I feel frustrated when I cannot do anything I want to do, like studying or talking to others. I suffer from a patulous eustachian tube condition in my right ear for the last two years, and I also had the same condition in my left ear for four years when I was from 16 to 20 and from 20 to 24. I had a heaviness in my ear, for which I had surgery. Currently, symptoms occur intermittently throughout the day or some days symptomless.

When I am not facing the ear symptoms, I feel happy and feel like doing things and feel excited, but when I actually start to do those things, I feel fear and anxiety coming back, and then I feel frustrated. But when I have ear condition symptoms, I do not feel like doing anything and feel very fearful and anxious even if I am not doing anything and just lying in bed.

I do not feel hungry, but I always feel like eating something. Concentrating on studies feels very hard. If I keep reading the same text repeatedly, I still won't remember what I read just after it. The understanding of simple text feels very hard. I do not have a thyroid disorder. I feel very fearful and anxious when interacting with others.

I feel to stay aloof when I feel symptoms of my ear problem. Otherwise, I feel like getting involved in social activities. Social events feel very scary when I am part of them. I do not have any suspicious thoughts. I do not have any close friends, only acquaintances. I struggle to fall asleep at night and wake up late in the morning.



Welcome back to

What surgery did you undergo? If you have reports, please send that one.

Currently, please continue the same medicine. Tablet Paroxetine 12.5 mg 0-0-1 for one week, then followed by 25 mg 0-0-1 and tablet Clonazepam 0.25 0-0-1 for two weeks.

Please wait for at least two weeks for a response. Do not change the medicine frequently.

Thank you doctor,

I have attached the details of my surgery. Shall I take Paroxetine 12.5 mg in the first week, then after that Paroxetine 25 mg and Clonazepam 0.25 together for the second and third week? Or Paroxetine 25 mg for the second week and followed by Clonazepam 0.25 for the third and fourth week?



Welcome to

I saw your surgery report (attachment removed to protect patient identity), but that surgery is simple. Why are you overthinking about surgery? The deviated nasal septum is a very simple technique. Because of the deviated nasal septum, you will get a recurrent nasal blockage. So do not think about surgery. Nasal blockage and heaviness in the ear are very common.

Please follow my medicine for two weeks. You get the relief.

Take tablet Paroxetine 12.5 mg 0-0-1 for seven days then after 25 mg 0-0-1 to be continued, tablet Clonazepam 0.25 mg 0-0-1 for seven days, then 0-0-½ for the next seven days and then after stop.

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