The patient exercises infrequently. Does not drink alcohol. Moderate caffeine use. The patient's husband is attending school in a distant city. Thin white coat.
Noradrenergic neurotransmitters are important in producing anxiety.
The locus ceruleus, located in the 4th ventricle of the brain, with its numerous connecting pathways to the rest of the brain, is thought to be an important mediating center. Also to be ruled out are hyperthyroidism and pheochromocytoma. Skin rash, nausea, headache, impaired sexual function and vertigo. Also, drowsiness and ataxia. There are reports of paradoxical effects such as increased levels of anxiety, psychotic episodes and suicidal impulses.