Suggest Remedy For Panic Attacks And Anxiety

Posted on Mon, 12 Jan 2015

Question: I suffer from serious panic attacks and anxiety. Help!!! Nothing seems to work

Answered by Dr. Ravi Soni (21 minutes later)

Brief Answer:
Drugs should be changed

Detailed Answer:
Hi, thanks for writing through HCM.

You experience panic attacks, how often? Have you visited a psychiatrist? for How long have you been suffering from panic attacks?

How long you have taken citalopram? were you taking citalopram and mirtazapine together?

If you have taken these drugs for more than 2 months with no significant improvement then drugs should be changed.

I have good experience with paroxetine which a SSRI antidepressant drug similar to citalopram but somewhat different activity in brain. At the time of panic attacks you have to go for anxiolytics. Zopiclone will induce sleep only, it has nothing to do with treatment of anxiety. How many times do you take propranolol in a day and in which dose?

In my patients I usually give paroxetine 12.5 mg sr preparation along with clonazepam 0.25 mg three times a day. Sometimes I use propranolol also.

Give answeres to above questions. it will help me in giving a opinion. Do not make changes in the drugs or dosage without permission of your doctor.

Hope I have tried to answer your query. I am waiting for your reply.
Wish you good health.

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Ravi Soni (27 hours later)

Ive ad panic attacks for 10 years, however the past year the frequecy has increased dramatically. It used to happen once every few months. Now it hapoens every week, but I get the "feelings" every day. They used to only occur at night but they now are starting to happen in the day. I havent seen a psychiatrist its difficult to on the NHS. I took all the listed drugs but none helped. I now only take zopiclone to get me to sleep and propranalol. A slow releasing one at night. Nothing seems to help though. The panic sttacks are really bad atm but i dont know if thats because ive come off all the medication. I may suggest what you say to my GP. I have a family history of bipolar depression. Do you think this is linked? Thank you. h

Answered by Dr. Ravi Soni (8 hours later)

Brief Answer:
Drugs need to be continued

Detailed Answer:
Hi, thanks for your reply and required information for me.

So, depending upon the history I can say that you are suffering from panic disorder for last 10 years, the severity of which has been increased recently.

Drugs which are effective and approved in panic disorders are SSRI antidepressants like lexapro, celexa, paxil, zoloft, prozac etc while other class of drugs like SNRIs [effexor, cymbalta, pristiq] is also effective.

I have suggested in previous conversation, the regime of drugs for management of panic disorder, which I use in my patients. These drugs are to be continued for long term for at least 1 year. The clonazepam should be withdrawn within 2 months of starting it. If you have not been given the drugs I have mentioned above then you can ask for one to your prescribing doctor.

Bipolar depression can be genetically linked but it is more associated with history of depression or bipolar depression in family. Genetic association of bipolar depression with anxiety disorder is rare, but can be possible.

Hope I have answered your query. If you do not have further query then close the discussion and rate the answer. Your feedback is very valuable for me.

Wish you good health.

Note: For further guidance on mental health, Click here.

Above answer was peer-reviewed by : Dr. Bhagyalaxmi Nalaparaju