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Suggest Treatment For Giddiness, Severe Headache, Panic Attacks, Depression And Lack Of Sleep

Posted on Wed, 9 May 2018

Question: hi, my wife is 48 years old and is a housewife. no children at home. for past 1 week she is facing major giddiness, severe headache, panic attack, depression and lack of sleep. i am her husband, travelling mostly for work. she was treated with Vertin but no major improvement till now. BP is normal and ECG also came out normal. no major findings in blood tests either. panic attacks and giddiness increases significantly during evenings and worsens through the night. i am living in XXXXXXX please help me with suggested treatment. thanks,

Answered by Dr. Neeraj Kumar (36 minutes later)

Brief Answer:
Get examined by a neurologist and get investigated if advised

Detailed Answer:
Hello,
I have gone through your question and understand your concerns.
Possibility of tension type headache or migraine should be kept.
Is there any vomiting, throbbing pain sensation, sensitivity to light or sound during headache episodes?
Get timely food, adequate night sleep.
Avoid fasting, excessive tea or coffee or chocolates.
Amitriptyline 10 mg at night along with Flunarizine 10 mg at night should be tried.
Get examined and evaluated by a neurologist.
Hope you found the answer helpful.
Regards
Dr N Kumar

Above answer was peer-reviewed by : Dr. Yogesh D

Follow up: Dr. Neeraj Kumar (25 minutes later)

hello Doc, thank you for the advise. During headache episodes there is no vomiting but throbbing pain and high sensitivity to sound is more pronounced. There is a high degree of fear from staying alone leading to panic attacks, crying, etc. Should the treatment involve psychological counselling/treatment as well? thanks

Answered by Dr. Neeraj Kumar (29 minutes later)

Brief Answer:
Take treatment as advised

Detailed Answer:
Hello,
These symptoms are of migraine with anxiety.
Options like amitriptyline,flunarizine, divalproate, Topiramate or propranolol can be used .
You should visit to a neurologist.
I prefer in my patients a combination of amitriptyline along with flunarizine.
Hope you found the answer helpful.
Regards
Dr N Kumar

Above answer was peer-reviewed by : Dr. Kampana