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Suggest Treatment For Panic Attack

Posted on Sat, 26 Apr 2014

Question: Dear Sir I have been taking clonazepam .25mg*3 and paxil 12.5mg CR *1 for 10 days . My doctor prescribed them for anxiety related problem after i had my 1st panic attack . Now i just want to continue with CBT and stop taking the medication . My doctor has advised to cut down paxil by takin rexipra 5mg for 10 days and then stop altogether , if i want to stop . But according to him i shd really continue taking paxil and not thinking of stopping for at least 6 months. What should i do ?

Answered by Dr. Abhishek Kapoor (11 minutes later)

Brief Answer: Just take clonazepam on sos basis Detailed Answer: HI Thanks for using healthcare magic. I, Dr Abhishek Kapoor, would help you in this query. You have panic attack rather than panic disorder. In that case, there is no need to take paxil or rexipra or any antidepressant for one episode of panic attack. Just take clonazepam on sos basis and if you get further attack, then antidepressant can be started. You can take CBT, there is no harm in it. In case, you need further help, you can ask. Regards Dr. Abhishek Kapoor Psychiatrist

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Abhishek Kapoor (4 minutes later)

Sir , actually after that 1st panic attack , i was pretty much scared out . It has been 15 days since the incident , and from then onwards i have trouble sleeping , i wake up to a racing heart mostly, and i feel adrenaline surge for atleast 8 - 10 times a day . Is it normal after a panic attack? By the way , the night before panic attack i did binge drinking too :( .

Answered by Dr. Abhishek Kapoor (6 minutes later)

Brief Answer: Relaxation exercise would help to decrease it Detailed Answer: Hi This is called apprehension about further attacks. This lead to progression of disease. In that case, you can take clonazepam twice a day rather than thrice a day. Clonazepam has 12 to 17 hour of half life and twice a day would able to control underline anxiety. In between, if you get any anxiety symptoms, then take clonazepam on sos basis. You can also do relaxation exercise like JPMR. That would keep you calm and relax. Relaxation exercise and CBT would decrease apprehension about the further attack. Regards Dr. Abhishek Kapoor Psychiatrist

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Abhishek Kapoor (4 minutes later)

Thanks a lot sir , One last question . My doc has advised me to taper of clonazepam and by coming 12 days i will stop taking it . And as per his recommendation i shd take on sos basis afterwards. So shd i do as he suggests ?

Answered by Dr. Abhishek Kapoor (4 minutes later)

Brief Answer: Follow his suggestion Detailed Answer: Hi Yes, first take it twice a day and gradually once a day. After that on sos basis. Try to stop one tablet in a week. Tapering depends upon under anxiety symptoms. If you do not get any symptoms, then after two or three weeks, you can take it on sos basis. Regards Dr. Abhishek Kapoor Psychiatrist

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar