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Suggest Treatment For Panic Attacks And Insomnia
Question: Ive been having troubles at home which are leading to extreme panic attacks and insomnia. What can i do?
Brief Answer:
Drugs will help
Detailed Answer:
Hi, thanks for your query. You have not given the details about the symptoms.
What is bothering you at home? What are the troubles you are talking about? Are they your panic symptoms?
Usually people get panic attacks if they have associated their anxiety with some unrelated circumstances. Some people have anxiety and panic attacks due to fear of heights. Some have due to fear of crowded places that is called agoraphobia.
I need details of your symptoms.
What you feel at home? What are the symptoms?
When do these symptoms present?
Whether they are associated with some stress or situation or something?
Do they reach to the peak within 10 minutes and goes on its own?
Do you have to rush to ER for relief?
Do you have undergone any cardiac investigations like EKG, 2D echo?
What is the total duration if the symptoms? For how long they are present?
Do they occur in episodes or continuously?
Do you have sleep problems at initiation of sleep?
Whether you have problems with maintenance of the sleep? (Waking up in between)
I need your answers. Answer the question accordingly in same order.
I am waiting for your reply. Wishing you good health.
Drugs will help
Detailed Answer:
Hi, thanks for your query. You have not given the details about the symptoms.
What is bothering you at home? What are the troubles you are talking about? Are they your panic symptoms?
Usually people get panic attacks if they have associated their anxiety with some unrelated circumstances. Some people have anxiety and panic attacks due to fear of heights. Some have due to fear of crowded places that is called agoraphobia.
I need details of your symptoms.
What you feel at home? What are the symptoms?
When do these symptoms present?
Whether they are associated with some stress or situation or something?
Do they reach to the peak within 10 minutes and goes on its own?
Do you have to rush to ER for relief?
Do you have undergone any cardiac investigations like EKG, 2D echo?
What is the total duration if the symptoms? For how long they are present?
Do they occur in episodes or continuously?
Do you have sleep problems at initiation of sleep?
Whether you have problems with maintenance of the sleep? (Waking up in between)
I need your answers. Answer the question accordingly in same order.
I am waiting for your reply. Wishing you good health.
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
I usually go though the VA heathcare system but it is garbage. I have been diagnosed with ptsd and insomnia and recently its been getting the better of me. My wife left me and i havent gotten a good nights sleep in a few months. I would rather not take drugs because they dont work on me like most people. I was wondering if there is something else i can do
Brief Answer:
You can go for psychotherapy
Detailed Answer:
Hi, thanks for writing again.
PTSD and Insomnia together are somewhat difficult to control but drugs will definitely help you. I am just mentioning the drugs I used to give to my patients.
Paroxetine [paxil 12.5 mg SR] preparation initially at night and gradually increasing the dose as per the improvement in symptoms. I also give anxiolytics to manage anxiety initially particularly if it is the primary concern.
If you are not willing to take drugs then you have option of the psychotherapy. There are specific therapies recommended in PTSD.
These are:
1. Cognitive behavioral treatments typically include a number of components, including psychoeducation, anxiety management, exposure, and cognitive restructuring. Other approach is known as cognitive processing therapy [CPT].
2. There is strong evidence for exposure therapy (7-12), and of the various approaches, Prolonged Exposure (PE) is most effective.
3. Eye Movement Desensitization and Reprocessing (EMDR).
Exposure [PE] and cognitive restructuring [CPT] are thought to be the most effective components.
Other approaches are combination of psychodynamic and cognitive behavioral therapy, Acceptance and Commitment Therapy (ACT), supportive therapy etc.
You need to consult a psychologist or counselor for this.
For your sleep, first of all read the sleep hygiene and how to get and maintain proper good night sleep.
If after all these you wont find any benefit, then i would say that you need drugs to control sleep and symptoms.
Remaining active through the whole day, good exercise in a day for at least 30 minutes, meditation, yoga and relaxation exercises will help in anxiety as well as in sleep.
I hope this will be helpful to you.
If you do not have any clarifications, you can close the discussion and rate the answer. Wish you good health.
You can go for psychotherapy
Detailed Answer:
Hi, thanks for writing again.
PTSD and Insomnia together are somewhat difficult to control but drugs will definitely help you. I am just mentioning the drugs I used to give to my patients.
Paroxetine [paxil 12.5 mg SR] preparation initially at night and gradually increasing the dose as per the improvement in symptoms. I also give anxiolytics to manage anxiety initially particularly if it is the primary concern.
If you are not willing to take drugs then you have option of the psychotherapy. There are specific therapies recommended in PTSD.
These are:
1. Cognitive behavioral treatments typically include a number of components, including psychoeducation, anxiety management, exposure, and cognitive restructuring. Other approach is known as cognitive processing therapy [CPT].
2. There is strong evidence for exposure therapy (7-12), and of the various approaches, Prolonged Exposure (PE) is most effective.
3. Eye Movement Desensitization and Reprocessing (EMDR).
Exposure [PE] and cognitive restructuring [CPT] are thought to be the most effective components.
Other approaches are combination of psychodynamic and cognitive behavioral therapy, Acceptance and Commitment Therapy (ACT), supportive therapy etc.
You need to consult a psychologist or counselor for this.
For your sleep, first of all read the sleep hygiene and how to get and maintain proper good night sleep.
If after all these you wont find any benefit, then i would say that you need drugs to control sleep and symptoms.
Remaining active through the whole day, good exercise in a day for at least 30 minutes, meditation, yoga and relaxation exercises will help in anxiety as well as in sleep.
I hope this will be helpful to you.
If you do not have any clarifications, you can close the discussion and rate the answer. Wish you good health.
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
Yes im willing to take medication for a short term.
Brief Answer:
SSRIs will help
Detailed Answer:
Hi, thanks for writing again.
If you are willing to take drugs then I have mentioned them before.
For PTSD, panic disorder and other prominent anxiety symptoms SSRI antidepressant drugs are indicated and my choice is paroxetine [paxil], this drug has some sedative properties which decreases the anxiety also.
In my patient I used to start with 12.5 mg SR preparation at night and gradually build the dose in upper range. Most patients respond within 2 to 4 weeks with more than 50 % improvement overall. If the anxiety symptoms are very disturbing in initial period, I used to give benzodiazepines like klonopin 0.25 mg twice daily and 0.5 mg at night for sleep.
Benzodiazepines to be tapered off within next 2 to 4 weeks, by this time you have effect of paroxetine.
drugs you have to take for longer duration for remission of the symptoms, which may be 6 to 8 months depending upon the response. Stopping the drugs suddenly may cause discontinuation symptoms and has risk of relapse of the symptoms.
If you have waiting for consultation to your psychiatrist then I can not help because these drugs you can take only after written prescription from him. His advice may differ from mine.
This site is not providing prescription to the patients because it does not take any responsibility of the client, if something unusual happens. This is the policy of the site and we are bound to it.
If drugs are not available within short period of time then you should go for changing the routine for daily activities as I have described previously.
I hope this will be helpful to you.
If you do not have any clarifications, you can close the discussion and rate the answer. Wish you good health.
SSRIs will help
Detailed Answer:
Hi, thanks for writing again.
If you are willing to take drugs then I have mentioned them before.
For PTSD, panic disorder and other prominent anxiety symptoms SSRI antidepressant drugs are indicated and my choice is paroxetine [paxil], this drug has some sedative properties which decreases the anxiety also.
In my patient I used to start with 12.5 mg SR preparation at night and gradually build the dose in upper range. Most patients respond within 2 to 4 weeks with more than 50 % improvement overall. If the anxiety symptoms are very disturbing in initial period, I used to give benzodiazepines like klonopin 0.25 mg twice daily and 0.5 mg at night for sleep.
Benzodiazepines to be tapered off within next 2 to 4 weeks, by this time you have effect of paroxetine.
drugs you have to take for longer duration for remission of the symptoms, which may be 6 to 8 months depending upon the response. Stopping the drugs suddenly may cause discontinuation symptoms and has risk of relapse of the symptoms.
If you have waiting for consultation to your psychiatrist then I can not help because these drugs you can take only after written prescription from him. His advice may differ from mine.
This site is not providing prescription to the patients because it does not take any responsibility of the client, if something unusual happens. This is the policy of the site and we are bound to it.
If drugs are not available within short period of time then you should go for changing the routine for daily activities as I have described previously.
I hope this will be helpful to you.
If you do not have any clarifications, you can close the discussion and rate the answer. Wish you good health.
Note: For further guidance on mental health, Click here.
Above answer was peer-reviewed by :
Dr. Bhagyalaxmi Nalaparaju
Answered by
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