Suggest Treatment For Severe Panic Attacks While On Eliquis
I would recommend as follows:
Detailed Answer:
Hello!
Welcome and thank you for asking on HCM!
Regarding your concern, I would explain that there are different treatment options for anxiety and panic disorder.
Benzodiazepines are very effective in controlling panic attacks and anxiety, with a quick effect, but they can not be used regularly more than 1 month. I would recommend taking alprazolam 0.5mg three times daily for a short period or in case of panic attacks or anxious situations. It doesn't interact with eliquis.
For the long term treatment (preventive therapy for panic attacks and anxiety) I would recommend nortriptiline. This is a trycyclic antidepressant, which doesn't interact with eliquis. You should use it with caution (start in low doses an increase slowly), because its possible adverse effects especially on older patients.
Another long term treatment option would be buspirone. This is not an antidepressant drug, but has only anxiolytic effects and can be used for a long term treatment. This drug has fewer adverse effects than nortriptiline and does not interact with eliquis.
Nevertheless, both nortriptilin and buspiron show their effects after about 2 weeks from the start of the therapy, and I would recommend taking alprazolam too during this short period, to have a better control of your symptoms.
You should know that antidepressants of SSRI and SNRI class can not be used in this clinical situation , because of their interactions with eliquis, increasing the risk of bleeding.
You should discuss with your doctor on the above options.
Besides medical treatment, I would recommend psychotherapy and a lot of physical activity. You should know that physical activity leads to several changes in your brain, which are similar to the antidepressant's effects.
Hope to have been helpful!
Kind regards,
Dr. Iliri