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Suggest Treatment When Diagnosed With Panic Attack Disorder
Question: Hi Doctor,
Around 4 months ago, I was suffering from panic attacks where I used to feel that my heart pulpitation is increasing rapidly and I used to get lot of sweat in my hands and feet. I consulted Cardiologist and they performed a series of tests all of them were fine. Finally they told me to consult a psychaitrist and he said it is called Panic disorder and he put me on Paroxetine 25 mg(1 Tab/day) and Lorazepam 0.5mg(1/2 Tab at bed time). He told me to continue paroxetine 25 mg for 1 year and stop lorazepam after a month.
Currently, I am on paroxetine 25 mg. My condition is better but sometimes I feel again my heart is beating very fast and I usually get throttling kind of effect in the back of my head. Also I am not able to sleep properly and I feel tired through out the day.
I consulted my doctor again and he suggested to take Clonozipam 0.5mg(at bed time) which I haven't started yet. One of my relative is a doctor and he suggested to take Etizola beta 0.5mg which also I haven't started yet.
Please let me know what medicine I should take and how can I get well soon.
Can you please answer my question.
Forgot to metion that I have always sweaty hands and headache...
Around 4 months ago, I was suffering from panic attacks where I used to feel that my heart pulpitation is increasing rapidly and I used to get lot of sweat in my hands and feet. I consulted Cardiologist and they performed a series of tests all of them were fine. Finally they told me to consult a psychaitrist and he said it is called Panic disorder and he put me on Paroxetine 25 mg(1 Tab/day) and Lorazepam 0.5mg(1/2 Tab at bed time). He told me to continue paroxetine 25 mg for 1 year and stop lorazepam after a month.
Currently, I am on paroxetine 25 mg. My condition is better but sometimes I feel again my heart is beating very fast and I usually get throttling kind of effect in the back of my head. Also I am not able to sleep properly and I feel tired through out the day.
I consulted my doctor again and he suggested to take Clonozipam 0.5mg(at bed time) which I haven't started yet. One of my relative is a doctor and he suggested to take Etizola beta 0.5mg which also I haven't started yet.
Please let me know what medicine I should take and how can I get well soon.
Can you please answer my question.
Forgot to metion that I have always sweaty hands and headache...
Brief Answer:
Need addition of medicine for better control
Detailed Answer:
Hello,
Thanks for your query.
I appreciate your efforts for medical consultation in so much distress.
Important aspects of your query are:
• 29 year old male
• Known case of Panic disorder
• Currently on Paroxetine 25mg with residual anxiety symptoms
Anxiety occur due to neurotransmitters imbalance in brain most commonly involving serotonin neurotransmitter. You may need treatment with psychiatrist to treat your anxiety and panic disorder.
In drug treatment two types of medicine used. For immediate relief of anxiety benzodiazepines group of medicines (Like Lorazepam) are used and for long term relief most commonly SSRI (selective serotonin reuptake inhibitors Like Paroxetine) are used. SSRI takes around 3-4 weeks to show its effect. Non drug treatment like cognitive behaviour therapy (form of psychotherapy) also takes weeks to show its effect.
Some time patient (40% cases) improve partially with initial treatment, in that case one of the following steps are used:
-Detection and correction of vitamin deficiency (especially vitamin B12): so take vitamin supplement and fruits/milk in diet.
-Screening of thyroid dysfunction: Get serum T3/T4 and TSH level done
-Checking compliance to treatment: Take medicine regularly: as medicine used to show effect after 4-6 weeks of continuous use.
-Addition of other medicine: Like addition of Clonazepam or Etizola Beta during anxiety symptoms according to your current psychiatrist advice.
Panic disorder patient respond well to the treatment, but treatment should be taken under regular psychiatrist supervision only, as dose adjustment needed according to patient latest condition.
I hope this information has been both informative and helpful for you.
Wish you good health.
Regards,
Need addition of medicine for better control
Detailed Answer:
Hello,
Thanks for your query.
I appreciate your efforts for medical consultation in so much distress.
Important aspects of your query are:
• 29 year old male
• Known case of Panic disorder
• Currently on Paroxetine 25mg with residual anxiety symptoms
Anxiety occur due to neurotransmitters imbalance in brain most commonly involving serotonin neurotransmitter. You may need treatment with psychiatrist to treat your anxiety and panic disorder.
In drug treatment two types of medicine used. For immediate relief of anxiety benzodiazepines group of medicines (Like Lorazepam) are used and for long term relief most commonly SSRI (selective serotonin reuptake inhibitors Like Paroxetine) are used. SSRI takes around 3-4 weeks to show its effect. Non drug treatment like cognitive behaviour therapy (form of psychotherapy) also takes weeks to show its effect.
Some time patient (40% cases) improve partially with initial treatment, in that case one of the following steps are used:
-Detection and correction of vitamin deficiency (especially vitamin B12): so take vitamin supplement and fruits/milk in diet.
-Screening of thyroid dysfunction: Get serum T3/T4 and TSH level done
-Checking compliance to treatment: Take medicine regularly: as medicine used to show effect after 4-6 weeks of continuous use.
-Addition of other medicine: Like addition of Clonazepam or Etizola Beta during anxiety symptoms according to your current psychiatrist advice.
Panic disorder patient respond well to the treatment, but treatment should be taken under regular psychiatrist supervision only, as dose adjustment needed according to patient latest condition.
I hope this information has been both informative and helpful for you.
Wish you good health.
Regards,
Above answer was peer-reviewed by :
Dr. Prasad
Thanks Doctor for your answer. I usually get spinning kind of feeling in my head. For that what should I do? . Also I will start Etizola Beta, but Could you please tell for long should I continue. Additionally I will get my Vitamin B12 and Thyriiod test done and will update you with the reports.
Brief Answer:
Need supervised treatment.
Detailed Answer:
Hello,
Thanks for follow up,
Spinning feeling can occur in many cases with panic symptoms. In that case it will improve with anxiety. If not, then you need to consult ENT specialist to rule out vertigo.
You should use Etizola plus under your psychiatrist regular supervision as decision regarding medicines change during follow up, depending on patient condition. For time being you can use it for 1 week then meet your psychiatrist within 1 week.
Wish you fast recovery.
Regards,
Need supervised treatment.
Detailed Answer:
Hello,
Thanks for follow up,
Spinning feeling can occur in many cases with panic symptoms. In that case it will improve with anxiety. If not, then you need to consult ENT specialist to rule out vertigo.
You should use Etizola plus under your psychiatrist regular supervision as decision regarding medicines change during follow up, depending on patient condition. For time being you can use it for 1 week then meet your psychiatrist within 1 week.
Wish you fast recovery.
Regards,
Note: For further follow up on related General & Family Physician Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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