What Causes Dizziness And Lightheadedness With Panic Attack?
I have been suffering from dizziness for last 2 months . diziness which h does not involve spinning sensation ,but I get feeling spaced out and light headed or heavy headed at times . this happens mostly after exercise and at evenings .
I also had a panic attack on 23march 2014 after which I started taking clonazepam .25 mg a day . I have now stopped taking it (with proper tapering). Even when I was taking clonazepam dizziness was always there which got worst after exercise.
I am taking CBT for the treatment of whatever anxiety I have(which is usually low as per suggested by my psychologist). I am not keen on medicational therapy as I have seen people getting worse after stopping the medication(antideprassants).
I have also got tested for the following
1.ECG and stress echo . (no issues)
2.vitamin d3 (somewhat low than normal)?
3.ear infection(infection not found but certain has been prescribed for vertigo or dizziness and vestibular exercises are recommended0).
I always have problems sleeping for past few months , where I wake up with pounding heart and fear in initial hours of my sleep but sleep fine till morning after a few such occurunces .
Please suggest me as to which type of treatment will be more effective for me (benzos or SSRIs or CBT) and do I need sleeping pills ? Whether j can get better without medicine?
Need combination of treatment
Detailed Answer:
HI
Thanks for using healthcare magic. I, Dr Abhishek Kapoor, would help you in this query.
I think, the symptoms which you have mentioned, are towards anxiety disorder. In that case, you should consult a psychiatrist. You have already got number of investigations done and all are normal. In that case, there is no need to consult any other specialist except psychiatrist. In anxiety disorder, we prefer to give combination of treatment which include antidepressant, benzodiazepine and psychotherapy. In antidepressant, i would prefer paroxetine for you. It is very good antidepressant and has very less side effect. Generally, people think antidepressants are addictive. It is a myth. We try to maintain patient on antidepressant and then after few months stop them gradually. Main aim behind antidepressant is to control benzodiazepine dose. Benzodiazepines are addictive. You can take them on sos basis for sleep and anxiety. In psychotherapy, both CBT and relaxation exercise would help you. You should consult a psychiatrist for proper management plan.
In case, you need further help, you can ask.
Regards
Dr. Abhishek Kapoor
Psychiatrist