Propranolol

[starshadow]

I had a panic attack two month ago.after that i started contantly thinking about my breath. i  feel i don't get eough air a lot of time.  (i haven't experience any panic attack after the initial one) My doctor prescribed me ativan. If i took Ativan, it made me feel i can breath better. It takes my mind away from thinking about breathing.
I went to doctor yesterday for Klonopin, since  Ativan can't be used daily. instead of giving me Klonopin, he gave me Propranolol 10mg instead. he told me to use it as needed.I don't know if this medine is good for me or not. Anyone has any idea with this medine and any bad side effect of it?

thanks in advance.

[RCA7591]

You are suffering primarily from Hyperventilation Syndrome, which is a sub-category of Panic Disorder. Chronic Hyperventilation leads to the sensations of "air hunger" or "smothering". Prolonged Hyperventilation increases arterial pH and decreases arterial CO2, leading to respiratory alkalosis. The symptoms of alkalosis are those of panic - Numbness/Tingling sensations, lightheadedness, air hunger, rapid pulse, tetany, and panic attacks. While you may feel the sensation of shortness of breath, it is, in reality, a "false alarm".

Unless you present with cardiac manifestations of "panic" (tachycardia, ectopic beats, labile hypertension), the Propranolol (Inderal) is unlikely to be of any significant benefit. Inderal is a non-selective beta blocker, and blocks the effects of Catecholamines (adrenaline) primarily on the myocardium (heart).

Propranolol is not a good p.r.n option, as is best reserved for maintanence use when cardiac manifestations are present.

Front line treatment for Hyperventilation Syndrome or Panic Disorder is Klonopin, 1/2 mg, twice daily. Ativan may be effective over the short term, but tolerance occurs rapidly, and will render the drug less effective or ineffective over the long term, thereby worsening your condition. Therefore, a long acting drug such as Klonopin would be warranted for long term treatment and prevention of your Hyperventilation.

I would suggest consulting with a Psychiatrist, as your symptoms are psychogenic in origin. Most GP's are not well versed on treating psychogenic illnesses, and often prescribe the wrong treatment modalities.

Ryan

[starshadow]

Thank you so much for your answer.
I am in canada, i can't visit a psychiatrist without my GP's referal. Therefore, I have to stay with my GP until he refers me to a specialist.
I am not going to take propranolol anyway. I will visit my GP this week or next to ask for klonopin again. It is so hard to get the right doc and right medicine.
Thank you once again. You are so helpful for this forum.