use of medication for Panic Disorder

[Roy]

I sufferred periodically from PD from the age of eleven. At twenty PD set in on a regular basis, and I sought treatment through pyschotherapy. (no medication was used) This was not unusual in the nineteen fifties.  PD was accompanied by phobias and occasional depression. Psychotherapy was extremely helpful in helping me to understand the roots of the problem, that is, its psycho dynamics,etc. However, it did not reduce the frequency or severity of attacks.  On the contrary, the discussion of difficult emotional issues sometimes brought on attacks (most attacks occurred during sleep) Consequently I developed serious sleep disorder. In the eighties I discovered xanax and used it off and on for PD and sleep deprevation. One quarter mg. helped me to get a good night of sleep. I realized the danger of doing this because of the addictive qualities of most benzodiazepines so I always tappered gradually after a few months. Tappering was never easy, but I managed it.  Lately that has not been the case. I retired recently from a very satisfying career, and my wife developed what I thought was a serious illness. I became depressed and started experiencing clusters of PD.  I increased the use of xanax, and when I finally started to taper I experienced repeated attacks of palpitation during the night waking me up. I wasn't at first sure if the attacks were the result of tappering or a rebounding of the original anxiety.  I increased the xanax and brought the symptoms under control. I've switched from xanax to Klonopin to gain the benefit of longer half life of medication in the belief that I can taper more easily from the Klonopin. What would be my best next step?  Should I use an anti-depressent and gradually go off the Klonopin? I fear the palpitations will bring on Atrial Fib, from which I've sufferred for last few years. One of the reasons I increased the xanax was to bring Atrial Fib, which accompanied panic, under control.  It worked and I was able to avoid going to the ER for infusion of Heprin.

[HFHS MD-JJM]

Roy,



   Panic disorder is often a chronic and recurrent condition which responds very well to medications and therapy in the majority of cases.  The benzodiazepines (ie xanax, klonopin) are very helpful but have an addictive potential.  Many people stay on them lonterm without problems.  If the panic disorder is associated with depression then these agents would not be a first line choice.  The SSRI's (Zoloft, Paxil, Celexa, Prozac) are usually the drug of first choice for panic disorder.  They are very safe, non-addictive and are very effective in treating panic disorder.

   I suggest that you speak with your psychiatrist to discuss adding an SSRI and perhaps then consider tapering klonopin.  Klonopin is generally easier to taper than xanax.  Good luck.  Please follow up with your medical doctor regarding atrial fibrillation.  Remember this information is intended for general educational purposes only.  Please consult your personal physician for specific health concerns.



Sincerely,



HFHS MD-JM



Keywords: Panic disorder

[sue]

Roy,

I suffer from panic attacks and have for about 4 years. They started to get worse about a year ago. I have them in the day time at home

now.  Before I had them when I went out. I had as many as 4 in a week.

I can't take depression meds because of the side effects.  I have been on at least 15.  About a month ago I had panic attacks in Wal Mart 2 differnt times so my Dr. put me on Buspar.  This is mainly for the panic attacks but I am finding its helped my depression also.  I have been able to go out of the house about everyday and I can tell such a difference.  It might be something you want to try. So far I haven't had any major side effects and that's an added plus for me.

Good luck

[chad]

I have also suffered from panic attacks for about seven years now  it can be pretty scary . I was also put on buspar, It has helped tremendously although I still have my bad days where I feel real anxous I have maybe 2 or 3 attacks a year now and they are less severe ,goodluck .

[Elizabeth]

I have suffered from PD for the past 15 years.  After years of suffering and trying to beat this on my own, I have finally accepted the fact that I have to be treated with medication.  I was referred to a psychiatrist 2 months ago who prescribled Celexa.  I am taking 20 mg a day, and it has totally changed my life.  The anticipatory anxiety and panic attacks have finally disappeared.  I had a few side effects in the beginning, but they went away after 2 weeks.  Good luck!

[karma]

when you have panic disorder, do you ever truly get rid of it?  I've suffered with it for 13 years.  Took zoloft and xanax which helped immensely. Took myself off all meds last august.  Feel ok, still have some anxious times. Can a person take meds for depression or anxiety for a certain period, then be "cured".  Why do some people say they will be on meds for the rest of their life and some dr.'s say drug therapy will last x amount of months?  How can meds treat a disorder such as panic or depression in a specific timeframe?  To me it seems like it will always be a battle.  comments?

[lori]

i can recall having feelings of anxiety when i was in grade school.i began to have panic attacks as a teenager but was told i had ibs.during my pregancy with my second child i was under alot of stress.after about seven months after his birth my anxiety was a everyday thing.i have tried ativan,buspur,inderal,paxil,celexa,wellbutrin,and serzone.though most didnt help or they had unpleasant side-effects.i also take xanax.05.it has been the only thing that has helped but i am aware of the possibities of addiction.but i will not abuse something that is helping me feel better.i am looking for other options.i want to be able to go to field trips with my children.be able to take them to the zoo.take them to florida so they can see the ocean as i once did.i want to be the mother they deserve.

[lori]

i can recall having feelings of anxiety when i was in grade school.i began to have panic attacks as a teenager but was told i had ibs.during my pregancy with my second child i was under alot of stress.after about seven months after his birth my anxiety was a everyday thing.i have tried ativan,buspur,inderal,paxil,celexa,wellbutrin,and serzone.though most didnt help or they had unpleasant side-effects.i also take xanax.05.it has been the only thing that has helped but i am aware of the possibities of addiction.but i will not abuse something that is helping me feel better.i am looking for other options.i want to be able to go to field trips with my children.be able to take them to the zoo.take them to florida so they can see the ocean as i once did.i want to be the mother they deserve.