dizzy and lite headed

for over a year now i have been getting litheaded exspecially when in open spaces and when im driving i get dizzy and almost panicy i dont know what this is can you help

[Christopher R Newey, DO]

Thanks for using the forum. I am happy to address your questions, and my answer will be based on the information you provided here. Please make sure you recognize that this forum is for educational purposes only, and it does not substitute for a formal office visit with a doctor.

Without the ability to examine and obtain a history, I can not tell you what the exact cause of the symptoms is. However I will try to provide you with some useful information.

Lightheadedness can be a result of blood pressure dropping or a direct effect of medication. Does your lightheadedness change with positions such as from lying down to sitting up? If so, this may be an indication of orthostatic hypotension. You also mention dizziness and panic as well as symptoms in “open spaces” which may be agoraphobia (i.e., fear of being in a space that would be difficult to escape). It is important to remember that anxiety/panic attacks can present with nonspecific dizziness and may be associated with symptoms of “impending doom”, palpitations, sweating, shortness of breath, and/or sensory changes.

Since I am unable to examine you and get a more thorough history, I would recommend that you follow up with your primary doctor. It may be worthwhile to do orthostatic vitals and an EKG to evaluate your heart. You should also have your thyroid and parathyroid evaluated because these disorders can present as a panic attack. If these are normal and the remainder of your examination is normal, it may be worthwhile to start escitalopram. This medication is an antidepressant, but is also commonly used to treat anxiety due to its low side effect profile. Lastly, if you drink much soda or coffee, you should taper yourself off since caffeine is a stimulant and can exacerbate the anxiety.

Thank you for this opportunity to answer your questions, I hope you find the information I have provided useful, good luck.