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Can Menopause Cause Panic Attacks?

Posted on Mon, 5 Dec 2016

Question: I am suffering from panic disorder. I get really bad ones and called 911 a few times. Went to hospital ,did blood test, EKG and everything came out ok. during panic i get shakey, can't move, my fingers get kinda numb and thingely, short of breath, feeling like i will faint. My doctor told me to take xanax 0.5mg 3 times a day, since i do not want to go on antidepresant. I used to take prozak for 3 years . had a hard time adjasting to that medicine and gain weight, but it did helped. Now I am in menopause andd the panics started again. I put a bio identical hormone replacement , pellet with estrogen, tostestorone and pill of progestoron 100mg at night. Since i got the pellet the panic got more often. And the thing is thosee pellets can not be removed from you. Its Biote pellet. I don't know what to do anymore . I had some good days, but very bad as well. Today i am in panic all day. How can i deal with the panic situation , the horible symptoms without antidepresant. And which one are good if i have to yake them at some point. My doctor suggested brintelix, but I am ttrying to avoid them. Thank you

Answered by Dr. Chintan Solanki (55 minutes later)

Brief Answer:
cognitive behvaior therapy, meditation and clonazepam

Detailed Answer:
Hello,

Thanks for writing to us. I can understand your concern.

Menopause and hormone therapy both can worsen panic disorder. In your case If I were your treating doctor I would recommend medicines as first line therapy. However you do not want it so I would suggest other options.

Best treatment of panic disorder includes both medicines and psychotherapy. .

In psychotherapy I recommend cognitive behavior therapy (CBT). In mild cases only CBT is sufficient. In moderate to severe cases initially medicines and then CBT is added. And later on medicines stopped gradually.

In medicines SSRI group of drugs (fluoxetine, paroxetine, sertraline, escitalopram) are main stay of the treatment. I prefer paroxetine when anxiety is more. Benzodiazepines group of drugs (clonazepam, lorazepam, alprazolam or etizolam) are used initially for short duration for fast symptomatic relief.

I don't recommend xanax as it is more addictive. I prefer clonazepam (klonopin) in such cases. If you cannot find prozac is good for you, paxil (paroxetine) or remeron (mirtazapine) can help when you want to try for medicines.

CBT is a type of psychotherapy and very useful in most of the anxiety spectrum disorders. In CBT psychiatrist/psychologist helps person to identify his/her automatic thoughts and faulty behavior which would ultimately be modified by person with active efforts and help of therapist. It also includes time management, daily sleep, meals and exercise timing. Ask her psychiatrist for the same. Doctor can provide sessions of CBT or he will refer you to concerned therapist available there.

Adding meditation-yoga with relaxation techniques can also help to reduce panic attack severity and frequency.

Hope I have answered your query, I will be happy to help further.

Regards,
Dr. Chintan Solanki.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Chintan Solanki (41 minutes later)

Thank you for your reply. I was told that the hormone therapy will ease up the panics, that is the reason i did it. I did not have hot flashes or things like that. So once the pellet run its course i will not put a new one. Any suggestions how to eliminate the symptoms when i get the panic? It feels horrible, like you diying. Sick to my stomack, shaking, chills, can't breath.

Answered by Dr. Chintan Solanki (4 hours later)

Brief Answer:
deep slow breathing will help

Detailed Answer:
Hi,

Thanks for follow up.

Yes hormone therapy help in panic episodes but only when menopause is the only causing factor. In your case story is different.

During panic attack you can use mouth dissolving clonazepam if you want to use medicine for this.

Other approach is deep breathing exercise. Whenever you feel anxious take deep slow breathing. Inhale for 3 seconds, keep breath in for 3 seconds and exhale for 3 seconds. Do it for 10 minutes. You will feel relax.

Either alone or both above approaches together will ease your symptoms fast.

Take care.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Chintan Solanki (34 minutes later)

Thanks so much, you have been very nice and helpful.

Answered by Dr. Chintan Solanki (2 hours later)

Brief Answer:
welcome

Detailed Answer:
Hi,

You are welcome and wish you speedy recovery and good health.

In future if you wish you can contact me directly with following link:

http://bit.ly/drchintansolanki

by clicking on 'Ask me a question' on same page with three follow up questions.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Chintan Solanki (7 hours later)

Thank you , will do.

Answered by Dr. Chintan Solanki (9 hours later)

Brief Answer:
Wish you early recovery

Detailed Answer:
OK dear.

Wish you early recovery.

Note: For further guidance on mental health, Click here.

Above answer was peer-reviewed by : Dr. Nagamani Ng