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Dr. Andrew Rynne

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Headache and neck pain. Prescribed medicine for panic attack. Treatment to be done?

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Dr. Jonas Sundarakumar

Psychiatrist

Practicing since :2003

Answered : 2190 Questions

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Posted on Tue, 29 Jan 2013 in Headache and Migraines
Question: Hi,
This is XXXXXXX. My brother is having Neck pain and head ache from last one month and also he is having BP 130/90 ( He is using Metostartan 25 tablet from last 2 months once in a day) he consulted neuro physician few days back and he examined and he said that my brother is having Panic attack. And he gave two tablets 1. Etilite 0.5 daily 2 times 2. Petril Beta 20 daily one time at night. Shall i use Petril beta and Metro Prolol in same day? both tablets are same or different. Is Pani attack discese and wht is the treatment for that. How many date we need to use those tablets?
Can you please suggest a solution.
Content of Etilite 0.5 is Etizolam (daily 2 times)
Content of Petril Beta 20 is Clonazepam and Proplanolol Hydrochloride (Daily one time at Night)
Content of Metostarton 25 is Metoprolol (Daily one time Morning )
Regards,
XXXXXXX
doctor
Answered by Dr. Jonas Sundarakumar 9 hours later
Hello and welcome to Healthcare Magic. Thanks for your query.

Panic disorder is a type of anxiety disorder where the person has sudden bouts of intense anxiey. This anxiety can be manifeste as psychological symptoms (like fearfulness, tension, fear of death, negative thoughts, etc.) or as physical symptoms (palpitations, chest tightness, sweating, breathing difficulty, dizziness, headache, churning sensation in the stomach, etc.)

The treatment for panic disorder is with medication or psychological therapies. First line treatment is with SSRI anti-anxiety agents. Other anti-anxiety medication - like benzodiazepines (e.g. Clonazepam) can be used on a short-term basis to quickly control the symptoms. Beta blocker medication (like propranolol, Metaprolol, etc.) are often prescribed to treat the physical symptoms of panic disorder.

Regarding your brother's current medication...
- Both Metoprolol and Propranolol (found in Petril Beta) are Beta blocker medication. They can be used both for the treatment of hypertension (high BP) as well as for panic attacks. Since both medication belong to the same category and can lower the BP, it is better to use them with caution. I would advise you to recheck with the doctor, specifically telling him that your brother is already on Metoprolol.
- Similarly, both Etizolam and Clonazepam are similar medication belonging to the benzodiazepine class, and I would not personally recommend two benzodiazepines at the same time.

Regarding the duration of medication, firstly, it has to be remembered that benzodiazepines should be used only on a short term basis, since there is a chance of developing habituation and withdrawal symptoms on stopping. If other non-addictive anti-anxiety agents like SSRIs are prescribed, they are recommended for a period of 3 to 6 months, after which the patient has to be re-evaluated, and if he is symptom-free, then the medication can be gradually reducaed and stopped.

My advise to you would be to see a psychiatrist, so that your brother can have a proper psychological assessment and if the diagnosis of panic disorder is confirmed, then appropriate medication can be started.

Wish you all the best.

Regards,
Dr. Jonas Sundarakumar
Consultant Psychiatrist
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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