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Dr. Andrew Rynne

Family Physician

Exp 50 years

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Hello, my question is this: is there any away, including

Answered by
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Dr. Ashok Kumar

Psychiatrist

Practicing since :2000

Answered : 2815 Questions

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Posted on Thu, 24 Jan 2019 in General Health
Question: Hello, my question is this: is there any away, including taking extra medications, to reduce anxiety/panic attacks that are very severe, cause me to have cold hands and feet, my head is all covered with excessive sweat, my hands also are a little bluish which might-I think- relate to poor circulation. Other psychological symptoms are: extreme fear and worry, fear of death, distorted reality. The symptoms are so serious that they prevent me from thinking clearly. They are possible to last even 3 hours!
doctor
Answered by Dr. Ashok Kumar 59 minutes later
Brief Answer:
There are many options

Detailed Answer:
Hello,
Thanks for using Healthcaremagic.

I read your query and understand your concerns.

From the available description there is possibility that you are dealing with panic attacks a form of severe anxiety attacks lasting from minutes and hours. For the management of panic attacks there are lot of options and most remarkably include benzodiazepines at the time of attack (on need basis). The examples include alprazolam and clonazepam which are studied extensively and demonstrated effect.

For the long term management almost all antidepressants and b blockers can be used to manage anxiety.

In addition psychological interventions such as CBT can be of immense help.

I hope this answers you.
Feel free to write back to me if you have more questions.
Thanks and regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Ashok Kumar 12 minutes later
Dear Dr. XXXXXXX
Thank you for your answer. I will ask my doctor for a prescription of Clonazepam and/or Alprazolam. I was taking also hydroxizine 50 mg up to 4 times a day. However, I had the impression that it was having a very moderate effect on my attacks. I had read that some people take 50 mg, and that dose knocks them out. Not me. May I have a different response to the med? I take Trazodone, it helps as it puts me to sleep, and the following day I am a new person.
doctor
Answered by Dr. Ashok Kumar 2 hours later
Brief Answer:
Follow up

Detailed Answer:
Hello,
Thanks for follow up.

It is true that every person have different response to medications and no two persons are similar in this regard. Having said this I like to make it very clear that Hydroxizine is poor choice for management of severe anxiety attacks also known as panic attacks.

However trazodone can be useful agent for prevention of further panic attacks. The dose for this purpose ranges from 100-300 mg per day.

In case maximum tolerated theurapetic dose of trazodone does not help we can think of alternative options for prevention of panic attacks I.e. Paroxetine.

I hope this answers you further.
Thanks and regards.
Above answer was peer-reviewed by : Dr. Vaishalee Punj
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Follow up: Dr. Ashok Kumar 13 hours later
Hello, thank you for your answer. I have requested permission from my therapist to enter his DBT class. I note that hydroxizine is a poor choice to manage anziety/panic attacks. I note to take Trazodone 200 mg per day. It helps a lot with sleep. I will consider Paroxetine. Will talk to my psychiatrist about Prescription for Paroxetine.
doctor
Answered by Dr. Ashok Kumar 1 hour later
Brief Answer:
Thanks for feedback

Detailed Answer:
Hello,
Thanks for reverting back to me with positive feedback.

I am glad to know that the provided information was useful for you and you decided to discuss with your psychiatrist for possible other options with more clinical utility.

In case you have more queries feel free to write back to me.
I will be glad to assist you further.
Thanks and regards.
Above answer was peer-reviewed by : Dr. Prasad
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