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Suggest treatment for anxiety with acute panic attacks

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Internal Medicine Specialist
Practicing since : 1980
Answered : 1357 Questions
Hello Doctor, I am 41 years old and have a 13 year old kid. Post delivery, I have thyroid issues and have been taking thyronorm. My current dosage is 175 mcg.As my TSH levels went high to 21.34 , so my endocronolis has increased the dose to 175. For the last 9 years, I suffer from anxiety and panic attacks ( which are severe) initially i used to imme run to the hospital and get admitted, but offlate i realised its just no use. Everytime my ECG is done, which comes normal. Last year in march i got my Echo done which was normal too. But I am unable to come out of anxiety and these attacks. ( I do meditation, walks) keep my mind kool most of the times.My weight is 62kgs..Sometimes i take aplrax half a tablet before i sleep. The panic attacks are majorly in nights.. Now past one month, i have palpitations. Initaially they were severe, but slowly they have come down. I got ECG done, which came again normal. The paliptations are as if someone is knocking the door..thy just come on and off..sometimes i dnt have them full day, sometimes, evry haf hour i get a Thud beat...which is not painful at all...but its annoying.. what could be the reason ? Can you please help and guide. Do i need to take some test done, and should i go to a cardio for this..
Posted Sun, 9 Mar 2014 in Hypertension and Heart Disease
Answered by Dr. Rakesh Karanwal 16 minutes later
Brief Answer: Consult a Psychiatrist at the earliest. Detailed Answer: Hi Mrs. XXXXXXX Thanks for your query. I fully appreciate your concern regarding your chronic problem. I don't foresee any cardiac problem, as the palpitations are manifestation of acute anxiety / panic attacks. You need not worry unduly on this account, as anxiety + Acute Panic Reactions can easily be brought under control with long-term course of anti-anxiety drug + Atenolol/Metoprolol (a drug used for hypertension)- with, or without- an anti-depressant drug, under close medical supervision. The medication will be tapered off and eventually stopped, once you have been completely cured. You need not run around to different doctors or a cardiologist. Neither, do you require to undergo any tests, except for monitoring your thyroid status. The BEST course of action would be consult a Psychiatrist and apprise him of my opinion. I am certain that he will agree with me and prescribe suitable treatment as advised, in appropriate doses. Hope I have addressed to your concerns to your complete satisfaction and you find my response helpful and informative. I will be happy to answer further queries, if any. Fond regards and have a nice day, Col (Dr.) Rakesh Karanwal
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