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What is the treatment for anxiety and panic attacks?

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Practicing since : 2007
Answered : 2770 Questions
I have had anxiety disorder in the past, may be Seasonal disorder.. I have noticed with I go out in the evenings to go dancing or tonight went to a casino I feel a very tight feeling below my sternum but a feel inches and do not feel like I am breathing right.. if I get my mind off of it the feeling seems to go away... I am 64... and do have some documented Cardio blockage in my left circumflex.. 30% about 4 years ago in an angiogram. I do not get this sensation at all when I am doing cardio workouts in the day.. and the night I went dancing I ran up and down a short hill and the feeling backed off some... is this Panic disorder or Angina... I have not noticed this exact low level pressure in the past that I can remember.. between the naval and sternum... and feel like I am not breathing right unless I can get my mind off of it.
Posted Mon, 27 Jan 2014 in Mental Health
Answered by Dr. Srikanth Reddy 9 minutes later
Brief Answer: Panic disorder it is Detailed Answer: Hello, Thanks for choosing health care magic for posting your query. I have gone through your question in detail and I can understand what you are going through. Yes your suspicion is right and this is indeed a panic disorder. Angina pain will not come down if you are not paying attention o it. Moreover angina pain will increase on exertion which is not happening. You need to treat yourself for anxiety disorder. Paroxetine and venlafaxime are my drug of choice. Also cognitive behavioural therapy is one of the non drug choice of therapy which will be useful. Hope I am able to answer your concerns. If you have any further query, I would be glad to help you. If not, you may close the discussion and if possible you may rate the answer for me, so that I get a good feedback. In future if you wish to contact me directly, you can use the below mentioned link: Wish you good health, Kind regards Dr. Srikanth Reddy M.D.
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Follow-up: What is the treatment for anxiety and panic attacks? 14 minutes later
I do take low dose Inderal less than 10 MG and 1 MG Lorazepam in the past if I feel panic disorder and it seems to go away rather quickly and now it does not seem that this year that I am getting the same sedative effect.. Also in the past if I felt Panic (hyperventilation) I could run in place or go up and down a hill as I mentioned and the breathing and feeling would subside.. not it seems like it does not subside to the same degree and the feeling seem to linger longer.. think a higher dose of the Ativan (PRN) would help say 1 1/2 MG to 2MG .. As I said I do not feel this exercising in the AM but when I went dancing had felt the feeling coming on the more I thought about it dancing the more I felt like I was not breathing right and the stomach was very tight.. after drinking 1 oz of TEquiila the sensation backed of and did not re-occur.. seems to occur not mostly in social situations in the evenings.. just trying to rule out cardio. Ps.. I do not drink except once / twice of month... or even put tequila in my mouth for the burning sensation (Disassociative technique) and the building anxiety seems to abate. The reason I do not drink is I get benign PAC's and the triggers seem to be salt and very low levels of alcohol seem to set off some PAC's so w/o either very infrequent. thanks XXXX
Answered by Dr. Srikanth Reddy 8 hours later
Brief Answer: Benzodiazepines cannot be a permanent solution Detailed Answer: Hello Thanks for the follow up question. Benzodiazepines like clonazepam or lorazepam are all temporary solutions which will just mask the illness but not treat the anxiety. You will need treatment with paroxetine or venlafaxine or bupropion etc. Alcohol also acts on the gaba molecules and hence act like bensodiazepines in masking the illness temporarily. Also exercising releases endorphins which are feel good hormones. Cognitive behaviour therapy as i had previously suggested shouldb be good for the anxiety. Hope that helps Regards Dr. Srikanth Reddy
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