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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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How Can Acute Panic Attacks Be Treated?

My mother-in-law is wondering if you would recommend her going to the ER for a panic attack or waiting it out. She has had panic attacks in the past, the last one she had to go to the ER was 10 years ago, she has had ones since but none that could not be controlled at home. She is on medication for panic attacks, Zanxanx 0.5mg/twice a day as needed and Klonapian 0.5mg/day as needed, and she has taken both of those today and her symptoms have progressively gotten worse. When she goes to the ER they in the past have given her adavan shots 1mg every hour until she responds and calms down. Her symptoms are she is anxious, she can t sit or lay down, and feels she has to move all of the time, she fell, she feels like she wants to scratch her skin all over, and she hasn t slept since Friday night. What would you suggest.
Wed, 21 Jan 2015
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Psychiatrist,  's  Response
Hello thanks for asking from HCM

She is taking Xanax (Alprazolam) and Clonazepam on SOS basis for panic attacks. Both are benzodiazepine drugs and should be reserved for use in SOS basis only or under proper prescription. Regular use for prolonged periods of time may result in development of tolerance and individual start needing high doses of drug to see full effect. This is probably the reason for her poor response with medicines. As per my opinion she should be shown to a psychiatrist for proper treatment and evaluation.

For severe panic attacks medicines like Propranolol can help apart from benzodiazepines. For proper treatment of anxiety and panic drugs like Escitalopram, Sertraline etc are approved. These drugs help to control anxiety and reduce the frequency of panic attacks.

Ask her to avoid excess tea, coffee, carbonated drinks. Relaxation exercises will help her in relaxing herself. Visit a psychiatrist for prescription of the drugs.

Thanks, hope this helps you. Take Care
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How Can Acute Panic Attacks Be Treated?

Hello thanks for asking from HCM She is taking Xanax (Alprazolam) and Clonazepam on SOS basis for panic attacks. Both are benzodiazepine drugs and should be reserved for use in SOS basis only or under proper prescription. Regular use for prolonged periods of time may result in development of tolerance and individual start needing high doses of drug to see full effect. This is probably the reason for her poor response with medicines. As per my opinion she should be shown to a psychiatrist for proper treatment and evaluation. For severe panic attacks medicines like Propranolol can help apart from benzodiazepines. For proper treatment of anxiety and panic drugs like Escitalopram, Sertraline etc are approved. These drugs help to control anxiety and reduce the frequency of panic attacks. Ask her to avoid excess tea, coffee, carbonated drinks. Relaxation exercises will help her in relaxing herself. Visit a psychiatrist for prescription of the drugs. Thanks, hope this helps you. Take Care