Panic Disorder: Medication Use and Symptoms Explained

Medication Use

I would like to ask what would happen if someone takes Escitalopram for panic disorder without having the condition.
If there are no symptoms of hyperventilation, can it still be considered panic disorder? However, there are times when there is a feeling of pressure in the chest, occasional palpitations, bloating, stomach pain, a sensation of a foreign body in the throat, and discomfort in the chest.
There are also frequent feelings of losing control and fear of going crazy.
If all medical examinations show no issues, could this still be panic disorder or anxiety disorder? If symptoms improve with Escitalopram, is it necessary to continue taking the medication?

Han Yu, 10~19 year old female. Ask Date: 2016/04/17

Dr. Liang Sunyuan reply Psychiatry

Hello, panic disorder can be considered a more severe form of anxiety disorder, and the physical symptoms you described may indeed be related to anxiety and depression.
Escitalopram is primarily used to treat depression, anxiety, and panic disorder.
If symptoms improve after treatment, it is generally recommended to continue taking the medication for a period to maintain stability and prevent relapse.
As for when to discontinue the medication, it is advisable to discuss this with your physician during your follow-up appointment.
Wishing you all the best.

Reply Date: 2016/04/17

More Info

Panic disorder is a type of anxiety disorder characterized by recurrent and unexpected panic attacks, which are sudden periods of intense fear or discomfort that peak within minutes. Symptoms can include palpitations, sweating, trembling, shortness of breath, feelings of choking, chest pain, nausea, dizziness, chills, or hot flashes, as well as feelings of unreality or detachment from oneself. Individuals may also fear losing control or "going crazy," or fear dying during these episodes.

If someone without a diagnosed panic disorder takes medication such as Escitalopram (often referred to as "易思坦" in Chinese), which is an SSRI (selective serotonin reuptake inhibitor) commonly used to treat anxiety and depression, they may experience side effects without the therapeutic benefits. Common side effects of SSRIs can include nausea, fatigue, insomnia, sexual dysfunction, and increased anxiety during the initial weeks of treatment. It is important to note that taking medication without a clear diagnosis can lead to unnecessary side effects and may not address the underlying issues.

Regarding your symptoms—such as feelings of pressure in the chest, palpitations, gastrointestinal discomfort, and a sensation of losing control—these can indeed be associated with panic disorder or generalized anxiety disorder (GAD). However, they can also stem from other medical conditions, including gastrointestinal issues, cardiovascular problems, or even hyperventilation syndrome. It is crucial to have a thorough medical evaluation to rule out any underlying physical health issues, especially since you mentioned that all medical tests have returned normal.

If you do not experience hyperventilation but still have sensations of pressure and discomfort, it could indicate anxiety rather than panic disorder specifically. Anxiety can manifest in various physical symptoms, including gastrointestinal distress (like bloating and stomach pain), which you have described. The feeling of having a lump in the throat or difficulty swallowing can also be a common symptom of anxiety.

As for the question of whether you would need to continue taking medication if your symptoms improve, this is a nuanced decision that should be made in consultation with your healthcare provider. Many individuals with panic disorder or anxiety may benefit from a combination of medication and therapy (such as cognitive-behavioral therapy). If your symptoms are well-managed with medication, your doctor may suggest a gradual tapering off of the medication, especially if you have also engaged in therapy and developed coping strategies. However, it is essential to do this under medical supervision to avoid withdrawal symptoms or a resurgence of anxiety.

In summary, while your symptoms could indicate panic disorder or generalized anxiety disorder, it is essential to have a comprehensive evaluation by a mental health professional. They can provide a proper diagnosis and tailor a treatment plan that may include therapy, medication, or both. If you are currently taking medication without a clear diagnosis, it is advisable to discuss this with your doctor to ensure that you are receiving appropriate care.

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