Panic Disorder Linked to Autonomic Nervous System Dysfunction

Q: Panic Disorder Linked to Autonomic Nervous System Dysfunction

Hello, sir： Among your current medications, bromazin (generic name bromazepam) belongs to the benzodiazepine class of anxiolytics, which provides an immediate sense of relaxation upon ingestion. <br>Sertraline is a medication that enhances serotonin levels and improves anxiety ov

Panic disorder caused by autonomic nervous system dysregulation?

About a year ago, I was diagnosed with autonomic nervous system dysfunction.
However, after taking the first dose of medication the next day, I experienced hand tremors and an accelerated heartbeat, which caused me to panic.
As a result, I was afraid to continue taking the medication and instead relied on traditional Chinese medicine to adjust my sleep, reassuring myself that I would get better.
Over the past year, although my sleep has been relatively good (with occasional dreams), my anxiety and fear have fluctuated, and I have only been able to suppress them myself.
Recently, I discovered that I even feel afraid to drive, especially when going to work, which has caused significant distress.
Therefore, I sought help from a mental health specialist, and the doctor diagnosed me with panic disorder.

Could you please provide information on the efficacy of the medications prescribed by the doctor, which are BROMAZEPAM and SERTRALINE? Are they addictive? Thank you.

Apu, 30~39 year old female. Ask Date: 2018/02/22

Dr. Tang Jiahong reply Psychiatry

Hello, sir: Among your current medications, bromazin (generic name bromazepam) belongs to the benzodiazepine class of anxiolytics, which provides an immediate sense of relaxation upon ingestion.
Sertraline is a medication that enhances serotonin levels and improves anxiety over time; its effects typically begin to manifest gradually after four to six weeks of continuous use.
Autonomic nervous system dysregulation is not considered a "diagnosis" in psychosomatic medicine but rather a collection of "symptoms" often associated with anxiety disorders and panic disorders.
Since the autonomic nervous system regulates internal organs and glands, dysregulation may lead to symptoms such as palpitations, diarrhea, and sweating.
"Autonomic nervous system dysregulation" and "panic disorder" can coexist, and both types of medications mentioned above can be used for treatment.
Lastly, regarding the issue of addiction, benzodiazepines are more prone to dependence when misused, whereas serotonin medications do not carry a risk of addiction.
It is advisable to discuss with your physician to adjust the medication dosage according to your condition to avoid the potential for addiction.

Reply Date: 2018/02/22

More Info

Panic disorder is a complex condition that can be intricately linked to autonomic nervous system (ANS) dysfunction. The ANS regulates involuntary bodily functions, including heart rate, digestion, and respiratory rate, and is divided into the sympathetic and parasympathetic nervous systems. When the ANS is out of balance, it can lead to a variety of physical and psychological symptoms, including those seen in panic disorder.

Your experience with autonomic nervous system dysfunction and the subsequent development of panic disorder is not uncommon. Many individuals with ANS dysregulation report symptoms such as heart palpitations, trembling, and feelings of impending doom, which can trigger panic attacks. The physical sensations associated with these attacks can be so intense that they may lead to a cycle of fear and avoidance, further exacerbating anxiety and panic symptoms.

Regarding the medications prescribed to you, Bromazepam and Sertraline, both have distinct roles in managing anxiety and panic disorders. Bromazepam is a benzodiazepine, which is often used for its anxiolytic (anxiety-reducing) properties. It works by enhancing the effect of a neurotransmitter called gamma-aminobutyric acid (GABA), which has a calming effect on the brain. While effective for short-term relief of anxiety symptoms, benzodiazepines can lead to dependence if used for extended periods. Therefore, they are typically prescribed for short-term use or in conjunction with other long-term treatments.

Sertraline, on the other hand, is a selective serotonin reuptake inhibitor (SSRI) commonly used to treat depression and anxiety disorders, including panic disorder. It works by increasing the levels of serotonin in the brain, which can help improve mood and reduce anxiety. SSRIs are generally considered safer for long-term use compared to benzodiazepines and are less likely to cause dependence.

It's important to note that while both medications can be effective, they may take several weeks to show their full therapeutic effects. During this time, it is crucial to maintain open communication with your healthcare provider about any side effects or concerns you may have. If you experienced hand tremors and increased heart rate after taking the initial medication, it is essential to discuss these symptoms with your doctor, as they may need to adjust your treatment plan.

In addition to medication, therapy can be a valuable component of managing panic disorder. Cognitive-behavioral therapy (CBT) is particularly effective in helping individuals understand and change the thought patterns that contribute to anxiety and panic attacks. Mindfulness and relaxation techniques can also help regulate the autonomic nervous system and reduce anxiety symptoms.

Lastly, lifestyle modifications can play a significant role in managing panic disorder. Regular physical activity, a balanced diet, adequate sleep, and stress management techniques can all contribute to improved mental health and a more balanced autonomic nervous system.

In summary, your diagnosis of panic disorder linked to autonomic nervous system dysfunction is a valid concern. The medications prescribed can be effective in managing your symptoms, but it is essential to monitor their effects closely and maintain communication with your healthcare provider. Combining medication with therapy and lifestyle changes can provide a comprehensive approach to managing your condition and improving your overall well-being.

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