Panic Disorder Medications: Your Questions Answered

Medication Consultation (Panic Disorder Medications)

Hello Doctor: At the beginning of the month, while chatting with friends, I suddenly felt weak all over and uncomfortable, and I started to have difficulty breathing as if I were having a heart attack.
After about ten minutes of resting, I gradually felt better and everything was fine.
This situation has occurred about three to five times over the past year.
(During that time, I was indeed feeling a bit down emotionally, and I would even cry while watching funny variety shows.) Later, I went to a large hospital for a heart check-up, and they said there was no issue with my heart, diagnosing it as hyperventilation syndrome.
I then visited a psychosomatic clinic, where the doctor diagnosed me with panic disorder, but since the episodes occur about three to five times a year, the other symptoms are mild.
(Although I always consider myself optimistic, I can't understand why I have panic disorder.
I often serve as a sounding board and emotional support for my friends—what a bitter laugh.) I'm not sure if this is related to the severe domestic violence I experienced in childhood.
Sorry for the lengthy introduction.
I would like to ask the doctor about the medications prescribed at the psychosomatic clinic: I was given 10 mg of Escitalopram and Sertraline.
I usually take only collagen and vitamin C as dietary supplements.
My menstrual cycle is usually very regular, but this month it was about six days late (I took a pregnancy test, and it was negative).
I wonder if this could be related to the medications I am taking?

mei, 30~39 year old female. Ask Date: 2022/01/25

Dr. Zhang Gengjia reply Psychiatry

Dear Sir/Madam,
From your letter, it is evident that you are experiencing discomfort and distress due to autonomic nervous system dysregulation and panic disorder.
As for whether this is related to severe childhood abuse, a professional physician needs to make a personal diagnosis.
1.
Facing an uncertain future, psychosomatic disorders are common in modern society.
This is a chronic condition that requires long-term treatment for recovery.
2.
Psychosomatic disorders are chronic illnesses that have periods of exacerbation, remission, recovery, and relapse.
More than half of patients may experience a recurrence of symptoms even after they have improved.
Due to individual differences in physiology, it takes time to determine the appropriate medication, and it cannot be simply attributed to which medication is more effective.
Please be patient and cooperate with your physician.
3.
Regarding medications such as Eslon and Sertraline, each medication may have side effects.
It is advisable to note the duration and frequency of any adverse symptoms you experience and discuss them with your physician.
4.
In addition to medication and psychotherapy, repetitive transcranial magnetic stimulation (rTMS) is a non-invasive treatment that does not require anesthesia, has a high safety profile, and does not necessitate hospitalization.
It can improve anxiety and depressive moods.
For patients with treatment-resistant depression or poor medication response, significant improvement in depressive symptoms can be observed after rTMS treatment.
Our clinic is open for consultations from Monday to Friday, both in the morning and afternoon.
I recommend that you consider visiting the clinic for a personal assessment of your symptoms by a physician, so that we can collaboratively discuss the best decision for you.
Wishing you mental and physical well-being.
Sincerely,
Dr.
Chang Geng-Jia
Department of Psychiatry

Reply Date: 2022/01/25

More Info

Panic disorder is a condition characterized by recurrent and unexpected panic attacks, which can lead to significant distress and impairment in daily functioning. The symptoms you described, such as sudden weakness, difficulty breathing, and feelings akin to a heart attack, are classic manifestations of panic attacks. It's understandable that you might feel confused about why you experience these episodes, especially if you generally consider yourself an optimistic person. However, panic disorder can affect anyone, regardless of their personality traits or coping mechanisms.

The medications prescribed to you, including Escitalopram (often referred to by its brand name, Lexapro) and Sertraline (known as Zoloft), are selective serotonin reuptake inhibitors (SSRIs). These medications are commonly used to treat anxiety disorders, including panic disorder. They work by increasing the levels of serotonin in the brain, which can help improve mood and reduce anxiety. While these medications can be effective, they may also come with side effects, which can vary from person to person.

Regarding your concern about the delayed menstrual cycle, it's important to note that SSRIs can sometimes affect hormonal balance and menstrual regularity. While not everyone experiences this side effect, some individuals may notice changes in their menstrual cycle when starting or adjusting their medication. Stress and anxiety can also contribute to menstrual irregularities, so it could be a combination of factors at play.
In your case, the history of severe childhood trauma, such as domestic violence, may also play a significant role in your current mental health challenges. Trauma can have long-lasting effects on emotional regulation and anxiety levels, potentially leading to conditions like panic disorder. It’s crucial to address these underlying issues in therapy, as they can significantly impact your recovery and overall well-being.

To manage panic disorder effectively, a combination of medication and psychotherapy is often recommended. Cognitive-behavioral therapy (CBT) is particularly effective for panic disorder, as it helps individuals identify and challenge irrational thoughts and beliefs that contribute to their anxiety. Additionally, learning coping strategies and relaxation techniques can be beneficial in managing panic attacks when they occur.

If you find that your symptoms persist or worsen, or if you experience significant side effects from your medications, it’s essential to communicate openly with your healthcare provider. They can help you assess whether your current treatment plan is effective or if adjustments are necessary. It’s also important to discuss any concerns regarding your menstrual cycle, as they can provide guidance and reassurance.

In summary, panic disorder can be a challenging condition to navigate, especially when compounded by past trauma and medication side effects. However, with the right support and treatment, it is possible to manage symptoms effectively and improve your quality of life. Remember to prioritize self-care, seek support from trusted friends or professionals, and stay engaged in your treatment process. Your journey towards healing is valid, and taking proactive steps can lead to positive changes.

Similar Q&A

Understanding Panic Disorder: Medications and Treatment Options

Hello, Doctor. Recently, I have been experiencing unexplained tension and increased heart rate while driving or exercising. After an examination, my doctor diagnosed me with panic disorder. Initially, I was prescribed Deanxit and Lowen to take before bed, but I still feel fear wh...

Dr. Song Chengxian reply Psychiatry
Dear Mr. Jian, There are many medication options available in psychiatry for panic disorder. If the current medication is not providing satisfactory results, I recommend discussing this with your psychiatrist as soon as possible. As for non-pharmacological treatment options, su...

Understanding Panic Disorder and Autonomic Nervous System Dysfunction

Hello, doctor! Last year, after several visits to the emergency room, I was diagnosed with autonomic nervous system dysfunction and panic disorder, which led to hospitalization. The doctor prescribed the following medications. I would like to know if these medications can lead to...

Dr. Song Chengxian reply Psychiatry
Dear Mr. Zheng, Panic disorder can be cured with appropriate medication and psychotherapy, provided that you maintain close collaboration with your treatment team. The questions you raised are ones that every patient wants to know and has the right to ask. I am unsure why you di...

Understanding Panic Disorder: Treatment Duration and Recovery Insights

Hello Dr. Zhou, my wife has panic disorder. She is currently taking four medications: Erispan, Rivotril, Venlafaxine, and Inderal. Could you please tell me if panic disorder can improve? How long does she need to take the medication before she can stop? Thank you for your guidanc...

Dr. Zhou Sunyuan reply Psychiatry
"Panic disorder" is treatable, and it is currently recommended to use a combination of medication and cognitive behavioral therapy for optimal results. However, like all diseases, there is a possibility that some individuals may develop a chronic condition. There is con...

Understanding Panic Disorder Medications: Risks and Recommendations

Hello, doctor. I have panic disorder, and yesterday I visited a psychiatrist who prescribed me clonazepam (1/4 tablet in the morning and 1/4 tablet at night), perphenazine (1 tablet at night), and zapine (1 tablet at night). I would like to know if these medications have a risk o...

Dr. Huang Xiaoxian reply Psychiatry
Hello Ms. Liu, I apologize for the late reply. Regarding the medication clonopam, it is a sedative and short-term use should not be a concern. Zapline is an antidepressant and is not likely to cause addiction issues. Additionally, taking just one dose and then stopping the medica...