Managing Panic Disorder: Medication Insights and Doctor Communication - Psychiatry

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Managing panic disorder can be a challenging journey, especially when it involves medication adjustments and finding the right healthcare provider. Based on your description, it seems that you are currently taking Prozac (an SSRI) and Ativan (a benzodiazepine) to manage your panic disorder. Let's break down your concerns and provide some insights into your treatment options and communication with your doctor.


Understanding Your Medications
1. Prozac (Fluoxetine): This medication is commonly prescribed for anxiety and panic disorders. It works by increasing the levels of serotonin in the brain, which can help improve mood and reduce anxiety over time. It may take several weeks to notice the full effects, so patience is essential.

2. Ativan (Lorazepam): This is a benzodiazepine that can provide quick relief from acute anxiety and panic attacks. It works by depressing the central nervous system, which can help calm you down during a panic attack. However, it is important to use Ativan cautiously due to the potential for dependence and withdrawal symptoms.


Managing Panic Attacks
Your current doctor has advised you to take additional Ativan during a panic attack. This is a common practice, as benzodiazepines can be effective for immediate relief. However, it’s crucial to follow your doctor's instructions regarding dosage and frequency to avoid developing a dependency.


Communication with Your Doctor
You mentioned that your current doctor has limited patience and spends very little time addressing your concerns. This can be frustrating, especially when you have questions about your treatment. Here are some strategies to improve communication:
- Prepare for Appointments: Write down your questions and concerns before your appointment. This can help you stay focused and ensure that you cover all the topics you want to discuss.

- Request More Time: If possible, ask for a longer appointment or express your need for more thorough discussions about your treatment plan.

- Seek a Second Opinion: If you feel that your current doctor is not meeting your needs, consider finding another psychiatrist who may be more attentive and willing to engage in a dialogue about your treatment.


Addressing Blood Pressure Concerns
You mentioned experiencing elevated blood pressure, which your cardiologist attributed to stress and anxiety rather than a primary hypertension issue. It’s important to address this with your healthcare providers:
- Monitor Your Blood Pressure: Keep a log of your blood pressure readings, especially during times of stress or panic. This information can be helpful for your doctors.

- Discuss Medication Interactions: Since you are taking multiple medications, it’s essential to discuss any potential interactions that could affect your blood pressure. For instance, some antidepressants can influence blood pressure.

- Lifestyle Modifications: Incorporating stress-reduction techniques such as mindfulness, yoga, or regular exercise can help manage both anxiety and blood pressure.


Conclusion
Managing panic disorder requires a comprehensive approach that includes medication, effective communication with healthcare providers, and lifestyle adjustments. It’s essential to find a doctor who listens to your concerns and collaborates with you on your treatment plan. If you continue to feel that your needs are not being met, don’t hesitate to seek a second opinion or a new provider who can offer the support and guidance you deserve. Remember, you are not alone in this journey, and there are resources and people who care about your well-being.