Psycho-Babble Medication Thread 25424

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Panic Disorder and Anxiety

Posted by Nan on March 2, 2000, at 7:55:31

I have a question. Has there been any documented research regarding panic disorder and anxiety and their etiology? Is general anxiety and panic disorder a biochemical or physiological phenomenon? Do certain foods, other than caffeine(a trigger for me) , trigger something in the digestive tract that may trigger an attack? Anxiety and panic disorder is so complicated with so many outside influences, but how come some of us handle situations OK and some not? Is it biochemically based? I am new to this board and it is incredibly helpful. I have lived with some form of anxiety for most of my life and now it is complicated with fibromyalgia. Would appreciate any input.
Thanks, Nan

 

Re: Panic Disorder and Anxiety

Posted by kelly on March 2, 2000, at 12:42:54

In reply to Panic Disorder and Anxiety, posted by Nan on March 2, 2000, at 7:55:31

> I have a question. Has there been any documented research regarding panic disorder and anxiety and their etiology? Is general anxiety and panic disorder a biochemical or physiological phenomenon? Do certain foods, other than caffeine(a trigger for me) , trigger something in the digestive tract that may trigger an attack? Anxiety and panic disorder is so complicated with so many outside influences, but how come some of us handle situations OK and some not? Is it biochemically based? I am new to this board and it is incredibly helpful. I have lived with some form of anxiety for most of my life and now it is complicated with fibromyalgia. Would appreciate any input.
> Thanks, Nan

Nan,panic attacks? Existing evidence indicates that both biological & cognitive factors play a role.W/ respect to boilogical factors, it has been found that there is a genetic component in this disorder: about 50 percent of people w/ pd have relatives w/ this problem.
As defined by DSM-IV, such attacks involve a discrete period of fear or discfort in which at least four of the following symptoms occur suddenly & rise to a peak within ten minutes: palpitations,pounding heart,sweating,trembling or shaking,sensations of shortness of breath, feeling of choking,chest pain or discomfort,nausea,feeling of dizziness or
lightheadedness,feeling of unreality,fear of losing control,fear of dying,numbness or tingling sensation,chills or hot flashes.
I also have been living w/ panic disorder for over 10yrs now,slowly getting better.

 

Re: Panic Disorder and Anxiety

Posted by Nan on March 3, 2000, at 4:49:34

In reply to Re: Panic Disorder and Anxiety, posted by kelly on March 2, 2000, at 12:42:54

Kelly, thanks for sharing. I am dealing with this satisfactorily with medication and therapy, but it has taken years to figure it all out. Nan

 

Re: Panic Disorder and Anxiety

Posted by Noa on March 3, 2000, at 14:25:43

In reply to Re: Panic Disorder and Anxiety, posted by Nan on March 3, 2000, at 4:49:34

Check out Dr. Bob's book page. This book is a good resource.

Anxiety and Phobia Workbook
by Edmund J. Bourne
Recommended by Yardena:
I recommend this book. It talks about different types of anxiety, various symptoms, and a comprehensive approach to managing anxiety. It is readable, practical, and comprehensive.

 

Re: Panic Disorder and Anxiety

Posted by Scott L. Schofield on March 3, 2000, at 16:09:06

In reply to Panic Disorder and Anxiety, posted by Nan on March 2, 2000, at 7:55:31

> I have a question. Has there been any documented research regarding panic disorder and anxiety and their etiology? Is general anxiety and panic disorder a biochemical or physiological phenomenon? Do certain foods, other than caffeine(a trigger for me) , trigger something in the digestive tract that may trigger an attack? Anxiety and panic disorder is so complicated with so many outside influences, but how come some of us handle situations OK and some not? Is it biochemically based? I am new to this board and it is incredibly helpful. I have lived with some form of anxiety for most of my life and now it is complicated with fibromyalgia. Would appreciate any input.

As an answer to your first question, yes. However, the studies conducted addressing the cause(s) of anxiety disorders are far from producing an understanding of exactly what mechanisms are involved. These investigations study the relative contributions of psychological , biological, and genetic factors. Until these disorders are sufficiently understood, the most productive focus for the clinician is to discover what works (and what doesn't).

I found a good abstract to give you some idea as to what's happening in the field. I have included it below.

What I find striking about your condition is that you also suffer from both an anxiety disorder and fibromyalgia. You may be able to successfully treat both conditions with one drug. Many investigators believe that there are biological factors common to both depression and chronic pain disorders. Several tricyclic antidepressants are commonly used to treat chronic pain disorders, including fibromyalgia and neuralgia. Among these, amitriptyline has been the drug most studied and favored by clinicians. However, other tricyclics have been shown to be effective as well. On the other hand, SSRIs don't seem to show a similar rate of success.

A good strategy might be to combine a tricyclic with a SSRI.

It might be a good idea to find a book that includes a section devoted to anxiety disorders.

- Scott

-----------------------------------------------------

J Clin Psychiatry 1999;60 Suppl 22:18-22

Overview of antidepressants currently used to treat anxiety
disorders.

Feighner JP

Feighner Research Institute, San Diego, Calif 92121, USA.

The syndromes of anxiety and depression may reflect separate
disorders with overlapping symptoms. They also may be comorbid or
reflect illnesses with similar underlying pathophysiology based
upon a spectrum of central nervous system dysfunction.
Antidepressants effectively treat both anxiety and comorbid
anxiety-depression. Tertiary tricyclic antidepressant agents
(TCAs) with dual serotonergic-noradrenergic effects, such as
imipramine and amitriptyline, appear consistently effective across
the anxiety disorders. Selective serotonin reuptake inhibitors
(SSRIs) are particularly effective in panic disorder and
obsessive-compulsive disorder. SSRIs are similar in efficacy to
TCAs but are more tolerable and cause fewer serious adverse
events. However, they are relatively slow to act, and efficacy
data are limited in states such as generalized anxiety disorder.
Newer antidepressants, such as mirtazapine, nefazodone, and
venlafaxine XR, may provide some benefits across the broad
spectrum of anxiety disorders with the safety and tolerability
that are the hallmarks of third generation antidepressants.


--------------------------------------------------


 

Re: Panic Disorder and Anxiety

Posted by Nan on March 4, 2000, at 21:24:42

In reply to Re: Panic Disorder and Anxiety, posted by Scott L. Schofield on March 3, 2000, at 16:09:06

Scott and Noa, thanks for the info regarding the book, background and the meds. Have tried most of the amytripiline meds with no sucess due to lethargy and weight gain. The SSRI's exacerbated the fibromyalgia terribly, specifically Paxil and Prozac. Tried the new Remeron with terrible side affects. Currently I am on Klonapin (low dose) twice daily and Trazadone 100mg at night. This seems to help but do not know how long the doc will let me stay on Klonapin, which also helps the fibro and lessens the frequency of the migraines. Have only been on this drug regemin for a month. We will see. thanks for all your input. Will look for the book. Nan

 

Re: Panic Disorder and Anxiety

Posted by bob on March 4, 2000, at 22:06:25

In reply to Re: Panic Disorder and Anxiety, posted by Noa on March 3, 2000, at 14:25:43

Hi Nan,

I've been taking klonopin for 18 months now for my PD. It's been virtually non-existent all that time. I've also found hypnotherapy/self-hypnosis and meditation to be very helpful ... the big problem with any similar sort of behavior technique is that you have to REMEMBER to do it in the middle of an attack ... meditation is ususally the LAST thing on my mind in such situations ;^)

cheers,
bob

 

Re: Panic Disorder and Anxiety

Posted by Nan on March 5, 2000, at 11:55:43

In reply to Re: Panic Disorder and Anxiety, posted by bob on March 4, 2000, at 22:06:25

Bob, thanks for the input. Glad to know someone else has found some help with the klonopin. You are right regarding remembering to do the relaxation and self hypnosis during an episode. It is hard. I have a hard time doing simple exercises for my physical therapist for the fibro,
Good luck. Nan

 

Re: Panic Disorder and Anxiety

Posted by judy on March 6, 2000, at 22:24:35

In reply to Re: Panic Disorder and Anxiety, posted by Nan on March 5, 2000, at 11:55:43

Another klonopin fan here; it totally eradicated my attacks. If your doc won't continue to prescribe it find another doc. Nothing works as well (except xanax)- not buspar, paxil or therapy. Take care.


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