Please suggest medicines for my newly developed panic attack.

Patient's Query

My age is 48, I was a very active person before Covid. I was in lock down, didn't go out of the house unless highly necessary. recently I have developed panic and anxiety disorder for the last two months (on and off, 12-15 episodes or so). I may have depression, but it has never affected me in anyway in the past. My symptoms were typical : high pulse, in voluntary swallowing, shortness of breath, high BP )140/95) for 30-45 mins (no H/O HTN), restlessness, fear of death, fear of loosing control, sleeplessness.

I never take medication without checking about the side-affects, whatever I am prescribed . I just want to make sure that I do not grow any dependency on the drug. This may be my fault.

I consulted two psychiatrists:

One prescribed : APLRAX 1mg Xr 0+0+1 Prozac 20 mg 2+0+0 agotin 25 mg 0+0+2 lexotanil 3mg late night

the 2nd doc prescribed : Zoloft 50 mg 1/2 +0+0 for 6 days and then 1+0+0 clonazepum 0.5 0+0+1

I planned to follow the 2nd one after reading a lot. But I had a severe reaction on my personality and had two severe panic attack after taking full 50 mg zoloft. I couldn't sleep whole night ever after taking clonazepum. Next day I stopped zoloft tried to follow the first Docs medication , but at a low dosage

Prozac 20 mg 1+0+0 clonazepum 0.5 0+0+1

I consulted the 2nd Doc about the reaction , I suggested if he could put me on prozac. He insisted that I continue zoloft 25mg 1+0+0 for 10 days and consult again.

However, I haven't followed his instruction and its my third day on prozac 20. I feel much better , slightly restless time to time. Bp , Pulse normal. No panic attacks yet. Sleeping pattern so so, as i have a habit of late night prayers.

Please help me. Which one should I take for my newly developed panic attack?

whether u suggest zoloft or prozac I would like to have a clear understanding why am I being prescribed that , also how do u plan to taper me off the medication , and for how long I have to take it. These are the question doctors here rarely answer to patients. I need help. regards.

Answered by Dr. Vishal Anilkumar Gandhi

# thank you for taking help from a psychiatrist. Prozac and Zoloft both medications belong to the same group (SSRI) for depression /anxiety/panic attack. sometimes it depends upon the patient. some patient responds well to Zoloft and someone responds well to Prozac. if you are feeling well on Prozac then you can take it. you fo do not need to take Zoloft.
you can take tablet clonazepam mouth dissolving (md)0.25mg when you have a panic attack in the day time. you do not need to take it regularly but as per requirement. you can also take it (clonazepam md) extra with your regular clonazepam 0.5 at night if you sleep disturbance.
you need to take medication for at least 6 months, once you get stable on it.
after 6 months, we can gradually taper off the medication. it will take time to taper off. mostly it depends upon your dose. if you get stable on high dose than you need more time to taper off.
you should also follow below lifestyle to deal with your problem. it is non-pharmacological management for it.
it will really help you.
You should do exercises daily for 30 - 45 minutes like at least going for a walk. if you can not go outside then do some physical activity at home. try to get sun exposure or fresh air daily through your window or balcony.
You should do meditation for 20 minutes daily, just sit at one place in a comfortable position and try to concentrate on your normal breathing, don't stop or force yourself to stop your thoughts, just let it be.
You should eat healthy home-cooked foods, avoid junk foods.
You must drink enough water.
You should spend quality time with friends and family daily or do video calls if you are living away from your family.
You should spend time on creative hobbies like reading good books, writing journals, painting, drawing, learning new skills or language or musical instruments.
You should take enough 7 - 8 hours of sleep daily.
You must avoid tobacco or alcohol or any substance abuse.
Live your life, don't just spend it.
Be bold and confident.
I hope that you get your answer.
Please, let me know if you want some help.
Thank you.

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