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  • Am I having an Anxiety or Panic attack



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    Old 01-30-2014, 12:36 AM   #1
    Shelley48
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    Am I having an Anxiety or Panic attack

    Hi there

    I have been diagnosed with anxiety and depression on been on 1 x Nuzak a day. No other meds for anxiety or depression.

    My question is am I having Anxiety or Panic attacks?

    I have had this on and off over the last two years.

    I get a sort of squeezing pain in my head and I can feel it moving down my neck and into my throat. Its really painful and painful to swallow.

    This squeezing sort of pain then goes into my chest. Lasts about 10 minutes. I also end up with a headache after these attacks.

    I have had quite a few ECG's and they were all fine. The doctor says seems to be anxiety and that's all I have had from them.

    Please advise as this happened again this morning and pretty upsetting.

    Thank you
    Shelley

    Last edited by Shelley48; 01-30-2014 at 12:43 AM.

     
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    Old 01-30-2014, 10:19 AM   #2
    flitz
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    Re: Am I having an Anxiety or Panic attack

    a panic attack is the extreme variant of an anxiety experience. It can be modeled after a scale that goes from one to ten ten being almost paralyzing fear. What you are experiencing, I believe is a side effect from your ssri. It sounds like a mild form of serotonin syndrome. To test this hypothesis ask your doc to reduce your dose and see how that works. If it continues you may do better with another med and see if that helps. Prozac is very stimulating and has a profound effect on 5ht receptors thagt isn't as clean as newer ssri's so it may effect various soft tissue sites as well causing a spasm and vasodilation and constriction. Panic attacks can have many physical symptoms but they are usually preceded by an increasing level of anguishing fear and dread. This is rather unmistakeable as you feel as if you are going to die, pass out, lose control or are losing your mind. It is an escalating cascade of events that can be rather quick or a bit slower, coming in waves. It can happen seemingly out of the blue, or from various thoughts, physical stimuli, or proximal to a place or external environmental factor you fear having panic in or from. Serotonin syndrome manifest as mild, moderate or severe muscle tonus with clonic and tonic spasm, increased blood pressure, uncontrolled muscle movement, tremor, dry mouth, increased body temp, increased respiration and pulse rate. It can be confused with a panic attack but the involvement of muscle or neurological factors makes it more dramatic. One can have muscle tension and shaking during panic but they are more akin to the type of muscle tone and shaking one demonstrates during fear response rather then as if their body is almost having a mild seizure. I know some panic suffers who actually have seizures evoked by panic but the panic is rather unmistakeable and not something that one would ask did I panic, they know they panicked.

    Last edited by msmod; 01-30-2014 at 02:30 PM.

     
    Old 01-31-2014, 01:38 AM   #3
    Shelley48
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    Re: Am I having an Anxiety or Panic attack

    Thank you Flitz.

    This makes sense to me as sometimes when I swallow the Prozak it hurts my throat. It seems once the outer shell bursts, the powder seems to affect the tissue in my throat and it is painful.

    So your advise really makes sense. Thank you so much. I will speak to my doctor about another antidepressant. Can you recommend a newer one that is good please ?

    Regards
    Shelley

     
    Old 01-31-2014, 07:49 AM   #4
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    Re: Am I having an Anxiety or Panic attack

    If being treated for depression alone and you want a newer med that may be less serotonergic I prefer citolopram or sertraline from the ssri group or venlafaxine or duloxetine from the snri group but for anxiety and depression I prefer older tca meds like amitriptyline, desipramine, doxepin, nortriptyline as they have a larger less selective effect on brain amines are easier to get off and if not contraindicated by heart disease are easier to get on. For most people using a benzo to wean onto a antidepressant helps and for those with just anxiety they work well alone or with an ad med. All of these drugs cause dependency and for some are difficult to stop if they can ever be stopped. The best drug is the one that works is well tolerated and very often takes trial and error. There are some newer meds but they are pretty much old drugs in new clothing that cost more. For complex depression one can add novel antipsychotics with close monitoring, for depression without anxiety buproprion is a great med but highly stimulating, people with anxiety would need really hefty benzo doses to tolerate it but for some it works well. You will need to wean off prozac and it takes awhile because of its long half life so as your doc weans you off over a month or so ask him about giving you some lorazepam or alprazolam or diazepam in sufficient enough dose to abate some discontinuation symptoms and while you wean on to another ad med. If he is good he can tailor a cross wean off and wean on if he isn't he will have you go off the proazac let it was out for a few weeks and then wean you onto another ad med.

    Last edited by msmod; 01-31-2014 at 11:21 AM.

     
    Old 01-31-2014, 08:01 AM   #5
    Shelley48
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    Re: Am I having an Anxiety or Panic attack

    Thank you Flitz for this amazing and helpful information.

    I have tried to come off Prozak before and onto another antidepressant but it was rather difficult.

    Thanks again. I think I need a doctor who cares more.

    Shelley

     
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