There are now a whole range of drugs for panic attacks on the market. For all of these drugs you will need a doctor’s prescription; none of them are available over the counter. All of these drugs have pros and cons, and some have serious side-effects.
The most effective Panic Attack Drug I have ever come across is Xanax (generic name: alprazolam). It works super-fast (in as little as twenty minutes if it is taken sub-lingually, or under the tongue). It is a benzodiazepine class drug, but unlike the others I have tried it doesn’t make you feel spacey, drunk, “out of it” or lethargic and sleepy. On Xanax I feel fairly normal, although I did once fall asleep on a large dose.
Xanax does have its drawbacks though. If you take it when you are having the occasional panic attack then that will probably be fine. But if you are a regular sufferer then Xanax might not be wise. While it’s side-effect profile is good, any prolonged use (more than a week or two of even small doses such as 0.5mg a day) can become habit forming. Being hooked on Xanax is not fun. It can lead to severe rebound anxiety and a host of other problems. Xanax carries a greater risk of rebound anxiety than other tranquillisers and benzodiazepines because it has a short half-life. The other drugs with their longer half-life are in a way “self tapering”.
Clonazepam, Diazepam (Valium), Lorazepam (Ativan) all have significantly longer half-lives than Xanax and therefore are less habit-forming (but that does not mean that they are totally safe – addiction is still common!)
Side-effects include drowsiness and amnesia. Some people get paradoxical effects, in other words the opposite reaction to what they expected. In the case of someone taking these drugs for panic attacks that would be heightened excitement and possible anxiey and panic attacks! Therefore it is useful to start at a low dose and see how the drugs work for you. Some people don’t like using benzodiazepines because they feel out of control because they are so used to feeling anxious and panicky.
There are newer tranquillisers known as Nonbenzodiazepines, but their side-effect profile is no better and at the moment they are used chiefly for insomnia, not for panic attacks.
All in all, it’s important to remember that drugs don’t provide an overall solution to panic attacks but are fine for occasional use.
Xanax (alprazolam), like other benzodiazepines, is famous for its rebound anxiety – the anxiety that you can get after you stop taking a drug or as the effects of the drug wear off.
With Xanax you can get a rebound effect just from taking the drug once. It is in essence a bit like a hangover. People have reported different symptoms and plenty of people don’t get any rebound anxiety from just taking xanax once or only occasionally. Some of the symptoms people have reported from Xanax come-down are:
- Feeling Groggy/Spacey
- Lacking Motivation
- Feeling Lazy
- Feeling Anxious
- Having a Headache
This straight-forward Xanax hangover tends to be mild and pass over the course of the day.
Much more unpleasant and persistent is the rebound anxiety that you can get after you have been taking Xanax for some time (normally at least 2 weeks but less for some people). For an explanation of why rebound anxiety happens please click here.
Some common symptoms of rebound anxiety from Xanax:
- Palpitations (racing heart)
- Panic Attacks
- Intense feeling of fear
- Tight chest and difficulty breathing
- Upset stomach
- Aching Muscles
Rebound anxiety is often described as much much worse than the anxiety that lead the patient to take Xanax in the first place. It can be very serious and that is why you should never stop Xanax abruptly and always follow the doctor’s advice!
If you are suffering from rebound anxiety then speak to a doctor and talk about tapering your dose. Else you can be in for a miserable few weeks or months, as rebound anxiety can really go on (length of rebound anxiety seems to depend on amount of time you were taking Xanax, size of dose and personal differences).
Remember, drugs are not the answer to anxiety. If you are interested in permanent solutions to anxiety I recommend reading Killing Anxiety From The Roots, which is all about the underlying physical causes of anxiety.
You might also consider reading our Panic Away Review.
I recently read about a woman who had a mental disorder and was trying to come to terms with the possibility she had been abused as a child. As I read I became angry at the arrogance of psychology. The idea that everything we feel has a psychological basis is accepted not because it’s true, but because it has been repeated until everyone was brainwashed.
While psychological theories are cute and seem to make sense, they are very hard to prove. That doesn’t mean they are wrong and have no use whatsoever, but it does mean they should be considered alongside other ideas and theories.
It is strange that, for example, when a woman is pregnant or menstruating we are perfectly happy to accept that those physical and hormonal changes are having an emotional effect. But the idea of a physical issue having emotional symptoms is not one which is universally accepted, and psychologists are the keenest deniers of all! Psychologists don’t like to talk about the effect for example a vitamin deficiency can have on our emotions, or how an otherwise unrelated long term health concern can cause panic attacks or depression.
We need to free ourselves from psychology and look at the whole picture. That is all I am saying.
If you are interested in underlying physical causes of anxiety then Killing Anxiety From The Roots will interest you.
A while back I blogged about the links between anxiety and dizziness and how more often than not the two seem to go together: people experiencing dizziness as part of an anxiety attack or a panic attack.
Today I want to look at dizziness and vertigo as potential causes of anxiety and panic disorder – things like agoraphobia. It has often been said that stress and anxiety can bring on what is often referred to as giddiness, dizziness, light-headedness and vertigo. The reason being that blood is diverted to the muscles, the oxygen balance in the blood changes. This is perhaps true however it doesn’t tell the whole story.
The fight or flight response is meant to save us, but why did we evolve to disable our balance mechanism when poise and stability is needed most, when we are in danger? That begs a question along the lines of the chicken and the egg: what comes first dizziness or anxiety/panic?
For sure anxiety or a big shock can bring on balance problems like vertigo, often very short sharp bouts. However I think, and there is a certain amount of scientific evidence to back this up, that there are a lot of people with panic disorder who actually have an underlying balance problem.
If you into a supermarket and feel funny, maybe get derealization or feel dizzy or lightheaded the doctor will no doubt send you to a psychologist that will tell you that your subconscious doesn’t like being out of control and in a supermarket there is no easy way of escape. Maybe this is rubbish. Maybe the lighting and long aisles of a supermarket make it such a strange environment that the signal from ear and eye get somewhat out of sync in people with a slightly defective vestibular system. Maybe that is what causes the panic like symptoms and leads for the desire for an easy escape route.
If you think about it, the agoraphobics’ worst nightmares are all places that tend to be unnatural and odd and somewhat disorientating: supermarkets, shopping malls, motorways and highways: all places that could cause strange feelings in a person with a vestibular balance problems.
Also read Does Anxiety Cause Dizziness?
This is potentially important because in such cases your psychologist or charlatan hypnoanalyst will be telling you your neighbor sexually abused you. In fact there are types of vestibular rehabilitation and other physio techniques, as well as drugs, that might well help.
If your anxiety seems heavily related to dizziness or vertigo, or you experience balance problems elsewhere in life it might well be worth looking into.
Xanax, also known by the generic name Alprazolam, has been licensed in the USA to treat anxiety and panic attacks since 1981. It is used in the treatment of anxiety disorders, panic disorder and, in some cases, depression. It is a member of a family of drugs known as Benzodiazepines. It is a mild tranquilizer.
Many people who have experienced drugs like Valium may be aware of how Benzodiazepines can make you feel doped and sleepy. Xanax is not like this for many people. In my own personal experience Xanax didn’t make me feel very different at all, just much much calmer. I didn’t get any of the side effects listed, and in an ad hoc experiment to see how my reaction times were effected I actually found my reactions to be almost exactly as good as when I wasn’t on Xanax.
Some people do suffer from side effects, sleepiness, dizziness and vertigo, nausea. But these drugs are rather well-tolerated.
In terms of dose, it is important to follow your doctor’s instructions. I personally worked my way up from the 0.25mg dose which is the lowest available and now take 1.5mg on an as needed basis.
Initially I took a tiny amount of one Xanax tablet to see how I tolerated it. As I was fine I took the rest. Some people who suffer from anxiety may have a psychosomatic side effect of feeling a sudden onset of anxiety or panic whenever they try something new. This can mean that at first a Benzodiazepine has a paradoxical effect. If I were you I would persevere, as for the short term relief of temporary anxiety and panic attacks this drug is very useful and very effective.
A word of caution. Like all Benzodiazepines, Xanax can be habit forming. If you take it for too long you may need to taper off slowly to avoid withdrawal effects. Also, if you take it often you may find you need to take more to get the same effect. Your doctor will be able to advise you on this.
I don’t recommend you buy from online pharmacies without prescription, you don’t know what you are getting or how safe it is, or even if it will arrive or not!
Panic Attack Symptoms can be similar to anxiety# symptoms but usually feel much more intense. Often people say things like “I feel like I’m losing it” or “It felt like I was going mad”. In fact neither of those things are true, but as Panic Attacks cause such a rush of adrenaline and your body is so tense some quite bizarre symptoms can develop.
The typical symptoms are:
Racing heart (palpitations)
Feeling like you are going to have a heart attack
Increased breathing (hyperventilation)
Dizziness or vertigo
A feeling of unreality or depersonalization.
Sweating or feeling hot or sometimes cold
The great news is that all of these symptoms are harmless. They have been specifically designed by nature to feel as unpleasant as possible to encourage you to take action, but they are designed to protect you not harm you.
Many people find the feeling of unreality the hardest to cope with. Some people report that colors become more vivid, like when the sun is low at the end of summer. Or that sound is out of sync or doesn’t sound real, and that people don’t seem real. Some people think that this is a symptom of fainting, but in the case of panic attacks fainting is very rare, as blood pressure is raised somewhat and people normally faint from low blood pressure. I have never known anyone faint from panic.
Other people feel like they are having a heart attack, and if you have experienced an elevated heart rate you should have this checked out by a doctor just to be safe. Many people who are admitted to emergency rooms feel they are having a coronary but are in fact just panicking.
There are lots of treatments for panic attacks.
Also read more on feelings of unreality.
And a little more on feelings of unreality!
Medication tends to fall into two categories: SSRI’s and Benzodiazepines.
The SSRI’s, like prozac, celexa, zoloft etc have pros and cons. They are clinically proven to be effective (although all data from big pharma companies has been called in question at sometime or other). Unfortunately they do have side-effects of which weight gain, nausea (normally temporarily) and sexual dysfunction/loss of libido (normally temporary) are the most severe and commonly reported. SSRI’s normally take 4-6 weeks to start working and may need to be tapered off slowly at the end of treatment.
Benzodiazepines, like Xanax alprazolam and valium also have pros and cons. They are fast working, normally taking considerably less than an hour to kick in, and are extremely effective. On the downside they can be highly addictive and therefore are not best suited to long term use (although they are prescribed long term sometimes). They also can effect concentration and alertness so hinder the consumer’s ability to drive for example.
On the CBT front, over ten or twelve sessions a trained therapist will help you see panic attacks for what they are (harmless natural responses which appear nasty), will show you how to rationalize out the faulty and extreme negative thinking which causes panic attacks, and show you some physical techniques to calm your breathing and relax your mind and body.
Some people argue that CBT doesn’t really get to the heart of the problem, that you need some kind of psychotherapy to do that. Others argue psychotherapy is a pointless and long-winded waste of money.
Often a combination of therapy and drugs work best.
There are other potential treatments for panic attacks involving herbs and supplements like 5-htp which many people swear by. It should be noted that the effects of long term use of these other therapies has not bee fully studied.
Physical symptoms of anxiety can be mild or severe and for some people are worse than the mental symptoms. The physical symptom which worries people most is a racing heart or palpitations. Often with anxiety the heart can race to similar pulse rates as if you were running, and for many people this is the beginning of a panic attack.
As anyone who works in an Emergency Room or an Accident and Emergency department will tell you, it is very common for people to be admitted who are convinced they are having a heart attack. In fact this racing heart is just the bodies way of preparing for danger, the fight or flight response. Like all physical symptoms of anxiety, it is harmless.
The second most common symptom of anxiety is often described as tightness in the chest. This tends to be a combination of two things: a slight narrowing of the airway caused by the increased blood flow through the veins in the neck and hyperventilation. The combined effect is a feeling that we can’t breath, but this is just a feeling. In fact our breathing is working fine, again the fight or flight response is preparing us for action. The problem is that as we feel we can’t breath so we try to breath more and end up gasping for breaths we don’t need, when in fact we want to be slowing down our breathing, and taking calming belly breaths instead of fast shallow chest breaths.
Other physical symptoms of anxiety include tingling in the limbs, which is caused by blood being diverted to the core of the body, and a feeling of weakness which comes about for the same reason.
How do I stop the physical symptoms of anxiety?
The best way to stop anxiety symptoms is to start off the Parasympathetic Relaxation Response. This natural nervous system response to the fight or flight response is designed to calm us down after the danger has passed. As there is no real danger from an anxiety attack or a panic attack we can calm ourselves down immediately quite safely.
How do we set the relaxation response in motion? Well, there are several ways. Meditation is one and I recommend Mindfulness Meditation, which will also help you become aware of your breathing and recognize when you are hyperventilating unnecessarily. Learning to meditate takes time and commitment but will be worth it.
In the meantime, you can elicit the relaxation response by re-breathing carbon dioxide by breathing into a paper bag, or my concentrating on things at the periphery of your vision.
Remember though one important thing. the physical symptoms of anxiety are harmless!