by Giancarlo Cerveri
The pharmacological treatment of choice based on serotonin reuptake inhibitors: these are drugs that take a long time before they prove effective but are generally quite well tolerated
I have been suffering from panic attacks and hypochondria for a month, I did some tests and everything was normal, including the electrocardiogram because I had severe arrhythmias. I take bisoprolol, paroxetine, diazepam and alprazolam. Now I no longer have attacks, but I still live with anxiety, I’m afraid to get up from the sofa because my head is spinning and I feel all over shaking. I’m 40, I’ve been locked up for a month and I don’t know how to react.
Answered by Giancarlo Cerveri, Director of the Complex Operational Unit of Psychiatry, Asst of Lodi (GO TO THE FORUM)
Panic disorder is a psychiatric pathology often considered minor but very widespread and a source of great suffering and impact on the lives of individuals who suffer from it. You describe very well some essential aspects such as the sense of anguish, the physical symptoms (tachycardia, subjective breathing difficulties, tremors, sweating) which lead to the belief that one is suffering from an acute and serious medical condition. Sufferers often go to the emergency room all the time. The fear of dying, however recognized as irrational, becomes irrepressible. Yet the most disabling symptoms are others. After the attack, which generally lasts less than 30 minutes, symptoms attributable to anticipatory anxiety prevail, the fear of a new attack that ends up occupying the whole day and night.
Demoralization
Avoidance behaviors are implemented, that is, everything that suggests that it could trigger a new crisis is avoided. Some patients end up giving up everything and remain locked up at home, losing any form of activity. it is clear that often the result is a deeply disabling secondary demoralization. In summary, the disorder, if left untreated, is very serious. How is it treated? The interventions are different depending on the moment and the severity. The pharmacological treatment of choice based on serotonin reuptake inhibitors (SSRIs), of which paroxetine is a part. These are drugs that require a considerable amount of time before they prove effective. They are generally quite well tolerated.
Act on lifestyles
Transiently, in the first stages of treatment, anxiolytics can be associated (as in your case diazepam or alprazolam), to loosen the grip of anxiety. it is then necessary to change lifestyles, for example by improving sleep and limiting the use of stimulants (coffee, energizing drinks). good to do aerobic exercise at least three times a week. All these interventions help to achieve a stable improvement of the disorder. then a psychotherapeutic intervention aimed at reducing the psychic mechanisms that fuel anxiety and the risk of new episodes is useful.
September 7, 2023 (change September 7, 2023 | 07:21)
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