The 8 best remedies for panic attacks

Review of the best according to the editors. About the selection criteria. The the material is subjective, is not advertising and is not serves as a guide to the purchase. Before purchase is needed consultation with a specialist.

One of the most unpleasant sudden conditions, which, despite on absolute safety for life and health, may occur in person – is a panic attack. This is a sudden occurrence extreme anxiety, internal tension, sharp and irresistible fear of death, which is accompanied by a “vegetative storm”, for example, facial flushing, palpitations, and others symptoms.

Doctors who diagnose panic attacks identified more than 13 vivid symptoms, and if a person has 4 or more characteristic signs during an attack, you can set diagnosis of panic attack. However, there are so-called small forms when there are only two or three symptoms. What for it took such a complex diagnostic technique, reminiscent of questionnaire or case study? Just because There are a lot of symptoms of a panic attack, and they are all “vague”. At some are indescribable horror, others – unusual physical sensations that are difficult to describe in words, for example, “mobilization the whole organism. “Sometimes it happens that a feeling of fear does not arise in general, this is the so-called “headless panic” or “panic without panic attacks. ”

These sudden episodes are often accompanied by severe anxiety, and may recur in contact with in a similar situation, for example, when stuck in an elevator. IN in some cases, however, panic disorder may occur and in any other situation and in other circumstances.

Quite often, in addition to purely physical symptoms, such as chest pain, dizziness, feeling short of air or palpitations, the symptoms that are dealt with psychiatrists. These are signs such as feelings of absolute unreality, isolation from reality, the illusory nature of everything what is happening, that is, a sense of derealization and sometimes – depersonalization. Depersonalization is a complex feeling: “I am not me. “Quite often the patient is afraid during a panic attack go crazy and this is a higher level of fear than just animal fear of death.

After the first attack, secondary fear, fall into this situation again, or fear of panic relapse attacks. As a result of this, a rigid style of behavior is formed. patient, and he aims to avoid similar situations and subsequent attacks, and at all costs panic attack, and how often does it occur?

Etiology and risk factors

It turned out that panic attacks often occur in families with increased hereditary levels of anxiety when there is in history of severe neurosis when applied to a person in childhood violence, both physical and sexual.

In general, any stress, starting from a serious illness, divorce and the death of a loved one to the death of a pet, may play the role of a trigger, or trigger factor in the formation panic attack.

Physiologically and biochemically it is not completely clear which ones structures of the central nervous system and disorders in which neurotransmitter environments are eventually realized by a panic attack. However, it turned out that there is a violation in the GABA-ergic transmission, and also changes in serotonin metabolism.

Panic attacks are most common in women, on average, the second more often than men. Their prevalence in the population makes, on average, from 2 to 5%. Age at which occur panic attacks – from 20 to 40 years. This is the heyday hormonal life and saturation, and it becomes clear why: because the role of hormones – catecholamines, adrenaline is the key in implementation of “vegetative storms”. The debut of a panic attack that has arisen for the first time in old age, or during menopause in women is extremely rare and can be considered clinical casuistry. What is the typical clinical picture of a developed panic? attacks, and where did this body reaction come from?

The physiological “base” of a panic attack attack

A typical panic attack can be described as an alarm extreme extent when a person is deaf to the voice of reason and logical arguments, he is influenced by very strong fears. it fear of death or loss of consciousness, fear of going crazy, and these fears plentifully seasoned with vegetative symptoms expressed through sympathoadrenal crises. This is tachycardia and chest pain, nausea and increased sweating, redness of the face and dizziness, feeling fever or even cold chills with trembling and tremors.

Particular insidiousness of a panic attack is that in advance of her it is usually impossible to recognize, and no harbingers in Unlike a migraine attack, a panic attack does not. She begins all of a sudden, just like a large epipressure, and is associated with the release adrenaline. So the old doctors who put the mark are right equality between panic attack and vegetative-vascular sympathoadrenal crisis.

It can be said that in patients with vegetovascular dystonia and sympathoadrenal crises in the presence of fear of death and severe anxiety during a crisis can be completely diagnosed with panic attacks. Sympathoadrenal crisis is nothing but ancient, but untimely and inappropriate in this situation reaction, which It is aimed at the full and most rapid mobilization of all body defenses. As a result, in nature man, or any other the living entity realizes this reaction through immediate flight, or attack – any way to protect your own life as soon as possible.

For this very reason, it is extremely quickly redistributed blood flow, blood begins to quickly supply the skeletal muscles and brain, flows from the skin and internal organs. There is a deepening and increased breathing, increased oxygen supply to the blood, increased the work of the heart. And all this, finding no way out in immediate muscle activity, without “discharge”, leads to the development of unpleasant symptoms If all patients who suddenly had panic attack, could rush to run, and would run a few tens of meters, then this would be the best treatment since all physiological reactions aimed at muscle activity, would be implemented in the normal way.

Panic attack or panic disorder?

The attack begins suddenly and usually lasts for a few minutes, and then everything ends happily. And here it’s very important for the doctor to figure out if the patient has an isolated panic attack, or panic disorder has already formed. What is the difference between these two states? But with what:

in case of isolated panic attacks, the patient is in bright the gap between them does not form a fear of expectation of the subsequent an attack.

That is, there is some unpleasant state, it was, and is over. He can explain this with external factors, for example stuffiness, quarrel with bosses at work, and such an explanation is quite acceptable. Hence the freedom of the future, and no new expectation panic attacks, stress formation and anxiety therefore not exist. This is the most favorable option.

But in the event that a person believes that external factors nothing, and this case is a feature of his body, then (especially in the presence of suspiciousness, suggestibility and hypochondria, melancholic temperament) he begins to form fear waiting for a subsequent attack, and the next step is the formation of ritual behavior.

A person very strictly avoids the situation in which past panic attack. If he had this happen in a store or shopping center, then he tries not to visit crowded places. If he became sick on the bus, then he starts to avoid using transport, and if a person became ill in the elevator, then from now on walks only on foot. By the way, avoiding the repetition situation is very not far to OCD, that is, to obsessive-compulsive a disorder, or a syndrome of obsessive conditions. Has already overvalued, obsessive thought of non-falling and non-repeating, and from it “at hand” and to the ritual of obsessive actions.

What do patients at the doctor complain about?

It should be remembered that the doctor does not see the panic picture “in “, the patient talks with him after everything that happened, as it says, “on a clear head.” Depending on the part which system has the most complaints, the patient can visit a cardiologist, and a neurologist, and even a gastroenterologist. So, if he has a large number of heart symptoms, such as pain in the heart and chest, fear of death, violation heartbeat, then he will most likely come to a cardiologist.

If tremor, numbness in the limbs or sudden weakness, some blurred consciousness, fainting and dizziness, then such a patient will be at the neurologist, because he will first suspect something like epilepsy, a brain tumor, or suddenly developed “temporary” stroke.

In this case, the emerging fear of death, the panic itself and pronounced patient anxiety is fully justified, and people say that it’s just a “normal reaction to a possible serious illness,” a heart attack or stroke, and in his place everyone would be scared.

In this case, specialist doctors, even if it becomes completely a clear diagnosis of panic attack or panic disorder, it’s extremely difficult at times to convince the patient that no real there is no threat to their life, no tumor, stroke and there are no other hypothetical serious diseases, and all this – elemental panic. These findings of the doctor are discouraging, and even offend a patient who is accustomed to consider himself a victim of the unknown, so far an unknown, but very serious illness.

Patients believe so much in their illness that they are able to express distrust to several doctors at once, and are inclined to form a heavier addiction for yourself. In some cases it comes to pathological psychoproduction with the formation of delusional disorder, but here it is already necessary serious treatment by a psychiatrist.

It goes without saying that diagnosing a panic attack must consider the presence or absence of psychiatric diseases such as schizophrenia, organic mental disorders, and other conditions, including – use various psychoactive drugs. Moreover, without a full psychiatric examination impossible to collect complete information and prescribe treatment for a patient with severe panic disorder.

Diagnose panic attack and panic disorder – it’s pretty hard work make sure that all the various symptoms, ranging from shortness of breath, rapid pulse, and ending with dizziness and fainting condition are not a sign of any somatic diseases. And this means that without a full examination, without ECG, without Holter monitoring, without spirography, sometimes – Bicycle ergometry is not possible. Although an experienced doctor often even at first glance it’s clear that we are talking about panic attack, it is necessary mechanically, routine, using various analyzes and instrumental research methods clearly prove in a medical history or an outpatient card that there are no serious diseases, such as thyrotoxicosis, or ischemic attacks heart diseases. Similarly, you need to make sure that the patient does not have psychiatric pathology, no post-traumatic stress disorders, specific phobias, for example, social and so Further. How to treat a panic disorder?

Treatment

Of course, the best way would be a non-drug treatment. panic disorders. After all, panic still lies at the heart of and a perverse and untimely, but still normal reaction saving a life. Good, for example, psychotherapeutic impact, individual and group psychotherapy. there is alternative and harsh methods when the patient is “driven” again and again into this situation until he disintegrates conditioned reflex connection, and he will not be freed from the influence of this situation.

You can give an example with perfume. If, for example, a man loved a woman who used a relatively rare perfume, then with chance encounter with this fragrance, he can remember in a second everything, and sometimes it is so amazing that a person can freeze in place influenced by surging memories. But if you give him constantly this fragrance again and again, if it will be used by his loved ones and colleagues, then after a while he will cease to influence memories. It is on this that provocative techniques are based. treating panic attacks.

In some cases, drug support is required. drugs, for example, monotherapy is indicated by any single a drug, but the best, after all, should be recognized as a combination psychotherapy and medication. There are many therapeutic strategies that are more effective but we will not dwell on them. Our task is to describe some drugs that are used in the fight against panic disorders.

It should be said right away that we will not talk about urgent help, that is, stopping the panic attack itself. It is separate topic, and in some cases, the patient just needs to breathe in balloon. When there is an increased amount carbon dioxide then many symptoms associated with excess oxygen in the blood pass without medication. In some cases enough glass of water and an open window, a few drops Corvalola, and sometimes an ambulance and administration are required Relanium.

Our task is to talk about drugs that aimed at stabilizing the condition, and prevention of subsequent attacks and relapses. They are all applied in courses in gaps between panic attacks. This review is composed of so called “real” drugs for treating panic attacks, and almost all of these drugs are prescription drugs. Many of them, for example, atypical antipsychotics, can prescribe only psychiatrist. Many of them are used to treat depression, anxiety, and even some great mental illnesses, for example, schizophrenia or bipolar disorder.

This review will not include those that have become traditional for the Runet over-the-counter nutritional supplements, folk remedies, herbal fees, and drugs that filled the entire RuNet, like Corvalol, tinctures peony and other means.

As usual, INN or international generic name, then first issued, or the original drug, if any, and then – a list of commercial copies, or generics that have much lower cost than the original drug. Medicinal prices preparations are relevant for the winter of 2020 for pharmacies of all forms property in the territory of the Russian Federation.

The list of drugs is compiled without the purpose of advertising or anti-advertising of any means, and the name of the drugs, and also the sequence of presentation is dictated exclusively national guidelines for the treatment of panic conditions and panic attacks, and information about drugs, indications and Contraindications taken from official instructions.

Panic Attacks Review

Nomination a place Name of product price
Antidepressants: SSRIs and Tricyclics 1 Venlafaxine (Velaxin, Velafax, Venlaxor) 228 r
2 Duloxetine (Simbalta) 886 rub
3 Fluoxetine (Prozac) 89 rub
4 Sertralin (Zoloft, Asentra, Serenata, Serlift, Stimuloton) 480 rub
5 Tricyclic: Imipramine (Melipramine) 357 r
Benzodiazepines 1 Alprazolam (Zolomax, Helex) 499 rub
Non-benzodiazepine anxiolytics 1 Hydroxyzine (Atarax) 311 rub
Atypical antipsychotics 1 Risperidone (Speridan, Rispolept, Risset, Torendo) 199 rub

Antidepressants: SSRIs and Tricyclics

Antidepressants of various groups are one of the main and the most effective remedies for long-term treatment of panic disorders. But the choice of a drug carried out by a doctor, taking into account additional criteria. For example, it depends on the influence of side effects, the presence of suicidal concomitant pathology behavior. Some benzodiazepines are able to well stop a panic attack, for example, that same diazepam.

But in long-term treatment regimens to prevent development panic attacks are used as tricyclic antidepressants, such as anafranil and melipramine, as well as high potential benzodiazepines, for example, alprazolam, or antidepressants selective effects, which include selective inhibitors serotonin reuptake – SSRIs. With them we will begin the medicinal overview.

Venlafaxine (Velaxin, Velafax, Venlaxor)

Rating: 4.9

Venlafaxine (Velaxin, Velafax, Venlaxor)

It is a popular antidepressant that comes in two dosages: 75 mg and 150 mg. In its chemical structure, it stands alone, but its therapeutic effect is associated with potent inhibition serotonin reuptake. For the treatment of panic disorder prolonged capsules are popular. It is assigned inside, during food. It must be swallowed whole, and it is very important to take daily dose once a day, and preferably at the same time time.

It is advisable to start treatment for panic disorder with the minimum dosage is 75 mg once daily. Excellent suitable as monotherapy, and it is advisable to increase the dose after 2 weeks, but not earlier than 4 days after the start of treatment. It is forbidden to take more than 350 mg daily. Launches Velaxin Hungarian pharmaceutical company Egis, and the cost of one 75 mg packs of 28 tablets per month treatment will be from 960 to 1560 rubles.

Advantages and disadvantages

Velaxin is contraindicated with the use of inhibitors monoamine oxidase (MAO), but this is a standard contraindication, with severe impairment of liver and kidney function in children, as well as pregnant and lactating women. Great care is needed in case of recent myocardial infarction, presence cardiovascular disease, with high blood pressure, glaucoma. Velaxin has side effects, and most often it is a decrease appetite, dry mouth, palpitations, sweating, and ejaculatory disorders in men, anorgasmia. In case of serious panic disorder treatment should last at least 6 months. In some cases, the use of Velaxin and analogues may cause psychomotor agitation, inability to sit and stand on location, and most often, this occurs in the first weeks of treatment.

Duloxetine (Simbalta)

Rating: 4.8

Duloxetine (Simbalta)

Simbalta is a highly effective drug from the group of not only reuptake of serotonin, but also of norepinephrine. His possibilities wider. His company is European Eli Lilly, and is the drug is not cheap. Its package of 14 tablets of 30 mg will cost retail from 1700 to 2300 rubles. A pack of 28 tablets of 60 mg (that is, in a dose twice as large) will cost from 3300 to 4300 rubles. This substance, in addition to suppressing the reuptake of mediators, also suppresses pain, increases the threshold of pain sensitivity. Duloxetine therefore it is used for various pains of central origin, for example, with diabetic polyneuropathy. In case of severe resistant panic conditions need to be prescribed 60 mg once a day at the beginning of treatment, and the maximum daily dose is 120 mg per day, in two divided doses.

Advantages and disadvantages

Duloxetine is contraindicated in a sufficiently small amount conditions, and this is a definite plus: this is angle-closure glaucoma. In some cases, it can be used during pregnancy and in the period of breastfeeding, and in case of impaired liver and kidney function can also be used, but only with caution. From side of effects quite often dizziness, dry mouth and constipation, palpitations, weight loss and hot flashes. It should be remembered that this drug should be used very carefully, however, as and other antidepressants with suicidal tendencies, and you cannot apply with monoamine oxidase inhibitors (MAOs). Need to restrict driving during the treatment period and potentially hazardous activities, as the patient may develop drowsiness as a side effect. Also not recommended use Simbalt and other drugs with alcohol, due to the mutual enhancement of effects.

Fluoxetine (Prozac)

Rating: 4.8

Fluoxetine (Prozac)

Prozac is the original drug of the same company (Eli Lilly) and is the next drug from the same groups of selective serotonin reuptake inhibitors under called fluoxetine. Prozac is naturally a prescription drug, and is the most expensive of all fluoxetines, as it original tool. One pack of 14 capsules of 20 mg will cost you from 450 to 530 rubles. Fluoxetine manufactured by Ozone LLC the same dosage and in the amount of 30 pieces per package will cost from 73 and up to 120 rubles. If you take a package of 20 capsules, then you can find at a price already from 33 rubles, you are unlikely to find anywhere fluoxetine is cheaper.

Prozac is a classic antidepressant that does not affect activity of receptors other than serotonin. After the first the maximum plasma concentration occurs after 8 hours, and a constant therapeutic concentration of this agent appears 2 weeks after the start of treatment. In addition to panic disorders, classic indications for use will be various depression, nervous gluttony, or bulimia syndrome obsessive states and thoughts, i.e. obsessive-compulsive disorder (OCD), and premenstrual dysphoric syndrome. For prevention of panic attacks usually lasts 20 mg daily, one once a day, at the same time.

Advantages and disadvantages

Side effects in Prozac are also characteristic of other SSRIs. it dry mouth, decreased appetite and decreased body weight, possible constipation and change in taste. This side effect is possible. like drowsiness, but insomnia is not excluded, characteristic decreased libido and lack of orgasm, and in men – a violation ejaculation and erection.

Some patients noted yawning, and restless legs syndrome on while taking this drug, but these were isolated cases. As in in the case of the drugs described above, one must be extremely careful, if a patient with panic attacks has a suicidal tendency, there are suicidal thoughts and so on. After all, the drug can make human move “from theory to practice”, which increases the risk suicidal attempts.

It is important that fluoxetine and Prozac cannot be used with Sonapax, or thioridazine. This drug, like a small antipsychotic, also used to treat severe panic disorder form, and just along with antidepressants, this must be remembered to the attending physician. Prozac and other fluoxetines have a long period elimination half-life, and this must be taken into account when combining Prozac with other medicines, as well as when replacing. Need to be very careful when combining fluoxetine with other drugs that affect serotonin, such as triptans for the treatment of migraine or Tramadol for pain management, this leads to a higher risk development of serotonin syndrome.

Sertralin (Zoloft, Asentra, Serenata, Serlift, Stimuloton)

Rating: 4.8

Sertralin (Zoloft, Asentra, Serenata, Serlift, Stimuloton)

Another drug from this group is Zoloft, or sertraline. It is a potent serotonin reuptake inhibitor, but without stimulating, without sedation or any other action. is he does not enhance adrenergic activity, which is very important, because it is the sympathoadrenal crises that underlie panic attack. Zoloft is shown, in addition to panic disorders, more and with social phobia, a syndrome of obsessive thoughts and conditions, with Depression and post-traumatic stress disorder. It should be emphasized that panic disorder is present in the official instructions, as an indication, and all previous drugs the main indication was depression.

The drug Zoloft is released by the Italian company Hauptfarma Latina, and 28 tablets of 100 mg will cost between 1,100 and 1,250 rubles. However, treatment with Zoloft should begin with a dosage of 25 mg per day, that is, half a tablet of 50 mg. This dosage is increased in a week. twice, up to 50 mg per day. A pack of 28 tablets of 50 mg will be already significantly cheaper, an average of 900 rubles.

Advantages and disadvantages

In extreme cases, this tool can be used by pregnant women. women, but nursing mothers do not use this medicine follows. Side effects of its classic for this drug groups: dry mouth, tachycardia, palpitations, involuntary muscle contraction, yawning, nocturnal grinding of teeth, decreased potency and ejaculatory disorder in men, anorgasmia. But, fortunately, these effects are dose-dependent, and against the background of a low dose, which is indicated for the treatment of panic disorders, usually they do not occur. Occasionally may appear withdrawal syndrome, so it is better to discontinue treatment, reducing the dose twice as at the beginning of the course.

Tricyclic: Imipramine (Melipramine)

Rating: 4.8

Tricyclic: Imipramine (Melipramine)

Melipramine is a bright representative of another group antidepressants, namely tricyclic antidepressants (TCAs). It was the tricyclics that first appeared in clinical practice, and SSRIs have become relatively recent. This is a cure except reuptake of norepinephrine and serotonin, and relief corresponding impulse transmission also blocks histamine, and acetylcholine receptors. The result is anticholinergic and sedation. This remedy is also intended for long-term therapy, and the optimal effect is achieved, on average, after 5 weeks of treatment.

In addition to panic disorder, melipramine is indicated for all depression, including anxiety, with atypical depression and with bipolar disorder. This is very convenient because anxiety, anxious expectation and underlies formation depending on the traumatic situation causing panic attack.

Melipramine is represented by a small number of different manufacturers, and currently only sold in Russia Egis Hungarian tablets from 320 to 420 rub for packing. In the package of 50 tablets of 25 mg. There are dragees in the same dosage, at an average cost of 300 rubles. for the same packaging. How to use melipramine? For panic disorders the lowest dose should be prescribed, i.e. 25 mg per day.

Advantages and disadvantages

It should be remembered that with a panic disorder, it is possible transient increase in anxiety at the very beginning of treatment, in which case benzodiazepines can be connected, for example Relanium or Seduxen, in order to stop the alarm. Then, as the effect develops and reduce anxiety, benzodiazepines cancel. Melipramine should also be canceled gradually, and the minimum duration The treatment for panic disorder averages 6 months. You need to take this remedy once after eating before going to bed. Side effects in tricyclics occur quite often, and this possible increased activity of liver enzymes, sinus tachycardia, tremors, dizziness, blurred vision and impaired accommodation. Due to the anticholinergic effect, constipation occurs and dry mouth, urination disorders, patients complain of increased sweating, sometimes to increase body weight. Drugs from the first group, SSRIs, most often reduced body weight due to a decrease in appetite, therefore, the purpose should be taken into account one or another drug, taking into account the anamnesis.

Benzodiazepines

Alprazolam (Zolomax, Helex)

Rating: 4.9

Alprazolam (Zolomax, Helex)

Benzodiazepines are drugs that are widely used as a maintenance treatment for panic disorders, and directly for stopping the episode itself panic attacks, for example, using intramuscular or intravenous administration of Seduxen or Relanium. Also these funds used to suppress anxiety, which may amplify at first during treatment with antidepressants. For example, the combination of tricyclics is widely known. antidepressants with benzodiazepines. However, for long treatment of panic disorders, it is desirable to use the so-called long-acting benzodiazepines, or high potential benzodiazepines, and their representative is alprazolam. Short-acting benzodiazepines, such as diazepam, we are here We will not consider.

Alprazolam is available in 1 mg tablets in a package of 50 pieces. This is a typical anxiolytic, or tranquilizer, which has sedative, muscle relaxant, anticonvulsant effect in large doses, as well as sleeping pills. These effects result lead to a significant reduction in emotional stress. At anxiety decreases or anxiety disappears, anxiety subsides and fear. Since the drug has concomitant sleeping pills effect, and shortens the period of falling asleep, its very good prescribed to people with panic disorder and various insomnia symptoms, with insomnia. This medicine other than panic disorder, is widely used for neurosis, irritability, as well as with somatized depression.

The drug is used using the minimum effective dosage, and usually the initial dose is from 250 to 500 mcg, micrograms. Dosage in micrograms is found among tablets are very rare and this is just the case, because the pills have a very a small dosage of 1 mg. Accordingly, 250 micrograms is Quarter tablets, and a dose of 500 micrograms is half the tablet. The drug should be discontinued gradually, with a decrease in dose, and apply the medicine also for a long time, as decided by the doctor. Alprazolam produces several companies. Currently in Russia available, and even then not always, the drug INN-generic alprazolam for the price of 940 rubles. for packaging produced by a domestic company Organics

Advantages and disadvantages

The advantage of alprazolam is a good reduction in anxiety and sleep improvement, and minus is its contraindications, among which chronic obstructive airways lesions, and rather severe depression. In addition, this drug it is advisable to use in lower doses, especially if a person first encountered with drugs such as antidepressants or anxiolytics. If you assign it for a long time and in high doses, then drug dependence may occur, and when rapid dose reduction or abrupt cancellation – severe syndrome, up to insomnia and abdominal cramps. It should be remembered that alprazolam is incompatible with other tranquilizers, and during alcohol is forbidden for treatment, and you also need to refrain from driving vehicles and working with machines and mechanisms.

Non-benzodiazepine anxiolytics

Hydroxyzine (Atarax)

Rating: 4.8

Hydroxyzine (Atarax)

There is a whole group of anxiolytics that are not related to the discharge of benzodiazepines, and its most famous representative considered hydroxyzine, which is known as commercial the name Atarax.

What are these medications used for? They initiate anti-anxiety action, and are appointed very first in complex treatment of panic disorder. The fact is that standard antidepressants from the group of selective inhibitors serotonin reuptake, or tricyclic antidepressants, able to develop an excellent anti-anxiety effect, but it arises slowly, as was said above, on average, through a month and a half after the start of admission. To cover up the patient in the first weeks after the appointment of antidepressants, for Atarax and his “colleagues” are used to quickly influence anxiety. of this group.

Consider the effect of non-benzodiazepine anxiolytics on the example of Atarax. Hydroxyzine has a very broad spectrum of action, because it affects choline and histamine receptors. IN As a result, it causes sedation, and an antiemetic effect. Atarax – this is a very quick remedy, after taking the pill after a while half an hour, its effect is noticeable. Other than that, except anti-anxiety effect, it is able to improve memory and attention, that is, cognitive abilities. Therefore he is very good at complex treatment of allergic manifestations, as it helps stop itching in patients with urticaria and eczema. In persons with with anxiety, it improves sleep quality and lengthens its duration. Atarax should be used in a dose of 25 to 100 mg per day, with this is the standard dosage – an average of 50 mg per day, which divided into three doses. It is 12.5 in the morning and at lunch, and 25 mg in the evening. Therefore, Atarax is available in this dosage – 25 mg each, and one a package of twenty-five such tablets costs from 230 to 290 rubles, manufactures its Belgian company YUSB Pharma.

Advantages and disadvantages

The advantage of Atarax can be considered a low price, the ability to stop itching, improve sleep, but if not itching and there is no bad sleep, then he still has excess sedative effect and anticholinergic action, which causes dry mouth and difficulty urinating. Also quite inconvenient that you need to take this drug three times a day, while in the morning and at lunch half a tablet, that is, it is necessary to break the tablet. However, it should be remembered that side effects are not pronounced, and pass quickly, a few days after the start of treatment, and this just constipation, urinary retention and dry mouth. Long time such side effects persist in the elderly. Contraindicated Atarax during pregnancy, breastfeeding and hereditary galactose intolerance.

Atypical antipsychotics

Risperidone (Speridan, Rispolept, Risset, Torendo)

Rating: 4.8

Risperidone (Speridan, Rispolept, Rissett, Torendo)

But what if panic attacks become frequent, panic disorder – severe, and do not help individually taken antidepressants, as well as in combination with anxiolytics, benzodiazepines, or non-benzodiazepine drugs? Then “heavy artillery” comes in, which refers to antipsychotics, which are also called atypical antipsychotic drugs

This is risperidone (Rispolept), and his “colleagues” are olanzapine (Ziprex, Egolanza), and aripiprazole (Zilaxera, Amdoal, Ariprizol). Neuroleptics prescribed only by psychiatrists, and field of activity antipsychotics – this is not depression, not anxiety, in their pure sense in outpatient practice, and real heavy mental diseases. Antipsychotics are needed for real hallucinations if there is delirium if there is a manic episode or psychosis. Antipsychotics needed in the treatment of schizophrenia, with episodes of physical aggressiveness in of these patients, as well as in severe cases of obsessive-compulsive disorders.

But, if you combine them with antidepressants, then for many studies, atypical antipsychotics showed a fairly high efficacy in case of severe and resistant panic attacks disorders that could not be cured by a separate drug. So, risperidone is indicated in all the above conditions, and chemically is not only a serotonergic blocker receptors, but also receptors for dopamine and alpha 1 – adrenergic receptors. As a result, it suppresses the feeling. the fear that dominates panic anxiety disorder, and in psychiatric practice reduces aggressiveness, and enhances the deep stage of sleep.

The dosage of risperidone is usually determined by the attending physician. psychiatrist Initial Dose for Panic Disorders should be less than with schizophrenia, or hallucinations. Usually it starts with a dose of 0.25 mg per day, then it goes insignificant climb. But you can not take the drug in a dose of more than 10 mg per day, under no circumstances. Rimperidone tablets are available in 2 mg, in a package of 20 tablets. There is also a dosage of 4 mg. Is worth 20 mg tablets in the amount of 20 pieces from 120 to 480 rubles., production of the domestic company Organika. Original Rispolept manufactured by Janssen cilag Johnson & johnson. And the packaging Rispolepta, similar to the previous one, will cost from 300 to 700 rubles.

Advantages and disadvantages

The drawback of risperidone is a rare development opportunity specific neuroleptic malignant syndrome effects characteristic of antipsychotics that are dose-dependent. Among insomnia, headache, muscle stiffness and hypersalivation, slowing down, constipation, erectile dysfunction and ejaculation, reflex tachycardia, and so on. Antipsychotics treat only severe panic disorder, and also perhaps more short courses. Doctors use antipsychotics only. psychiatrists who have experience in treating antipsychotics. During the period patients should be advised not to overeat, antipsychotics contribute to weight gain.

Instead of a conclusion

In order not to bore the reader without medical education, on this we stop listing in detail drugs that are used worldwide for treating panic disorder in the “cold stage”, between panic attacks. There are still whole classes of medicinal compounds that could be included in the list, but this significantly increase the volume of the article.

So, to affect the cognitive component of anxiety and the prevention of various phobias successfully used the so-called small antipsychotics such as sulpiride (Eglonil), Theraligen and Sonapax (thioridazine). Small depressants that are not used have their own group affiliation. Sometimes their destination enough to save the patient from a mild panic state severity, and these include trazodone (or trittiko), Valdoxan and other drugs.

To improve mood in patients with panic disorder various anticonvulsants are very widely used, or anticonvulsants. The list of these tools is extremely wide. it valproic acid and lamotrigine, pregabalin or gabapentin, and an underutilized drug like Trileptal, or oxcarbazepine.

It should be said that the recommended duration of treatment panic disorder of moderate severity is, in an average of three to six months. But this time is counted after of as soon as the therapeutic effect has occurred, the patient mood improved and anxious expectation disappeared next panic attacks, and not from the first day of taking the medicine. Therefore, it is possible to take a drug and more than 6 months, under the control of the necessary analyzes, taking into account side effects.

But in any case, the rule remains as universal as possible lower dosages, with a flexible approach, the possibility of replacing the drug and emphasis on non-pharmacological therapies. All together it leads to the elimination of panic attacks, reducing their number, lengthening the “bright spaces” between them, increasing mood the disappearance of anxiety and improving the quality of life in patients.

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