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Panic attack and medical intervention


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Has anyone had a panic attack so severe that they had to be medicated by a doctor?

My biggest fear right now is that all the stressors in my life may cause me to go over the edge into the mother of all panic attacks....crying, screaming, complete hysteria.

If anyone had this happen, what did the doctors give you? I imagine those 1970's movies where the hysterical woman gets an injection of a tranquilizer and sleeps quietly for the better part of a day.

Any clue what those types of drugsnmay be? Id like to kmow what im getting or what to ask for on the day the shit really hits the fan and i go batshit crazy again.....

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I had one bad enough that I went to the emergency room.  It lasted for twelve plus hours and I couldn't breathe.  Like I really felt like my lungs were in an iron vise.  Not crying or screaming, but trust me, all of that was going on on the inside.

 

They gave me Ativan.  I did in fact sleep quietly for the better part of a day.  But it helped.  

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I dunno.  

My panic attacks are these massive adrenaline dump affairs...five minutes of terror followed by complete exhaustion.

 

If I feel anxious (not the panic attack, which hits way too fast to stop) I may take diphenhydramine.  This helps me.

 

If I get overloaded, I shut down, which I suppose is better than freaking out, but it's kind of hard to do anything when you sleep 20 hours a day.

Edited by Stickler
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I don't know how to say this correctly...,do regular ER docs know how to medicate a 'hysterical' woman? I mean, do they know the diff between panic attacks and a psychosis?

I'm afraid if I get hysterical they wont know what to do and think I had psychosis and will give me like, Thorazine, and send me to the nuthouse for an eval..,when really I just would need super-industrial panic control medication.,, Does it make sense what I'm asking? Like I don't wanna be misdiagnosed and over medicated or sent to the county hospital.

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Yes, your concerns absolutely make sense.

 

The more able you are to communicate the specific nature of your distress and your needs, the more likely it is you will have outcomes closer to what you are hoping to get.

 

However, emergency departments as a whole really aren't set up well to manage mental health crises. There certainly is some degree of risk that you would end up with an outcome you didn't want. By and large, this depends on a) your presentation, b) your behavior and ability to cooperate while in the ER, and c) the attitudes, resources, and pressure on the people who work in the ER.

 

If you have any access to medication that would help with panic/anxiety outside of that setting, it might be a lot more comfortable for you and less risk of an undesired outcome.

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Ok makes sense... I'll call crisis services and have them collect me for IP if I go nuts. ER's are not useful I guess so I'll at least have a plan now if something does go wrong. I don't intend to go crazy but if my mom dies or something I'll need a plan for where to go.

Ty Woo

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My first panic attack was massive and lasted for at least 12 hours. My heart was beating so hard and so fast that I thought I was having a heart attack or some kind of heart rhythm problem. I went to the ER and all they did was give me some mild tranquilizer and told me to go to see my doctor the next day (all this went down on a Sunday). What they gave me didn't help and my panic attack continued. I took so many OTC sleeping pills and antihistamines that it would have knocked out a horse, but nothing really helped. Then when I saw my regular doctor the next day, he gave me an amazing benzo (Centrax) that immediately helped me. They don't sell Centrax any more in the US due largely to the popularity of other benzodiazapines.

 

None of this answers any of your questions ... I just felt the need to share.

 

A couple of comments about what you wrote ... If you were having a panic attack, Thorazine would most likely help. It would have helped me. It is, after all, a "major tranquilizer." Also, if you are so hysterical that you can't communicate with the doctors, perhaps IP would not be a bad idea until you could be stabilized on some appropriate meds. In other words, the alternative scenario that you mention would not be all that horrible and could even be helpful. You would likely not be misdiagnosed because psych diagnoses take time and snap diagnoses are not made.

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Actually that is totally helpful! Mine last for hours....i feel edgy when theyre coming....whenit finally hits, im hysterical with the crying and sobbing....then it goes away and im nauseaus and headachy. They seem to be getting worse too. Ive been breathing all day, walking, distracting myself....then it hit...i was hysterical on the phone with my mom and sobbed. Then it went away and now im nauseaus and tired.

i used to ward them off with distractions but when they come now i cant stop them.

My shrink is gone til the end of the month and her fill--in is a douche. My therapist is too positive to see im crashing. I do know if it gets bad i can call the crisis line and go IP...got them on speed dial and they know me now.

Oh and im moving as of monday so im sure thats a hige stressor....even though the guy is moving me and setting my stuff back up for me while im at work so i wont have to deal....its still nerve racking.

Just as an aside for everyone, im looking into this being a neurological thing too. Someone suggested that there are disorders that cause you to laugh or cry uncontrollably....sometimes related to MS or Parkinsons or something. Anyways, they can donbrain scans to see if that is an issue....I'm calling a neurologist monday morning and getting an appointment asap. If there is something wrong with my brain, id like to know instead of just assuming its a really really bad panic attack.

The neurologist group im going to are the ones who treated those girls who all came down with Tourettes. Im hoping they know what to look for in my head....otherwise im calling johns hopkins....id read the article there about this stuff so they gotta have a doctor there who could take a look and see why i'm this way.

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  • 3 weeks later...

ER docs, on the whole, don't seem to get things like panic attacks. I went this summer for one that had pretty much lasted days. I had taken my meds and tried all the things my tdoc told me to do...nothing was working. And I truly felt like I was dying by the time I went. They were horrid to me. I had to sit in the waiting room for an hour sobbing and having everyone stare at me...which made things worse. The nurse who triaged me told me I "really just needed to calm down and breathe" because my bp and heartrate were so high. And when I finally did get to see a doctor and explain why I was there and what was happening (as best I could through sobs and trying to breathe), he looked at me and said "OK, but you do realize this is an EMERGENCY room, right?" :(

Since then, my tdoc and I have talked about where to go if that happens again. She said I was completely right to go, but next time there's a better hospital equipped with a psych ER that I should go to instead. Scares me some, because I worry it will lead to an IP stint...which I REALLY don't want...but it would be better than the "treatment" I got at my local ER.

If you see a tdoc, maybe have that conversation. Does he/she have a place to recommend? I know it makes me feel better to know that I have a plan if I should need emergency psych help. I feel a bit more in control of my care...

Edited by LesMis4
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ER docs, on the whole, don't seem to get things like panic attacks.

 

I totally agree.  I had a panic attack and needed to call 911 ... I told 911 that my legs and arms were like lead and that I was having a hard time talking.  By the time the ambulance came I couldn't talk.  Then went unconscious in the ambulance. 

 

Next thing I know I wake up in a hospital bed, and my pdoc was called, who thankfully said it was a panic attack (I say thankfylly because the ER thought I OD'd ... they were convinced of it, even though my blood work all came back fine). 

 

When I was discharged, I think they still thought I OD'd, but because of pdoc saying that it was a panic attack they pretty much had to believe him because there was no other thing wrong with me.

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I've been put on metoprolol, it's a beta blocker/blood pressure medicine. You can take it everyday or in times of stressful events.
It's not addictive like most anxiety relief medications. I've not really had a chance to put it to the test in a really stressful environment but I have been in a few everyday ones and noticed I haven't got the lightheaded, heart racing, confused, sweaty feelings I usual do. Maybe worth exploring with your doc?
Anxiety is an 'off the label' use for this medication if you happen to look it up, but there is info about it if you include anxiety in the search. I guess prevention works better than cure and that is the general idea behind this.

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Remnants, I'm not trying to berate you or anything, I just want to make sure you are not confusing dependency with addiction. Benzos do have a potential for abuse, but if you follow your Dr's prescription, you will be okay. It takes a long time to titrate off a benzo, but again, dependency, not addiction. You will find several people (moi, for example) who have been on benzos without problems for years.

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I guess it's a similar deal to antidepressants, in some ways? I'd hate to go cold turkey off of venlafaxine (generic Effexor), I've missed a dose once before and felt awful. I don't think anyone would say I'm addicted though.

 

Addiction describes the behavior associated with abusing the substance, I think? You can have no addiction behavior related to a drug but still be dependent on it.

 

Back on topic: I went in to the on call doctor in the GP's office I use when I had a sort of panic attack thing for hours after some trauma stuff got triggered. He prescribed diazepam (valium), some to take immediately and some more in case of more panic returning. It was just a temporary thing and tiny doses of diazepam but because I don't usually take benzos even the small dose was pretty effective. It worked really well; that was pretty much all I needed. Well, also therapy, but I didn't need that as urgently or from an MD.

 

Would it be possible for you to see an on call GP/PCP rather than go to the ER? They probably see more panic/anxiety psych stuff than ER doctors. They could also advise on whether IP might be a good idea. Of course, if your PCP/GP is useless with all things psych related then this is probably not going to work as well.

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Remnants, I'm not trying to berate you or anything, I just want to make sure you are not confusing dependency with addiction. Benzos do have a potential for abuse, but if you follow your Dr's prescription, you will be okay. It takes a long time to titrate off a benzo, but again, dependency, not addiction. You will find several people (moi, for example) who have been on benzos without problems for years.

I think there's quite a significant difference between the way the medical community in Australia vs. America view these kinds of medications (as with a lot of things), so when I say things about them it is based on how it seems to work here. It is very rare to be prescribed anything like diazepam & xanax here. Some medical practices flat out won't prescribe them. Obviously I'm not a medical professional or know too much about these but they have been described to me as 'addictive' and 'habit forming' by professionals. They're used as a last resort, mostly under some sort of intensive supervision eg. IP. Other things seen this way are some of the strong pain medications. I think that it's potential for abuse and how easily people can become dependent on it makes in a no go drug here; this is regardless of how well a person can follow the instructions & isn't likely to abuse them. And it's definitely different to AD's because I've always been told when prescribe them that they aren't addictive. 

Like I said, I don't know all that much about them. All I know is how it appears here and what I've been told. So, as it's different there, feel free to disregard.

Edited by Remnants
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I think that it's potential for abuse and how easily people can become dependent on it makes in a no go drug here; this is regardless of how well a person can follow the instructions & isn't likely to abuse them. 

 

I think it's becoming more and more like that in the US, Remnants.

 

This is why we can't have nice things.

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