What should I do for ANXIETY and PANIC ATTACKS?

Resolved question:
Hello, I have Been suffering from anxiety ever since the birth of my 3rd child. It first evidenced itself in panic attacks an then also in every day life- constantly feeling rushed, panicked, unable to relax, a tightness around my chest, breathing shallow, etc. this last weekend it escalated to the point that I passed out from a panic attack. I had previously been on ascitalopram 20mg, bupropion, and Xanax .5 as needed for panic episodes. I noticed however that ever since I started the medicine i didn't feel like myself- felt very disconnected emotionally and had issues with my memory. I stopped the meds in march and still am having issues with short term memory. I remember the general ideas of what I did (I.e. went to a meal with friends and family) but can never remember the specifics, what we talked about, what I said, series of events, etc. I am beginning to worry that the memory effect had nothing to do with the medicine and more to do with a different underlying issue. I have noticed lately that when I am somewhere i don't feel like I am 100% there, I feel disconnected, like I am only 80% in reality- i think the main reason being that I know in the future looking back on that event, I won't remember. I am a happy and loving mom, have an incredible husband and family life and no traumatic history. I have hypothyroidism that is treated and balanced well no no other health issues. When the panic gets bad, I resort to my "safe place" which is my bedroom. If i travel ((which I do often for work)) i panic about the fact that I am not able to make it back to that place quickly If I need to. For instance: on a trip to NYC the other weekend i realized that the last train leaving was approaching, we had planned to stay overnight in the city- but all of the sudden it dawned on me that once that last train left i was STUCK no matter what happened and could not make it back to my home and my safe place. It was a terrible feeling of dread and doom. I survived but didn't think I would. My mind then went to crazy feelings that everyone in the hotel was going to try to trap me there forver and switch my room keys so i could never leave. I realize full well how ridiculous all of this sounds. I am a well educated successful business woman, wife, ad mother and it terrifies me that these thoughts go through my head. I have gone through therapy but am more interested now in medicine to STOP the anxiety and bring me back to feeling like my REAL self and not this paranoid version of myself. I am trying to get in with a local psychiatrist but it is a lot of hoops to jump through with insurance.

Submitted: 4 Days
Category: Psychiatrist

Expert:  Dr. Srikanth Reddy replied 4 Days.

Hello. Thanks for using DoctorSpring.com for posting your query.

I have gone through your post in detail and I can understand what you are going through. Panic disorder can be very troubling and repeated panic attacks can lead problems with concentration leading to pseudo (false) memory problems.

Although you are taking Escitalopram and Bupropion it is not helping you much. This suggests that you need to change medicines for the better. Among the available options, a better drug would be either Paroxetine or Venlafaxine. Both are good drugs and very effective. I generally use Paroxetine as a first line for all of my anxiety disorder patients.

Also, along with these medicines you may try restarting with cognitive behavioral therapy as well. This will help in bringing out remission along with the medicines.

Hope this helps. If you have any further queries, do let me know.

Kind regards,
Dr. Srikanth Reddy MD.

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