Panic Disorders: A Case Study

The article Cognitive-Behavioral Therapy, Imipramine, or Their Combination for Panic Disorder, evaluates the effect that drug and psychosocial therapies have on panic disorders. Furthermore, the authors also evaluate whether a particular treatment is more effective than another, a combination of treatments, or whether one treatment outdoes another. Patients who are afflicted with panic disorders have a reduction in lifestyle and lowered role functioning when compared to individuals who suffer from diabetes, heart disease, or arthritis. Researchers found that treating individuals with a panic disorder, led to a better lifestyle. However, medicine also found that treating patients with imipramine led fewer symptom manifestations. The authors of the article conducted trials in which they compared cognitive-behavioral therapy (CBT), imipramine with medical management, combination of CBT and imipramine, pill placebo with medical management, and CBT with placebo for for panic disorder. Researchers found that CBT alone and imipramine alone yielded greater results than the placebo for PD. Imipramine yielded a greater quality of response, however, CBT had greater

Selective serotonin reuptake inhibitors (SSRIs) have been prescribed by physicians for many years now. One reason SSRIs are so popular is because of the many mental disorders they can be used for such as anxiety, depression, obsessive-compulsive disorder (OCD), phobias, and many more (Weitzel & Jiwanlal, 2001). The four major types of SSRIs that are most commonly used by people with mental disorders are fluoxetine (Prozac), paroxetine (Paxil), sertraline (Zoloft), and citalopram hydrobromide (Celexa); SSRIs work on the brain by acting on the reuptake pathway of serotonin (Stone, 2010). There are some advantages for taking SSRIs. One advantage is that SSRIs have fewer side effects than most of the other antidepressant medications such as monoamine oxidase inhibitors (MAOIs) and tricyclics (Weitzel & Jiwanlal, 2001). Another advantage is that SSRIs have less of a risk of toxicity in overdose (Lane, Baldwin, & Preskorn, 1995). SSRIs are better tolerated than tricyclic antidepressant medication because they cause less sedation and problematic anticholinergic effects. There are also reports indicating that SSRIs have fewer negative effects on the cardiovascular system than tricyclic antidepressants (Edwards, 1992).

Doctors also prescribe Selective Serotonin Reuptake Inhibitors(SSRI) to individuals suffering from depression, but the same ailment can be treated with amino acid supplements. Some examples of SSRIs are Prozac, Paxil, Zoloft and Celexa. SSRIs increase the amount of serotonin in the synapse by blocking its reabsorption, helping the symptoms of depression improve. According to the American Academy of Family Physicians, benzodiazepines lose their therapeutic anti-anxiety effect after 4 to 6 months of regular use. Dr. White, clinical psychologist and a certified neurotherapist, compares antidepressants to a foreign chemical. She is completely against the use of SSRIs because it blocks the reuptake of the serotonin into the neuron. In simple words,

105). The other more recent treatment for generalized anxiety disorder is selective serotonin reuptake inhibitors (SSRIs).This type of medication became popular due to its ability to regulate serotonin. Also, another reason SSRIs became so popular is because it works for other disorders such as obsessive compulsive disorder, post-traumatic stress disorder, panic attacks, and agoraphobia in lowering symptoms by as much as 80% in over 50% of people taking the medication (Anxiety Disorders; Treatment).

The discovery that selective serotonin reuptake inhibitors can effectively treat anxiety disorders has led to the Serotonin Theory. The Serotonin theory indicates that serotonin mediated neurotransmitters in the brain may be involved in anxiety disorders. The fact that some antidepressant agents relieve symptoms of both anxiety and depression disorders indicate that there may be a correlation between the two disorders. Information also indicates a correlation between genetic susceptibility in depression and anxiety disorders (Lundbeck Institute, 2008.)

Not only do Prozac and other SSRIs provide results for those suffering from depression, they manage to have other purposes. Prozac succeeds in reducing symptoms of major depressive disorder such as suicidal ideation, depressed mood, worthlessness and loss of energy. SSRI antidepressants “have better overall safety and tolerability than older antidepressants” and allowed patients to take the medication for longer (SSRI Antidepressant Medications: Adverse Effects and Tolerability). Not only could they help people experiencing the side effects of tricyclic antidepressants, but they could also be prescribed to children and the elderly (SSRI Antidepressant Medications: Adverse Effects and Tolerability). This lead to “more patients now [being] successfully treated for depression than ever before” (SSRI Antidepressant Medications: Adverse Effects and Tolerability). The new discoveries continued pouring in as researchers linked SSRI antidepressants to increased abstinence for people trying to quit smoking and effectiveness in eliminating symptoms of panic disorder (Elevated positive mood: A mixed blessing for abstinence, Panic disorder and suicidal behavior: A follow-up study of patients treated with cognitive therapy and SSRIs in Hungary). A Hungarian study using SSRIs was able to eliminate symptoms of panic disorder in 38.5% of participants and significantly reduce their suicidal ideation and behaviour (Panic disorder and suicidal behavior: A follow-up study of patients treated with cognitive therapy and SSRIs in Hungary). Furthermore, multiple studies have been conducting showing a negative relationship between smoking and the use of SSRI antidepressants, specifically for patients with generally low positive mood (Elevated positive mood: A mixed blessing for abstinence, Multicenter trial of fluoxetine as an adjunct to behavioral smoking cessation treatment.). SSRI antidepressants

With an estimated 9.3% of Americans currently living with major depression or bipolar disorder, according to the NIMH, the safety of antidepressant drugs is at the forefront of many pharmaceutical discussions. At present, the most common drugs used to treat the debilitating lethargy, anxiety, and fatigue often associated with major depression fall into three key categories based upon mechanism of action: SSRIs, Tricyclics, and MAOIs. Since major depression and bipolar disorder are characterized by imbalances of certain chemicals within the brain, prescription medications are often the best way of relieving the symptoms of these disorders. As with any medication, antidepressants carry risks of side-effects, which usually relate to the drug

The cognitive behavioral therapy helps them to rationally think about situations when in panic mode and to effectively remain calm through their panic. In exposure therapy they are exposed to panic in a controlled environment where the patients can learn safe and healthy ways of coping. Medication therapy is important. Antidepressants are giving for long-term therapy and take a few weeks to start working, so that is when the benzodiazepines come in. They act quickly and are given to give rapid relief to symptoms during a panic

We all experience fear or some anxiety when faced with a stressful situation. When that fear becomes ongoing, it can be known as panic disorder. Panic disorder occurs when a person suffers from recurrent panic attacks that cause them to live in constant fear. The panic attacks are an unreasonable fear response to a typically non-threatening situation. There is no way to predict these attacks as they can be triggered at any time. Typically they last anywhere from one to ten minutes. The person becomes constantly worried about having another attack which greatly affects their ability to function and disturbs their quality of life. They might avoid certain situations or places in attempt to prevent another attack. There are numerous causes and symptoms for panic disorder and many ways for it to be treated.

SSRI medications such as Paxil, Celexa, Lexapro to name a few have been found to reduce anxiety in clients with Generalized Anxiety Disorder. Therefore, because of the less addictive nature in the medication, as a psychologist or counselor I would prefer prescribing a SSRI to my client. However, the client would need to be in weekly therapy so that the symptoms and medication could be closely monitored. Furthermore, it is important to give the client psychoeducation on the

Antidepressants are used when the symptoms of a sufferer of anxiety or depression are persistent and severe. Anxiety is the general term used to describe an array of disorders that cause intense fear, apprehension, and distress (Cassiday, 2016). A depressive disorder is a disorder that causes persistent sadness and loss of hope and interest in life (Malhi et al., 2015). As antidepressants tend to have side effects whereas many other treatments do not, a sufferer of anxiety will commonly be initially treated with cognitive-behavioural therapy or other forms of talking therapy, meditation, exercise, and healthy eating if these treatments are not effective a patient will be considered to be prescribed medication (Cassiday, 2016). However patients that are prescribed antidepressants additionally are typically treated with other therapies, as the combination of different remedies is almost always far more effective than only one (Sethi, 2012).

The eminent psychiatrist, Dr. Paul Hoch, in his classic treatise on differential diagnoses in the field of psychiatry made the observation that symptoms of anxiety and depression were components of every major psychiatric disorder (Hoch, 1972). Everyone also experiences anxiety which is typically defined as a diffuse, unpleasant, and sometimes vague sense of apprehension; however, anxiety disorders, psychological disorders whose main component is anxiety and lead to significant disruptions in a person's everyday functioning, are among the most prevalent psychiatric conditions in the world (American Psychiatric Association [APA], 2000). Moreover, there is abundant empirical evidence that anxiety disorders when left untreated may increase the risk of cardiovascular-related disorders and other health concerns (APA, 2000). Therefore it is important to be able to distinguish the proper anxiety disorder diagnosis and initiate treatment. One of the most disabling of all the anxiety disorders is Post Traumatic Stress Disorder (PTSD).

This should be the first action taken to attempt to control and treat the disorder. However, in more severe cases, this simple technique is not enough. Psychological therapy involved in treating panic disorder focuses on helping the patient modify behaviors and responses to situations that will ultimately reduce feelings of panic. These types of treatment can involve many sessions with a mental health professional in order to be successful. For example, McGrandles and Duffy (2012) state “there is a large body of research supporting the use of cognitive behavioral therapy across the spectrum of anxiety disorders” and “psychological interventions such as CBT tend to be considered safer than drug treatments” (p. 5). In the event that psychotherapy is not single-handedly successful, pharmacological therapy can come into play. Certain medications can be taken by the patient to help reduce the severity and frequency of panic attacks. “At present there are several different types of drugs which could be prescribed for the treatment of anxiety such as anti-depressants, benzodiazepines and beta blockers” (McGrandles & Duffy, p. 6). In the event that medication therapy is used, psychological therapy should also continue to be used in conjunction. The patient and doctor must work together in order to determine the best

. However, the effectiveness of the treatment intervention must also be considered in the context of preexisting pharmacological therapies. Despite discontinuing use of anxiolytic medication about 6 months into psychological treatment, Mark continued to evidence treatment gains at 9 months, as well as cessation of panic attacks by the end of treatment and at 2-year follow-up. This outcome advocates that the behavioral therapy component played a key role in reducing and preventing Mark’s panic attacks. Findings propose Mark’s asthma was significantly exacerbated by his anxiety and perhaps some of his reported asthma attacks were in fact panic attacks. Regardless, Mark’s physical health, as well as his psychosocial well-being, improved substantially with the use of evidence-based cognitive behavior therapy targeting stress and anxiety. Overall, these results support the implication that physical and mental health interact and that targeting psychological concerns can in turn have an important impact on physical health (Tien, Goodie, Duncan, Szabo, & Larson, 2014).

As I continue to grow as a beginning therapist, I have learned about the numerous medications that clients will be prescribed and used in conjunction with psychotherapy. Benzodiazepines are a commonly used drug for anxiety and panic disorders. With an interest in its common use, I think it is important to know the history and the benefit it may play for clients that will use them. In addition, I also think it is important that the negative aspects and results from studies on the drugs be reviewed prior to administering them to our clients. To further grow as a therapist, I plan to gain the most information I can on the benefits of this drug for my clients. In this paper I will explore the benefits of Benzodiazepines, results from various studies,