Question:
A friend of my wife has had severe panic disorder for three years and is not much better off than when she first sought treatment. She has tried various medications including Imipramine, Prozac and Klonopin. The Klonopin seems to work the best for her but she still has a severe amount of limited symptoms.
With no medication she simply can not function- the disorder is that progressed.
The Doctor keeps promising hope in the form of new medications but the process
of switching them is so agonizing that she cannot function ie. work, etc.
during this gradual medication changeover which can take months. I would
quantify her at approx. 60% cured on 3mg of Klonopin but she has severe
sleeplessness, thought racing and digestion overactivity in addition to being very agraphobic and afraid to drive. The doctor suggests Paxil or an MAO inhibitor but once again she is afraid to try anything new because the reduction of Klonopin causes such anguish. Can anyone post some success stories, ie.
happy endings after a struggle with panic disorder? What medications have worked? Is anyone totally symptom free ?
Answer:
I had severe panic disorder (300.01) with _mild_ agoraphobia (but not enough
to be included in the DSM-III-R nomenclature) for 11 years before treatment
began. Treatment consisted of Xanax over a period of 3 or so years before
1989 taken "as needed". In DEC89, I suffered from panic attacks every 15
min while on vacation at home. I thought I was having a nervous breakdown.
Saw a psychologist who recommended a psychiatrist for the "official" diagnosis
and medications. A continuation of Xanax, plus, 150mg of Desipramine
(aka Norpramin) 1x/day. I had a _terrible_ time adjusting to the Desipramine.
I took it at _10mg_ doses and worked up to 150mg. As my panic attacks tapered
off my need for Xanax "as-needed" went away.
Then I began the hard part: I spent a year in group therapy. I walked in
and told six other folx I had panic disorder and had absolutely _no idea_
why they were occurring. They (as many do) had problems understanding
what was going on. I sat quietly and listened to the others, interjecting
about _their_ stuff occasionally, but leaving my stuff in limbo.
I can, I'm happy to say. After a while, I began seeing the things that were
causing me internal strife. Things I could never get totally into
because I was forced to pay attention to the physical effects of attacks
instead of work on my own issues. About six months after Desipramine
started, I tapered off a little at a time over 30 days. To my surprise,
I had no attacks. Not even ones caused by the side effects of coming off
the medications. I've been medication and panic disorder-free since JAN91.
I also started a support group for men, two of which have the same disorder.
Working with their issues, I've been able to successfully help one get to
a place to lower his dosage of meds, in the other, reduce the number of
attacks (he usually had at least two a day. He now has as much as 30 days
between attacks.)
I'm not touting "The True Way" to get rid of this dastardly disorder. But
it is _generally_ true that folx who have long term panic disorder will
not be "cured" solely by a theraputic medication regimen. The source of the
attacks need to be explored, whatever they are. This also requires the
belief that these attacks, ending with physiological symptoms, are _usually_
triggered by the mind and body _together_.
