Suggest Treatment For Panic Attacks At Night And In The Morning While Recovering From Depression

Posted on Wed, 21 Jun 2023

Question: I am a long sufferer of depression and have within the last few weeks been put back on my original anti depressants ( escitalopram 20mg) after an attempt to ween me off them. Having gradually felt better I've found that this week my mood has gone back down and I'm now suffering from panic attacks at night and in the morning. I'm finding it frightening and unbearable, is their anything more i can do to help me sleep and calm down? And is the antidepressants still getting into my system?

Answered by Dr. Dr. Ashok Kumar Choudhary (1 hour later)

Brief Answer:
Clonazepam can be used on need basis

Detailed Answer:

Hello,

Chronic depression is a relapsing and remitting disorder and generally long term treatment is required. It is also the known fact that on repeat occasions medications generally take a longer time to act in comparison to initial episodes. Sometime on repeat occasions the patient needs a higher dose than the previous dose. In case increasing the dose is not possible, the recommended strategy is to augment the antidepressant with some other required medication.

Considering the fact that there is downward trend in mood over the last few weeks and panic attacks, I feel adding Clonazepam on a need basis may help you. Clonazepam is not an antidepressant but it excellently takes care of panic attacks and sleep.

I hope this helps you. If you have any further query, I would be glad to help you.

Thanks and regards,
Dr. Ashok Kumar
Psychiatrist

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. Ashok Kumar Choudhary (32 hours later)

Is clonazepam similar to diazepam? My doctor, although reluctantly prescribed me a small supply of diazepam of 2.5mg. He doesn't like the drug but prescribed it me back at the start of me returning to escitalopram as I just couldn't sleep from panic. I had taken diazepam briefly for the same reason a few years ago and found it more effective. Purely on a, as and when needed basis, but that was 5mg. Because of my doctors reluctance in prescribing it this time around, I feel a reluctance to take it alot of the time. This is in fear of using it up and not having a safety net. Is that unreasonable of me to ask for it? Baring in mind I've only ever been prescribed it twice. Also i dont think escitalopram can be prescribed any higher than 20mg here in the uk

Answered by Dr. Dr. Ashok Kumar Choudhary (13 hours later)

Brief Answer:
They belong to the same class

Detailed Answer:

Hello,

Both Clonazepam and Diazepam belong to the same class and have many similar features. However, Clonazepam acts very fast while Diazepam takes some time.

In my opinion, there is no point to ask for Clonazepam since you have prescriptions for Diazepam and it is helping you. In case the help offered by Diazepam is inadequate then we can think of adding some other medication like Clonazepam.

I must inform you that you are lucky to have a doctor who has concerns for you. He is taking your care in a reasonable way and there is a valid group for his reluctance to prescribe Diazepam and other similar medications.

I hope this answers you.

Thanks and regards,
Dr. Ashok Kumar
Psychiatrist

Note: For further guidance on mental health, Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar