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What Causes Dizziness, Chest Pressure, Syncope And Weakness In Arms?
Question: Hello,
Several weeks ago, I had what I thought was a panic attack. I am anxious all the time, and, all of a sudden, I became dizzy and faint, with extreme anxiety and a feeling of pressure in my chest. In any event, it went away and I later told my doctor. (He seemed to think nothing of it.) Now, fo several weeks, I have been getting symptoms in my arms and hands; my arms feel incredibly light - as if they're just hanging by my side. My hands are weak as well; I am even having mild trouble typing this! Also, I did some light exercise with one of my arms today, and the muscle tensed up but never relaxed (the muscle still feels tense now!). I've also noticed that the pitch of my voice has been going up an down. In any event, I am really worried about what's going on, and would like to hear what professional thinks would be the cause... I should also note that I have mental illness, which contributed to the anxiety (from hallucinations). I was taking Perphenazine up until October, 2015. I remember my hands were stiff and rigid at the time... They have now discontinued this medication, and I have been prescribed Risperdal instead. I should mention that I also "feel" someone through my hands. Almost as if my hands move differently, at times. I want to talk to a psychiatrist first, because these symptoms could be psycho-somatic or a side effect of antipsychotics...
Several weeks ago, I had what I thought was a panic attack. I am anxious all the time, and, all of a sudden, I became dizzy and faint, with extreme anxiety and a feeling of pressure in my chest. In any event, it went away and I later told my doctor. (He seemed to think nothing of it.) Now, fo several weeks, I have been getting symptoms in my arms and hands; my arms feel incredibly light - as if they're just hanging by my side. My hands are weak as well; I am even having mild trouble typing this! Also, I did some light exercise with one of my arms today, and the muscle tensed up but never relaxed (the muscle still feels tense now!). I've also noticed that the pitch of my voice has been going up an down. In any event, I am really worried about what's going on, and would like to hear what professional thinks would be the cause... I should also note that I have mental illness, which contributed to the anxiety (from hallucinations). I was taking Perphenazine up until October, 2015. I remember my hands were stiff and rigid at the time... They have now discontinued this medication, and I have been prescribed Risperdal instead. I should mention that I also "feel" someone through my hands. Almost as if my hands move differently, at times. I want to talk to a psychiatrist first, because these symptoms could be psycho-somatic or a side effect of antipsychotics...
Brief Answer:
Consultation
Detailed Answer:
Hello, and thank you for your premium question.
Let me reassure you that the most likely cause of your symptoms by far is anxiety and panic. Dizziness, a feeling of pressure in your chest, lightness in the arms, and preoccupation with somatic symptoms is all consistent with anxiety and panic. Given that you have started Risperdal recently, I would get some basic labwork, including a CBC, CMP, prolactin, TSH, and an EKG. But what you describe is all characteristic of anxiety and panic. I do not think this is related to the antipsychotic you have been taking or recently started. Anxiety and panic can be treated in the short term with benzodiazepines, and in the long term with an SSRI such as Lexapro, Zoloft, or Prozac.
I hope you found this helpful!
In the future, for continuity of care, I encourage you to reach out to me at my direct link below. My name is Dr. Sheppe, and I am an XXXXXXX doctor working in New York City at NewYork-Presbyterian Hospital, ranked #1 for Psychiatry in the United States. For a personalized comprehensive evaluation, treatment recommendations, or individual therapy, ask me at HealthCareMagic at this private link: XXXX
Consultation
Detailed Answer:
Hello, and thank you for your premium question.
Let me reassure you that the most likely cause of your symptoms by far is anxiety and panic. Dizziness, a feeling of pressure in your chest, lightness in the arms, and preoccupation with somatic symptoms is all consistent with anxiety and panic. Given that you have started Risperdal recently, I would get some basic labwork, including a CBC, CMP, prolactin, TSH, and an EKG. But what you describe is all characteristic of anxiety and panic. I do not think this is related to the antipsychotic you have been taking or recently started. Anxiety and panic can be treated in the short term with benzodiazepines, and in the long term with an SSRI such as Lexapro, Zoloft, or Prozac.
I hope you found this helpful!
In the future, for continuity of care, I encourage you to reach out to me at my direct link below. My name is Dr. Sheppe, and I am an XXXXXXX doctor working in New York City at NewYork-Presbyterian Hospital, ranked #1 for Psychiatry in the United States. For a personalized comprehensive evaluation, treatment recommendations, or individual therapy, ask me at HealthCareMagic at this private link: XXXX
Above answer was peer-reviewed by :
Dr. Prasad
Dr. Sheppe:
I believe the reason I had the probable anxiety attack is because I am constantly bombarded by hallucinations. They appear as "ghosts" who bother me almost non-stop. This causes me to have chronic anxiety... Also, there is a "ghost" with me who I can hear. That's who I "felt" taking over my hands... (It's almost as if my hands have different mannerisms when it happens...) In any event, the antipsychotics help to some extent, but I am on a very sedating dose, and they do not completely heal the disease. Therefore, is there some way through therapy that I can test these hallucinations to prove to myself that they are not real? I would hope that I can at least find relief for my anxiety. In any event, thank you for the response. I now have some relief in my arms and hands!
XXXXXXX
I believe the reason I had the probable anxiety attack is because I am constantly bombarded by hallucinations. They appear as "ghosts" who bother me almost non-stop. This causes me to have chronic anxiety... Also, there is a "ghost" with me who I can hear. That's who I "felt" taking over my hands... (It's almost as if my hands have different mannerisms when it happens...) In any event, the antipsychotics help to some extent, but I am on a very sedating dose, and they do not completely heal the disease. Therefore, is there some way through therapy that I can test these hallucinations to prove to myself that they are not real? I would hope that I can at least find relief for my anxiety. In any event, thank you for the response. I now have some relief in my arms and hands!
XXXXXXX
Brief Answer:
Followup
Detailed Answer:
Thank you for the additional history and information.
What dose of Risperdal are you on, and when did you start taking it? Risperdal is one of the least sedating antipsychotics available, and generally after a several weeks of treatment with it your body will get used to it and sedation will stop. Being on an adequate dose of Risperdal to completely treat your hallucinations is the best thing you can do to help control your anxiety.
If generalized anxiety remains a problem, as I mentioned you should begin therapy with an SSRI. I would speak to your prescribing doctor about this.
Yes, cognitive behavioral therapy for psychosis is a modality of therapy that can treat anxiety caused by hallucinations. I would be happy to provide this therapy for you at my private link below.
You are very welcome! Remember to rate and close this thread.
In the future, for continuity of care, I encourage you to reach out to me at my direct link below. My name is Dr. Sheppe, and I am an XXXXXXX doctor working in New York City at NewYork-Presbyterian Hospital, ranked #1 for Psychiatry in the United States (XXXX). For a personalized comprehensive evaluation, treatment recommendations, or individual therapy, ask me at HealthCareMagic at this private link: XXXX
Followup
Detailed Answer:
Thank you for the additional history and information.
What dose of Risperdal are you on, and when did you start taking it? Risperdal is one of the least sedating antipsychotics available, and generally after a several weeks of treatment with it your body will get used to it and sedation will stop. Being on an adequate dose of Risperdal to completely treat your hallucinations is the best thing you can do to help control your anxiety.
If generalized anxiety remains a problem, as I mentioned you should begin therapy with an SSRI. I would speak to your prescribing doctor about this.
Yes, cognitive behavioral therapy for psychosis is a modality of therapy that can treat anxiety caused by hallucinations. I would be happy to provide this therapy for you at my private link below.
You are very welcome! Remember to rate and close this thread.
In the future, for continuity of care, I encourage you to reach out to me at my direct link below. My name is Dr. Sheppe, and I am an XXXXXXX doctor working in New York City at NewYork-Presbyterian Hospital, ranked #1 for Psychiatry in the United States (XXXX). For a personalized comprehensive evaluation, treatment recommendations, or individual therapy, ask me at HealthCareMagic at this private link: XXXX
Above answer was peer-reviewed by :
Dr. Prasad
I am on 3 mg Risperdal, 100 mg Seroquel, and was on 10 mg of Lexapro. The Lexapro helped, but I became so spacey, I could not drive... Therefore, we cut it out. In any event, is there still more room to increase with the Risperdal/Seroquel? Is there some way I could use Lexapro that is not so sedating?
XXXXXXX
XXXXXXX
Brief Answer:
Followup
Detailed Answer:
I would increase the Risperdal, as this can certainly go higher (as high as 6-8mg total daily). Seroquel is very sedating, and there is absolutely no reason to be on two neuroleptics at once (Risperdal and Seroquel), so I would stop Seroquel and replace it with a higher dose of Risperdal. If Lexapro was giving you problems, I would try Zoloft instead, starting at 25mg and increasing to as high as 200mg daily as tolerated. This is what I would do if you were my patient!
Remember to rate and close this thread when you're done.
In the future, for continuity of care, I encourage you to reach out to me at my direct link below. My name is Dr. Sheppe, and I am an XXXXXXX doctor working in New York City at NewYork-Presbyterian Hospital, ranked #1 for Psychiatry in the United States (XXXX). For a personalized comprehensive evaluation, treatment recommendations, or individual therapy, ask me at HealthCareMagic at this private link: XXXX
Followup
Detailed Answer:
I would increase the Risperdal, as this can certainly go higher (as high as 6-8mg total daily). Seroquel is very sedating, and there is absolutely no reason to be on two neuroleptics at once (Risperdal and Seroquel), so I would stop Seroquel and replace it with a higher dose of Risperdal. If Lexapro was giving you problems, I would try Zoloft instead, starting at 25mg and increasing to as high as 200mg daily as tolerated. This is what I would do if you were my patient!
Remember to rate and close this thread when you're done.
In the future, for continuity of care, I encourage you to reach out to me at my direct link below. My name is Dr. Sheppe, and I am an XXXXXXX doctor working in New York City at NewYork-Presbyterian Hospital, ranked #1 for Psychiatry in the United States (XXXX). For a personalized comprehensive evaluation, treatment recommendations, or individual therapy, ask me at HealthCareMagic at this private link: XXXX
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
One last question: Is this your channel? XXXX > I get incredible relief from ASMR. Maybe try experimenting with it in your therapy.
Thank you. You're getting a good review> Your advice was helpful...
In case your interested, here is my channel: XXXX
(You can see the ASMR subscription...)
Thank you. You're getting a good review> Your advice was helpful...
In case your interested, here is my channel: XXXX
(You can see the ASMR subscription...)
Brief Answer:
Followup
Detailed Answer:
ASMR is certainly very helpful for a lot of people! I recommend it to a lot of my patients with anxiety or insomnia.
You're most welcome. Please feel free to contact me at my direct private link for therapy or with any further questions you have.
In the future, for continuity of care, I encourage you to reach out to me at my direct link below. My name is Dr. Sheppe, and I am an XXXXXXX doctor working in New York City at NewYork-Presbyterian Hospital, ranked #1 for Psychiatry in the United States (XXXX). For a personalized comprehensive evaluation, treatment recommendations, or individual therapy, ask me at HealthCareMagic at this private link: XXXX
Followup
Detailed Answer:
ASMR is certainly very helpful for a lot of people! I recommend it to a lot of my patients with anxiety or insomnia.
You're most welcome. Please feel free to contact me at my direct private link for therapy or with any further questions you have.
In the future, for continuity of care, I encourage you to reach out to me at my direct link below. My name is Dr. Sheppe, and I am an XXXXXXX doctor working in New York City at NewYork-Presbyterian Hospital, ranked #1 for Psychiatry in the United States (XXXX). For a personalized comprehensive evaluation, treatment recommendations, or individual therapy, ask me at HealthCareMagic at this private link: XXXX
Note: For further guidance on mental health, Click here.
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
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