Panic Attack and klonopin

[jmani]

Ok so I admit I haven't called DAN yet and I know I need to, but I would like to hear from the arm-chair dive docs before I call DAN.

I recently (like last Wednesday) suffered a Panic Attack, it came from nowhere. I was just happily driving home from the dive club meeting. I suddenly started pouring buckets of sweat, had an intense pain in my chest, light headed, tunnle vision. You know classic signs of a heart attack. But to go along with that I had the worst sense of impending doom I have ever felt.

Pulled off the freeway, called 911, and the wife. Told everybody I was dying.

Well 4 hours of ER stay later, EKG blood pressure of 149/114 the whole 9 yards later they told me I had a panic attack.

Prescribed klonopin and rest. It took 2 days but I am pretty much back to normal.

I have never had any sense of anxiety before, especially while diving. As a matter of fact, I am at my most relaxed when under the sea.

The question is does anybody know the effects of klonopin under pressure, as it seems I need to take this drug to maintain what I know of as "Normal".

p.s. I am willing to listen to any "Wild Speculation" from any SB'er and not take any advice with out consulting a Dive Doc/DAN

 

[Papa_Bear]

Have a blood test and get your thyroid tested! Hyper-thyroid can cause anxiety when you wouldn't normally be!

 

[jmani]

Yeah that was one of the first tests the Doc ordered...but I am lets say "healthy" weight wise to have hyperthyroid.

 

[shotthebreeze]

J,

I've been having panic attacks for a few years now. They come and go with stress for the most part. During the summer months, I don't tend to have any, but then again I'm a student and I'm usually chilling out. It's all a big mind game is what it is. The medicine doesn't help, it just puts me to sleep, so I discontinued it two days after being prescribed it. I wouldn't recommend taking any sort of antidepressant while on a dive.

My guess is that there was a bunch on your mind or something big going on. Have you had more than one?

Oddly enough, anxiety triggers anxiety. Its a vicious circle. You get anxious about having another attack and guess what you have? An attack.

If you want advice or to talk privately about it, send me a PM and I can help you out...

 

[bamamedic]

Excerpted from DAN article, available online at DAN Divers Alert Network : Psychological Issues in Diving II - Anxiety, Phobias in Diving
Hope this helps!

Medication For Anxiety, Phobias & Panic Disorders
(Note: Many of the medications listed under "depression" are also used for anxiety. Generic names are listed first; common brand names follow).
Benzodiazepines
Medications in this group used to treat anxiety include: Alprazolam / Xanax, Chlordiazepoxide / Librium, Clonazepam / Klonopin, Clorazepate / Tranxene, Diazepam / Valium, Halazepam / Paxipam, Lorazepam / Ativan, Oxazepam / Serax, Prazepam / Centrax.
Side effects adverse to diving:

• Drowsiness: A common side effect. Be sure you know how you react to this medicine before driving or using dangerous machinery.
• Dizziness: Be careful about standing up quickly, going up and down stairs and driving.
• Difficulty learning: An unusual side effect, it tends to go away quickly with continued use.

 

[piikki]

If you were told to start taking Klonopin on regular basis after having the first ever panic attack of your life, I would certainly seek a second opinion. I would also pursue to examine what might have triggered the attack, in an effort to maybe better understand how to prevent it from happening again - diving or otherwise.

 

[Papa_Bear]

Yeah that was one of the first tests the Doc ordered...but I am lets say "healthy" weight wise to have hyperthyroid.

Your thyroid can be miss firing so to speak causing excess adrenalin and wight has nothing to do with it.... Your thyroid can be just fine and then send extra hormones to the pituitary causing it to release extra adrenalin! Causing all the symptoms you have described! Your age? What was the "T" count on the test?

 

[fisherdvm]

First, how old are you, do you smoke, do you take any medicines.

Next, have you had any testing done for anxiety - thyroid profile or TSH done to make sure you don't have hyperthyroidism. How many cups of coffee do you drink. Do you take caffeinated power drink or supplement. Do you take illicit drugs - ice, amphetamines, ritalin? Some folks have hypoglycemia (low sugar) and hyperinsulinemia.

Has your blood pressure been followed up, have they returned to normal? I am not a "real" doctor. But I would say you should follow up with a cardiologist or endocrinologist just to be sure. I would not recommend that you dive while taking Klonopin. Are you sure that the panic attack is not the result of worrying that your wife will find out about that new hot chick you have for a dive buddy?? Or that new rebreather you're hiding under the bed?

 

[TSandM]

We don't have enough information to give you good advice, but I agree with piikki that being prescribed Klonopin on a regular basis after a single episode like the one you describe is an odd strategy, and certainly not one I would employ.

We do not know how old you are, how much you exercise, what cardiac risk factors you have, whether you had any risk factors for pulmonary embolism and whether the tests for that were done, whether you have any other psychiatric history, what your intake of medications and supplements and caffeine is . . . There are TONS of pieces of information that go into trying to decide what an episode like the one you had might have been. You can get severe chest pain from esophageal spasm from reflux, too; the problem didn't even need to lie in your chest.

I think you need to visit your own family physician and describe the episode to him. Depending on your age and risk factors, he may want to get a treadmill or thallium study to look at coronary perfusion, or he may think an endoscopy to look at your stomach and esophagus is warranted. There are a lot of directions to pursue this, but I do not think that settling for a diagnosis of panic attack, in the absence of supporting evidence, is reasonable at this point. It really is a diagnosis of exclusion, and a lot of things haven't been excluded yet.

 

[Saturation]

We don't have enough information to give you good advice, but I agree with piikki that being prescribed Klonopin on a regular basis after a single episode like the one you describe is an odd strategy, and certainly not one I would employ.

Concur with TS&M. You need a workup by your regular doc before ascribing this to panic attack. Since it came without warning, and if there is truly an organic medical issue [ i.e., not psychological] it could be a major issue if one returns to diving.