Patient’s question: Recurrence of panic disorder Description: In 2010, the patient had a sudden onset of panic attacks after drinking, with extreme fear and a feeling of near death, which subsided after 2-3 hours, and the attacks occurred almost every day. In the past 3 months, he had uncontrollable thoughts that he would die, knowing that they were unnecessary, but he could not overcome them. After taking paroxetine and alprazolam, the symptoms improved, but I still had the fear in the morning hours. He was cured after taking medication for more than six months and everything was normal for three years after that. 2014 the patient had a relapse of this disease 3 years after the last cure, before the relapse the patient had things insomnia, had drunk alcohol continuously at noon and at night, and was drunk after drinking a lot of alcohol at night. Help wanted: The patient believes that this relapse is due to two consecutive heavy drinking, is alcohol the only cause of this relapse? Since this is the second relapse, how long will it take for Dr. Victory to take the medication this time? Thank you! Medication: Drug name: Enox, Paroxetine, Clonazepam Dosing instructions: The first month take Enox 150mg daily, Clonazepam 2mg morning 1/8, afternoon 1/8, evening 1/4 daily, Paroxetine 20mg from 1 capsule gradually reduced to half a capsule Drug name: Enox, Paroxetine, Clonazepam Dosing instructions: The second and third month take Enox 75mg afternoon, 150mg evening; Clonazepam 150mg in the evening; Clonazepam 0.25mg in the afternoon and 0.5mg in the evening, with side effects of palpitations, dry mouth, constipation, high blood pressure Drug Name: Paroxetine, Tandospirone Citrate Tablets, Clonazepam Dosing Instructions: In the fourth month, take Paroxetine 20mg twice a day; Tandospirone Citrate Tablets 5mg, once in the morning and once in the evening; Clonazepam 0.25mg in the afternoon and 0.5mg in the evening, I have been taking it for one month with no significant discomfort and am now at the end of the fourth month. BJU Psychiatry Reply: Alcohol consumption can trigger anxiety attacks, but it is not the only factor that affects them. As for treatment, it is usually controlled in about a month, and stabilization in 2-3 months is considered a good response. Patient question: Hello, Dr. Shengli. The patient had a relapse three years after her first panic disorder was cured, can you tell me about how long she had to take medication for this relapse? The key is what are the similarities and differences between this relapse and the last one, based on the current psychological life and response to treatment, and the experience of the last one. Patient Question: Hello, Dr. Shengli, it is said on the internet that you have to take medication for 1-2 years for the first episode of panic disorder, 3-5 years for the second episode, and for three or more episodes, you have to take medication for life. BJU psychiatry’s reply: This is an application that is not based on research and is based on the pattern of recurrent depression. Patient question: Hi Dr. Shengli, the patient was cured after taking medication for 8-9 months for the first time, and is now taking paroxetine 20mg twice a day, tandospirone citrate 5mg once in the morning and once in the evening, and clonazepam 0.25mg in the afternoon and 0.5mg in the evening. Since this is my first relapse, I would like to ask you about how long I have to take the medication this time. BJU psychiatry reply: After the symptoms are controlled, the focus is on psychological recovery; that is, summarizing the lessons learned from falling into the disease state and changing the parts of it that can be changed. If you want to live a more fulfilling and solid life, you can stay away from anxiety and not fluctuate even if you gradually reduce your medication and stop taking it. Now that you are stable, you can see your doctor and start adjusting your medication by reducing clonazepam, while discussing psychological recovery. Patient question: Dr. Victory, I would like to know how long do I have to take medication for a panic disorder relapse, usually? Thank you. BJU psychiatry reply: The deciding factor is how quickly you progress on the road to recovery, and this varies greatly from person to person, so it’s hard to have a certain rule. Some people don’t “progress” for years, while others learn their lessons in time and change their attitude and response to life. But even in the latter case, habits don’t get established overnight, and it takes about six months for good habits to take hold. Patient question: Dr. Shengli, I’ve looked up a lot of information on the internet and it says that even if the symptoms of panic disorder are gone, you still have to take medication for more than a year to consolidate it, is that right? BJU psychiatry reply: It depends on the factors that trigger the panic disorder and the state of life. I’d like to know if my father has panic disorder and if his children will inherit it. BJU psychiatry’s reply: It is not a direct inheritance, but the likelihood of having anxiety problems is higher than the average person. Of course, it also depends on the genetic quality of the mother. Patient question: Hello, Dr. Shengli, I have a question that I didn’t have time to ask on the phone: After the acute symptoms of panic disorder are gone, there is a maintenance period. How long does it take to stop the medication? Can you tell me an approximate time? Thank you. BJU Psychiatry Reply: The goal of the consolidation period is achieved when you maintain your medication for a few months to six months and experience some normal ups and downs in your life (not malignant stimuli) and are able to stabilize. However, this is not the same as necessarily reducing the medication, because whether or not you can remove the crutch of medication, the effort is in the psychological recovery. Patient question: Hello Dr. Shengli, what is the best way to prevent relapse in patients with panic disorder? Thank you. BJU psychiatry reply: The triggers are relatively clear, such as alcohol consumption, but it may not be good to change. The first thing you need to do is to take a look at the actual website. In fact, this is already involved in the cause of the vegetation, or a spiritual life can and extremely smooth problem. Patient question: Hello, Dr. Shengli. Can you tell me what is the cause of panic disorder? What is wrong with the body? Thank you! BJU psychiatric department reply: Panic disorder is an acute anxiety attack, physically, the origin is the disorder of brain function, below the brain, is the disorder of the plant nervous system that governs the internal organs follow. The disorder in the brain, in addition to the trigger (alcohol use subsides), is more importantly a problem in the mental life (i.e., the interaction between the brain and the external environment). Patient question: Hello, Dr. Victory. Is it possible to cure the disorder of panic disorder? Thank you! BJU Psychiatry’s reply: It can be controlled, but it’s not a “cure”. Patient Question: Hello, Dr. Shengli. Does that mean that panic disorder is mainly a psychological problem? The treatment also relies mainly on psychological treatment? Is that right? Thank you for your reply. BJU psychiatry’s reply: The diagnosis of panic disorder is not only due to the presence of panic attacks, but also the related attitude and practice of dealing with the attacks, and the psychological background of life behind them. Only if the panic attack, the person can continue to devote himself to the revolution, like Jiao Yulu, and not surround himself with attacks, does not constitute panic disorder. Therefore, psychological rehabilitation is an inescapable theme. The stage of prominent and intense symptoms is very effectively treated with medication, which is the foundation for the later recovery.