Consultant: I went to the psychiatry/psychology/psychosomatic medicine department of XXX Hospital today, the physician diagnosed anxiety disorder, the physician gave me paroxetine, I used to be allergic to penicillin, I don’t know if I will be allergic to this drug ah, what kind of drug will not be allergic to it? Answer: The issue of drug safety is a great concern to everyone, next, I and you systematically say the relevant knowledge: anxiety disorders were once known as cardiac neurosis, provoked heart, neurocirculatory weakness, vasomotor neurosis, autonomic dysfunction and other various names. I. Etiology and its pathogenesis 1, genetic factors 2, biochemical factors Panic disorder is one of the few mental disorders that can be induced experimentally. 3. Psychological factors Anxiety is a conditioned reflex formed by fear of certain environmental stimuli. Anxiety attacks are conditioned reflexes to frightening situations acquired through learning. (b) Clinical manifestations There are two main forms of anxiety disorders: (i) Generalized anxiety disorder Mental anxiety 1. Frequent worry about some dangerous or unfortunate event that may occur in the future and is difficult to predict. 2, can not clearly realize the content or object of the worry, just a kind of fearful, trance-like strong inner experience. Often have a premonition of panic, all day upset, worried, restless, as if there is a feeling of impending disaster. Physical anxiety 1, movement restlessness rubbing hands and feet, can not sit quietly, keep walking back and forth, increase in purposeless small movements, tongue, lips, finger muscle tremor or limb tremor. 2. Physical symptoms Sensation of compression behind the sternum, often accompanied by shortness of breath. 3. Muscle tension Tension headache, uncomfortable tension in the muscles, and severe muscle aches and pains. 4.Autonomic dysfunction Tachycardia, flushed or pale skin, dry mouth, constipation or diarrhea, sweating, frequent urination, premature ejaculation, impotence, menstrual disorders. Increased alertness Sensitivity to external stimuli; difficulty in concentrating; difficulty in falling asleep, awakening from sleep; agitation; hypersensitive to sensations, feeling one’s own muscles beating, blood vessels pulsating, gastrointestinal tract peristalsis. Other symptoms often combined with fatigue, depression, obsessive-compulsive, fear, panic attacks and other symptoms, however, these symptoms are not the main clinical phase of the disease. (ii) Panic disorder: A sudden and unexpected experience of panic, accompanied by a sense of near death or loss of control and severe autonomic dysfunction, often in the absence of a specific fearful situation. It seems like death or disaster, or running, screaming, whistling for help, accompanied by autonomic symptoms such as chest tightness, tachycardia, irregular heartbeat, difficulty in breathing or hyperventilation, headache, dizziness, vertigo, numbness of the limbs and sensory abnormality, sweating, throbbing, shivering or general weakness, etc. The attack is unpredictable and unpredictable. Seizures are unpredictable and sudden, usually lasting 5 to 20 minutes and rarely more than 1 hour. During the seizure, the patient is conscious and highly alert. After the seizure, the patient has palpitations, fear of recurrence, and weakness, and can only recover in a few hours to days. 60% of the patients do not dare to go out alone or go to crowded and busy places. The above are only common clinical manifestations of the disease, whether it is the disease, but also need to be analyzed by a specialist physician according to the specific circumstances of each patient. Allergic reaction refers to the tissue damage or dysfunction that occurs when an immunized organism receives the same antigenic stimulus again. The characteristics of the reaction are rapid onset, strong reaction, and quick receding; generally will not destroy tissue cells, and will not cause tissue damage, there is a clear genetic predisposition and individual differences. Characteristics of allergic reaction: 1, generally do not occur in the first use of drugs. 2, the body is in a sensitive state. 2, the body is in a sensitive state, re-exposure to allergens can be minutes to 24 hours after the onset of individual cases can be delayed to a few days after the occurrence. 3.After the allergic reaction occurs, stop using the drug, the mild one can subside more quickly, and the prognosis is good. 4, has been sensitized patients for the drug’s pathogenicity can last a long time, or even lifelong, and again with the drug can reproduce the original symptoms or more serious, the more often the number of exposure to the drug, the more serious the reaction tends to be. 5, with a similar structure of the drug often occurs cross or completely cross allergic reactions. 6, certain diseases can make the drug sensitization of the body increased, but when serious illness, trauma or major surgery, some of the original drug allergic reaction will also reduce or disappear. Personal opinion: drug allergic reaction has obvious genetic predisposition and individual differences. Any kind of drug exists in the allergic population, for a particular patient we can not predict whether he is allergic to a particular drug, however, psychiatric drug allergic reaction is still rare and mild, therefore, we do not have to worry too much, feel free to use it!