Posted by Scott L. Schofield on March 3, 2000, at 16:09:06
In reply to Panic Disorder and Anxiety, posted by Nan on March 2, 2000, at 7:55:31
> I have a question. Has there been any documented research regarding panic disorder and anxiety and their etiology? Is general anxiety and panic disorder a biochemical or physiological phenomenon? Do certain foods, other than caffeine(a trigger for me) , trigger something in the digestive tract that may trigger an attack? Anxiety and panic disorder is so complicated with so many outside influences, but how come some of us handle situations OK and some not? Is it biochemically based? I am new to this board and it is incredibly helpful. I have lived with some form of anxiety for most of my life and now it is complicated with fibromyalgia. Would appreciate any input.
As an answer to your first question, yes. However, the studies conducted addressing the cause(s) of anxiety disorders are far from producing an understanding of exactly what mechanisms are involved. These investigations study the relative contributions of psychological , biological, and genetic factors. Until these disorders are sufficiently understood, the most productive focus for the clinician is to discover what works (and what doesn't).
I found a good abstract to give you some idea as to what's happening in the field. I have included it below.
What I find striking about your condition is that you also suffer from both an anxiety disorder and fibromyalgia. You may be able to successfully treat both conditions with one drug. Many investigators believe that there are biological factors common to both depression and chronic pain disorders. Several tricyclic antidepressants are commonly used to treat chronic pain disorders, including fibromyalgia and neuralgia. Among these, amitriptyline has been the drug most studied and favored by clinicians. However, other tricyclics have been shown to be effective as well. On the other hand, SSRIs don't seem to show a similar rate of success.
A good strategy might be to combine a tricyclic with a SSRI.
It might be a good idea to find a book that includes a section devoted to anxiety disorders.
- Scott
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J Clin Psychiatry 1999;60 Suppl 22:18-22
Overview of antidepressants currently used to treat anxiety
disorders.Feighner JP
Feighner Research Institute, San Diego, Calif 92121, USA.
The syndromes of anxiety and depression may reflect separate
disorders with overlapping symptoms. They also may be comorbid or
reflect illnesses with similar underlying pathophysiology based
upon a spectrum of central nervous system dysfunction.
Antidepressants effectively treat both anxiety and comorbid
anxiety-depression. Tertiary tricyclic antidepressant agents
(TCAs) with dual serotonergic-noradrenergic effects, such as
imipramine and amitriptyline, appear consistently effective across
the anxiety disorders. Selective serotonin reuptake inhibitors
(SSRIs) are particularly effective in panic disorder and
obsessive-compulsive disorder. SSRIs are similar in efficacy to
TCAs but are more tolerable and cause fewer serious adverse
events. However, they are relatively slow to act, and efficacy
data are limited in states such as generalized anxiety disorder.
Newer antidepressants, such as mirtazapine, nefazodone, and
venlafaxine XR, may provide some benefits across the broad
spectrum of anxiety disorders with the safety and tolerability
that are the hallmarks of third generation antidepressants.
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poster:Scott L. Schofield
thread:25424
URL: http://www.dr-bob.org/babble/20000302/msgs/25835.html