Inderal for Panic Disorder

Hi cyp

Welcome to the forum!

Have you looked at the Panic Attacks programme? Lots of helpful stuff there!

I'm London based - you can visit my website from the link below, and are welcome to get in touch if you would like more help.

Kathleen

Hi cyp!

I am 16 now, and have been suffering from GAD and panic attacks from when I was around 9 or 10 and went into therapy only seven months ago. I also have experienced a similar pattern to my panic attacks at night time, I feel more aware of my symptoms as I lie down and the worry keeps me awake. Sometimes, this awareness launches me into a panic attack, other times not, but if it does, I can be up till all hours, usually 3am or something, just terrified to lie down again. I have the added stress of being in school on time though, as I need to get up at 6:45 to catch two trains to get there, so often as I don't sleep well in the first place, I am severely deprived of sleep in school, which my teachers love!

Recently I have been put on the tricyclic antidepressant Amitriptyline (at 20mg now), sometimes called Elavil, (mainly for pain relief from GAD's awful digestive symptoms, but it can also curb panic, though it has not been effective for me in this way). I am assuming from my knowledge of anti-anxiety drugs that Inderal is the brand name for the beta-blocker propranolol? I have received this drug a week ago from my GP and have yet to take it, so I'm particularly interested in seeing others responses. I am on 10mg as required up to 3 times a day, but I am a bit of a medicine phobic, so I am waiting for just the right time to start it, as it is a drowsy medication though at such a low dosage I should be fine. The main side effects associated with this drug are light-headedness, low blood pressure etc, and I have generally heard nothing but good reports about this drug. My mother is also on the drug and she has nothing but praise for it. It's FDA approved for treatment of heart attack patients and palpitations etc, but it is well known that this drug is very effective in the reduction of anxiety and panic.

Inderal is used for "stage-fright" anxiety, and is normally taken before public speaking or stage performances, like a concert performance or the likes. It is usually taken about 40 minutes or an hour before this performance. The drug itself blocks the effect of adrenaline in your body and so dramatically reduces the heart palps, the sweaty hands and body, the shaking etc, and the panic symptoms you identify with. BUT it should be noted that propranolol CANNOT stop the mental symptoms of panic disorder, and you should seek out some therapy to help you deal with this side. Medications should only be considered a short-term option to "break the cycle" so to speak as they are a prevention and not a cure. Ideally, you would want to never have to face the panic attacks again right? Popping pills when you feel panicky does not help you solve the problem, but in a way only delays it. The dysfunctional thoughts you are having that are causing panic are still there (for example I'd imagine you get anxious about going to sleep now in case you have an attack? I am like this) and it is those thought you want to work on to help you get back on your feet and lead a normal life. If desired, you can live on medication (which, like you, I disapprove of as I don't see it as a cure), you can fix your thoughts by therapy, or a combined approach of medication and therapy (which I am currently trying) The main medications open to you are anti-depressants (though not used for treating depression, but these can be highly effective if you suffer from both) in the tricyclic or SSRI form. SSRI's are the newer range which include zoloft, paxil etc. Buspar is a standalone drug and is relatively ineffective in treating panic disorder but can be used in conjunction with others to treat it effectively. also there are the beta blockers which are highly effective for panic attacks. Lastly there are the benzodiazepines which I think would be effective for you (though I'm not a doctor lol) because of their sedative effect they could help you to sleep better, and they work instantly whereas the other antidepressants etc generally take 4-6 weeks to kick in.

There are generally two types of therapy available for treatment of this disorder which are called Cognitive Behavioural Therapy (CBT) and psychotherapy. CBT is a highly structured program aimed at changing your thoughts and psychotherapy is designed to look into your past and make connections between the past and the present. Psychotherapy is quite invasive and many people liek this treatment as it gives them an opportunity to talk their story through start to finish and there is always new material to talk through everyday, so the therapy can go on for years. CBT requires much work and determination, and looks at replacing the irrational thoughts causing your panic/anxiety and changing them to rational one. Changing your automatic negative thoughts to positive ones. Both are options I urge you to consider - The more types of treatment you try, the better the results. Don't give in quickly, as all of these, medication or therapy, take a long time to start working, though it is well worth the wait.

It would also be useful to invest your time learning some breathing and relaxation techniques. I can run over some if you want to start you off. Yoga is a GREAT stress reliever if you can find a video, book or - even better - a class. Hypnosis is another option which you could try - I probably will be getting this treatment sometime soon, my GP is considering this.

Education about the disorder is essential in recovery. It is highly beneficial to research your condition and learn how it works. This is why therapy is a great option. This is how I know quite a lot about medications and such as I go to great lengths to find out more about the disorder and how it works in me. You could buy a few books. I've read three and 2 out of the 3 have been brilliant and very informative and helpful. I recommend The Anxiety Cure by Robert L Dupont, Elizabeth Dupont Spencer and Caroline M Dupont (I feel this book is good in that it teaches you about anxiety and then goes on to help you work through it) and Panic Attacks by Christine Ingham. Invest in a good book and it will be well worth your while.


I realise I went on a bit All the best!

Excellent post, junglemonkey!

That was an amazing post JungleMonkey. Thanks so much for all those great tips and for imparting your knowledge and experiences.

I recently purchased the Christine Ingham book and look forward to reading it. I have also subscribed to the email programme here and have already started to benefit from the 7/11 breathing technique.

Thanks again guys. This is a pretty cool place to hang out.

cyp wrote:I also would like to take up some form of cognitive therapy and wondered if anybody here knows of or can recommend a therapist in the London (England) area.

A word to the wise though: psychotherapy is a largely unregulated industry - there are a range of people with varying abilities. There are some who are very capable and some who are downright dangerous. You're probably going to have to make up your own mind when the meet the person. If the person doesn't feel right to you, walk away. Try the British Association for Behavioural and Cognitive Psychotherapies http://www.babcp.org.uk/ If you're using the BABCP site, you may want to look for someone with an NHS mental health unit practice in addition to their private practice, simply because there are slightly greater supervisory requirements for undertaking NHS work.

Hi cyp
I do not have medical knowledge, but I took beta blockers for panic disorder, and my experience was a good one.
The main effect is to slow down the heartrate so that one feels calm, and this gave me much-needed relief so that I was able to think clearly. I know this drug is used by some performers ( be it concert violinists or snooker players) because it enables them to perform to their maximum potential, without being paralysed by nerves. Intellectual capacity is not affected in any way, which is why beta blockers are preferable to tranquillisers (although I took those too!). I also saw the effect in my father, who was given them for high blood pressure, but the effect on his nerves was very noticeable - without them he was very highly strung, but when he took beta blocking drugs he became very much calmer.
One word of warning, though. You need to take these under medical supervision. It is particularly important not to stop taking them suddenly, as there can be a kind of rebound reaction - they need to be gradually reduced when they are no longer required.
I hope my personal experience is helpful to you. I should just add that I too do not like taking medication, but as a short-term measure to relieve the extreme discomfort I was feeling, I found they brought much-needed relief.

Hi cyp
It's me again - I just read you have the Christine Ingham book. I thought it was excellent, so get reading!

Hi again cyp Thanks for all the nice comments lol!

I have started taking Inderal now as I wean off my antidepressants and I have nothing but praise!! I was having panic attacks every day after lunch in school and it was causing me much embarassment and pain etc, and I have begun to take one 10mg at breaktime ( tiny dosage! ) and it has almost completely curbed the panic after lunch! I am so ecstatic! I recommend you give it a go! I noticed absolutely no side effects (I became very hyperactive a couple of hours after taking it, but I just wonder if this was a result of being panic-free for a day!) I am so glad I started taking these beta-blockers

However, I must note that I am still getting the persistant GAD-related thoughts that really irritate me (for example last night my dad put 3 painting up above my bed, and I was convinced they would fall down and either injure or kill me, and whats funny is I was more worried about them sending me into a panic attack then being afraid to sleep from then on! Strange eh?) so it is still very worthwhile getting some sort of therapy as medication should only be considered a last resort and a temporary measure.

Nona - That book was fantastic in my opinion. It's well worth a read to anyone dealing with panic attacks

hi i'm liam and i'm new here as well
ive taken paoxatine seroxat and now i'm on half indral.

i've taken these tablets for 18 months now and the only side effect i've had is a dry mouth. i've had panic attacks since 1997.
i've been told panic attacks are partly due to lack of happiness in your life and a lack of the natural chemical called seritonin produced in the brain,
which is the chemical that makes us happy also there is suposed to be plenty of seritonin in brazil nuts. i really feel for you because i know it can be a living nightmare take care and hope all is well soon for you.
liam

Excellent post, Junglemonkey! Just a couple of thoughts to add here ....

I took Inderal/propranalol for several years because I was afraid of "harder" medications. My experience was that it did help curb the palpitations, etc, but did not help thoughts. I finally "graduated" to Xanax and I have found it much more useful. With a combination of meditation, progressive exposure, and the judicious use of Xanax, I have gotten much better (though still not well, which is why I am here at this forum! LOL!).

A word about the cognitive method: I saw several different therapists who all SAID they used the cognitive method, but as soon as they got me into their clutches they all wanted to turn into Freud ... "So, tell me about your mother again?" Also, beware of therapists who tell you, "You have to get worse before you get better!" Grrrr .... My first therapist told me that and had me believing her. I went from slight depression and occasional panic attacks to being ready to be hospitalized! Take charge of your therapy. If it isn't working for you, don't accept excuses! Tell your therapist that you either expect them to help you feel somewhat better by a certain deadline (say, one or two months -- something reasonable), or you'll be finding a different therapist. Be proactive and protect yourself. I know that is hard when you feel wretched, but think of your therapist as a contractor, like someone who is remodelling your house. Would you accept excuses forever from someone who is supposed to be installing a new kitchen counter for you? Of course not. Expect results with your therapist too, or get a different one.

Just my .02, of course! YMMV.

I found the inderal/propanolol very good for performance anxiety (public speaking, etc) but only for calming down palpitations, light headedness and other physical symtoms. It does't get rid of the fear and so you still show anxiety on your face/posture. You have to hunt around at psychological approaches as mentioned in all these other great replies to get rid of the fear response.