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Hi Dr. I'm really worried. I recently saw a local psychiatrist for recurrent panic attacks & was prescribed Clonazepam 0.25 mg SOS. Today @ clg I had one of the worst panic attacks I've had, even though there was no obvious trigger. I took 1 tab exactly as advised, but it didn't seem to help. The attack lasted around 20–30 mins.
I've been getting these attacks even w/o stress. I've already had cardio tests (ECG/Echo, etc.), and they were normal. I'm not sure what to do now. Should I continue with the same psychiatrist or consult you? I can visit offline in Hyderabad if needed. Pls advise.
Answers (7)
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I'm sorry you had such a distressing experience. Panic attacks can sometimes occur without an obvious trigger, and clonazepam taken as needed may not always stop an attack once it has started. Since you're having recurrent attacks despite a normal cardiac evaluation, it's important to have a comprehensive psychiatric review to confirm the diagnosis and discuss long-term treatment options rather than relying only on SOS medication. Psychotherapy, especially Cognitive Behavioural Therapy (CBT), is highly effective for panic disorder and is often recommended alongside medication. You may continue with your current psychiatrist or seek a second opinion. If the attacks become more frequent, severe, or you have thoughts of self-harm, seek urgent medical care promptly.
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I'm sorry you're going through this. Panic attacks can feel frightening, but the fact that your ECG, Echo, and other cardiac evaluations are normal is reassuring.
Since this was one of your worst panic attacks and the clonazepam 0.25 mg taken as prescribed did not provide adequate relief, I would recommend that you follow up with the psychiatrist who evaluated you, rather than changing doctors immediately.
Sometimes the dose, timing, or overall treatment plan needs to be adjusted after reviewing your symptoms. Clonazepam is generally used for short-term or as-needed relief .One episode not responding doesn't necessarily mean the treatment isn't appropriate.
Next Steps
If you are in Hyderabad and would like a second opinion, an in-person psychiatric consultation is certainly reasonable, especially if the attacks are becoming more frequent or are affecting your daily life.
However, I would first encourage you to review your response to treatment with your current psychiatrist, as continuity of care is often beneficial
Health Tips
If you develop chest pain that is different from your usual panic symptoms, fainting, persistent difficulty breathing, or thoughts of harming yourself, or any new other concerning symptoms seek emergency medical care immediately.
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"Hi there, I understand that seeking help can feel overwhelming, but you’ve already taken the first brave step. I can guide you with a clear treatment plan tailored just for you, so you can feel better and regain control over your life. You can reach me directly on WhatsApp for quick support on seven zero eight two zero two two zero six two."
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Hi, how are you? Thanks for reaching out.
I’m sorry you’re going through this. Since your ECG and other cardiac tests are normal, these episodes are more likely to be panic attacks than a heart problem. Clonazepam may not stop every attack immediately, and if you’re having recurrent panic attacks even without obvious triggers, it’s important to follow up with your psychiatrist rather than changing the medication on your own.
Along with medication, CBT is one of the most effective treatments for panic attacks because it helps reduce both the frequency of attacks and the fear of future attacks. If your symptoms continue despite treatment, getting a second opinion from a psychologist or psychiatrist is also reasonable.
Take therapy. You can connect with me on nine two six six seven two six zero six five.
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Hi. Will need further history regarding the same to advise appropriately. Panic attacks can be due to multiple reasons. Medicines and therapy can help. Consult online for treatment
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Dr. Indraja Sharma
Neuropsychiatrist
7 yrs exp
Kota
You can continue with your current psychiatrist, but since you’re having recurrent panic attacks despite SOS clonazepam, it’s important to schedule a follow-up soon. Panic disorder often requires regular treatment (such as an SSRI) along with CBT, rather than relying only on SOS medication. If symptoms worsen, become very frequent, or you develop new concerning symptoms, seek urgent medical attention. A second opinion is reasonable if you’re not improving.
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Dr. Bharti Kaundal
Psychiatrist
3 yrs exp
Nanded
Hi. I’m sorry you had to go through that. Panic attacks can feel extremely frightening, especially when they seem to come out of nowhere, but it’s reassuring that your cardiac evaluation has been normal.
Regarding the clonazepam, a dose of 0.25 mg may not always stop an ongoing panic attack immediately, and it can take some time to start working. One episode not responding doesn’t necessarily mean the treatment isn’t appropriate.
Next Steps
Since you are continuing to have recurrent panic attacks, including without any obvious trigger, I would recommend a follow-up with your treating psychiatrist rather than making changes to your medication on your own.
If you would like a second opinion, I would be happy to evaluate you in detail. During a consultation, we can go through your symptoms, medical history, previous investigations, and discuss the most appropriate treatment options for you.
Take care, and feel free to message me if you have any questions or if you’d like to schedule a consultation.
Health Tips
In the meantime, if you experience chest pain unlike your usual panic attacks, fainting, severe breathlessness, or any new concerning symptoms, please seek emergency medical care immediately.
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