Does Fluoxetine help with panic attacks? (3 solutions)
By
Ivan Kahwa
Author bio
Mr Ivan Kahwa is a chemist and phytopharmaceutical scientist with expertise in chemistry, pharmacology, phytochemistry, and Nanobiotechnology. He writes and reviews content on these topics.
Mr Ivan Kahwa’s Highlights:
Guest Researcher at the University of Leipzig, Senior Research Fellow/Scientist, and Lecturer at the Department of Pharmacy, Faculty of Medicine, Mbarara University of Science and Technology.
Professional Experience:
Mr Ivan joined PHARMBIOTRAC as a research fellow/scientist during his master of science tenure. He contributed to the development of most of the phytopharmaceutical products in the project. Furthermore, he participated in carrying out the pharmacological activities of the developed products in laboratory animals such as mice and rats in order to develop proper doses hence leading to pre-clinical studies.
With the above relevant research experience, Ivan started to work with the University of Leipzig on collaborative projects with Mbarara University to develop the chemistry of Ugandan Medicinal plants and their pharmacological activities. This was coupled with several consultative positions by different German NGOs. Mr. Kahwa is also a supporting in the teaching and learning at the Departments of Pharmacy and Pharmaceutical Sciences, Faculty of Medicine, Mbarara University of Science and Technology.
With the increase in antimicrobial resistance globally, Ivan retooled his thinking towards developing new naturally derived antibiotic regimens from Ugandan propolis with the assistance of nanotechnology to improve their delivery to microbial cells. Kahwa has also published over 28 articles in peer-reviewed journals and he is currently reviewing for many journals.
Education:
2023-2027: PhD in Pharmaceutical Sciences (ongoing) with a focus on Pharmaceutical Microbiology and Nanobiology at Mbarara University of Science and Technology.
2022: 2Msc. in Pharmacognosy and Natural Medicine Science at Mbarara University of Science and Technology.
2018: Bachelor of Science (Chemistry) at Mbarara University of Science and Technology.
Publications:
▪ Iqbal, S., Jabeen, F., Kahwa, I., & Omara, T. 2023. Suberosin Alleviates Thiazolidinedione-Induced Cardiomyopathy in Diabetic Rats by Inhibiting Ferroptosis via Modulation of ACSL4-LPCAT3 and PI3K-AKT Signaling Pathways. Cardiovascular Toxicology. https://doi.org/10.1007/s12012-023-09804-7
▪ Gupta, A. K., Yadav, R., Sharma, S., Sawale, J., & Kahwa, I. 2023. Anti-ageing Activity and Antioxidant Activity of Methanol Extracts of Leaves and Flowers of Salvia officinalis and Rosmarinus officinalis. Journal of Young Pharmacists, 15(3), 448–455. https://doi.org/10.5530/jyp.2023.15.60
▪ Tolo, C.U., Kahwa, I., Nuwagira, U., Weisheit, A. and Ikiriza, H., 2023. Medicinal plants used in treatment of various diseases in the Rwenzori Region, Western Uganda. Ethnobotany Research and Applications, 25, pp.1-16.
https://ethnobotanyjournal.org/index.php/era/article/view/4683
▪ Kahwa, I., Ajayi, C.O., Yadav, R., Chauhan, N.S., Shah, K., Abdelgadir, A.A., Shegena, E.A., Daniel, S., Omara, T., Asiimwe, J.B. and Ikiriza, H., 2023. Pharmacognostic and phytochemical studies as an invaluable approach for correct identification of medicinal plants: The case of Artemisia vulgaris L. substituted for Artemisia annua L. in Western Uganda. TMR Integr Med, 7, p.e23004.
https://doi.org/10.53388/TMRIM202307004
▪ Nalimu, F., Oloro, J., Kahwa, I. and Ogwang, P.E., 2021. Review on the phytochemistry and toxicological profiles of Aloe vera and Aloe ferox. Future Journal of Pharmaceutical Sciences, 7, pp.1-21.
https://doi.org/10.1186/s43094-021-00296-2
▪ Elamin, O.H.S., Ali, M.A., Elgezuli, I.A.A., Bashir, M.A. and Kahwa, I., 2021. Diagnosis of pre-and post-treatment of echinococcus granulosus with counter current immune electrophoresis and bacterial co-agglutination. Journal of Microbiology and Infectious Diseases, 11(02), pp.88-94.
https://doi.org/10.5799/jmid.951600
Published book Chapter
▪ Kahwa, I., Ayesiga, I., Nakalema, S., Alinaiswe, R., Mbabazi, R. and Iqbal, S., 2023. Natural products in the management of onchocerciasis. In Natural Products in Vector-Borne Disease Management (pp. 63-80). Academic Press. Book Chapter.
https://doi.org/10.1016/B978-0-323-91942-5.00012-4
Submitted manuscripts Under Review:
▪ Comparison of the Wound Healing Activity of the Leaf and Leaf Ash Extracts of Vernonia amygdalina in Rats. Journal name: Clinical Phytoscience
▪ Ethnobotanical Survey of Medicinal plants used in the management of cancer in Uganda. Journal name: Journal of Herbal Medicine
▪ Ethnobotanical survey and phytochemical screening of medicinal plants used in treatment of epilepsy by PROMETRA-Uganda Traditional Health Practitioners in Mpigi District, Uganda. Journal name: Journal of Ethnopharmacology
Submitted book chapters under review
1.Book title: Algae as a Natural Solution for Water-Food-Energy Nexus, Section 4: Microalgae and cyanobacteria for food applications, Chapter 4.6: Safety, toxicological and allergenic aspects of using algae for food. Authors: Christine Kyarimpa, Tom Omute, Caroline K. Nakiguli, Alice V. Khanakwa4, Christopher Angiro, Ivan Kahwa, Fortunate Ahumuza, Timothy Omara*. Publisher: Springer Nature Singapore Pte Ltd. 152 Beach Road, #21-01/04 Gateway East, Singapore 189721, Singapore.
2.Book title: Nutraceuticals Inspiring the Contemporary Therapy for Lifestyle Diseases. Chapter: Nutraceutical applications of Seaweeds and their Phytocompounds in Nutrition and Treatment of Diseases. Authors: Ivan Kahwa, Timothy Omara , Innocent Ayesiga , Gael Noel Neh Neba Ambe , Zehbanaz Javidbhai Panwala , Rachel Mbabazi , Shabnoor Iqbal , Christine Kyarimpa , Christine Betty Nagawa , Kamal Shah ,Nagendra Singh Chauhan* Publisher: CRC Press
You can view my works on the following professional sites:
Research Gate: https://www.researchgate.net/profile/Ivan-Kahwa
Google Scholar: https://scholar.google.com/citations?user=tOwrvqoAAAAJ&hl=en
ORCID: https://orcid.org/0000-0002-6440-3437
Linkedin: https://de.linkedin.com/in/ivan-kahwa-865450159
In this article, we will explore whether Fluoxetine helps with panic attacks. Furthermore, we will discuss the mechanism through which Fluoxetine helps with panic attacks, the research findings, the time taken by Fluoxetine, what to do if it does not help panic attacks, and alternatives to Fluoxetine.
Does Fluoxetine help with panic attacks?
Yes, Fluoxetine helps with panic attacks. Fluoxetine, also known as Prozac, is FDA-approved to treat panic disorder. Fluoxetine should be started at low doses to increase its adaptability in the patients, as higher doses may pose an increased risk of side effects.
Fluoxetine is a selective serotonin reuptake inhibitor (SSRI) antidepressant, used to treat depression (children of 8 years and above), eating disorders, premenstrual dysphoric disorder, panic disorder, and other related conditions (1).
Panic disorder is a psychological condition characterized by episodes of intense fear and anxiety, which are termed “panic attacks”. Patients with panic attacks may experience fast heart rate and breathing difficulties (2).
How does Fluoxetine help with panic attacks?
Fluoxetine helps with panic attacks through its mechanism of inhibiting the reuptake of serotonin in the synaptic regions of the brain. Serotonin, a neurotransmitter, regulates mood, sleep, appetite, emotions, and the body’s stress response.
By blocking the reuptake of serotonin, Fluoxetine increases the serotonin levels in the brain cells. Serotonin remains in the synaptic region for a longer period, and due to this prolonged persistence, serotonin controls the symptoms of panic attacks (1).
What does research suggest about Fluoxetine’s effectiveness for panic attacks?
According to a research study, participants were given Fluoxetine for about 12 months to monitor their response towards the treatment. Patients with panic disorder were administered Fluoxetine in low doses of 5mg per day to reduce the incidence of side effects that were previously observed with higher doses.
The study suggested that approximately 76% of patients got better while using Fluoxetine for panic attacks; however, 16% of patients discontinued Fluoxetine due to side effects. Therefore, it is recommended to start Fluoxetine treatment at lower doses to prevent discontinuation due to the occurrence of side effects (3,4).
How long does Fluoxetine take to treat panic attacks?
Fluoxetine may take 6 to 8 weeks to treat panic attacks. A clinical trial was conducted on 30 participants with panic disorder while using Fluoxetine. A few patients experienced anxiety in the initial phase of Fluoxetine treatment. Most of the patients had a significant reduction in the frequency of panic attacks and reduced anxiety levels after 8 weeks of Fluoxetine treatment.
The majority of patients were panic-free at the end of 8 weeks of Fluoxetine treatment. However, some of the patients discontinued Fluoxetine as their anxiety levels increased, or it did not help with their panic attacks. Therefore, the time taken by Fluoxetine for panic attacks may vary from person to person (5).
What to do if Fluoxetine does not help your panic attacks?
If you suspect that Fluoxetine does not help your panic attacks, you should at least wait for 8 weeks before making any changes to your Fluoxetine treatment. Some patients may respond earlier or later, compared to others due to variations in pharmacological responses.
However, if panic attacks persist even after 8 weeks, you should consult your healthcare provider. They may examine you for your current condition, your family history, and any other underlying health condition.
Your doctor may try to adjust the dose of Fluoxetine and suggest some management therapies such as cognitive behavioural therapy (CBT) along with antidepressant treatment. These adjustments in the dose of Fluoxetine along with therapy, may help to control your panic attacks (6).
What are the alternatives to Fluoxetine for panic attack treatment?
The alternatives to Fluoxetine for panic disorders may be considered if you do not notice any improvements in your panic attacks after dose adjustment along with behavioural therapy. Your doctor may gradually discontinue Fluoxetine as sudden discontinuation may lead to withdrawal symptoms.
However, withdrawal effects of Fluoxetine are rare and mild due to the prolonged half-life of the medication (7). After successful discontinuation of Fluoxetine, your doctor may switch you to an alternative antidepressant that might suit you better, such as tricyclic antidepressants (TCAs).
TCAs have similar efficacy as Fluoxetine and may help to control panic attacks in non-responder patients to Fluoxetine. Other medications can also be used to treat panic attacks, such as Benzodiazepines (Alprazolam and Clonazepam) (6,8).
In my opinion, Fluoxetine helps with panic attacks by reducing the frequency of attacks and even making patients panic-free. Fluoxetine may take about 8 weeks to treat panic disorder, however, this timeline may vary among individuals.
Fluoxetine success rates are higher for panic disorder, but if it does not help you, please consult your healthcare provider. They will examine all the aspects of your condition, and take necessary actions according to your specific needs.
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References
1.-
Sohel AJ, Shutter MC, Molla M. Fluoxetine. 2022 Jul 4. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan–. PMID: 29083803. Available from: https://pubmed.ncbi.nlm.nih.gov/29083803/
2.-
Abbar M. Trouble panique et attaque de panique [Panic disorder and panic attack]. Encephale. 1996 Dec;22 Spec No 5:13-8. French. PMID: 9138941. Available from: https://pubmed.ncbi.nlm.nih.gov/9138941/
3.-
Schneier FR, Liebowitz MR, Davies SO, Fairbanks J, Hollander E, Campeas R, Klein DF. Fluoxetine in panic disorder. J Clin Psychopharmacol. 1990 Apr;10(2):119-21. doi: 10.1097/00004714-199004000-00007. PMID: 2341585. Available from: https://pubmed.ncbi.nlm.nih.gov/2341585/
4.-
Gorman JM, Liebowitz MR, Fyer AJ, Goetz D, Campeas RB, Fyer MR, Davies SO, Klein DF. An open trial of fluoxetine in the treatment of panic attacks. J Clin Psychopharmacol. 1987 Oct;7(5):329-32. Erratum in: J Clin Psychopharmacol 1988 Feb;8(1):13. PMID: 3500189. Available from: https://pubmed.ncbi.nlm.nih.gov/3500189/
5.-
Pecknold JC, Luthe L, Iny L, Ramdoyal D. Fluoxetine in panic disorder: pharmacologic and tritiated platelet imipramine and paroxetine binding study. J Psychiatry Neurosci. 1995 May;20(3):193-8. PMID: 7786880; PMCID: PMC1188684. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1188684/
6.-
Ham P, Waters DB, Oliver MN. Treatment of panic disorder. Am Fam Physician. 2005 Feb 15;71(4):733-9. PMID: 15742911. Available from: https://pubmed.ncbi.nlm.nih.gov/15742911/
7.-
Blum D, Maldonado J, Meyer E, Lansberg M. Delirium following abrupt discontinuation of fluoxetine. Clin Neurol Neurosurg. 2008 Jan;110(1):69-70. doi: 10.1016/j.clineuro.2007.08.016. Epub 2007 Oct 29. PMID: 17913343. Available from: https://pubmed.ncbi.nlm.nih.gov/17913343/
8.-
Wood WG. The diagnosis and management of panic disorder. Psychiatr Med. 1990;8(3):197-209. PMID: 2202023. Available from: https://pubmed.ncbi.nlm.nih.gov/2202023/
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