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Help needed, Panic attacks.


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Hi to all CH friends!

It has been a long since i posted here.

As you may know i am an Episodic, my last attack ended in mid-April 2019.

This time CH attacks started on 28 September 2020. But this time i had prepared myself before attacks as i smoke Cannabis. I smoked well before attacks in summer but attacks came, even I ate Cannabis one time during start of a CH attack. This time CH prolonged to 1 month and 15 days (more or less), usually it takes 1 month (more or less). I suspect Cannabis for prolonged CH, as it causes dilation of blood vessels (i have heard), and dilated vessels are not good for CH.

I tried Cannabis because i couldn’t find MMs.

Now i am pain free, but something strange happened to me. During last days of my CH period i stared Verapamil (40 mg day/40 mg night) for prophylactic, and Zolmitriptan and Diclofenac Sodium for cute treatment. This time i tried oxygen but it not worked for me.

The main thing: I smoked a few times (eaten once) during CH period, and when my attacks were vanishing and it had been 15 days that i haven’t touched Cannabis, all of  sudden i got a panic attack, i told my physician about it he told me to take Alprazolam 0.5 mg (a benzo tab) and Paroxetine CR 12.5 mg. When i started tapering  on Alp life become a hell. Eventually i did, now taking Paroxetine CR 12.5 mg once daily and  Quetiapine 25 mg before sleep, since past 15 days. Now life is good, not ideal. Going to taper in mid-February. These Panic Attacks are worse than CH, can you people believe it?? I prayed that let CH come but not Panic Attack!

I believe it was due to Cannabis, Panic Attacks came after taking Cannabis 15 days earlier, i think there was Cannabis in my body (its THC compound)  and Verapamil further complicated the situation as it also dilate the blood vessels (but Verapamil dilation is not bad for most CH patients).

Did this happened to you people?

Or someone can give me any advice?

Any guess?

I need your help!  

Remember i am not a Cannabis smoker.

 

 

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A-Z,

I've tried cannabis a few times.  Every time, I've had an almost panic reaction.  I think my body is wired differently than most other peoples.  It didn't make me feel good at all, just wayyyyy nervous and all I could think about was never doing it again. 

It seems odd that the feeling occurred after several weeks for you.  I'm no doctor, but to me it would seem like it's not related to the cannabis.  

Cheers,

J

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Thanks J for replying, well i am replying late as i saw no one was is interested in my post,,, so checked it late.

Yes! i too had the feeling of being nervous during and after smoking cannabis but after few hours later i am fine. However, this time i took a bit lot and i suspect only cannabis, a year go first time when i smoked a little panic attack came after a week but it was manageable and it went away after some medication. It seems my body takes cannabis differently than majority. My pothead friends say same as you said, they had anxiety and low/high mood but have no panic attacks. It is better for me never to touch it again, as i said earlier it is worst than CH. Now i am becoming normal again, i myself believe that i exaggerated by saying it is worst than CH but no i was right it is really bad than life-hating CH.

Regards!     

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A-Z,

Glad you're asking for help.  It can be challenging, I know.  I'd highly recommend seeing your doctor.  There are several antidepressants that even at low doses can really help your symptoms.  I took a generic version of zoloft for close to a year recently.  I had some situational challenges going on with a lawsuit against a contractor that had damaged my home.  I'm not familiar with most of the drugs listed in your first post.  I'd wonder if something you've taken recently, Zomig etc, might have created a serotonin imbalance?  Please, do go see your doctor.  (I'm in a bit of withdrawn place myself, so can relate).  I can vouch that the zoloft (I think 50mg a day), made a difference enough that I was able to function much better w/o distracting thoughts.

J

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I have only had a few panic attacks in my life and they ere not 'bad' ones. My daughter does suffer from them though and she won't touch pot. So, not sure that matters much, but it is the only connection I personally have to panic attacks.

I would definitely try to talk to the doctor about something for depression. It is debilitating at times!! I have taken Wellbutrin and done well with that one, but likely THMH has better advice on the Zoloft. 

Please, don't beat yourself up. Stuff happens and we do what we can figure out to do to get through it. I don't know of any benefit for CH from smoking or eating pot, but some do post hit to relax. 

Keep us posted on how it goes? 

ATB!

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Hi A-Z, I remember reading way back that benzo withdrawals can cause severe suicidal depression, not sure if the source was scientifically legit or what though. Plus it sounds like you're pretty much over the benzo withdrawal side effects by now. 

Modern day cannabis, bred to be super strong, gives me anxiety and some paranoia, so I don't imbibe. Not sure if it's just a change in my biochemistry or what, but the old, much milder, 70's style cheap "commercial" weed in California never triggered any of that for me. Quite the opposite, in fact, it was relaxing and mellowing.

The following are not suggestions so much as stuff I find interesting on the subjects in this thread:

  • Depression: I was going through a questioning existence phase there for a bit. Mighta just been mid-life crisis that was about to end anyway, but around that time I started (successfully) busting with vitamin M for CH, and it not only removed my CH related PTSD-like symptoms, but I also found myself in a better, non existential crisis sort of head space. Of course it's all over the news as of late about psilocybin treatment for depression, and for someone in Oregon, or who could go there, I find the whole thing about Oregon will become the first state to formally legalize the medical use of psilocybin to treat mental health conditions in licensed facilities using registered therapists  interesting and encouraging. I'm already thinking about trying to get a relative to head there for such treatment when available and possible. I would stop short of encouraging people to try to wing it with DIY psilocybin for depression therapy though.
  • Panic attacks: I have to wonder if the cannabis could really be a culprit 15 days after the fact? Meantime I found this bit about a new testosterone spray to kill panic attacks seriously intriguing. It sure sounds to me (someone who doesn't even resemble a doctor) like you've experienced some manner of lasting biochemical imbalance induced by a substance intended to be therapeutic for CH, that you can and will regain the balance you were enjoying previously, at which point you'll be so over these side effects, and will be golden. :)

 

 

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Spiny, J and Bejeeber no words left for your kindness in this difficult time,,,,,, at present i figured out that i should only continue Paxil (Paroxetine CR 12.5 mg) without mixing it with other tabs, it seems it is working.

Sure, going to update you in coming days!

Love, Respect and Happiness to you people! 

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  • 1 month later...

Hi CH companions!

i wanted to reply earlier but thought it would be much better to present a sold view, because my mental health presented different mood levels during this time, so now i am, as i feel, in a better position to tell my story. Try to tell my ordeal in some detail, maybe someone get a gain from it:

-Left benzo on 16 December (took it from 15 November) 

-Left taking Quetiapine 25 mg, on 13 January, just taking 18 of it in total (left it in taper process)

-Left Paxil on 22 January,  was taking it from 15 November

-Started taking magnesium oxide 500 mg tabs (1 morning-1 night) from 20 December, still taking them

-Different doses of D3 with calcium and zinc 

-Took 6 tablets of citicoline sodium 500 mg at different days (heard somewhere that weed reduces this chemical/citicoline in brain)

-Tested my vitamin B12 tens days ago, it was on border line (between 200-300 pg/ml), as of now taken two 500 mg methycobal injections. Felt its positive impact instantly 

My assumptions:

As J put it rightly that maybe Zomig interacted with cannabis and created a chemical  imbalance, i agree with him because i sensed that Zomig has the feelings of an SSRI-type. Bejeeber too was on the point that benzo withdrawal or tapering is hard, as on 9 December i missed my dose at night i got a panic attack but i didn't took any tab then on evening panic attack came in vengeance this was the worst attack of my panic attacks (a strange and a bad experience of my life). There i decided i have to leave benzo for good. Again, Bejeeber was right! Maybe i was/am in mid-life "existence crisis" cannabis brought it in open in a bad way. As in the past i enjoyed existence questions and liked reading such stuff, but this time evening just slight thinking of mysterious universe brought terrifying feelings,,,, culprit was the cannabis! As Spiny said "it is the only connection I personally have to panic attacks". Now i am feeling normal or close to baseline. And, did a experiment: took a few pegs of whisky on two consecutive nights, just 10 days ago, as i heard that it will lessen or interact with THC chemicals (see my confidence that here i am taking risk by taking alcohol to test my brain, means i am becoming good). Albeit i was late, because alcohol lessens (or worsen, it depends) THC impact just after you took cannabis.   

BUT, still terrified that i might not return to November 2020 :)    

Conclusion: Never to touch cannabis and benzo again.

In coming days, maybe, i tell you my tips how i combat my CH.

Love you friends

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Struggling with your humanity and existence with the burden of cluster headaches challenges even the most stable of souls.  Add the element of a panic attack, which can feel like the arrival of death itself, and life's burden can be overwhelming.  Every human is defined by their underlying physiology, spirituality, history and aspirations,  Its what makes us unique and why treatment is rarely a one size fits all problem.  Certainly on a basic level cause and effect can be directly related but because we inherit slightly different metabolisms, slightly different anatomy, vastly different toxin/nutritional exposure and upbringings the manifestations of disease and response to treatment can be predictable or paradoxical.  I believe that is why some folks can use alcohol and drugs without much long term consequence and others ruin lives from the onset.   I also suspicion its partially why we hear about some things working for some clusterheads and the same treatment gets no traction with others.

If possible get a support network into place so you can vent and express yourself.  I believe you must work hard not to be dramatic and emotional.  Express your experience in as calm a manner as possible.  People turn off fast if they sense a drama king/queen.  Not fair but true.  It helps if you write it down and codify it before verbalizing to others.  This is true if you are talking to a support person or a medical professional.  It helps you align the facts and reduce the embellishments and makes the communication as succinct as possible.  Writing it down also helps putting things into perspective and understanding your personal journey and what a strong warrior you really are.

Thats thought and opinion take it for what its worth.

 

Panic attacks are very challenging and can be disabling.  THC ingestion can often fuel because some folks get paranoid, feel guilty or are not comfortable being relaxed.  Most of us who know potheads marvel at how they use it to alter perception, mellow out and frequently use.  This behavior is unique to a subset of individuals as there are many more who get no joy from pot.  It is possible to have a panic attack proximate to THC use but very unlikely its physiologic 24-48 hours later unless the person is a chronic.  THC is stored in the fat and the brain is a big gob of fat.

Triptans like Imitrex and Zomig can induce anxiety mostly through reaction to decreased stomach activity and non cardiac chest wall tightness.  The uncomfortable feeling can precipitate anxiety.

Diclofenac is a non steroidal like ibuprofen and usually doesn't cause or mitigate anxiety.

Paroxetine is a serotonin reuptake inhibitor (SSRI) and the model drug this antidepressant class was popularized.  Since we suspicion clusterheads have a serotonin regulation problem you can get all sorts of atypical responses.  It is worthy to note in a depression paradigm many believe it is a spectrum and to become depressed one must pass through anxiety first.  Conversely to defeat depression you must pass back through anxiety.  Since anxiety is such a horrible debilitating state most folks get stuck in depression.  If the Paroxetine is helping you get out of a depression you may be approaching the anxiety as a path to wellness.  Thats where support and counsel helps to get you across the threshold.  Meds alone rarely are an effective intervention expect for be pharma.

Don't know much about Quetiapine  but from what I read it looks like a supplement to help with brain function and  healing.  Some promising results but the jury is still out.  Unlikely to be harmful.

Verapamil is a calcium channel blocker used historically for hypertension.  You were on a very low dose.  Its possible it could drop your pressure a bit and cause anxiety or in very rare cases cause your heart to beat abnormally which can also provoke anxiety.  It has other anxiety provoking side effects but its rare.  Its not use too much anymore because it wasn't a very good antihypertensive and heart rhythm disturbances had to monitored.

Steroids and steroid weans can cause anxiety.

Lorazapam is a benzo as you mentioned.  The prototypical benzo is valium.  Long term benzo use can lead to physical and psychological dependence but usually you are talking about moths to years of use.  Lorazapam is a very short acting medication and 0.5 mg is a very low dose.  While its possible lorazapam contributed to the anxiety its more likely you were under treated and got in that horrible zone between panic attack and relaxed.  Judicious use of benzos can be very helpful in managing anxiety but are best used in conjunction with coordinated counselling.  They also can also help while busting during that anxious period.

Vitamin supplementation is being vigorously studied and reported.  While the data is promising and impressive definitive studies are ongoing.  Hopefully these studies will further our understanding of cluster headaches and their management.  Until then I would suggest the risk benefit calculus favors trying vitamin supplementation following the guidelines put forward.

As with most cluster heads you search for explanation and cause/effect in a desperate attempt to manage.  Imaginary thinking predominates especially during a cycle.  We look for triggers, blockers and treatments to end the horror of an attack.  Our uncommon disorder doesn't get much attention from medical science so we are left to ourselves and citizen science to explore options and support each other.

 

At the end of the day it helps to know panic attacks are real, debilitating and manageable.  Acknowledging them and exploring management options are important to quality of life. 

 

 

Edited by Pebblesthecorgi
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