Bipolar 1 with horrible panic attacks

I was taken off lorazepam and now I have horrible anxiety and panic attacks. My panic attacks last 4-5 hours. I'm wondering if anyone has any idea what meds I can take. I'm on gabapentin, hydroxyzine, zyprexa. Buspar, propanolol. Still having 4-5 hour long panic attacks. They have made my life really small bc I'm always trying to avoid having one. I cant get back on lorazepam because the clinic I go to is taking everyone off benzos. They are the only place that takes my insurance.

Do you have any ideas of what else I could try? I'm so sick of the panic attacks. They're so scary and are just paralyzing me. Any ideas is greatly appreciated.

How can a psych clinic "take everyone off benzos?" That is just craziness!

In my experience with panic attacks, the only truly effective medication was Klonopin for me. I refuse to take it now, as it aggravates my depression. So, I use deep breathing and prayer now, but I do not get them often any more.

Buspar did not work for me. Some people say Seroquel can help them, so, might also look at that. But if you are getting frequent, lengthy panic attacks, the treatment of choice is generally Klonopin. How your clinic is ever going to take care of people with anxiety disorders with this odd policy is truly beyond me. Some people do really need them.

AAAAAHHHH...I am so angry at mental health professionals who pull people off benzos. Such a stupid thing to do, and is also a display of their inexperience.

The only med that has really helped me with severe and extreme anxiety/panic is the typical (older class) AP Trilafon (perphenazine). It's been a miracle for me.

As far as non-benzos go, Seroquel has helped give me more of a calming effect compared to a lot of other meds. That's terrible that they are taking everyone off benzos! I hope you find some relief soon.

It can be very difficult to have the benzo abruptly stopped with no strategy to replace it with. I am wondering if you have any insight into the reason why you are having these panic attacks. Did something stressful happen? Is it usually at a particular time of day? Anxiety is perpetuated by both biology and situational stress. Perhaps doing some work in therapy to assess what unconscious or automatic thoughts you could be having that are leading to the anxiety in the first place. I definitely don't mean to dismiss the biologic basis of what's going on but looking at the situational factors can help you take steps to mitigate other factors that may be responsible.

How do you breathe during the panic attack? I imagine you are probably breathing very rapidly. Slowing down the breathing to one breath every 4 seconds can be a way to sort of regain control. Once you are able to become more grounded, take your focus on your immediate surroundings. Take it in via your five senses. I know visual cues really help me, really paying attention to what is going on visually. Smells and feelings can also help as well as the other senses. Going for a walk. Sometimes it might come down to acceptance. Say to yourself you are in a state of anxiety, but don't reject or challenge it, just accept it.

Let me know if any of that helps.

Abruptly stopping a benzo usually will cause anxiety. It's a rebound effect.

Yes, my panic attacks usually occur at night. I was weaned off, it took about 9 months. Yes my breathing becomes really shallow. I will try some of your suggestions. I have tried using lavender, breathing techniques, and counting. They are really intense though and sometimes the only thing that helps is just waiting it out...

I've heard some say Zyprexa was good for curbing anxiety, but perhaps not everyone. If you haven't tried it already, I second the Seroquel recommendation. I prefer Seroquel XR for moodstabilization purposes, which is long since available as a generic. I also think BethRag's suggestion Trilafon (perphanazine) is also worth a try. I found great improvement on Trilafon in many respects, but likely went off of it prematurely (long story). Seroquel has been just as good for me as a benzo. In fact, though I do still have Ativan as a PRN for "extra" anxiety (and it works well for that), I have taken small dose Seroquel iR (regular type) for PRN anxiety, when my Ativan wasn't available. It also worked well. Maybe a low dose Seroquel iR could be used just for anxiety rather than switching to it in higher doses? Certainly the adjustment to low dose Seroquel can take a bit of time, as it can be sedating, but once used to it, the sedation effect eases. I actually take Seroquel in the morning and it doesn't make me tired at all anymore. Seroquel at night, however, does aid with my sleep.

How severe and frequent are your manic/hypomanic episodes? Sometimes an antidepressant can be used for anxiety and that might help, but there is a risk of causing mania. Antipsychotics like zyprexa are pretty good at mitigating that risk though.
Like others have said, Seroquel is pretty good for anxiety too.

Not very severe right now. I'm on zyprexa already, I'm on viibryd for my antidepressant. I'm also on invega, so adding a new antipsychotic isnt practical. I could see about switching to seroquel but I've gained a lot of weight already on these meds...I'll talk to my psychiatrist...

I'm going to keep track of my panic attacks here.

I'm still having hour long panic attacks. The other night I had one that lasted 6 hours! There's no way I can get back on lorazepam. Now they are saying bc I have sleep apnea. Its bs. But I have no other options. I'm on max doses of meds used usually for anxiety.

can I ask why you stopped the ativan>?

They said bc it can cause dementia in the older years...now they're saying I can't go back on it bc I have sleep apnea...

Buspar, gabapentin, and seroquel can help maybe.

I'm on those except seroquel. I'm on zyprexa and invega for my ap.

I haven't had a panic attack for 3 days! I've been having them about every 2 days. I'm hoping I don't have one tonight...

Any of your coping skills to help with a panic attack I'd appreciate. Keep in mind, mine last for hours...

That's awesome Coolbreeze! I hope this lasts as long as possible for you

Deep breathing is my go-to when I feel a panic attack coming on (if I notice it coming on, that is). I've been trying to be more grounded in general by incorporating yoga into my daily routine hoping to prevent things like dissociation and panic attacks. You could try daily (or more) meditation as well. I also have a music playlist for nearly every mood and vibe I experience so I throw a calming one on when I need it. I hope you find something healthy that helps, whatever it may be.

Thanks, yes deep breathing helps to a point. I think I need to practice it more...

Are you being treated for sleep apnea? I use a bipap machine. Have you had a sleep study? If not, how do they know you have sleep apnea?

Yes I did a sleep study and it came up sleep apnea. I tried the mask, I mean really tried it and it just dried me out and I would wake up with my throat so dried out I would cough and cough. It would take a half hour till I stopped coughing. The mask just wont work for me...