Also known as 'hyperventilation anxiety syndrome', panic attacks may be linked to psychiatric disorders like agoraphobia (fear of open spaces). More frequently, they simply appear on their own - without warning - out of nowhere. The patient lapses into a state of terror, overbreathes, complains of chest pain and often feels as if death is near. Re-breathing from a paper bag may sometimes relieve the symptoms. Otherwise, the attack will stop spontaneously. Muscle cramp and twitching may also occur.
The first port of call is to eliminate organic causes. These include hyperthyroidism, magnesium deficiency, abnormal calcium metabolism related to vitamin D deficiency, alkalosis, hypoparathyroidism, or consuming too much alkaline salts (e.g. sodium bicarbonate).
In innumerable cases, I have found in my practice that those who suffer from periodic panic attacks also test positive for a decreased pancreatic exocrine function, and the panic attacks disappear once pancreatic function is corrected. So, a pancreatic function test is my first line of investigation in these patients.
There are many successful alternative strategies for dealing with this problem, including:
* Homoeopathy. In a study of 600 women (aged 20 to 60) suffering from panic attacks, the homoeopathic combination remedy L.72 (comprising 10 different remedies) was found to be just as effective as the benzodiazepine diazepam in dealing with the symptoms of panic attacks (Heulluy B. Centre for Therapeutic Research and Documentation. Paris, 1988). These symptoms included irregular heartbeat, shortness of breath, intestinal problems, frequent urination and dizzy spells. The combination remedy caused no changes in weight, lowered pulse rates and markedly increased the number of hours of sleep. There were no cases of addiction and no interaction with alcohol, even though 10 per cent of the women were alcohol-dependent. In my own practice, I have also found this remedy to be effective and reliable.
* Standard (single-remedy) homoeopathic treatment has also proved effective in reducing bouts of agitation in children after surgery (P'ediatrie, 1990; 45: 465-6).
* Exercise. Aerobic exercise can significantly reduce the frequency of panic attacks (J Sports Med Phys Fitness, 1991; 31: 277-82). However, in patients suffering from both panic attacks and agoraphobia, 10 weeks of walking (6.5 km three times a week) was found to be less effective than the tricyclic antidepressant clomipramine, though better than a placebo (Am J Psychiatr, 1988; 155: 603-9).
* Relaxation and cognitive behavioural therapy. Relaxation was less effective than cognitive behavioural therapy, according to a randomised clinical trial of 64 subjects, although both were superior to doing nothing (J Consult Clin Psychol, 1994; 62: 818-26).
* Meditation. Transcendental meditation has been shown to reduce panic attacks and neuroendocrine responses to stress in volunteers subjected to stressful conditions (Ann NY Acad Sci, 1994; 746: 381-4). In one randomised clinical trial, 28 subjects underwent an eight-week stress-reduction programme based on mindfulness meditation. Compared with the non-intervention control group, the meditators demonstrated greater reductions in symptoms of stress and an improved sense of control (Psychother Psychosom, 1997; 66: 97-106).
* Electrotherapy. Cranial electrotherapy uses a stimulation apparatus to deliver a high-frequency, low-intensity electrical current through the patient's skull. A review of eight subject-blind, randomised clinical trials, involving 249 patients with anxiety syndromes, found evidence of its effectiveness (J Nerv Ment Dis, 1995; 183: 478-85).
Harald Gaier is a registered naturopath, osteopath, homoeopath and herbalist. He can be contacted at The Diagnostic Clinic, London, tel: 020 7009 4650