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Query: UMLS:C0012833 (dizziness)
 9,689 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

This study compared 50 patients presenting to an otolaryngology clinic with a complaint of dizziness and 50 patients presenting with hearing loss on questionnaire measures of panic, phobic avoidance, generalized anxiety, and depression. Clinical and laboratory evaluations of vestibular and audiological complaints were also completed. Twenty percent of the group with dizziness and none of the group with hearing loss reported symptoms that met DSM-III-R criteria for panic disorder. Patients with dizziness and peripheral vestibulopathy had more symptoms of phobic avoidance, generalized anxiety, and depression than patients with confirmed hearing loss.
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PMID:Panic in otolaryngology patients presenting with dizziness or hearing loss. 803 60

Gepirone, an azapirone, is a potent 5-hydroxytryptamine 1A (5-HT1A) agonist. We report an uncontrolled 6-week study in 21 patients (4 men, 17 women: mean age, 36.71 years) with a concurrent DSM-III-R diagnosis of generalized anxiety disorder and panic disorder with agoraphobia. After a 2-week medication-free period, patients were started on 2 mg of gepirone per day increasing over 3 weeks to 12 mg/day. Three patients dropped out in the first week, and one patient violated the protocol. They were therefore excluded from analysis. Two patients who dropped out at weeks 4 and 5 because they found the treatment ineffective were included. Twelve of the 17 patients (70.6%) had at least a 50% reduction in their panic attacks by week 6, and 9 of them had at least a 50% reduction by week 3. Ten patients had "0" panic attacks by week 6 (59%). On the Hamilton Anxiety Scale, 65% had a 50% or greater reduction in total score, mostly beginning in week 1. On Global Assessment, by week 6, 11 were much improved or better (65%). Adverse effects were rare and consisted of stomach upset, dizziness, or headaches. This preliminary study suggests the possible efficacy of gepirone in panic disorder.
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PMID:Gepirone and the treatment of panic disorder: an open study. 809 26

A panic attack is characterized by the abrupt onset of apprehension or fear, accompanied by symptoms such as dyspnea, palpitations, chest pain, dizziness, sweating, the feeling of going mad or the fear of dying. The feeling of anxiety often recedes into the background and such patients present to nonpsychiatric physicians with mainly somatic symptoms. The consequences of frequent panic attacks, named panic disorder, are agoraphobia with impairment of psychic and social functioning, increased prevalence of alcohol abuse, depression and, in particular, suicidal attempts. It is of the utmost importance that physicians recognize the somatic symptoms of panic anxiety and plan integrated treatment. The main therapeutic resources at present include antidepressants, selected benzodiazepines and behavioral treatments and are very successful in improving panic attacks and their consequences, which may long go undiagnosed.
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PMID:[Panic attacks]. 809 64

Panic disorder is relatively common in older patients and may have serious consequences. The diagnosis is based on an accurate history of symptom onset and intensity. Symptoms include shortness of breath, dizziness, increased heart rate, trembling, and sweating. Effective treatment can be achieved with several kinds of medication, including benzodiazepines. Although physician and patient fears about benzodiazepines persist, panic-disordered patients with no history of drug abuse rarely develop substance dependence problems. Physical dependence occurs in a minority of patients and can be minimized by a slow tapering schedule. As with most medications, benzodiazepines need to be used with caution in older patients, who are more susceptible to adverse effects.
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PMID:Panic disorder: guidelines to safe use of benzodiazepines. 810 Jul 94

Patients with panic disorder often describe dizziness as a disturbing symptom, with more severe episodes reported than in other psychiatric populations. Nineteen patients diagnosed as having a panic disorder were tested for vestibulo-ocular (VOR) abnormalities with the Vestibular Autorotation Test (VAT), a computerized test of the high-frequency (2 to 6 Hz) VOR. The patients were unselected for the presence or absence of balance disorders. Results showed VOR abnormalities, relative to a normal population, in the horizontal and/or vertical VORs of all 19 patients. Vestibulo-ocular reflex asymmetries were commonly present. Because the VAT tested the VOR over a frequency range encountered during common daily activities, the observed abnormalities could result in a perceptually moving visual field (oscillopsia). We hypothesize that the resulting experience of a visual-vestibular disturbance--perhaps in a biologically or psychologically predisposed individual--is catastrophically misinterpreted, leading to more bodily symptoms and anxiety. These could then contribute to more misinterpretation in a positive feedback sense, ultimately leading to a panic attack.
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PMID:Autorotation test abnormalities of the horizontal and vertical vestibulo-ocular reflexes in panic disorder. 813 36

Side effects play a significant role in the selection of drugs to be used in panic disorder/agoraphobia whose polyphobic symptomatology often includes a suspiciousness about taking drugs and a fear of undesired side effects which may lead to the refusal of treatment. The safety, side effects and patients' acceptance of alprazolam and imipramine versus placebo were evaluated in 1168 subjects with panic disorder/agoraphobia who had been enrolled in the second phase of the Upjohn World Wide Panic Study. Side effects that worsened over baseline to a greater extent with alprazolam than with imipramine and placebo were sedation, fatigue/weakness, memory problems, ataxia and slurred speech. In the imipramine group blurred vision, tachycardia/palpitations, insomnia, sleep disturbance, excitement/nervousness, malaise, dizziness/faintness, headache, nausea/vomiting and decrease in appetite were worse than in the other groups. In the placebo group the anxious symptoms were most prominent. The highest level of compliance was shown in the alprazolam-treated group and the lowest in the placebo-treated group. Strong predictors of side effects were not observed. If a side effect profile is known, it will be easier for a clinician to choose the right drug and the appropriate management by taking into account compliance, safety and efficacy in each patient under treatment. Further information about side effects in long-term maintenance treatment would be of great clinical pertinence in ensuring safety and enhancing patients' quality of life.
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PMID:Adverse effects associated with the short-term treatment of panic disorder with imipramine, alprazolam or placebo. 820 96

Seventy-six in- and outpatients seeking help for complaints of dizziness in a neurological clinic were assessed by the Structured Clinical Interview for DSM III (SCID). Neurological assessment included electrophysiological and otological examination. We established criteria to differentiate between dizziness as a symptom of panic disorder and dizziness as a symptom of neurological illness. Criteria for dizziness as a symptom of panic disorder are: adverse life events before the onset of dizziness, current comorbidity with depression, a high number of vegetative symptoms typical for panic attacks, a specific cluster of symptoms and little evidence of a neurological illness. We conclude that patients with complaints of dizziness often suffer from anxiety disorders. Thus we describe a vestibular subtype and contribute to the classification of panic disorder.
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PMID:[Panic disorder and vertigo. On the psychopathologic differentiation between neurologic and psychiatric disease]. 833 30

Individuals with panic attacks evaluate physical anxiety symptoms as dangerous and tend to respond to them with fear. In a retrospective questionnaire study, we explored childhood and adolescent learning experiences with respect to somatic symptoms of panickers. Compared to normal controls (N = 61), patients with panic disorder (N = 121), infrequent panickers (N = 86) and patients with other anxiety disorders (N = 38) reported more frequent instances prior to age 18 when they had experienced symptoms like dizziness, shortness of breath, palpitations or nausea, accompanied by special attention from their parents and instructions to restrain from strenuous or social activities. The differences were due to higher symptom frequencies in the anxiety groups. All anxiety groups reported more frequent uncontrolled behavior of their parents than controls. Patients with panic disorder and infrequent panickers reported that their parents had suffered more frequently from physical symptoms typical of anxiety than patients with other anxiety disorders or normal controls. Panickers, but not patients with other anxiety disorders, had observed sick-role behavior related to panic symptoms in their parents more often than controls. Panic attack Ss reported a higher number of household members suffering from chronic illnesses than controls and patients with other anxiety disorders. No group differences were found in the reported behavior of parents when Ss had colds. Overall, the results point to the role of severe illnesses and physical symptoms typical of anxiety in significant others in the history of Ss with panic attacks. These experiences during childhood and adolescence may contribute to their belief that physical symptoms are dangerous. In contrast, there was no specificity for panic with respect to the Ss' own physical symptoms or cold-related symptoms.
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PMID:Somatic symptoms and panic attacks: a retrospective study of learning experiences. 847 1

Fifteen panic disorder patients with prominent dizziness underwent audiologic, caloric, and vestibuloocular reflex activity testing and were compared with normal controls. There were no abnormalities detected on audiologic and caloric tests. Compared with normal controls, panickers with dizziness showed a greater discrepancy between eye and head movements on vestibulo-ocular reflex activity in the dark. Panickers with prominent dizziness did not differ from a second control group of panickers with severe heart palpitations on a number of psychological tests. The results did not support the hypothesis that organic dizziness is etiologically important in the causation of panic or agoraphobia, but do suggest that vestibuloocular reflex activity should be further studied in panic disorder.
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PMID:Otoneurological functioning in panic disorder patients with prominent dizziness. 848 81

Anxiety is a common symptom is vertigo patients. ACute anxiety is known in neurology and psychiatry as panic disorder. The cardiovascular and the gastrointestinal subtypes have been used in the classification of panic disorders up to now. Frommberger and co-workers (1993) have also defined a vestibular subtype. In this study, we have compared the neurotologic test results of 53 patients with vertigo in combination with panic disorder and of 53 patients with balance disorders without anxiety to clarify, whether disturbances in the vestibular systems can be objectivated or not. Differences of both groups were found in history data, especially in the vertigo characteristics, the accompanying vegetative symptoms, the releasing mechanisms, the duration of the attacks, and the total time of the dizziness complaints. The mean age was less significant in the patients with panic disorder than in the control group. The test results of the anxiety group showed a higher rate of right-directed spontaneous nystagmus and less pathological vestibular findings in the caloric and rotating test as well as in the Unterberger stepping test when compared to the control group. Some of the patients with panic disorder developed acute anxiety during the examination.
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PMID:[Anxiety syndrome in vertigo patients. A comparison of neuro-otologic findings in patients with and without anxiety]. 867 98


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