Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0012833 (dizziness)
 9,689 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Despite much recent research, there is still little systematic information about the phenomenology of panic attacks, and their possible causes remain obscure. We investigated panic attacks in the natural environment using an event sampling approach. Twenty-seven panic attack patients and 19 matched normal controls kept panic attack and self-exposure diaries for 6 days and wore an ambulatory heart rate/physical activity recorder for 3 days. Patients reported 175 attacks, generally of moderate severity. The most frequent symptoms were palpitations, dizziness/lightheadedness, dyspnea, nausea, sweating, and chest pain/discomfort. The results did not support the classification of panic attacks recently proposed by Sheehan and Sheehan, which requires three symptoms as a cutoff for panic attacks. Panic attacks classified by the patients as situational (i.e., occurring in feared situations) were more severe and occurred in situational contexts different from spontaneous attacks, but were otherwise phenomenologically similar. Heart rates did not change during spontaneous attacks and were only mildly elevated during situational attacks or during the 15 minutes preceding these attacks. These heart rate changes were interpretable as effects of anxiety, although physical activity showed a similar pattern of changes. Some normal control subjects reported on the panic diary primarily situational anxiety episodes that were phenomenologically similar to, albeit less severe than, the patients' episodes. Panic patients may sometimes fail to perceive environmental triggers for their attacks because many attacks classified as spontaneous occurred in classical "phobic" situations. Furthermore, the comparison of concurrent diary and retrospective interview and questionnaire descriptions showed that panic patients have a tendency toward retrospective exaggeration. Implications for the assessment, definition, and classification of panic attacks are discussed.
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PMID:Panic attacks in the natural environment. 365 82

Alprazolam treatment was tapered in 17 panic patients at a rate of 10% of the starting dose every 3 days. Only four subjects completed withdrawal on schedule (4-5 weeks); four additional subjects discontinued treatment in 7-13 weeks. During withdrawal 15 patients had recurrent or increased panic attacks and nine had significant new withdrawal symptoms. Most common among the latter were malaise, weakness, insomnia, tachycardia, lightheadedness, and dizziness. None had seizures, psychosis, or significant neurological or EEG abnormalities. Results indicate that relapse and withdrawal are important considerations in the choice of alprazolam treatment for panic attacks.
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PMID:Discontinuation of alprazolam treatment in panic patients. 382 28

A battery of vestibular and audiological tests was administered to eight patients with panic disorder and 13 patients with agoraphobia and panic attacks, all of whom experienced dizziness during their panic attacks. Positional or spontaneous nystagmus was present in 67% of the subjects. Abnormal responses were found in caloric testing (56%), rotational testing (35%), and posturography (32%). Pure tone audiograms were abnormal in 26% of the subjects and acoustic reflexes were abnormal in 44% of the subjects. Six of eight patients tested had an abnormal brainstem auditory evoked potential. The possible importance of the findings and their implications for further research are discussed.
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PMID:Otoneurological examination in panic disorder and agoraphobia with panic attacks: a pilot study. 387 76

In symptomatic mitral valve prolapse patients (MVP): (1) the frequency and nature of symptoms were analyzed (n = 313); (2) metabolic studies were performed (n = 20), and (3) the response to isoproterenol infusions were studied (n = 16). Chest pain is more often the initial symptom in men; palpitations are more common initially in women. Fatigue, palpitations, dyspnea and arrhythmias are more frequent in women. Chest pain and neurologic events occur with the same frequency in both sexes. Women have more symptoms than men. MVP patients have normal thyroid function tests, normal plasma cortisol, normal diurnal variation of cortisol and normal 24-hour 17-ketosteroids and 17-hydroxycortico-steroids excretion. They have a normal response to oral glucose but higher glucose and insulin levels than controls. MVP patients have increased 24-hour urinary catecholamine excretion. Isoproterenol infusions produce symptoms in a dose-related fashion in MVP patients but not in controls. Isoproterenol infusion-related symptoms included chest pain (7), extreme fatigue (6), dyspnea (6), dizziness (4), numbness (2), panic attacks (2). Isoproterenol infusions produced a greater increase in heart rate in MVP patients compared to controls. Thus, MVP patients have increased catecholamines and hyperresponse to isoproterenol infusion which indicates that their symptoms may be catecholamine related or mediated. The complex relationships of MVP symptoms are not clear; the coexistence of anxiety states and MVP is one explanation; another equally plausible explanation is that MVP may be a specific marker for the symptom complex.
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PMID:Mitral valve prolapse: a marker for anxiety or overlapping phenomenon? 636 71

The relationship between 23 specific panic attack symptoms and the 16 items of the Anxiety Sensitivity Index was investigated using a factor analytic procedure with a large sample (N = 209) of panic disorder patients. A five-factor model resulted in three panic symptom clusters (cardio-respiratory, dizziness-related, and cognitive symptoms) and two anxiety sensitivity factors (fear of physical symptoms and fear of psychological symptoms). The five-factor model accounted for 50% of the variance. There was some overlap between anxiety sensitivity and panic symptomatology and the cognitive panic symptom "fear of dying" loaded strongly on the anxiety sensitivity fear of physical sensations factor rather than on any of the panic symptoms factors. These results demonstrate that anxiety sensitivity can be independent of panic and are also consistent with a cognitive view of panic in which catastrophic cognitions that occur during a panic attack are more associated with a cognitive style or personality trait than with the severity of physical symptoms.
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PMID:Anxiety sensitivity and panic attack symptomatology. 767 22

Panic attack symptomatology was investigated in 212 panic disorder patients (60 men, 152 women) using the Panic Attack Questionnaire, Feelings of helplessness and thoughts of escape had the highest mean severity ratings, but are not currently listed in the DSM-III-R. The DSM-III-R symptoms labeled choking or smothering sensations, paresthesias, nausea, and chest pain had low severity ratings. Evidence was obtained for a three-factor model of panic symptomatology consisting of dizziness-related symptoms, cardiorespiratory distress, and cognitive factors. These results provide only limited support for the current DSM-III-R symptom structure, and support the notion that panic disorder is a heterogeneous condition.
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PMID:The symptom structure of panic attacks. 799 26

In recent years research has shown that subsets of patients with mitral valve prolapse also have associated autonomic or neuroendocrine dysfunction that can result in a number of related symptoms, including fatigue, palpitations, chest pain, exercise intolerance, dyspnea, dizziness, headache, sleep disorders, gastrointestinal disturbances, cold extremities, and panic attacks. These patients have been classified as having mitral valve prolapse syndrome. This article discusses the pathogenesis and management of mitral valve prolapse syndrome and serves to make clinicians aware of newer developments in the study of autonomic function and dysfunction.
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PMID:The phenomenon of dysautonomia and mitral valve prolapse. 800 50

The recent publication of the Diagnostic and Statistical Manual of Mental Disorders, third edition (D.S.M-III) has provided the basis for the separate diagnostic entity of panic disorder. A panic attack is characterized by the abrupt onset of apprehension or fear accompanied by symptoms such as dyspnea, palpitation, chest discomfort, dizziness, sweating, feeling of unreality, and fear of dying. Panic disorder, defined as four panic attacks in a four week period, has a lifetime prevalence of 1 to 2 percent of the general population. In these patients, panic disorders can be provoked by pharmacological challenge with sodium lactate, yohimbine, caffeine and carbon dioxide inhalation. Recently, the relationship between panic disorder and depression became a subject of investigation from various points of view.
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PMID:[Panic disorder]. 800 10

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


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