Panic attacks are sudden, intense episodes of fear that trigger strong physical reactions. These episodes typically involve a racing heart, rapid breathing, sweating, and a sense of impending doom or loss of control. Symptoms usually peak within ten minutes, though emotional effects can linger for hours. Certain substances can directly induce or worsen these experiences.
Prescription Medications Linked to Panic
Several classes of prescription medications can contribute to panic attacks or heightened anxiety as a side effect. Stimulants, commonly prescribed for attention-deficit/hyperactivity disorder (ADHD), increase nervousness and anxiety. These medications, like methylphenidate and amphetamines, affect the central nervous system, intensifying anxiety symptoms.
Corticosteroids, used as anti-inflammatories and immunosuppressants, are linked to psychiatric side effects like anxiety and panic. Effects can emerge days or weeks after starting treatment, with higher doses increasing risk. Thyroid medications can induce anxiety or panic symptoms if dosage leads to an overactive thyroid state.
Bronchodilators, prescribed for asthma, relax airway muscles but can stimulate the cardiovascular system, leading to an increased heart rate and nervousness that may be perceived as panic. Withdrawal from central nervous system depressants, such as benzodiazepines and opioids, can trigger panic attacks. Their absence can cause rebound anxiety, tremors, and panic symptoms.
Over-the-Counter Drugs and Supplements
OTC medications and certain dietary supplements can elicit panic or anxiety reactions. Decongestants, like pseudoephedrine and phenylephrine, relieve nasal congestion by constricting blood vessels. This action can lead to increased heart rate, nervousness, and anxiety, potentially triggering panic episodes, particularly with higher doses.
Caffeine, a stimulant, can induce anxiety, particularly in high doses or sensitive individuals. Intake exceeding 400 mg can increase anxiety and panic attacks, especially for those with pre-existing panic disorder. Herbal supplements like ephedra have been associated with adverse cardiovascular and psychiatric effects, including anxiety and panic.
Illicit Substances and Panic Reactions
Illicit substances cause panic attacks by directly impacting brain chemistry. Stimulants like cocaine and methamphetamine affect the central nervous system, rapidly increasing heart rate and blood pressure. This physiological stimulation can mimic panic, leading to anxiety and panic attacks.
Hallucinogens, like LSD, psilocybin, and MDMA (ecstasy), alter perception and thought processes. These substances induce anxiety, paranoia, and a sense of lost control, escalating into panic attacks, especially in unpredictable environments or with high doses.
Cannabis, particularly strains with high tetrahydrocannabinol (THC) content, can trigger panic attacks in susceptible users. THC can overstimulate the brain’s fear response system, leading to heightened awareness, paranoia, and a rapid heart rate, which users may interpret as an impending panic attack.
How Drugs Can Trigger Panic
Drugs can trigger panic attacks through physiological and neurological mechanisms. Many substances stimulate the central nervous system, increasing neurotransmitter activity (e.g., norepinephrine, dopamine). This heightened neural activity can lead to hyper-arousal, manifesting as a racing heart, increased breathing, and feeling on edge.
Other drugs disrupt the balance of neurotransmitters involved in mood regulation, like serotonin and GABA. Imbalances destabilize brain function, increasing anxiety and reducing stress coping ability, lowering the threshold for a panic attack. Withdrawal from depressant substances like benzodiazepines or alcohol causes the brain to rebound with excessive excitatory activity, contributing to anxiety and panic.
Beyond neurological effects, some drugs induce physical symptoms like increased heart rate and blood pressure, which can be misinterpreted as a health crisis. This misinterpretation can initiate a fear response, escalating into a panic attack. Psychological factors, including paranoia and altered perceptions, can contribute to panic by creating a distressing internal experience.