What factors may trigger panic (attack)?

Updated: Mar 27, 2019
  • Author: Nita V Bhatt, MD, MPH; Chief Editor: David Bienenfeld, MD  more...
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Answer

The cognitive theory regarding panic is that patients with panic disorder have a heightened sensitivity to internal autonomic cues (eg, tachycardia). Triggers of panic can include the following:

  • Injury (eg, accidents, surgery)

  • Illness

  • Interpersonal conflict or loss

  • Use of cannabis (can be associated with panic attacks, perhaps because of breath-holding) [18]

  • Use of stimulants, such as caffeine, decongestants, cocaine, and sympathomimetics (eg, amphetamine, MDMA ["ecstasy"]) [19]

  • Certain settings, such as stores and public transportation (especially in patients with agoraphobia)

  • Sertraline can induce panic in previously asymptomatic patients. [20]

  • The SSRI discontinuation syndrome can induce symptoms similar to those experienced by panic patients.


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