Treatment of panic attacks by neurologist Ihor Stanislavovych Shkinder in Dnipro.

Patients present with recurrent panic attacks, a feeling of shortness of breath, a rapid heartbeat, or sudden fear without an obvious cause.

The doctor performs a thorough clinical assessment, carefully reviews the symptoms and medical history, and, if necessary, orders additional tests to clarify the condition.

As a result, the patient receives a clear action plan: what to do during attacks, which examinations are important, and how to monitor their condition over time.

Particular attention is given to accurately diagnosing the causes of panic attacks and providing regular follow-up, which helps adjust therapy as needed and reduce the risk of exacerbations.

When to See a Doctor

Panic attacks can appear in different ways and affect your quality of life. Sometimes symptoms occur for the first time or return after a while, making everyday activities and rest more difficult. If you are experiencing such symptoms, it is important to clarify their causes and get a professional assessment for the next steps. You should make an appointment with a neurologist if, during panic attacks, you notice:

• Frequent episodes of intense fear or anxiety without an obvious cause
• A feeling of shortness of breath or difficulty breathing during an attack
• Rapid heartbeat or irregular heart rhythm during moments of anxiety
• Dizziness, weakness, or darkening of the vision during anxious episodes
• A feeling that things are unreal or that you are detached from yourself during an attack
• Symptoms that keep recurring and become more frequent or intense
• Panic symptoms that interfere with work, studying, or getting proper rest
• No improvement despite trying to manage the symptoms on your own or after previous treatment
• Attacks that appear for the first time or return after a long break
• A worsening of the condition after stressful events or major life changes
• A need to clarify the causes of anxiety before starting new treatment
• Difficulty controlling the condition and understanding what to do next

If some of these situations sound familiar, a consultation can help identify the causes and choose an appropriate support plan. You should not wait until the symptoms become more severe — seeing a specialist can help ease your condition and improve your daily life.

Emergency situations or when you need to see a doctor urgently

• A sudden worsening of shortness of breath or choking sensation
• A sharp and marked increase in heart rate or irregular heartbeat
• Severe dizziness accompanied by loss of balance or consciousness
• Progressive weakness or numbness in the limbs
• Symptoms appearing after a head injury or severe stress

If you experience these symptoms, do not wait for a scheduled appointment — seek urgent medical care. Our clinic offers a house-call doctor service, allowing you to receive a timely assessment without unnecessary delays.

Causes and Risk Factors of Panic Attacks

Understanding the possible causes and risk factors helps you better navigate the situation and determine what should be checked when seeing a doctor. Panic attacks require careful evaluation to find out what may be triggering or worsening the condition.

Main causes / mechanisms (briefly)

• May be related to increased reactivity of the nervous system to stress
• Often occur in the context of prolonged emotional and psychological stress
• Sometimes linked to dysfunction in brain structures responsible for emotion regulation
• May develop as a complication after previous illnesses or head injuries
• Often associated with changes in the brain’s chemical balance

Risk factors

• A family history of anxiety disorders
• Frequent or prolonged stressful situations in life
• Major changes or losses that cause emotional strain
• Misuse of caffeine, alcohol, or other substances
• Lack of sleep and chronic fatigue
• The presence of other neurological or psychiatric conditions
• Age — panic attacks most often begin in young or middle adulthood
• Unresolved anxiety and a tendency to worry

Reversible causes that are important to rule out

• Side effects of certain medications or sudden discontinuation of drugs
• Thyroid dysfunction and hormonal imbalance
• Conditions associated with threatening cardiovascular symptoms
• Acute reactions to the use of psychoactive substances

Panic attacks can have different causes and mechanisms, so a professional evaluation is necessary to determine the most likely factors and choose the right approach.

Diagnosis

The diagnosis of panic attacks is aimed at identifying possible causes of symptoms and ruling out other conditions. The approach is designed to make the examination as clear and comfortable for the patient as possible.

Diagnostic approach

• Taking a detailed medical history, including symptoms and how they developed
• Assessing the general condition and performing a neurological examination
• Ordering basic laboratory tests when indicated to exclude somatic causes
• Additional investigations (for example, ECG, neuroimaging) based on individual indications
• Analyzing the collected information and forming a plan for further steps
• Discussing the results and options for managing the condition with the patient

Typical tests when indicated

• Complete blood count and blood biochemistry
• ECG to assess heart function
• Thyroid function tests if necessary
• Magnetic resonance imaging (MRI) of the head as prescribed by a doctor
• Consultation with related specialists if there are comorbid conditions

What to bring to your appointment

• All available results of previous examinations and tests
• A list of medications being taken and their dosages
• A symptom diary or description of attacks, if available
• Copies of medical records extracts, if available

Diagnosing panic attacks requires a step-by-step, comprehensive approach that helps determine the causes of the condition and select measures to improve well-being.

Treatment

Treatment for panic attacks is aimed at reducing symptom severity and improving overall well-being. The treatment plan is selected individually, taking into account the patient’s specific characteristics and medical indications.

Goals of therapy

• Reduce the frequency and intensity of panic attacks
• Address possible causes and factors affecting the condition
• Improve quality of life and the ability to cope with anxiety
• Prevent complications and future flare-ups

Main treatment approaches

• May include medication when indicated to reduce symptoms
• Key directions: psychotherapeutic support and training in relaxation techniques
• Rehabilitation measures to restore a normal lifestyle
• Additional non-drug methods may be used on a doctor’s recommendation
• Therapy is individualized and adjusted based on the patient’s response and comorbid conditions

What the doctor does

• Selects and adjusts the treatment plan based on changes in the patient’s condition
• Takes into account comorbidities and possible interactions
• Monitors side effects and changes treatment strategy if necessary
• Explains how treatment effectiveness is assessed
• Coordinates care with other specialists if needed

What to expect: plan and follow-up

• The condition is assessed regularly; timing varies depending on the situation
• If there is no improvement, the doctor adjusts the treatment plan
• Follow-up visits are important for monitoring and maintaining stability
• The treatment plan is developed gradually, taking individual patient characteristics into account

To create an individualized treatment plan, book a consultation with Dr. Igor Stanislavovich Shkinder.

Prevention

Preventing panic attacks helps reduce the risk of exacerbations and maintain a stable condition. The prevention plan is selected individually and depends on each patient’s specific characteristics.

Main primary prevention measures

• Managing stress levels and avoiding chronic psycho-emotional strain
• Maintaining a proper sleep and rest routine to help the body recover
• Limiting caffeine and other stimulating substances
• Quitting smoking and avoiding excessive alcohol consumption
• Staying physically active in a way that is appropriate for your health status
• Monitoring chronic conditions and seeking medical attention in a timely manner

Screening and secondary prevention / regular monitoring

• Regular neurologist checkups as indicated
• Assessing the effectiveness of current treatment and adjusting it if necessary
• Monitoring the cardiovascular system and hormonal balance as recommended by a physician
• Timely identification and treatment of coexisting psycho-emotional disorders

Practical tips

• Learn relaxation methods and breathing exercises after consulting a doctor
• Keep a mood and symptom diary to track changes in your condition
• Discuss possible lifestyle changes with your doctor that may help reduce anxiety
• Avoid making abrupt changes to treatment without consulting a specialist
• Maintain open communication with your doctor about your condition and recommendations

Preventing panic attacks requires regular monitoring and close cooperation with a physician to achieve the best results.

Important to Know

Panic attacks are accompanied by intense anxiety and physical symptoms that can cause significant discomfort. It is important to understand that treatment is aimed not only at reducing symptoms, but also at identifying the causes that trigger them. Early assessment helps determine the optimal treatment plan and reduce the risk of complications. Ongoing monitoring and timely adjustment of treatment help ensure a more stable patient condition. The course of panic attacks is also influenced by general factors such as stress, sleep quality, and comorbid conditions. Self-treatment can make it harder to establish the correct diagnosis and may lead to unwanted effects.

• Treatment should be accompanied by identifying the causes and triggering factors
• Early professional assessment helps adjust the treatment plan in a timely manner
• Ongoing monitoring makes it possible to adapt treatment to changes in the condition
• Stress, sleep disturbances, and chronic illnesses affect the frequency and severity of attacks
• Attempts at self-treatment may mask symptoms and complicate diagnosis
• Dr. Shkinder Igor Stanislavovich pays close attention to accurate diagnosis and treatment control

If you are experiencing symptoms of a panic attack or are dealing with vague, unpleasant sensations, do not delay consulting a specialist. Understanding the specifics of your condition and receiving professional help will help you regain control and improve your quality of life. You can learn more about panic attacks and their treatment methods on our general page.

Self-help before the appointment: what to do and what not to do

Before an appointment for panic attacks, it is important to follow safe actions that will not worsen the condition or distort the clinical picture. If your condition worsens, seek help immediately from Dr. Shkinder Igor Stanislavovich.

What you can do before the appointment

• Write down when and how the symptoms started: the time, circumstances, and what helps or makes them worse
• Bring a list of all current medications to the appointment, including names and dosages if you know them
• Keep a symptom diary: their intensity, possible triggers, and when they appear
• Reduce physical activity and try to rest if you are feeling anxious
• Measure and record your vital signs: blood pressure and pulse, if you know how and it is safe to do so
• Drink water to avoid dehydration if you feel dry or weak
• Pay attention to your emotional state and try simple relaxation techniques
• Stay calm and avoid sudden changes in your lifestyle without consulting a doctor

What you should not do before the appointment

• Do not stop your usual medications without consulting a doctor
• Do not start taking new medications or remedies without a specialist’s instructions
• Do not rely on unverified folk remedies that promise quick relief
• Do not try to diagnose yourself based on symptoms or internet sources
• Do not increase physical activity if it causes anxiety or makes you feel worse
• Do not ignore a worsening condition or the appearance of new symptoms
• Do not make sudden changes to your sleep or diet without a doctor’s recommendations
• Do not delay a doctor’s visit if your condition worsens

If there are signs of an emergency, seek help from Dr. Shkinder Igor Stanislavovich immediately.

How I can help as a doctor with panic attacks

When dealing with panic attacks, it is important to receive not just symptomatic treatment, but a comprehensive assessment of the situation and guidance on next steps. During the consultation, I will help identify the causes of the condition, assess how much it affects your life, and choose the best management strategy. The plan will be built in stages, with the possibility of adjustment depending on the results.

During a consultation for panic attacks, I can help you with the following:

• Analyze your symptoms and the history of how the condition developed to look for possible causes
• Assess the severity of the symptoms and identify risk factors affecting the condition
• Review your current prescriptions and evaluate how well you tolerate previously prescribed medications
• Create a plan for further steps: examinations, treatment, and follow-up
• Take into account comorbidities and medications to avoid drug interactions
• Provide recommendations on routine and lifestyle, taking individual characteristics into account
• Discuss monitoring criteria and the timing of follow-up if the condition changes
• Carry out an initial assessment of possible causes using a differential diagnostic approach
• Choose a treatment strategy with step-by-step monitoring and the option to adjust it

A comprehensive approach helps not only reduce panic attack symptoms, but also improve quality of life, minimize the risk of complications, and prevent recurrent flare-ups. The doctor will provide ongoing follow-up so that the treatment plan can be adjusted in time to meet your needs.

What questions can you ask a doctor about panic attacks?

At an appointment about panic attacks, you can discuss the following with Igor Stanislavovich Shkinder:

• Frequent episodes of intense fear or anxiety without an obvious cause
• A feeling of shortness of breath and difficulty breathing during an attack
• Increased heartbeat and a sense of anxiety that interferes with everyday life
• Recurrent symptoms that make it difficult to work or sleep
• No improvement with prescribed treatment or self-help measures
• Associated heavy workload, chronic stress, or other illnesses
• The need for a second opinion on tests or examinations already performed
• Unclear symptoms after stressful events or trauma

If shortness of breath suddenly worsens, consciousness becomes significantly impaired, or there are severe interruptions in heart rhythm, emergency care is needed — do not wait for a scheduled appointment.

Questions you can discuss during the consultation:

1. What is happening to me, and what could it be?
2. Why did the panic attacks start now?
3. How can a panic attack be distinguished from other conditions?
4. What examinations will be needed in my case?
5. Which tests or studies can be skipped?
6. How should I prepare for the examinations and the doctor’s appointment?
7. What treatment options are available for panic attacks?
8. Can this condition be completely cured, or is it a long-term process?
9. What should I do if the current treatment does not help?
10. Is it possible to avoid medication or procedures?
11. How long does treatment last, and how often are follow-up visits needed?
12. What signs indicate improvement or worsening of the condition?

If worrisome, acute, or new symptoms appear, it is best to seek help immediately. During the appointment, you can discuss your concerns in detail, determine the next steps, and plan examinations to ensure comprehensive and safe management of the condition.

How the consultation takes place

A consultation with a neurologist for panic attacks is a detailed review of your complaints, an assessment of your current condition, and the creation of a plan for further steps. The scope of examinations is determined individually, based on your symptoms and medical indications. We do not make a final diagnosis in a single appointment — the goal of the initial visit is to understand the key issues and outline possible solutions.

Main stages of the consultation:

1. Clarifying your complaints and the purpose of the visit: what exactly is troubling you, when it started, what makes the symptoms worse or better, and what you expect from the consultation.
2. Taking a medical history, with attention to risk factors, stressful events, and the overall condition of the nervous system.
3. Discussing any previous treatment and examinations — it is important to bring test results, examination reports, or a list of medications.
4. Assessing your general condition and performing a neurological examination, including checking basic reflexes and cognitive functions if necessary.
5. Preliminary review of the situation, identifying likely causes, and ruling out dangerous conditions (without making an exact diagnosis based on the description alone).
6. Creating an individualized examination plan, which may include laboratory tests, an ECG, brain MRI, or other studies based on the initial assessment.
7. Determining a treatment strategy and follow-up plan, taking into account your individual characteristics, comorbidities, and response to previous therapies.
8. Discussing the timing and format of follow-up visits: when you should return and what to pay attention to in the course of the condition.

If you are seeking help for this symptom for the first time, the main focus is on clarifying your complaints and identifying the possible cause. If treatment was prescribed before but did not produce the desired effect, the goal of the consultation is to understand why this happened and adjust the plan accordingly.

Preparing for Your Appointment

Proper preparation for a neurology appointment helps identify the causes of symptoms more quickly and create an effective treatment plan. Follow our checklist to make your visit as productive as possible.

• Bring a list of all current medications, including names, dosages, and how often you take them
• Bring the results of any previous tests, including brain MRI, ECG, blood tests, and other examinations
• Write down when and how the symptoms begin, and what relieves or worsens them
• Do not stop taking prescribed medications without consulting your doctor
• If you are unsure about any preparation details, ask for clarification when booking or by phone
• If required, follow fasting instructions: do not eat or drink for 8–12 hours beforehand, unless otherwise advised
• Avoid applying makeup or creams, or wearing contact lenses before the appointment, if you were instructed to do so in advance
• Bring a list of questions and observations to discuss your condition more fully
• Prepare documents confirming any chronic conditions or specific health concerns
• If possible, note any changes in your condition over the recent period to share with the doctor

If you still have questions about preparation, it is best to уточнить the details at the reception desk. Do not change your treatment on your own without consulting a specialist.

About the Doctor

Shkinder Igor Stanislavovich is a neurologist of the highest category with over 20 years of experience. He works with patients who experience panic attacks, including cases with recurring symptoms, a chronic course, or no effect from previous treatment.

In his practice, the doctor emphasizes accurate diagnosis of the underlying causes and ongoing follow-up, which helps adjust treatment tactics in a timely manner. Special attention is paid to comorbidities and the patient’s individual characteristics.

During the consultation, you will receive a clear explanation of the situation and a plan for next steps.

Why Patients Choose Dr. Igor Stanislavovich Shkinder

When treating panic attacks, a comprehensive approach is essential, one that focuses on accurately identifying the causes and taking into account the patient’s individual characteristics. Igor Stanislavovich Shkinder structures his work so that each stage of therapy is clear, transparent, and adapted to the current situation. Unlike other specialists, he pays special attention to reviewing previous prescriptions and possible side effects, as well as monitoring changes in the patient’s condition.

• A clear action plan with stages: examination, treatment, monitoring, and adjustment
• Tests are prescribed only when indicated, to avoid unnecessary procedures
• Consideration of comorbidities and drug interactions to ensure treatment safety
• Review of previously prescribed medications and analysis of tolerability to adjust treatment
• Monitoring of effectiveness and timely correction if the response to treatment is insufficient
• Emphasis on identifying the causes of panic attacks in complex and ambiguous cases
• Opportunity to discuss and interpret the results of examinations already completed
• Ongoing follow-up of the patient over time, including new symptoms and therapy adjustments

This systematic and precise approach makes it possible to work directly with the underlying causes of the condition, minimize risks, and manage the course of the illness. For patients, this means a clearer path to improvement and greater treatment safety.

Case Studies

Initial Consultation for Panic Symptoms

A middle-aged patient presented with frequent episodes of anxiety accompanied by shortness of breath and palpitations. The sudden onset of symptoms and their impact on work were a concern. It was important to rule out acute somatic causes and identify the main triggers of the condition. A detailed interview, neurological examination, and additional tests were ordered as indicated. Over the course of several weeks, the frequency of attacks decreased, and the condition stabilized. Further management included regular follow-up and lifestyle modification.

Treatment Adjustment Due to Lack of Effect

A young woman presented with persistent panic attacks despite treatment already prescribed at another clinic. The physician reviewed the medical history in detail, assessed medication tolerance, and identified additional stress factors. Adjustments were made to the patient’s management, including a revision of the support strategy and recommendations regarding daily routine. After one month, her condition improved, and the attacks became less severe and less frequent. Monitoring continues to maintain stability.

Chronic Course with Comorbid Conditions

An elderly female patient presented with a long history of panic episodes, worsened by arterial hypertension and sleep disturbance. The situation required a comprehensive approach, taking comorbid conditions and drug interactions into account. The physician performed a detailed review of the current medications, ordered additional examinations, and developed a plan for gradual improvement. Over several months, the symptoms stabilized and quality of life improved. The plan includes regular monitoring and therapy adjustment according to the patient’s condition.

Exacerbation After a Stressful Event

A middle-aged man sought care during a period of sudden worsening of panic symptoms following severe stress. It was important to quickly rule out life-threatening conditions and adjust treatment. After the initial examination and necessary diagnostic procedures, a support and relapse-prevention plan was developed. Over time, the severity of symptoms gradually decreased. Follow-up visits are planned to monitor the condition and adapt treatment.

Recurrent Symptoms and the Need for a Second Opinion

A middle-aged female patient presented with recurrent anxiety episodes and doubts about previously established diagnoses. The physician conducted a comprehensive assessment of her complaints, medical history, and prior test results. Particular attention was paid to differential diagnosis in order to exclude other possible causes. Based on the examination, a plan for further monitoring and treatment was proposed. The patient’s condition is being monitored, with emphasis on adjusting therapy if necessary and maintaining quality of life.

How long does a consultation last?

A consultation usually takes 30–60 minutes; please confirm when booking.

How should I prepare for the appointment?

Prepare a list of symptoms, your questions, and all available test results or examinations for discussion.

What should I bring to the appointment?

Bring your test results, medical reports/discharge summaries, and a list of medications you are taking.

Do I need to come on an empty stomach?

Usually no, unless otherwise specified when booking.

How many visits are usually required?

It depends on your condition; in most cases, several visits are needed for assessment and follow-up.

When can I expect the first results from treatment?

It depends on your individual response and the chosen treatment approach.

What should I do if I get worse before the appointment?

If you have urgent symptoms, seek emergency care and do not wait for the appointment.

Can treatment be combined with my current medications?

Discuss this with your doctor; do not stop or add medications on your own.

Can I have an online consultation?

Yes, online consultations are available by prior appointment.

Can I come with tests that have already been done?

Yes, bring all your results for a more complete assessment.

Do I need to come back for follow-up, and how often?

The frequency depends on how your condition changes and the goal of treatment.

Can I get a second opinion about my condition?

Yes, the doctor is ready to review and discuss any examinations you have already had.

What should I do if symptoms return after improvement?

Inform your doctor; your monitoring plan may need to be adjusted.

What tests may be needed for panic attacks?

The list is determined individually, and the doctor will discuss the necessary tests with you.

Can I book an appointment without preliminary tests?

Yes, many issues can be addressed during the initial consultation, with a further plan to follow.

How do I know when I need to see a doctor urgently?

If you have sudden worsening, severe shortness of breath, loss of consciousness, or severe heart-related symptoms.

Can I receive treatment if I have other chronic conditions?

Yes, we take comorbid conditions into account to ensure safe treatment.

What is the goal of the first consultation?

To identify the causes of your symptoms and create a plan for examination and treatment.

What if I can’t come to the consultation in person?

Remote consultations are available for a full review of your situation.

Should I keep a symptom diary?

Yes, it is recommended to make it easier to analyze your condition during the appointment.