Acupuncture treatment for a patient with panic disorder

a case suggesting the importance of understanding pathology and building trust

Abstract

[Introduction] We report our experience with a patient with panic disorder (PD) , which suggests the importance of building a trusting relationship between the patient and the acupuncturist.[Case] A 69-year-old woman with PD presented to our acupuncture clinic with anxiety and difficulty breathing. Her symptoms appeared six months prior, and later, she presented to the emergency department of A Hospital with dyspnea and nausea. Shehad a significant medical history of RLS and rheumatoid arthritis. She was diagnosed with PD at the Department of Oriental Medicine of the same hospital. Her symptoms improved with herbal remedies; however, anxiety and difficulty breathing persisted. Her symptoms at the first acupuncture visit were dyspnea, chest tightness, and anxiety regarding seizures that occurred once or twice a week. She also experienced insomnia and nocturnal hot flashes in her legs. She had no panic attacks or prevailing anxiety, and her neurological and cardiovascular parameters were normal. During the treatment period of 91 days, 14 acupuncture and moxibustion treatments were performed once a week. GV20, PC6, HT7, ST36, SP6, LV3, GB20, BL13, BL15, LI4, BL23, and BL33 were used for mood symptoms, and KI9, BL57, and KI3 were used for toe symptoms. After the second visit, BL10, GB21, and SL14 were performed for neck and shoulder symptoms, and Ex-LE10 and plantar nerve acupuncture were performed for coldness in the lower extremities. Moxibustion was applied to SP6, KI3, and LV3.[Course] After the initiation of acupuncture, anxiety and difficulty breathing were almost resolved by the second treatment session; however, insomnia and hot flashes in the lower extremities worsened in the seventh round of treatment. The patient had also hoped for the resolution of the insomnia-related symptoms using acupuncture. However, since acupuncture was ineffective, we explained the need for specialized treatment and referred her case to a psychiatrist. She was diagnosed with restless leg syndrome, and treatment was initiated using pramipexole, which improved hersymptoms.[Discussion] In this case, acupuncture and moxibustion treatment were effective for the symptoms associated with panic disorder. Additionally, the importance of providing opportunities for appropriate medical consultations as needed was demonstrated.