What are the discharge instructions for a patient who had a panic attack induced by Vyvanse (lisdexamfetamine) and was treated with lorazepam?

Discharge Instructions for Patient with Vyvanse-Induced Panic Attack Treated with Lorazepam

Patients who experience a panic attack induced by Vyvanse (lisdexamfetamine) and treated with lorazepam should discontinue Vyvanse immediately, monitor for recurrence of anxiety symptoms for 24-48 hours after lorazepam administration, and follow up with their primary care provider within 1 week.

Medication Management

Vyvanse (Lisdexamfetamine)

• Stop taking Vyvanse immediately until you can discuss with your prescribing physician
• Amphetamines like Vyvanse can cause tachycardia, hypertension, and anxiety symptoms that may precipitate panic attacks 1
• Do not restart this medication without consulting your healthcare provider

Lorazepam

• Take lorazepam only as prescribed for breakthrough anxiety symptoms
• Typical dosing is 0.5-1 mg every 4-6 hours as needed for anxiety 1
• Do not exceed prescribed dose or frequency
• Be aware that benzodiazepines like lorazepam can cause:
  • Drowsiness and sedation
  • Increased risk of falls
  • Potential for dependence with prolonged use 1
• Do not drive or operate machinery while taking lorazepam
• Avoid alcohol and other CNS depressants while taking lorazepam

Monitoring Instructions

• Monitor for recurrence of anxiety symptoms for 24-48 hours after lorazepam administration
• Watch for signs of respiratory depression, especially if additional doses of lorazepam are taken 1
• Be aware that even a single dose of lorazepam can have effects lasting 24-72 hours 2
• If severe anxiety returns after lorazepam wears off, contact your healthcare provider rather than taking additional doses

Warning Signs Requiring Immediate Medical Attention

Seek immediate medical care if you experience:

• Difficulty breathing or shortness of breath
• Chest pain or palpitations
• Severe dizziness or fainting
• Worsening anxiety despite medication
• Thoughts of harming yourself or others
• Confusion or disorientation

Follow-up Care

• Schedule an appointment with your primary care provider within 1 week
• Schedule an appointment with your psychiatrist or the provider who prescribed Vyvanse within 2 weeks
• Bring a list of all medications you are currently taking to your appointments
• Be prepared to discuss alternative treatment options for your original condition that required Vyvanse

Lifestyle Recommendations

• Practice stress-reduction techniques such as deep breathing, progressive muscle relaxation, or mindfulness meditation
• Maintain regular sleep patterns and adequate sleep hygiene
• Avoid caffeine, energy drinks, and other stimulants that may trigger anxiety
• Engage in regular physical activity as tolerated, which can help reduce anxiety symptoms
• Consider cognitive-behavioral therapy (CBT) as a non-pharmacological approach to managing anxiety 3

Additional Information

• Panic attacks, while frightening, are not life-threatening
• The combination of stimulants (like Vyvanse) and anxiety disorders increases the risk of panic attacks
• Benzodiazepines like lorazepam are effective for acute management of panic symptoms but are not recommended for long-term use 4
• Alternative non-stimulant medications may be considered for your underlying condition

Remember that this was likely a medication-induced panic attack, and proper medication adjustment can prevent future episodes. Follow up with your healthcare providers as recommended to develop an appropriate treatment plan.