Taking Securon (Verapamil) For Panic Attacks
In our latest question and answer, the pharmacist discusses the use of Securon (verapamil) for panic attacks.
Hi my doctor prescribed me Securon today for panic attacks. Are these safe to use for panic attacks?
Securon SR is a brand name extended release tablet containing the drug verapamil hydrochloride. Securon SR 240 mg, and the lower dose version, Half Securon SR 120 mg, are formulations that from what I can gather are marketed in the United Kingdom. For readers on either side of the pond, I'll just refer to the actual drug, verapamil.
Verapamil - Calcium Channel Blocker
Verapamil is the first drug developed in a class called calcium channel blockers (CCBs). These drugs block a certain type of receptor in your body that is normally activated by calcium. Since these calcium receptors are especially concentrated in parts of your heart and blood vessels, their main effect is to lower blood pressure by causing your blood vessels to relax and widen.
Use Of Verapamil For Panic Attacks
The use of CCBs in treating anxiety and panic disorders is not very well documented. In my research, I was able to find only a couple mentions of the possible role of calcium in anxiety disorders, and essentially no information on the safety or efficacy of using verapamil, or any CCB for that matter, in management of panic attacks or other mood disorders.
One small study, completed in 2006, reported some positive results stating that verapamil has modest antianxiety and antipanic properties,. Nevertheless, more studies are needed to show whether or not verapamil is a better or safer option than other therapies available.
Having nothing to go on, I can at least give you some more information about verapamil in general, because there is a wealth of information on its use in treating high blood pressure and chest pain (called angina pectoris in medical terms). Verapamil is a pretty old drug, and while it is still in consistent use, it has some downsides that make it a less preferred option compared to some of the newer calcium channel blockers.
Information About Verapamil
The most common side effect of verapamil is constipation (7.3%). Others include dizziness (3.3%), nausea (2.7%), low blood pressure (2.5%), and headache (2.2%).
The main concern with verapamil is that it interacts with a lot of other medications, often in ways that could potentially be harmful if not accounted for. This is because in addition to being metabolized by a large number of different enzymes, it also reduces the activity of those same enzymes, and also of transporter proteins that move metabolic products and other chemicals out of the body. The most significant of these are cytochrome P450 3A4 (CYP 3A4), one of the main metabolic enzymes in your liver, and p-glycoprotein, a transporter responsible for keeping potentially harmful molecules out of sensitive areas of your body (the brain, for example).
Verapamil can have serious interactions with other drugs that alter the activity of CYP 3A4, and especially with other drugs that are metabolized by CYP 3A4. The most important of these to be aware of is the class of cholesterol lowering drugs called statins. The blood levels of simvastatin (Zocor), lovastatin, and atorvastatin (Lipitor) can be greatly increased when taken with verapamil, and this has been associated with increased risk of statin-induced muscle damage.
Verapamil can also interact with alcohol, aspirin, beta-blockers (propranolol, metoprolol, atenolol), digoxin, other drugs for high blood pressure, grapefruit juice, and others. These drugs can be safely used together, but it's very important that the doctor who prescribed you verapamil is aware of any other prescription or non-prescription drugs or dietary supplements you take. Basically, whatever you ingest that isn't food or drink, you should make your doctor aware of. That's by far the best way to reduce your risk of problems with your treatment.
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