Hyperventilation Syndrome Medication
- Author: Brian Kern, MD; Chief Editor: Ryland P Byrd, Jr, MD more...
Benzodiazepines are effective in reducing stress that may provoke hyperventilation syndrome (HVS) and are thought to reset the central nervous system (CNS) response to a variety of “panicogens.” Selective serotonin reuptake inhibitors (SSRIs) have been reported to reduce the frequency and the severity of episodes of hyperventilation.
Benzodiazepines are useful in the treatment of hyperventilation resulting from anxiety and panic attacks. By binding to specific receptor sites, these agents appear to potentiate the effects of gamma-aminobutyric acid (GABA) and to facilitate inhibitory GABA neurotransmission and the actions of other inhibitory transmitters.
Alprazolam is indicated for treatment of anxiety and management of panic attacks.
Lorazepam is a sedative-hypnotic of the benzodiazepine class that has a short time to onset of effect and a relatively long half-life. By enhancing the action of GABA, a major inhibitory neurotransmitter, it may depress all levels of the CNS, including the limbic area and reticular formation.
Diazepam depresses all levels of the CNS (eg, limbic and reticular formation), possibly by increasing the activity of GABA. It is considered second-line therapy for seizures.
SSRIs are useful in treating hyperventilation associated with anxiety.
Paroxetine is the alternative drug of choice for HVS. It is a potent selective inhibitor of neuronal reuptake of serotonin and has a weak effect on neuronal reuptake of norepinephrine and dopamine.
Shu BC, Chang YY, Lee FY, et al. Parental attachment, premorbid personality, and mental health in young males with hyperventilation syndrome. Psychiatry Res. 2007 Oct 31. 153(2):163-70. [Medline].
Martinez JM, Kent JM, Coplan JD, et al. Respiratory variability in panic disorder. Depress Anxiety. 2001. 14(4):232-7. [Medline].
Bartley J. Nasal congestion and hyperventilation syndrome. Am J Rhinol. 2005 Nov-Dec. 19(6):607-11. [Medline].
Castro PF, Larrain G, Perez O, et al. Chronic hyperventilation syndrome associated with syncope and coronary vasospasm. Am J Med. 2000 Jul. 109(1):78-80. [Medline].
Ong JR, Hou SW, Shu HT, et al. Diagnostic pitfall: carbon monoxide poisoning mimicking hyperventilation syndrome. Am J Emerg Med. 2005 Nov. 23(7):903-4. [Medline].
Malmberg LP, Tamminen K, Sovijarvi AR. Orthostatic increase of respiratory gas exchange in hyperventilation syndrome. Thorax. 2000 Apr. 55(4):295-301. [Medline].
Gibson D, Bruton A, Lewith GT, et al. Effects of acupuncture as a treatment for hyperventilation syndrome: a pilot, randomized crossover trial. J Altern Complement Med. 2007 Jan-Feb. 13(1):39-46. [Medline].
Barker NJ, Jones M, O'Connell NE, Everard ML. Breathing exercises for dysfunctional breathing/hyperventilation syndrome in children. Cochrane Database Syst Rev. 2013 Dec 18. 12:CD010376. [Medline].
Chenivesse C, Similowski T, Bautin N, et al. Severely impaired health-related quality of life in chronic hyperventilation patients: exploratory data. Respir Med. 2014 Mar. 108(3):517-23. [Medline].
Jones M, Harvey A, Marston L, O'Connell NE. Breathing exercises for dysfunctional breathing/hyperventilation syndrome in adults. Cochrane Database Syst Rev. 2013 May 31. 5:CD009041. [Medline].
Nardi AE, Freire RC, Zin WA. Panic disorder and control of breathing. Respir Physiol Neurobiol. 2009 May 30. 167(1):133-43. [Medline].