A member asked:

Normal mri . having episodes of scintillating scotoma when i panic. doctor gave me prozac (fluoxetine) and told me it will go away when panic goes. is this true?

6 doctors weighed in across 3 answers

Depends on cause: Scintillating scotomata are much more common in migraine headaches. I don't see Prozac (fluoxetine) as being a very effective drug for migraine. It is possible to have scintillating scotoma in what is called acephalgic migraine, which is migraine minus the pain. It is possible that that symptom is triggering your panic. It is not in itself likely to be part of the panic attack although it may cause the panic attack. You may need some migraine prophylaxis. Please see a neurologist and coordinate treatment with your psychiatrist.

Answered 6/30/2014

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Dr. Brian Sucheski answered

Specializes in Ophthalmology

Likely migraine: Scintillating scotomas that last 20-30 minutes are likely a form of visual migraines. I'm glad the MRI is normal. Stress (panic) will often increase the likelihood of migraine, hence your doctor's recommendation. Several classes of drugs may reduce your migraines, so your doctor can help find the proper one for you.

Answered 6/10/2014

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Maybe...: If the 'scotoma' is due to migraine, then stress and anxiety is a common trigger, so reducing them helps. But Prozac (fluoxetine) isn't a very effective migraine prevention medication, so if these are migrainous events something else may work better. If on the other hand you have flashers due to hyperventilation, then stopping the panic attack is the successful strategy. Lifestyle change is key with either.

Answered 2/4/2017

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