Freespira Offers New Hope for Patients with Panic Attacks

Physician shares insights on promising new therapy

The space between breaths: It's here, perhaps, where a panic attack begins — and where a small seed of worry planted in a person’s mind begins to grow, morphing into paralyzing “what ifs.”

Before panic strikes, patients often breathe irregularly, typically too deeply. This hyperventilation leads to an imbalance of CO₂ in the bloodstream and fuels the panic cycle of dizziness, nausea, and other physical symptoms.

That's where Freespira can help.

A medication-free approach helping patients with panic

Freespira is an FDA-cleared treatment that recently became available to non-Medicare-Advantage Highmark members. The at-home, medication-free, one-month treatment addresses certain underlying physiological causes of panic: chronic hyperventilation and/or other irregular breathing patterns.

“Freespira retrains patients to breathe correctly,” said Alicia Kaplan, MD, a psychiatrist with Allegheny Health Network (AHN) in Pittsburgh, who has prescribed the therapy to roughly a dozen of her patients who are Highmark members. “They are taught to breathe with their lower abdominal muscles. Shallow abdominal breathing helps them achieve proper CO₂ levels, which can reduce or eliminate panic symptoms.”

With an authorization from their network physician or behavioral health specialist, eligible Highmark members receive a tablet computer containing the Freespira app. They also get a highly advanced sensor that measures their breathing rate and exhaled CO₂ level, sending these values to the tablet in real-time.

Patients complete two 17-minute sessions daily for four consecutive weeks, and then the treatment is complete. They use Freespira in the comfort and privacy of their homes, and a clinician trains and monitors each patient.

“The Freespira app actually shows patients what their CO₂ level is while they are completing the therapy,” said Dr. Kaplan, who participated in a Freespira Quality Improvement Program from 2015 through 2017 with VITAL , Highmark Health, and AHN. “So patients can actively participate in learning how to gradually bring up their CO₂ level over time by adjusting their breathing.”

Traditional treatments for panic include cognitive behavioral therapy and use of anti-depressant medications. But a growing number of therapists are incorporating innovative approaches as part of treatment, Dr. Kaplan said.

“Panic disorder can be a very disabling condition. Patients avoid situations that make them panic, so their world literally becomes a lot smaller,” said Dr. Kaplan, who specializes in treating anxiety disorders. “My patients who were treated with Freespira have reported they experience fewer panic symptoms. And it's giving them sustained results. So they are seeing their world — their lives — opening up again.”

Encouraging results

The Freespira Quality Improvement Program showed promising improvements for patients. Dr. Kaplan presented the following Freespira results at the Anxiety and Depression Association of America's annual meeting last April in Washington, DC:

• 85% of patients reported they were free of panic attacks immediately after treatment ended
• 83% reported significant symptom reduction immediately after treatment concluded
• 81% said they were free of panic attacks 12 months after treatment
• 94% reported significant symptom reduction 12 months after treatment

The program also showed that Freespira reduced costs. Overall medical expenditures for Highmark members who completed the treatment decreased by 50%. Costs for care provided in the emergency department (where many panic disorder patients go during or after an attack) dropped by 64%.

Dr. Kaplan said Freespira is a viable treatment option for panic attacks, giving patients a tool to effectively manage their symptoms for the long term, with confidence.

“They're learning how their bodies can feel differently if they breathe in a different way. It's very empowering for patients to know they can help themselves,” Dr. Kaplan said. “I want people to know there is hope, and Freespira is a tool that may help them.”

Watch Provider News for more information and updates on Freespira.

Important note: This article is informational only. Highmark does not recommend particular treatments or health care services. Members’ access to Freespira is conditioned upon the authorization of a physician or health care professional. Coverage of Freespira is subject to the terms of each member’s benefit plan. Additionally, state laws and regulations governing health insurance, health plans, and coverage may apply and will vary from state to state. VITAL is a program funded by Highmark Health. Please visit the link above for more information about VITAL.