Panic Attack Medications: Common Panic Disorder Treatments

Important Information About Panic Attack Medications:

• If prescribed panic attack medications:
• Do not stop taking them or change your dosage without talking to your healthcare provider first.
• Some medications can cause serious or even life-threatening withdrawal symptoms if you stop taking them suddenly.

Medications are a common and effective treatment for panic disorder, panic attacks, and agoraphobia. Panic attack medications can help reduce the severity of panic attacks, ease general anxiety, and even treat other conditions that often occur along with panic disorder, such as depression.

Panic Disorder Treatment:

Treatment for panic disorder may include both medication and psychotherapy. In some cases, people with panic disorder may be prescribed two or more medications to better manage their symptoms of panic and anxiety.

For example, a person might take an antidepressant every day to help reduce the frequency of their panic symptoms, and they might also take a benzodiazepine as needed to help relieve the severity of their panic attacks.

On-Label vs. Off-Label Medications:

Medications that are approved by the FDA to treat panic disorder include fluoxetine (Prozac), sertraline (Zoloft), paroxetine (Paxil), venlafaxine (Effexor XR), clonazepam (Klonopin), and alprazolam (Xanax). However, your healthcare provider may prescribe other medications “off-label” based on your specific needs.

Psychotherapy can also be helpful for managing panic disorder. Some types of psychotherapy that may be helpful for panic disorder include:

• Cognitive-behavioral therapy (CBT)
• Exposure therapy
• Psychodynamic therapy

Antidepressant Medications for Panic Disorder:

• Antidepressants were first introduced in the 1950s, and although they were originally used primarily to treat mood disorders, it was later discovered that they could also be effective for reducing anxiety, easing panic symptoms, and decreasing the frequency and severity of panic attacks.
• Antidepressants are now widely used to treat a variety of anxiety disorders, including panic disorder and agoraphobia. They work by affecting the levels of certain neurotransmitters in the brain that are involved in mood and anxiety.

Selective Serotonin Reuptake Inhibitors (SSRIs):

• A popular class of antidepressants that are prescribed to relieve symptoms of depression and anxiety.
• SSRIs work by selectively targeting serotonin, a neurotransmitter that is involved in mood, and preventing nerve cells in the brain from reabsorbing it.
• Common SSRIs include:
• Fluoxetine (Prozac)
• Sertraline (Zoloft)

• Paroxetine (Paxil)

• Studies have shown that SSRIs are effective for long-term treatment of panic disorder, and they generally have fewer side effects than other types of antidepressants. This makes SSRIs the preferred prescription medication for panic disorder.

Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs):

• SNRIs work similarly to SSRIs by blocking the reuptake of serotonin and norepinephrine. Norepinephrine is a neurotransmitter that is involved in focus and alertness.
• Common SNRIs include:
• Venlafaxine (Effexor XR)

• Duloxetine (Cymbalta)

• SNRIs have been found to be effective for treating a variety of anxiety disorders, including social anxiety disorder.

• Side effects of SNRIs can include fatigue, insomnia, changes in appetite, and sexual dysfunction.
• Effexor XR is approved by the FDA to treat panic disorder, while Cymbalta may be prescribed off-label for this condition.

Tricyclic Antidepressants (TCAs):

• TCAs have become less popular since the introduction of SSRIs, but they may still be effective for treating anxiety disorders.
• Like SSRIs, TCAs block the reuptake of serotonin, and they may also affect the reuptake of norepinephrine.
• Common TCAs include:
• Amitriptyline (Elavil)
• Nortriptyline (Pamelor)

• Desipramine (Norpramin)

• TCAs can cause side effects such as dry mouth, constipation, blurred vision, and difficulty urinating.

Monoamine Oxidase Inhibitors (MAOIs):

• MAOIs are among the oldest antidepressants, and they are effective for treating mood disorders and anxiety disorders.
• MAOIs work by inhibiting the activity of monoamine oxidase, an enzyme that breaks down neurotransmitters such as serotonin, norepinephrine, and dopamine.
• Common MAOIs include:
• Selegiline (Eldepryl)
• Phenelzine (Nardil)
• Isocarboxazid (Marplan)

• Tranylcypromine (Parnate)

• Although MAOIs are effective, they are prescribed less often because they require dietary restrictions and can interact with many other medications.

Anti-Anxiety Medications:

• Anti-anxiety medications are prescribed to provide rapid relief from symptoms of anxiety.
• These medications work by calming the central nervous system, which can help reduce the intensity of panic attacks and promote a sense of relaxation.

Benzodiazepines:

• Benzodiazepines are the most commonly prescribed class of anti-anxiety medications for panic disorder.
• Benzodiazepines work by targeting GABA receptors in the brain, which helps to produce feelings of calmness.
• Because benzodiazepines are sedatives, they can quickly relieve symptoms of panic attacks and promote relaxation.
• Common benzodiazepines include:
• Lorazepam (Ativan)
• Clonazepam (Klonopin)
• Chlordiazepoxide (Librium)
• Diazepam (Valium)

• Alprazolam (Xanax)

• Benzodiazepines can be habit-forming, so they are typically prescribed for short-term relief of anxiety symptoms.

• Although benzodiazepines are effective, they can cause physical dependence and withdrawal symptoms if they are stopped suddenly.
• It is important to gradually taper off of benzodiazepines under medical supervision to avoid withdrawal complications.

If you or someone you know is struggling with anxiety, you can call the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 1-800-662-HELP (4357) for information on support and treatment facilities in your area.