Panic Attacks and Panic Disorder

Medicines for panic disorder are often used to control the symptoms of panic attacks, reduce their number and severity, and reduce the anxiety and fear associated with having another attack. Medicines work best if they are used along with counseling and home treatment, such as relaxation exercises.²

Medication Choices

Medicines used most often to treat panic attacks include the following:⁸

• Selective serotonin reuptake inhibitors (SSRIs), such as Prozac, Zoloft, or Paxil
• Benzodiazepines, such as Xanax, Valium, Ativan, or Klonopin

Medicines sometimes used to treat panic disorder include the following:

• Antidepressants with mixed neurotransmitter effects, such as venlafaxine (Effexor)⁷
• Tricyclic antidepressants (TCAs), such as Tofranil, Norpramin, or Anafranil
• Monoamine oxidase inhibitors (MAOIs), such as Marplan, Nardil, or Parnate

What To Think About

Panic disorder is best treated with both medicines and counseling such as cognitive-behavioral therapy, which focuses on modifying certain thinking and behavior patterns. When these two therapies are combined, relapses of panic attacks occur far less frequently than when only one treatment is used.¹¹

Your symptoms of panic disorder should start to improve within a few weeks after beginning medicines. If improvement is not seen within 6 to 8 weeks, a higher dose or another medicine may be needed.¹⁰

Most medicines used to treat panic attacks need to be continued for a year or longer and then may be decreased gradually over several weeks.¹² If you experience panic attacks again while medicines are being stopped, the medicines may be continued for at least a few months more. Some people may need to stay on medicines for a long time to keep symptoms under control.

You may also need to be reevaluated for other conditions associated with panic disorder, such as depression or substance abuse, because having one of these conditions makes treatment more difficult.^{8, 1}