Helpful Panic Attack Medications
While almost all sources recommend the use of some form of psychological or behavioral therapy for the long-term treatment of panic attack and panic attack disorder, for many patients drug therapy is an appropriate treatment choice, at least initially, and sometimes for extended periods. Panic attack medications can greatly benefit the user, if used appropriately and only for the duration in which you need it.
For an acute, active panic attack, anti-anxiety medication can significantly reduce the immediate effects of the episode. This is often the treatment of choice for patients who arrive at the emergency room. The most commonly prescribed anti-anxiety drugs, or benzodiazepines, include clonazepam (Klonopin) and alprazolam (Xanax). Since the benzodiazepines are quick-acting drugs, they are often prescribed temporarily at the beginning of treatment to control symptoms until an anti-depressant can take effect. Though some experts feel that benzodiazepines are effective for continued treatment, they are not generally recommended long-term since they create dependency quickly and their effectiveness tends to decline after a few weeks. As sedatives, the benzodiazepines are also likely to cause sleepiness, impair coordination, and slow reaction time. Less than two weeks is the recommended length for someone to remain on a standing dose of these medications. However, they can also be prescribed for use on an as-needed basis for immediate treatment of an attack.
For longer-term treatment, anti-depressants are currently the preferred class of drug for panic attacks. Although anti-depressants are of course best known for treating depression, most are also effective against a variety of anxiety disorders, including panic attacks. Tricyclic antidepressants, monoamine oxidase inhibitors (MAOIs), selective serotonin reuptake inhibitors (SSRIs), and serotonin/norepinephrine reuptake inhibitors (SNRIs) have all been found effective. Current thinking seems to prefer the SSRIs (e.g., Prozac, Zoloft, Paxil, Celexa, Lexapro, and Luvox) as having fewer side effects. Tricyclics have been available longer and have been more widely studied for treating panic attacks, but doctors and patients often prefer the newer drugs because tricyclics sometimes cause dizziness, drowsiness, dry mouth and weight gain. Monoamine oxidase inhibitors are the least favored because they make dietary restrictions necessary and can interact with other medications to cause a dangerously elevated blood pressure and other serious reactions.
Anti-depressants are usually started at low dosages and gradually increased until a therapeutic level is reached. Anti-anxiety drugs will often be prescribed to control symptoms during this initial period. Anti-depressants need to be discontinued gradually as well, since a sudden cessation can actually induce panic attacks.
Beta blockers such as propranolol block some of the peripheral symptoms of anxiety. For someone who suffers from panic disorder, taking a beta blocker in advance of some potential triggering event (such as a plane flight or a public performance of some kind) can prevent physical symptoms like rapid heartbeat, hot flash, or dry mouth, which are for many people are the first signs of a panic attack and quickly escalate to a full blown panic attack.
All of these medications do have some undesirable side effects. In the long run all of them are probably best combined with other therapies, with the goal of allowing the patient to gain sufficient control of their panic disorder so that drug treatment can be eventually discontinued.
For an acute, active panic attack, anti-anxiety medication can significantly reduce the immediate effects of the episode. This is often the treatment of choice for patients who arrive at the emergency room. The most commonly prescribed anti-anxiety drugs, or benzodiazepines, include clonazepam (Klonopin) and alprazolam (Xanax). Since the benzodiazepines are quick-acting drugs, they are often prescribed temporarily at the beginning of treatment to control symptoms until an anti-depressant can take effect. Though some experts feel that benzodiazepines are effective for continued treatment, they are not generally recommended long-term since they create dependency quickly and their effectiveness tends to decline after a few weeks. As sedatives, the benzodiazepines are also likely to cause sleepiness, impair coordination, and slow reaction time. Less than two weeks is the recommended length for someone to remain on a standing dose of these medications. However, they can also be prescribed for use on an as-needed basis for immediate treatment of an attack.
For longer-term treatment, anti-depressants are currently the preferred class of drug for panic attacks. Although anti-depressants are of course best known for treating depression, most are also effective against a variety of anxiety disorders, including panic attacks. Tricyclic antidepressants, monoamine oxidase inhibitors (MAOIs), selective serotonin reuptake inhibitors (SSRIs), and serotonin/norepinephrine reuptake inhibitors (SNRIs) have all been found effective. Current thinking seems to prefer the SSRIs (e.g., Prozac, Zoloft, Paxil, Celexa, Lexapro, and Luvox) as having fewer side effects. Tricyclics have been available longer and have been more widely studied for treating panic attacks, but doctors and patients often prefer the newer drugs because tricyclics sometimes cause dizziness, drowsiness, dry mouth and weight gain. Monoamine oxidase inhibitors are the least favored because they make dietary restrictions necessary and can interact with other medications to cause a dangerously elevated blood pressure and other serious reactions.
Anti-depressants are usually started at low dosages and gradually increased until a therapeutic level is reached. Anti-anxiety drugs will often be prescribed to control symptoms during this initial period. Anti-depressants need to be discontinued gradually as well, since a sudden cessation can actually induce panic attacks.
Beta blockers such as propranolol block some of the peripheral symptoms of anxiety. For someone who suffers from panic disorder, taking a beta blocker in advance of some potential triggering event (such as a plane flight or a public performance of some kind) can prevent physical symptoms like rapid heartbeat, hot flash, or dry mouth, which are for many people are the first signs of a panic attack and quickly escalate to a full blown panic attack.
All of these medications do have some undesirable side effects. In the long run all of them are probably best combined with other therapies, with the goal of allowing the patient to gain sufficient control of their panic disorder so that drug treatment can be eventually discontinued.
