Panic attacks

The goal of treatment is to help you function well during everyday life. A combination of medication and cognitive-behavioral therapy (CBT) works best.

Antidepressant medications called selective serotonin reuptake inhibitors (SSRIs) are most commonly prescribed for panic disorder. These include:

• Fluoxetine (Prozac)
• Sertraline (Zoloft)
• Paroxetine (Paxil)
• Other SSRIs

Other medications that may be used include:

• Other types of antidepressants, such as serotonin-norepinephrine reuptake inhibitors (SNRIs)
• Antiseizure drugs in severe cases
• Benzodiazepines, including diazepam (Valium), alprazolam (Xanax), clonazepam (Klonopin), and lorazepam (Ativan) may be used for a short time.
• Monoamine oxidase inhibitors (MAOIs) are only used when the other drugs do not work, however they can have serious side effects.

Your symptoms should slowly get better over a few weeks. Talk to your doctor if they do not. Do not stop taking your medications without talking with your health care provider.

Cognitive-behavioral therapy helps you understand your behaviors and how to change them. You should have 10 to 20 visits over a number of weeks. During therapy you will learn how to:

• Understand and control distorted views of life stressors, such as other people's behavior or life events.
• Recognize and replace panic-causing thoughts, and decrease the sense of helplessness.
• Manage stress and relax when symptoms occur.
• Imagine the things that cause the anxiety, starting with the least fearful. Slowly become involved in the real-life situation may help you overcome the fears.

The following may also help reduce the number or severity of panic attacks:

• Regular exercise
• Getting enough sleep
• Regularly scheduled meals
• Reduce or avoid caffeine, certain cold medicines, and stimulants

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Panic disorder Symptoms

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Panic disorder Prevention

Review Date: 04/11/2011
Reviewed By: David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc., and Fred K. Berger, MD, Addiction and Forensic Psychiatrist, Scripps Memorial Hospital, La Jolla, California.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org)