Panic Disorder Treatment Options
While panic disorder can be an extremely frightening and disabling condition, it can respond well to treatment. Treatment typically consists of a combination of therapy and medicine.
Psychotherapy
Through psychotherapy, or talk therapy, a clinician can help you learn more about panic disorder, what triggers your panic attacks, and tools for dealing with them. The most effective form of psychotherapy for panic attacks, and most anxiety disorders, is called cognitive behavioral therapy (CBT). CBT helps you reduce the intensity and frequency of panic attacks, as well as cope with them better when they do happen, by focusing on the following:
- Learning about the condition: Many people with panic disorder find comfort when they understand what they are experiencing. Education about the physiology, psychology, and neurochemistry of panic attacks and panic disorder can be very valuable to help you understand your condition.
- Cognitive restructuring: CBT therapists will help you recognize and change anxiety-provoking thought patterns and cognitive distortions, like negative life-outlook, catastrophic thinking, or all-or-nothing thinking.
- Stress-reduction techniques: Learning to relax your body when you feel a panic attack building can help you stave off panic attacks, shorten the duration, or lessen the intensity of a panic attack. CBT tools may include specific breathing exercises, practicing progressive muscle relaxation, and other relaxation techniques.
- Exposure treatment: CBT focuses on helping you face the places or situations you’re beginning to avoid out of fear of having a panic attack. A CBT therapist will work with you to take small, manageable steps to help you be desensitized to what scared you. The goal is to resume the activity or behavior that was causing you panic.
Medications
Medications can help reduce physical symptoms of panic attacks, decrease your likelihood of experiencing an attack, and reduce the anxiety of having another panic attack. Commonly prescribed medications for panic disorder include:
- Selective serotonin reuptake inhibitors (SSRIs): This class of medications is the most commonly prescribed for anxiety and panic disorders. These medications prevent the reuptake of serotonin after it has been released, increasing available serotonin in the brain, which helps to regulate mood and decrease anxiety and panic. SSRIs are safe and have a low risk of serious side effects. Effective SSRIs for panic disorder include escitalopram (Lexapro), fluoxetine (Prozac), and sertraline (Zoloft).
- Serotonin and norepinephrine reuptake inhibitors (SNRIs): If SSRIs aren’t effective for you, you can try SNRIs, which improve symptoms of panic disorder by increasing available levels of the neurotransmitters serotonin and norepinephrine in the brain. Commonly prescribed SNRIs for panic disorder include venlafaxine (Effexor XR), duloxetine (Cymbalta), and desvenlafaxine (Pristiq).
- Benzodiazepines: Benzodiazepines can be especially effective for acute relief of panic attacks while they’re happening, or for help tolerating triggering situations like phobias. These medications are sedatives, meaning they are central nervous system depressants that inhibit or stop the fight-or-flight response that causes panic symptoms. Benzodiazepines that can help treat panic disorder include alprazolam (Xanax), clonazepam (Klonopin), and lorazepam (Ativan). However, because benzodiazepines can be habit-forming, they are not ideal for long-term use or for those with a history of drug or alcohol addiction or abuse.
There are other medications available to treat panic disorder, and sometimes a combination of multiple medications can be the most effective treatment for you. Some medications can take several weeks to reach full effectiveness, and some may have side effects that improve once your body gets used to them. Work closely with your doctor when beginning, taking, or tapering off of a medication in order to monitor side effects, effectiveness, and risks.