Medications for Treating Panic Disorder

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Panic Disorder Treatment

Antidepressant Medications

Anti-Anxiety Medications

Frequently Asked Questions

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What is the most important information I should know about panic attack medications?If you are taking panic attack medications:do not suddenly stop taking your medicine or reduce your dose without talking to your doctor;some medications can cause serious or dangerous withdrawal symptoms.

What is the most important information I should know about panic attack medications?

If you are taking panic attack medications:do not suddenly stop taking your medicine or reduce your dose without talking to your doctor;some medications can cause serious or dangerous withdrawal symptoms.

If you are taking panic attack medications:

Medication is one of the most popular and effective treatment options for panic disorder, panic attacks, andagoraphobia. Your doctor may prescribe panic attack medications to reduce the intensity ofpanic attacks, decrease overall feelings of anxiety, and potentially treat co-occurring conditions, such as depression.

Medications for panic disorder are typically from one of two categories: antidepressants and anti-anxiety drugs.

This article discusses how medications are used to treat panic disorder and which medications are most often prescribed. It also covers some of the other treatment options that may be effective for panic symptoms.

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Treatment for panic disorder may involve medication in addition to psychotherapy. In some cases, more than one medication may be prescribed to help manage symptoms of panic and anxiety.

For example, an antidepressant may be prescribed to help reduce the frequency of panic symptoms, while benzodiazepines may be used on an as-needed basis to help reduce the severity of panic attacks.

On-Label vs. Off-Label MedicationsMedications that are FDA-approved to treat panic disorder include fluoxetine, sertraline, paroxetine, venlafaxine, clonazepam, and alprazolam.However, your doctor may prescribe other medications off-label depending on your specific needs.

On-Label vs. Off-Label Medications

Medications that are FDA-approved to treat panic disorder include fluoxetine, sertraline, paroxetine, venlafaxine, clonazepam, and alprazolam.However, your doctor may prescribe other medications off-label depending on your specific needs.

Psychotherapy can also be effectivein treating panic disorder. Types of psychotherapy that may be helpful include:

The Best Online Therapy for Anxiety, Tried and Tested

Treatment Options to Help Manage Panic Disorder

Antidepressant Medications for Panic Disorder

When first introduced in the 1950s, antidepressants were primarily used to treat mood disorders. However, it was later discovered that these medications effectively help reduce anxiety, lessen the symptoms of panic, and decrease the intensity and frequency of panic attacks.

Antidepressant medications are now commonly used to treat many anxiety disorders, including panic disorder and agoraphobia.

Antidepressants affect the chemical messengers in the brain,known as neurotransmitters. There are thought to be many different types of these chemical messengers that communicate between brain cells.

Selective Serotonin Reuptake Inhibitors (SSRIs)

Selective serotonin reuptake inhibitors(SSRIs) are a popular class of antidepressants prescribed to decrease symptoms of anxiety and depression.Serotoninis a naturally occurring neurotransmitter in the brain.

Common SSRIs include:

Studies have demonstrated the long-term effectiveness of SSRIs.These medications have also been found to cause limited side effects, making them the prescription medication of choice for panic disorder.

Negative Side Effects of Antidepressants

Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs)

Serotonin-norepinephrine reuptake inhibitors (SNRIs) also block the reuptake of serotonin and norepinephrine. Norepinephrine is a neurotransmitter that plays a role in concentration and alertness.

Common SNRIs include:

Research has found that SNRIs are effective for treating anxiety disorders, particularly social anxiety disorder.Side effects can occur while taking SNRIs and may include fatigue, insomnia, changes in appetite, and changes in sexual function.

Effexor XR is FDA-approved to treat panic disorder.While Cymbalta is not FDA-approved for this specific indication, doctors may still prescribe it off-label to treat the condition.

Tricyclic Antidepressants (TCAs)

Tricyclic antidepressants(TCAs) have become less popular in treating anxiety and mood disorders since SSRIs were introduced. However, TCAs can still be an effective treatment option for people withanxiety disorders.

Like SSRIs, TCAs work to block the reuptake of the chemical messenger serotonin. Additionally, many TCAs also prevent the reuptake ofnorepinephrine, another neurotransmitter in the brain that is often associated with thefight-or-flightstress response.

Common TCAs include:

Monoamine Oxidase Inhibitors (MAOIs)

This enzyme is involved in breaking down neurotransmitters like norepinephrine, serotonin, and dopamine. Dopamine helps regulate many functions, including movement, physical energy levels, and feelings of motivation.

Common MAOIs include:

Despite their effectiveness, MAOIs are prescribed less frequently due to necessarydietary restrictionswhen taking them and the potential for significant drug interactions that can occur when taking MAOIs with other medications.

Anti-anxiety medications are prescribed for their fast-acting relief of panic symptoms. These medications work to relax the central nervous system, which can lower the intensity of panic attacks and cause a person to feel calmer.

Due to their tranquilizing effect and rapid relief, anti-anxiety medications are often prescribed to treat panic disorder.

Benzodiazepines

Benzodiazepines are the most commonly prescribed class of anti-anxiety medication for panic disorder. Known for their sedative effect, these medications can quickly reduce panic attack symptoms and induce a more relaxed state.

Common benzodiazepines include:

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

While effective, benzodiazepines can produce physical dependence. This means you may experience withdrawal symptoms when you stop taking them, even if you have been taking them exactly as prescribed.

You should not stop taking benzodiazepines without talking to your doctor first. Benzodiazepine withdrawal can be dangerous.

It is important to gradually reduce your dose under the supervision of your doctor to avoid potential withdrawal complications.

If you or a loved one are struggling with anxiety, contact theSubstance Abuse and Mental Health Services Administration (SAMHSA) National Helplineat1-800-662-4357for information on support and treatment facilities in your area.For more mental health resources, see ourNational Helpline Database.

If you or a loved one are struggling with anxiety, contact theSubstance Abuse and Mental Health Services Administration (SAMHSA) National Helplineat1-800-662-4357for information on support and treatment facilities in your area.

For more mental health resources, see ourNational Helpline Database.

Frequently Asked QuestionsPsychotherapy can be very helpful for treating panic attacks.During a panic attack,deep breathingcan help you manage hyperventilation, a symptom that can play a role in increasing feelings of fear.Other strategies such as grounding techniques,mindfulness, andprogressive muscle relaxationcan also be helpful for preventing and relieving feelings of panic.Learn More:Why Panic Attacks Cause Shortness of BreathThe best way to ask is to be direct. Tell your doctor that you are experiencing panic attacks and need medication to help manage these symptoms. Your doctor should then ask more about your symptoms, suggest medications that can help, and talk to you about the potential side effects.Non-habit-forming medications that can help with panic attacks and anxiety include SSRIs, SNRIs, and beta-blockers. Others that may be helpful includeBusparandVistaril.Benzodiazepines are fast-acting and work to relieve anxiety symptoms right away. This is why they are a good option for short-term relief of panic attacks. Antidepressants often begin offering some relief within one to three weeks, but it may take several weeks to begin feeling the full effects of the medication.

Psychotherapy can be very helpful for treating panic attacks.During a panic attack,deep breathingcan help you manage hyperventilation, a symptom that can play a role in increasing feelings of fear.Other strategies such as grounding techniques,mindfulness, andprogressive muscle relaxationcan also be helpful for preventing and relieving feelings of panic.Learn More:Why Panic Attacks Cause Shortness of Breath

Psychotherapy can be very helpful for treating panic attacks.During a panic attack,deep breathingcan help you manage hyperventilation, a symptom that can play a role in increasing feelings of fear.Other strategies such as grounding techniques,mindfulness, andprogressive muscle relaxationcan also be helpful for preventing and relieving feelings of panic.

Learn More:Why Panic Attacks Cause Shortness of Breath

The best way to ask is to be direct. Tell your doctor that you are experiencing panic attacks and need medication to help manage these symptoms. Your doctor should then ask more about your symptoms, suggest medications that can help, and talk to you about the potential side effects.

Non-habit-forming medications that can help with panic attacks and anxiety include SSRIs, SNRIs, and beta-blockers. Others that may be helpful includeBusparandVistaril.

Benzodiazepines are fast-acting and work to relieve anxiety symptoms right away. This is why they are a good option for short-term relief of panic attacks. Antidepressants often begin offering some relief within one to three weeks, but it may take several weeks to begin feeling the full effects of the medication.

14 SourcesVerywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Imai H, Tajika A, Chen P, Pompoli A, Furukawa TA.Psychological therapies versus pharmacological interventions for panic disorder with or without agoraphobia in adults.Cochrane Database Syst Rev. 2016;10(10):CD011170. doi:10.1002/14651858.CD011170.pub2Garakani A, Murrough JW, Freire RC, et al.Pharmacotherapy of anxiety disorders: Current and emerging treatment options.Front Psychiatry. 2020;11:595584. doi:10.3389/fpsyt.2020.595584Bandelow B, Michaelis S, Wedekind D.Treatment of anxiety disorders.Dialogues Clin Neurosci. 2017;19(2):93-107.Carhart-Harris RL, Nutt DJ.Serotonin and brain function: A tale of two receptors.J Psychopharmacol. 2017;31(9):1091-1120. doi:10.1177/0269881117725915Edinoff AN, Akuly HA, Hanna TA, et al.Selective serotonin reuptake inhibitors and adverse effects: a narrative review.Neurol Int. 2021;13(3):387-401. doi:10.3390/neurolint13030038Jakubovski E, Johnson JA, Nasir M, Müller-Vahl K, Bloch MH.Systematic review and meta-analysis: Dose-response curve of SSRIs and SNRIs in anxiety disorders.Depress Anxiety. 2019;36(3):198-212. doi:10.1002/da.22854Food and Drug Administration.Highlights of prescribing information: Effexor XR.Schneider J, Patterson M, Jimenez XF.Beyond depression: Other uses for tricyclic antidepressants.CCJM. 2019;86(12):807-814. doi:10.3949/ccjm.86a.19005Culpepper L.Reducing the burden of difficult-to-treat major depressive disorder: revisiting monoamine oxidase inhibitor therapy.Prim Care Companion CNS Disord. 2013;15(5):PCC.13r01515. doi:10.4088/PCC.13r01515Farach FJ, Pruitt LD, Jun JJ, Jerud AB, Zoellner LA, Roy-Byrne PP.Pharmacological treatment of anxiety disorders: Current treatments and future directions.J Anxiety Disord. 2012;26(8):833-843. doi:10.1016/j.janxdis.2012.07.009Griffin CE 3rd, Kaye AM, Bueno FR, Kaye AD.Benzodiazepine pharmacology and central nervous system-mediated effects.Ochsner J. 2013;13(2):214-223.Balon R, Starcevic V.Role of benzodiazepines in anxiety disorders.Adv Exp Med Biol. 2020;1191:367-388. doi:10.1007/978-981-32-9705-0_20Reinecke A, Thilo KV, Croft A, Harmer CJ.Early effects of exposure-based cognitive behaviour therapy on the neural correlates of anxiety.Transl Psychiatry.2018;8(1):225. doi:10.1038/s41398-018-0277-5Ma X, Yue ZQ, Gong ZQ, et al.The effect of diaphragmatic breathing on attention, negative affect and stress in healthy adults.Front Psychol. 2017;8:874. doi:10.3389/fpsyg.2017.00874Additional ReadingAmerican Psychiatric AssociationDiagnostic and Statistical Manual of Mental Disorders, 5th ed. American Psychiatric Publishing.Preston JD, O’Neal JH, Talaga MC.Handbook of Clinical Psychopharmacology for Therapists, 6th ed. New Harbinger Publications.Silverman HM.The Pill Book, 15th ed. Bantam Books.

14 Sources

Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Imai H, Tajika A, Chen P, Pompoli A, Furukawa TA.Psychological therapies versus pharmacological interventions for panic disorder with or without agoraphobia in adults.Cochrane Database Syst Rev. 2016;10(10):CD011170. doi:10.1002/14651858.CD011170.pub2Garakani A, Murrough JW, Freire RC, et al.Pharmacotherapy of anxiety disorders: Current and emerging treatment options.Front Psychiatry. 2020;11:595584. doi:10.3389/fpsyt.2020.595584Bandelow B, Michaelis S, Wedekind D.Treatment of anxiety disorders.Dialogues Clin Neurosci. 2017;19(2):93-107.Carhart-Harris RL, Nutt DJ.Serotonin and brain function: A tale of two receptors.J Psychopharmacol. 2017;31(9):1091-1120. doi:10.1177/0269881117725915Edinoff AN, Akuly HA, Hanna TA, et al.Selective serotonin reuptake inhibitors and adverse effects: a narrative review.Neurol Int. 2021;13(3):387-401. doi:10.3390/neurolint13030038Jakubovski E, Johnson JA, Nasir M, Müller-Vahl K, Bloch MH.Systematic review and meta-analysis: Dose-response curve of SSRIs and SNRIs in anxiety disorders.Depress Anxiety. 2019;36(3):198-212. doi:10.1002/da.22854Food and Drug Administration.Highlights of prescribing information: Effexor XR.Schneider J, Patterson M, Jimenez XF.Beyond depression: Other uses for tricyclic antidepressants.CCJM. 2019;86(12):807-814. doi:10.3949/ccjm.86a.19005Culpepper L.Reducing the burden of difficult-to-treat major depressive disorder: revisiting monoamine oxidase inhibitor therapy.Prim Care Companion CNS Disord. 2013;15(5):PCC.13r01515. doi:10.4088/PCC.13r01515Farach FJ, Pruitt LD, Jun JJ, Jerud AB, Zoellner LA, Roy-Byrne PP.Pharmacological treatment of anxiety disorders: Current treatments and future directions.J Anxiety Disord. 2012;26(8):833-843. doi:10.1016/j.janxdis.2012.07.009Griffin CE 3rd, Kaye AM, Bueno FR, Kaye AD.Benzodiazepine pharmacology and central nervous system-mediated effects.Ochsner J. 2013;13(2):214-223.Balon R, Starcevic V.Role of benzodiazepines in anxiety disorders.Adv Exp Med Biol. 2020;1191:367-388. doi:10.1007/978-981-32-9705-0_20Reinecke A, Thilo KV, Croft A, Harmer CJ.Early effects of exposure-based cognitive behaviour therapy on the neural correlates of anxiety.Transl Psychiatry.2018;8(1):225. doi:10.1038/s41398-018-0277-5Ma X, Yue ZQ, Gong ZQ, et al.The effect of diaphragmatic breathing on attention, negative affect and stress in healthy adults.Front Psychol. 2017;8:874. doi:10.3389/fpsyg.2017.00874Additional ReadingAmerican Psychiatric AssociationDiagnostic and Statistical Manual of Mental Disorders, 5th ed. American Psychiatric Publishing.Preston JD, O’Neal JH, Talaga MC.Handbook of Clinical Psychopharmacology for Therapists, 6th ed. New Harbinger Publications.Silverman HM.The Pill Book, 15th ed. Bantam Books.

Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

Imai H, Tajika A, Chen P, Pompoli A, Furukawa TA.Psychological therapies versus pharmacological interventions for panic disorder with or without agoraphobia in adults.Cochrane Database Syst Rev. 2016;10(10):CD011170. doi:10.1002/14651858.CD011170.pub2Garakani A, Murrough JW, Freire RC, et al.Pharmacotherapy of anxiety disorders: Current and emerging treatment options.Front Psychiatry. 2020;11:595584. doi:10.3389/fpsyt.2020.595584Bandelow B, Michaelis S, Wedekind D.Treatment of anxiety disorders.Dialogues Clin Neurosci. 2017;19(2):93-107.Carhart-Harris RL, Nutt DJ.Serotonin and brain function: A tale of two receptors.J Psychopharmacol. 2017;31(9):1091-1120. doi:10.1177/0269881117725915Edinoff AN, Akuly HA, Hanna TA, et al.Selective serotonin reuptake inhibitors and adverse effects: a narrative review.Neurol Int. 2021;13(3):387-401. doi:10.3390/neurolint13030038Jakubovski E, Johnson JA, Nasir M, Müller-Vahl K, Bloch MH.Systematic review and meta-analysis: Dose-response curve of SSRIs and SNRIs in anxiety disorders.Depress Anxiety. 2019;36(3):198-212. doi:10.1002/da.22854Food and Drug Administration.Highlights of prescribing information: Effexor XR.Schneider J, Patterson M, Jimenez XF.Beyond depression: Other uses for tricyclic antidepressants.CCJM. 2019;86(12):807-814. doi:10.3949/ccjm.86a.19005Culpepper L.Reducing the burden of difficult-to-treat major depressive disorder: revisiting monoamine oxidase inhibitor therapy.Prim Care Companion CNS Disord. 2013;15(5):PCC.13r01515. doi:10.4088/PCC.13r01515Farach FJ, Pruitt LD, Jun JJ, Jerud AB, Zoellner LA, Roy-Byrne PP.Pharmacological treatment of anxiety disorders: Current treatments and future directions.J Anxiety Disord. 2012;26(8):833-843. doi:10.1016/j.janxdis.2012.07.009Griffin CE 3rd, Kaye AM, Bueno FR, Kaye AD.Benzodiazepine pharmacology and central nervous system-mediated effects.Ochsner J. 2013;13(2):214-223.Balon R, Starcevic V.Role of benzodiazepines in anxiety disorders.Adv Exp Med Biol. 2020;1191:367-388. doi:10.1007/978-981-32-9705-0_20Reinecke A, Thilo KV, Croft A, Harmer CJ.Early effects of exposure-based cognitive behaviour therapy on the neural correlates of anxiety.Transl Psychiatry.2018;8(1):225. doi:10.1038/s41398-018-0277-5Ma X, Yue ZQ, Gong ZQ, et al.The effect of diaphragmatic breathing on attention, negative affect and stress in healthy adults.Front Psychol. 2017;8:874. doi:10.3389/fpsyg.2017.00874

Imai H, Tajika A, Chen P, Pompoli A, Furukawa TA.Psychological therapies versus pharmacological interventions for panic disorder with or without agoraphobia in adults.Cochrane Database Syst Rev. 2016;10(10):CD011170. doi:10.1002/14651858.CD011170.pub2

Garakani A, Murrough JW, Freire RC, et al.Pharmacotherapy of anxiety disorders: Current and emerging treatment options.Front Psychiatry. 2020;11:595584. doi:10.3389/fpsyt.2020.595584

Bandelow B, Michaelis S, Wedekind D.Treatment of anxiety disorders.Dialogues Clin Neurosci. 2017;19(2):93-107.

Carhart-Harris RL, Nutt DJ.Serotonin and brain function: A tale of two receptors.J Psychopharmacol. 2017;31(9):1091-1120. doi:10.1177/0269881117725915

Edinoff AN, Akuly HA, Hanna TA, et al.Selective serotonin reuptake inhibitors and adverse effects: a narrative review.Neurol Int. 2021;13(3):387-401. doi:10.3390/neurolint13030038

Jakubovski E, Johnson JA, Nasir M, Müller-Vahl K, Bloch MH.Systematic review and meta-analysis: Dose-response curve of SSRIs and SNRIs in anxiety disorders.Depress Anxiety. 2019;36(3):198-212. doi:10.1002/da.22854

Food and Drug Administration.Highlights of prescribing information: Effexor XR.

Schneider J, Patterson M, Jimenez XF.Beyond depression: Other uses for tricyclic antidepressants.CCJM. 2019;86(12):807-814. doi:10.3949/ccjm.86a.19005

Culpepper L.Reducing the burden of difficult-to-treat major depressive disorder: revisiting monoamine oxidase inhibitor therapy.Prim Care Companion CNS Disord. 2013;15(5):PCC.13r01515. doi:10.4088/PCC.13r01515

Farach FJ, Pruitt LD, Jun JJ, Jerud AB, Zoellner LA, Roy-Byrne PP.Pharmacological treatment of anxiety disorders: Current treatments and future directions.J Anxiety Disord. 2012;26(8):833-843. doi:10.1016/j.janxdis.2012.07.009

Griffin CE 3rd, Kaye AM, Bueno FR, Kaye AD.Benzodiazepine pharmacology and central nervous system-mediated effects.Ochsner J. 2013;13(2):214-223.

Balon R, Starcevic V.Role of benzodiazepines in anxiety disorders.Adv Exp Med Biol. 2020;1191:367-388. doi:10.1007/978-981-32-9705-0_20

Reinecke A, Thilo KV, Croft A, Harmer CJ.Early effects of exposure-based cognitive behaviour therapy on the neural correlates of anxiety.Transl Psychiatry.2018;8(1):225. doi:10.1038/s41398-018-0277-5

Ma X, Yue ZQ, Gong ZQ, et al.The effect of diaphragmatic breathing on attention, negative affect and stress in healthy adults.Front Psychol. 2017;8:874. doi:10.3389/fpsyg.2017.00874

American Psychiatric AssociationDiagnostic and Statistical Manual of Mental Disorders, 5th ed. American Psychiatric Publishing.Preston JD, O’Neal JH, Talaga MC.Handbook of Clinical Psychopharmacology for Therapists, 6th ed. New Harbinger Publications.Silverman HM.The Pill Book, 15th ed. Bantam Books.

American Psychiatric AssociationDiagnostic and Statistical Manual of Mental Disorders, 5th ed. American Psychiatric Publishing.

Preston JD, O’Neal JH, Talaga MC.Handbook of Clinical Psychopharmacology for Therapists, 6th ed. New Harbinger Publications.

Silverman HM.The Pill Book, 15th ed. Bantam Books.

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