Panic attacks: Treatment

What is the treatment for panic attacks?

Thanks to research, there are a variety of treatments available, including several effective medications, and specific forms of psychotherapy. In terms of medications, specific members of the selective serotonin reuptake inhibitor (SSRI) and the benzodiazepine families of medications are approved by the Food and Drug Administration to treat panic disorder. Examples of such medications include sertraline (Zoloft) and paroxetine (Paxil) from the SSRI group and clonazepam (Klonopin) from the benzodiazepine group. Medications from the beta blocker family (for example, propranolol) are sometimes used to treat the physical symptoms associated with a panic attack. Before SSRIs became available, medications from the group known as the tricyclic antidepressants (TCAs) were often used to address panic disorder. However, SSRIs have been proven to be safer and better tolerated therefore, TCAs are used much less often. When used in the appropriate person with close monitoring, these medications can be quite effective as part of treatment for panic disorder. However, as anything that is ingested carries risk of side effects, it is important to work closely with the prescribing doctor to decide whether medication treatment is an appropriate intervention and if so, which medication should be administered. The person being treated should be closely monitored for the possibility of side effects that can vary from minor to severe and in some cases even be life-threatening.

The psychotherapy component of treatment for panic disorders is equally as important as medication treatment. In fact, research shows that the combination of medication and psychotherapy treatment for panic disorder is more effective than either intervention alone. To address anxiety, cognitive behavioral therapy is widely accepted as an effective form of psychotherapy. That form of therapy seeks to help those with panic disorder identify and decrease the irrational thoughts and behaviors that reinforce panic symptoms. Behavioral techniques that are often used to decrease anxiety include relaxation techniques and gradually increasing exposure to situations that may have previously increased anxiety in the individual.

Often, a combination of psychotherapy and medications produces good results. Improvement is usually noticed in a fairly short period of time, about two to three months. Thus, appropriate treatment for panic disorder can prevent panic attacks or at least substantially reduce their severity and frequency, bringing significant relief to 70 to 90% of people with panic disorder.

There are also things that people with panic disorder can do to help make treatment more effective. Since substances like caffeine, alcogol, and illicit drugs can worsen panic attacks, those things should be avoided. It may be worth engaging in aerobic exercise and stress-management techniques like deep breathing and yoga, as those activities have been found to help decrease the frequency and severity of panic attacks.

In addition, people with panic disorder may need treatment for other emotional problems. Depression has often been associated with panic disorder, as have alcohol and drug abuse. Recent research also suggests that suicide attempts are more frequent in people with panic disorder. Fortunately, these problems associated with panic disorder can be overcome effectively, just like panic disorder itself.
Tragically, many people with panic attacks do not seek or receive treatment.

What happens if panic attacks are not treated?
Panic attacks tend to continue for months or years. While it typically begins in young adulthood, in some people the symptoms may arise earlier or later in life. If left untreated, it may worsen to the point where the person's life is seriously affected by panic attacks and by attempts to avoid or conceal them. In fact, many people have had problems with friends and family or lost jobs while struggling to cope with panic attacks. There may be periods of spontaneous improvement in the attacks, but it does not usually go away unless the person receives treatments designed specifically to help people with panic attacks.

National Institute of Mental Health of the U.S. Department of Health and Human Services