Panic attacks may be a symptom of panic disorder, which can severely affect a person’s quality of life. Medications and other treatments may help reduce the frequency and severity of panic attacks.

Panic attacks are sudden and intense feelings of fear or terror that occur without warning and can peak within minutes. People who experience them repeatedly may have panic disorder. Panic attacks are also known as anxiety attacks.

Doctors usually prescribe medication according to the severity of a person’s symptoms and the frequency of their panic attacks. People may also benefit from other treatments, such as therapy and relaxation techniques.

This article looks at the most common medications doctors prescribe for panic disorder. It also outlines other treatments, how to speak with a doctor, and the outlook for those with panic disorder.

Learn more about panic attacks and panic disorder here.

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Taking medication is one way to mitigate the symptoms of anxiety.

Doctors most often prescribe antidepressants and benzodiazepines for people with panic disorder.

With all medications that affect serotonin levels, individuals should be aware of the risks of serotonin syndrome. This is a condition where an excess amount of serotonin, the chemical messenger in the brain, builds up in the body.

Symptoms of serotonin syndrome can include:

  • agitation
  • anxiety
  • disorientation
  • restlessness
  • sweating
  • tremors

Learn more about serotonin syndrome here.

Selective serotonin reuptake inhibitors (SSRIs)

SSRIs are the first-line medication for treating panic disorder. They increase synaptic serotonin, a neurotransmitter that has several different functions. However, there is some controversy among experts over the theory that anxiety and depression occur when serotonin levels are low. Recent research has cast doubt on exactly how SSRIs affect the brain.

Common SSRIs that doctors prescribe for panic attacks include:

The possible side effects of medications feature on the drug’s label. A person can also discuss side effects with a doctor before taking a medication. Common side effects of SSRIs include:

Serotonin-norepinephrine reuptake inhibitors (SNRIs)

SNRIs are a class of antidepressants that work by increasing levels of synaptic serotonin and norepinephrine in the body. Doctors prescribe them to treat depression, anxiety, and other mood problems.

Doctors commonly prescribe the following SNRIs to treat panic disorder:

At low doses, SNRIs can cause the following side effects:

At higher doses, SNRIs can cause the following side effects:

Learn about the difference between SSRIs and SNRIs here.

Tricyclic antidepressants

Tricyclic antidepressants (TCAs) are a type of antidepressant that doctors prescribe to treat major depressive disorder and anxiety disorders.

TCAs work by blocking the reuptake of serotonin, norepinephrine, and dopamine in the brain. This helps increase levels of these neurotransmitters to help improve mood, relieve anxiety, and decrease feelings of fatigue.

Examples of TCAs include:

TCAs may cause more side effects than SSRIs and SNRIs, so doctors usually prescribe other drugs before trying them. Side effects of TCAs include:

Learn more about TCAs here.

Monoamine oxidase inhibitors (MAOIs)

MAOIs are a class of antidepressants that work by increasing the levels of serotonin and norepinephrine in the brain. Doctors prescribe these drugs to treat panic attacks, mood swings, and depression.

Examples of MAOIs include:

MAOIs are not the first choice for treating panic disorder, as they can cause interactions with other drugs and certain foods. They also cause side effects, including:

  • dry mouth
  • nausea
  • diarrhea
  • constipation
  • drowsiness
  • insomnia
  • dizziness

Learn more about MAOIs here.

Benzodiazepines

Doctors may also prescribe benzodiazepines to help people with anxiety disorders. These drugs reduce electrical activity in the brain and the intensity of anxiety symptoms.

Examples include:

Benzodiazepine drugs are effective in the short term, but a person should not take them over long periods, as this may lead to addiction and withdrawal symptoms.

The most common side effects of benzodiazepines include:

Learn more about benzodiazepines here.

Beta-blockers

Beta-blockers do not have approval from the Food and Drug Administration to treat anxiety disorders. However, doctors sometimes prescribe them off-label to control physical symptoms of panic disorder, such as shaking or a rapid heartbeat. Propranolol (Inderal) is one example of a beta-blocker.

Beta-blockers may cause side effects such as:

  • slow heart rate
  • high blood pressure
  • fatigue
  • dizziness
  • nausea
  • constipation
  • sexual dysfunction

These side effects are usually mild, but they may become more severe if people do not take the medication properly or if the dosage is too high.

Learn more about beta blockers here.

There are no specific tests doctors use to diagnose panic disorder. Therefore, doctors use criteria from the Diagnostic and Statistical Manual of Mental Disorders, 5th edition, text revision (DSM-5-TR) to guide their diagnosis. They will diagnose panic disorder under the following circumstances:

  • panic attacks repeatedly occur, followed by 1 month or more of persistent concern about having another attack
  • a person changes their behavior to avoid situations they consider triggering, such as work or school
  • panic attacks do not happen solely as a result of substance use, medications, or other medical conditions
  • other diagnoses cannot better explain the symptoms
  • panic attacks are not always the result of a recognizable trigger
  • a person experiences anxiety both physically and mentally

Healthcare professionals must rule out other conditions before diagnosing panic disorder. Once they diagnose it, they may use rating scales to assess how severe the panic attacks are, which can inform the treatment they recommend.

Besides medication, there are other treatments for panic attacks. They include:

Learn how to treat anxiety naturally here.

Talking with a doctor about panic attacks can be difficult. Preparing questions before a doctor’s appointment may help a person get the most benefit.

An individual can ask about different types of treatment and whether another diagnosis could account for their symptoms. They may want to discuss practical measures they can take to reduce their symptoms.

It may also help to have a friend or family member at doctor’s appointments to hear the discussion.

If medications cause persistent adverse side effects, a person should discuss these with a doctor. The doctor may be able to adjust the medication or dose.

Many people with panic disorder also have other mental health conditions that complicate their recovery. Even after symptom-free periods, most individuals experience further panic attacks. Not sticking to medication or therapy regimens contributes to poorer outcomes.

According to a 2022 article, around 60% of people with panic disorder achieve remission of symptoms within 6 months.

Those with panic disorder are at higher risk of suicidal thoughts and decreased quality of life than people without the condition.

Suicide prevention

If you know someone at immediate risk of self-harm, suicide, or hurting another person:

  • Ask the tough question: “Are you considering suicide?”
  • Listen to the person without judgment.
  • Call 911 or the local emergency number, or text TALK to 741741 to communicate with a trained crisis counselor.
  • Stay with the person until professional help arrives.
  • Try to remove any weapons, medications, or other potentially harmful objects.

If you or someone you know is having thoughts of suicide, a prevention hotline can help. The 988 Suicide and Crisis Lifeline is available 24 hours a day at 988. During a crisis, people who are hard of hearing can use their preferred relay service or dial 711 then 988.

Click here for more links and local resources.

Was this helpful?

Panic attacks are the main symptom of panic disorder. They can happen suddenly without an obvious trigger and reach a peak within minutes.

Medications can help alleviate the symptoms of panic attacks and reduce the risk of a future attack. Examples include antidepressants, benzodiazepines, and beta blockers.

All medications can cause side effects, and a person must discuss these with a doctor before taking a drug.

Alternative treatments are available to treat panic disorder, such as therapy, relaxation techniques, and healthy lifestyle choices.