Panic attacks are sudden, brief experiences of extreme fear. Anxiety involves feelings of panic, fear, and nervousness that arise when a person feels stressed, threatened, and under pressure. Medication for panic and anxiety disorders aims to alleviate symptoms.
Panic attacks and disproportionate anxiety levels can be symptoms of panic disorder, an anxiety disorder that causes a person to have frequent, abrupt feelings of panic, stress, and fear. Usually, symptoms occur with no clear cause.
Treatment involves alleviating symptoms and reducing the amount of anxiety and panic attacks a person experiences. Depending on the symptoms and severity, a person may use a combination of medication and other treatments, such as talk therapy.
This article will cover the best medications for panic attacks and anxiety, common symptoms, additional treatment options, and getting support.
A healthcare professional will prescribe medication based on the severity and frequency of symptoms and a person’s medical history.
Antidepressants may help boost a person’s mood and reduce stress.
Common antidepressants include:
- Selective serotonin reuptake inhibitors (SSRIs): These medications are typically the first line of treatment for panic disorder. They increase the level of serotonin — a neurotransmitter that plays a role in mood — in the brain, which may improve anxiety symptoms. Types of SSRIs include sertraline (Zoloft), escitalopram (Lexapro), and paroxetine (Paxil).
- Serotonin-norepinephrine reuptake inhibitors (SNRIs): These medications increase the levels of serotonin and norepinephrine in the brain, which may also improve anxiety symptoms. Norepinephrine is a neurotransmitter that influences emotions, energy, and alertness. Types of SNRIs include venlafaxine (Effexor) and duloxetine (Cymbalta).
- Tricyclic antidepressants (TCAs): This kind of medication also increases the levels of serotonin and norepinephrine in the brain but causes more side effects than SSRIs and SNRIs. Types of TCAs include imipramine (Tofranil) and clomipramine (Anafranil).
Antidepressants may take 2–4 weeks to begin working and up to 8 weeks to work fully.
Antidepressant medications may also cause increased suicidal thoughts and behavior in children, teenagers, and adults under 25. These side effects are more common during the first several weeks of taking them.
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.
If a person wishes to reduce their antidepressant dosage, a healthcare professional can help them do so slowly and safely, as stopping these medications suddenly can lead to withdrawal symptoms.
Anti-anxiety medications may help alleviate symptoms of panic attacks and anxiety disorders, including intense fear and worry.
The most common anti-anxiety medications are benzodiazepines, which are sometimes the first-line treatment for generalized anxiety disorder but often second-line due to their potential for creating dependency. This risk of dependency
Benzodiazepines may work faster than antidepressants. However, a person may develop a tolerance to benzodiazepines, requiring higher doses to achieve the same effect.
For these reasons, healthcare professionals often only prescribe benzodiazepines for brief periods. They may also avoid prescribing them to people with a history of substance misuse.
Examples of benzodiazepines include:
Common side effects of benzodiazepines include:
- impaired coordination and an increased risk of falls, especially among older people
- slurred speech
- memory problems
- dry mouth
- blurred vision
- muscle weakness
Less common side effects include:
- changes in sexual desire
- digestive disturbances
- low blood pressure
- sight problems
A person may also experience paradoxical effects, where the medication does the opposite of what it is supposed to. These include:
If a person abruptly stops taking benzodiazepines, they may experience withdrawal symptoms, and their anxiety symptoms may resurface. A healthcare professional can provide guidance on how to slowly and safely decrease their dose.
Healthcare professionals typically prescribe beta-blockers to reduce high blood pressure. However, this kind of medication can also help reduce physical symptoms of panic attacks and anxiety, including:
People may take beta-blockers for short periods or as necessary to alleviate acute anxiety, including performance anxiety.
A 2020 study suggests that the beta-blocker atenolol (Tenormin) may be more effective and better tolerated than propranolol in people with anxiety disorders. More studies are necessary to investigate its efficacy.
Panic attacks and anxiety have many similar symptoms. However, anxiety symptoms are more common and less intense than those of panic attacks.
Panic attack symptoms
According to the United Kingdom’s National Health Service (NHS), a panic attack can cause sudden, severe mental and physical symptoms for no apparent reason.
It states that symptoms last around 5–20 minutes. During this time, a person may feel out of control and not connected to their body or experience a feeling of impending doom.
Panic attack symptoms also
- a rapid or pounding heartbeat
- feeling faint
- hot flashes
- stomach pain
- chest pain
- shortness of breath
- a sensation of choking
- trembling or shaking
- dry mouth
- a need to go to the toilet
- ringing in the ears
- a feeling of dread
- a fear of dying
- severe worry about another panic attack
The main symptom of anxiety is uneasiness. A person may experience mild to severe feelings of worry and fear.
Anxiety symptoms also include:
- a rapid heartbeat
- a feeling of dread
- fearing the worst
- feeling on edge or panicky
- difficulty concentrating
- feeling detached from the self or the world
- feeling dizzy or lightheaded
- wobbly legs
- tingling in your hands and feet
- shortness of breath or hyperventilation
- needing to use the toilet more or less often
- sleep issues
- panic attacks
In addition to medications, treatment options for anxiety disorders and panic attacks include psychotherapy, which aims to teach people to modify their behavior and stay calm when they feel anxious and fearful.
Acceptance and commitment therapy is a newer type of psychotherapy that may help alleviate discomfort and anxiety through mindfulness and goal setting. The technique involves learning to accept negative emotions, thoughts, and events.
Additional treatment options include:
If a person senses the onset of a panic attack, it is best to resist the urge to fight it. It may help to remember that the feeling will pass, is not dangerous or life threatening, and will not harm them physically.
Finding a peaceful spot may help if possible, as sights and sounds can intensify a panic attack. A person can also try some relaxation techniques, such as:
- taking long, slow, deep breaths
- smelling a soothing scent, such as lavender
- focusing on a physical object in the environment to help them feel more grounded
- repeating a mantra, which is a word, phrase, or sound that may help shift their focus away from fear
A person may wish to consult a healthcare or mental health professional if they regularly experience panic attacks and anxiety without a clear cause. This is especially important if they have severe symptoms that affect their daily life.
The healthcare or psychiatric professional will evaluate a person’s symptoms and may perform a physical exam to check for any underlying conditions before making a diagnosis and offering advice.
The Substance Abuse and Mental Health Services Administration is an online resource that offers a search tool for finding mental health treatment centers across the United States. The
People can also join an in-person or online support group if they wish. However, this is not a replacement for treatment from a healthcare professional.
Anxiety and panic attacks share similar symptoms, though anxiety is more common and less intense.
Medication and treatment options for anxiety disorders and panic attacks depend on the duration, frequency, and severity of a person’s symptoms.