Panic Disorder Treatment Classes of Antidepressants for Treating Panic Disorder By Katharina Star, PhD Katharina Star, PhD Facebook LinkedIn Katharina Star, PhD, is an expert on anxiety and panic disorder. Dr. Star is a professional counselor, and she is trained in creative art therapies and mindfulness. Learn about our editorial process Updated on October 23, 2020 Medically reviewed Verywell Mind articles are reviewed by board-certified physicians and mental healthcare professionals. Medical Reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more. by Daniel B. Block, MD Medically reviewed by Daniel B. Block, MD LinkedIn Twitter Daniel B. Block, MD, is an award-winning, board-certified psychiatrist who operates a private practice in Pennsylvania. Learn about our Medical Review Board Print Arman Zhenikeyev/Getty Images When first introduced in the 1950s, antidepressant medication was used to help reduce the symptoms of depression. However, research has shown that antidepressants can effectively treat a variety of mood and anxiety disorders. Antidepressants are currently one of the most common treatment options for panic disorder. How Antidepressants Treat Panic Disorder Neurotransmitters are naturally-occurring chemicals in the brain and are considered to be imbalanced for people with mood and anxiety disorders. Antidepressants work by affecting these neurotransmitters in a way that can help reduce anxiety and decrease the frequency and intensity of panic attacks. Different classes of antidepressants influence various types of neurotransmitters. The most frequently prescribed groups of antidepressants for panic disorder include the following. Panic Disorder Treatment Selective Serotonin Reuptake Inhibitors (SSRIs) Selective serotonin reuptake inhibitors, or SSRIs, are a popular type of antidepressant that can be used to treat panic disorder. SSRIs work to balance serotonin, a neurotransmitter that's associated with the regulation of several bodily functions, including mood and sleep. By preventing your brain cells from absorbing serotonin, SSRIs can assist in enhancing mood and reducing feelings of panic and anxiety. SSRIs were first introduced in the United States in the 1980s and have continued to remain a popular treatment option for numerous mental health disorders. SSRIs are often preferred due to their safety, effectiveness, and likelihood of producing fewer side effects than other types of antidepressants. Some of the most common SSRIs include: Prozac (fluoxetine) Zoloft (sertraline) Paxil (paroxetine) Celexa (citalopram) How SSRIs Are Used to Treat Panic Disorder Tricyclic Antidepressants (TCAs) Tricyclic antidepressants, or TCAs, originated in the 1950s. Despite becoming less popular since the introduction of SSRIs, TCAs are still used to successfully treat anxiety and mood disorders. Similar to SSRIs, TCAs also work to balance serotonin levels. TCAs also affect norepinephrine, a neurotransmitter linked to alertness and the fight-or-flight stress response. Some common TCAs include: Elavil (amitriptyline)Asendin (amoxapine)Norpramin (desipramine)Adapin, Sinequan (doxepin)Tofranil (imipramine)Pamelor (nortriptyline)Vivactil (protriptyline)Surmontil (trimipramine) Monoamine Oxidase Inhibitors (MAOIs) First available in the 1950s, monoamine oxidase inhibitors (MAOIs) are one of the earliest types of antidepressants. Due to the many dietary restrictions and potentially dangerous drug interactions associated with MAOIs, SSRIs and TCAs are often preferred over them. MAOIs are, however, still considered to be effective in treating conditions related to mood and anxiety. Like TCAs, MAOIs influence the availability of serotonin and norepinephrine. MAOIs additionally stabilize dopamine, a neurotransmitter that's linked to a variety of functions, such as a person's energy levels, physical movements, and feelings of motivation. Some common MAOIs include: Nardil (phenelzine)Parnate (tranylcypromine)Marplan (isocarboxazid)Emsam (selegiline) Antidepressants and Suicide Risk A warning was issued in 2004 by the United States Food and Drug Administration (FDA) after research showed a link between antidepressant use and the risk of suicide. The FDA requires a black box warning on all antidepressants because of an increased risk of suicidal thoughts and behavior in young adults, between ages 18 and 24, during initial treatment (first one to two months of therapy). Most people on antidepressants will not run into this risk. However, young people just beginning on an antidepressant should be carefully monitored for increased depression, thoughts of suicide, and any unusual behaviors. Always consult your doctor if you have any questions and/or concerns about your antidepressant prescription. If you are having suicidal thoughts, contact the National Suicide Prevention Lifeline at 988 for support and assistance from a trained counselor. If you or a loved one are in immediate danger, call 911. For more mental health resources, see our National Helpline Database. 7 Sources Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Bighelli I, Trespidi C, Castellazzi M, et al. Antidepressants and benzodiazepines for panic disorder in adults. Cochrane Database Syst Rev. 2016;9:CD011567. doi:10.1002/14651858.CD011567.pub2 Guaiana G, Barbui C, Caldwell DM, et al. Antidepressants, benzodiazepines and azapirones for panic disorder in adults: a network meta‐analysis. Cochrane Database Syst Rev. 2017;7:CD012729. doi:10.1002/14651858.CD012729. Quagliato LA, Freire RC, Nardi AE. Risks and benefits of medications for panic disorder: a comparison of SSRIs and benzodiazepines. Expert Opin Drug Saf. 2018;17(3):315-324. doi:10.1080/14740338.2018.1429403 Bystritsky A, Khalsa SS, Cameron ME, Schiffman J. Current diagnosis and treatment of anxiety disorders. P T. 2013;38(1):30–57. 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 Fornaro M, Anastasia A, Valchera A, et al. The FDA "black box" warning on antidepressant suicide risk in young adults: more harm than benefits? Front Psychiatry. 2019;10:294. doi:10.3389/fpsyt.2019.00294 Stübner S, Grohmann R, Greil W, et al. Suicidal ideation and suicidal behavior as rare adverse events of antidepressant medication: current report from the AMSP Multicenter Drug Safety Surveillance Project. Int J Neuropsychopharmacol. 2018;21(9):814-821. doi:10.1093/ijnp/pyy048 By Katharina Star, PhD Katharina Star, PhD, is an expert on anxiety and panic disorder. Dr. Star is a professional counselor, and she is trained in creative art therapies and mindfulness. See Our Editorial Process Meet Our Review Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? 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