Panic Disorder Treatment Medications 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 May 08, 2023 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 Steven Gans, MD Medically reviewed by Steven Gans, MD Steven Gans, MD is board-certified in psychiatry and is an active supervisor, teacher, and mentor at Massachusetts General Hospital. Learn about our Medical Review Board Print Tom Merton / Getty Images Table of Contents View All Table of Contents Panic Disorder Treatment Antidepressant Medications Anti-Anxiety Medications Frequently Asked Questions 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. Medication is one of the most popular and effective treatment options for panic disorder, panic attacks, and agoraphobia. Your doctor may prescribe panic attack medications to reduce the intensity of panic 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. Panic Disorder Treatment 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 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 effective in treating panic disorder. Types of psychotherapy that may be helpful include: Cognitive behavioral therapy (CBT) Exposure therapy Panic-focused psychodynamic psychotherapy (PFPP) How Long Do Panic Attacks Last? 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. Classes of Antidepressants for Treating Panic Disorder Selective Serotonin Reuptake Inhibitors (SSRIs) Selective serotonin reuptake inhibitors (SSRIs) are a popular class of antidepressants prescribed to decrease symptoms of anxiety and depression. Serotonin is a naturally occurring neurotransmitter in the brain. These medications work by influencing only serotonin ("selective") and by preventing serotonin absorption ("reuptake") by the nerve cells in the brain. By balancing serotonin functioning, SSRIs are able to reduce anxiety and improve mood. Common SSRIs include: Celexa (citalopram) Paxil (paroxetine) Prozac (fluoxetine) Zoloft (sertraline) 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: Cymbalta (duloxetine) Effexor XR (venlafaxine) 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 with anxiety disorders. Like SSRIs, TCAs work to block the reuptake of the chemical messenger serotonin. Additionally, many TCAs also prevent the reuptake of norepinephrine, another neurotransmitter in the brain that is often associated with the fight-or-flight stress response. Common TCAs include: Adapin, Sinequan (doxepin)Asendin (amoxapine)Elavil (amitriptyline)Norpramin (desipramine)Pamelor (nortriptyline)Surmontil (trimipramine)Tofranil (imipramine)Vivactil (protriptyline) Monoamine Oxidase Inhibitors (MAOIs) Monoamine oxidase inhibitors (MAOIs) are one of the earliest developed antidepressants used to effectively treat mood and anxiety disorders. MAOIs work by inhibiting the activity of the enzyme monoamine oxidase. 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: Emsam (selegiline)Nardil (phenelzine)Marplan (isocarboxazid)Parnate (tranylcypromine) Despite their effectiveness, MAOIs are prescribed less frequently due to necessary dietary restrictions when taking them and the potential for significant drug interactions that can occur when taking MAOIs with other medications. Anti-Anxiety 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. Benzodiazepines slow down the central nervous system by targeting the gamma-aminobutyric acid (GABA) receptors in the brain, inducing a sense of relaxation. In spite of the potential risks and side effects of these medications, benzodiazepines have been found to safely and effectively treat panic disorder. Common benzodiazepines include: Ativan (lorazepam) Klonopin (clonazepam) Librium (chlordiazepoxide) Valium (diazepam) Xanax (alprazolam) 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 the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 1-800-662-4357 for information on support and treatment facilities in your area. For more mental health resources, see our National Helpline Database. Frequently Asked Questions How do I handle a panic attack without medication? Psychotherapy can be very helpful for treating panic attacks. During a panic attack, deep breathing can help you manage hyperventilation, a symptom that can play a role in increasing feelings of fear. Other strategies such as grounding techniques, mindfulness, and progressive muscle relaxation can also be helpful for preventing and relieving feelings of panic. Learn More: Why Panic Attacks Cause Shortness of Breath How do I ask my doctor for panic attack medication? 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. What kind of non-habit-forming panic attack medication is there? Non-habit-forming medications that can help with panic attacks and anxiety include SSRIs, SNRIs, and beta-blockers. Others that may be helpful include Buspar and Vistaril. How long does panic attack medication take to work? 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 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. 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. 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Front Psychol. 2017;8:874. doi:10.3389/fpsyg.2017.00874 Additional Reading American Psychiatric Association Diagnostic 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. 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? Other Helpful Report an Error Submit Speak to a Therapist for Panic Disorder Advertiser Disclosure × The offers that appear in this table are from partnerships from which Verywell Mind receives compensation.