Panic Disorder Treatment Medications for Treating Panic Disorder By 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 Katharina Star, PhD Medically reviewed by Medically reviewed by Steven Gans, MD on November 23, 2019 Steven Gans, MD is board-certified in psychiatry and is an active supervisor, teacher, and mentor at Massachusetts General Hospital. Learn about our Review Board Steven Gans, MD Updated on March 21, 2020 Print Tom Merton / Getty Images Medication is one of the most popular and effective treatment options for panic disorder, panic attacks, and agoraphobia. Your doctor may prescribe medication 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. Antidepressants 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. Types of Antidepressants for 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. Tricyclic Antidepressants (TCAs) Tricyclic antidepressants (TCAs) have become less popular in treating anxiety and mood disorders since SSRIs were introduced. However, TCAs are still 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 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) 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. Was this page helpful? Thanks for your feedback! Learn the best ways to manage stress and negativity in your life. Sign Up You're in! Thank you, {{form.email}}, for signing up. There was an error. Please try again. What are your concerns? Other Inaccurate Hard to Understand Submit Article 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 Bandelow B, Michaelis S, Wedekind D. Treatment of anxiety disorders. Dialogues Clin Neurosci. 2017;19(2):93-107. Carhart-Harris RL, Nutt DJ. Serotonin and brain function: A tale of two receptors. J Psychopharmacol. 2017;31(9):1091-1120. doi:10.1177/0269881117725915 Taylor C, Fricker AD, Devi LA, Gomes I. Mechanisms of action of antidepressants: from neurotransmitter systems to signaling pathways. Cell Signal. 2005;17(5):549-557. doi:10.1016/j.cellsig.2004.12.007 Fiedorowicz JG, Swartz KL. The role of monoamine oxidase inhibitors in current psychiatric practice. J Psychiatr Pract. 2004;10(4):239-248. Farach FJ, Pruitt LD, Jun JJ, Jerud AB, Zoellner LA, Roy-Byrne PP. Pharmacological treatment of anxiety disorders: Current treatments and future directions. J Anxiety Disord. 2012;26(8):833-843. doi:10.1016/j.janxdis.2012.07.009 Griffin CE 3rd, Kaye AM, Bueno FR, Kaye AD. Benzodiazepine pharmacology and central nervous system-mediated effects. Ochsner J. 2013;13(2):214-223. Additional Reading American Psychiatric Association Diagnostic and Statistical Manual of Mental Disorders, 5th ed. 2013. Preston JD, O'Neal JH, Talaga MC. Handbook of Clinical Psychopharmacology for Therapist, 6th ed. New Harbinger Publications, 2010. Silverman HM. The Pill Book. 15th ed. Bantam Books, 2012. 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