Medications for Treating Panic Disorder

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.
Learn about our editorial policy
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 Medical Review Board
Steven Gans, MD
on November 23, 2019
woman taking medication
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 help reduce how intense your panic attacks are, decrease your overall feelings of anxiety, and potentially treat any co-occurring conditions, such as depression.

Medications for panic disorder are typically classified in 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 are communicating between brain cells.

Selective Serotonin Reuptake Inhibitors (SSRIs)

Selective Serotonin Reuptake Inhibitors, or simply SSRIs, are a popular class of antidepressants prescribed to decrease symptoms of anxiety and depression. This medication affects serotonin, a naturally occurring neurotransmitter in the brain. SSRIs work by influencing only the serotonin levels (selective) and by preventing serotonin absorption (reuptake) by the nerve cells in the brain. By balancing a person’s serotonin functioning, SSRIs are able to reduce anxiety and improve mood.

Studies have demonstrated the long-term effectiveness of SRRIs. These medications have also been found to cause limited side effects, making them the prescription medication of choice for panic disorder.

Common SSRIs include:

Tricyclic Antidepressants (TCAs)

Tricyclic antidepressants, or TCAs, were more popular in treating both anxiety and mood disorders before 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:

  • Amitriptyline (Elavil)
  • Amoxapine (Asendin)
  • Desipramine (Norpramin)
  • Doxepin (Adapin, Sinequan)
  • Imipramine (Tofranil)
  • Nortriptyline (Pamelor)
  • Protriptyline (Vivactil)
  • Trimipramine (Surmontil)

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.

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.

Common MAOIs include:

  • Phenelzine (Nardil)
  • Tranylcypromine (Parnate)
  • Isocarboxazid (Marplan)
  • Selegiline (Emsam)

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:

  • Xanax (alprazolam)
  • Klonopin (clonazepam)
  • Valium (diazepam)
  • Ativan (lorazepam)
  • Librium (chlordiazepoxide)
Was this page helpful?

Article Sources

Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial policy to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

  1. 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

  2. Bandelow B, Michaelis S, Wedekind D. Treatment of anxiety disorders. Dialogues Clin Neurosci. 2017;19(2):93-107.

  3. 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

  4. 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

  5. Fiedorowicz JG, Swartz KL. The role of monoamine oxidase inhibitors in current psychiatric practice. J Psychiatr Pract. 2004;10(4):239-248.

  6. 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

  7. 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 (2013). Diagnostic and Statistical Manual of Mental Disorders, 5th ed. Washington, DC: Author.
  • Preston, John D., O'Neal, John H., Talaga, Mary C. (2010). Handbook of Clinical Psychopharmacology for Therapist, 6th ed. 2010 Oakland, CA: New Harbinger Publications.
  • Silverman, Harold M. (2012). The Pill Book. 15th ed. New York, NY: Bantam Books.
Related Articles