Treatment for panic disorder varies considerably and it may take several tries before you find the treatment or combination of treatments that work for you. It is important that you keep this in mind, to try to keep from getting discouraged if it takes time. Panic disorder is usually treated with a cognitive behavior therapy (CBT), and medication when needed.
Cognitive behavioral therapy
When you undergo CBT, you work with a mental health care professional who helps you to identify triggers for your feelings of panic and anxiety. Once the triggers have been identified, you work with the therapist to break the cycle of anxiety. One way to do this is by recreating the situations that trigger your panic, and working through them within a safe and supportive setting. Some therapists also teach relaxation techniques, such as meditation and mindfulness, to help you calm your mind.
Medications may be taken alone or in combination with CBT. Both anti-anxiety and antidepressants have helped many people with anxiety disorder, but it may take trying several medications before you find one that may work for you. It is important to give the medicine time to work because it can take up to several weeks to see a noticeable difference. Some people find that medication is helpful as they begin CBT, until the therapy starts to have its effect.
Some of the most common medications used to treat panic disorder are:
- Selective serotonin reuptake inhibitors (SSRIs). These are often the first choice for treating panic disorder and the most commonly prescribed ones are fluoxetine (Prozac), paroxetine (Paxil, Pexeva) and sertraline (Zoloft).
- Serotonin and norepinephrine reuptake inhibitors (SNRIs). Venlafaxine hydrochloride (Effexor XR) is FDA approved for the treatment of panic disorder.
- Benzodiazepines. These medications are mild sedatives and may cause drowsiness. They may provide quick relief of acute anxiety, but they can become habit forming. For this reason, they should not be taken for extended periods. Benzodiazepines approved by the FDA for the treatment of panic disorder include alprazolam (Niravam, Xanax), clonazepam (Klonopin) and lorazepam (Ativan).
- Beta blockers. Medicines usually used to treat heart disease, called beta-blockers, can be effective in treating panic disorder in some people.
*Important note about antidepressants: Antidepressant medications have been proven to be very effective for most people who need them. However, antidepressants may cause some people to have suicidal thoughts or suicide attempts. Anyone who takes antidepressants should be monitored closely for signs of increasing depression and suicidal thoughts or behavior, particularly if it is a new prescription.