Treatments for panic attacks and determining suitable medications for you.
Panic disorder, a condition characterized by recurring panic attacks and persistent fear of another attack, can significantly impact an individual's life. Before a diagnosis is made, healthcare professionals rule out other conditions to ensure an accurate diagnosis.
According to the Diagnostic and Statistical Manual of Mental Disorders, 5th edition, text revision (DSM-5-TR), panic disorder is diagnosed when panic attacks repeatedly occur, followed by 1 month or more of persistent concern about having another attack, a person changes their behavior to avoid situations they consider triggering, panic attacks do not happen solely as a result of substance use, medications, or other medical conditions, other diagnoses cannot better explain the symptoms, and panic attacks are not always the result of a recognizable trigger.
When it comes to treatment, a variety of options are available. Common medications for panic attacks and panic disorder include Selective Serotonin Reuptake Inhibitors (SSRIs), Benzodiazepines, Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs), Buspirone, and Hydroxyzine.
SSRIs, such as paroxetine (Paxil), escitalopram (Lexapro), sertraline (Zoloft), and fluoxetine (Prozac), are often the first-line treatment. They work by increasing serotonin levels in the brain, which helps regulate mood and anxiety.
Benzodiazepines, such as alprazolam (Xanax), lorazepam (Ativan), clonazepam (Klonopin), and diazepam (Valium), are fast-acting and used primarily for short-term relief during acute panic attacks. They enhance GABA neurotransmitter activity, producing calming effects. However, due to their addiction risk, they are suitable for short-term use only.
SNRIs, like venlafaxine (Effexor) and duloxetine (Cymbalta), affect both serotonin and norepinephrine and are used if SSRIs are ineffective or unsuitable.
Buspirone is another anti-anxiety medication with fewer side effects and less risk of addiction, typically used for generalized anxiety but sometimes for panic disorder. Hydroxyzine, an antihistamine, is sometimes used as an alternative, especially when benzodiazepines are contraindicated.
Common side effects vary among these medications. For instance, SSRIs may cause nausea, diarrhea, trouble sleeping, nervousness, sexual dysfunction, headache, and weight changes. Side effects may improve over time, and sexual dysfunction can persist during treatment.
Benzodiazepines may cause sedation, dizziness, tolerance, dependence, and withdrawal symptoms if stopped suddenly. They are suitable for short-term use only due to addiction risk.
SNRIs may cause nausea, increased blood pressure, insomnia, and dizziness. Similar side effects to SSRIs; monitor blood pressure is advised.
Buspirone is generally well tolerated, with no addiction risk. Common side effects include dizziness, headache, and nausea.
Hydroxyzine is used as a second-line or as-needed treatment and may cause drowsiness and dry mouth.
It's important to note that those with panic disorder are at higher risk of suicidal thoughts and decreased quality of life than people without the condition. If you or someone you know is in crisis and considering suicide or self-harm, please seek support: Call or text the 988 Lifeline at 988 or chat at 988lifeline.org, text HOME to the Crisis Text Line at 741741, or call 911 or your local emergency services number if you feel safe to do so.
In addition to medication, treatments for panic disorder include cognitive behavioral therapy, relaxation techniques, dialectical behavioral therapy, exposure therapy, group therapy, hypnosis, staying physically active, eating a nutritious and balanced diet, taking herbal supplements, and talking with a doctor about different types of treatment and whether another diagnosis could account for symptoms. It may also help to have a friend or family member at doctor's appointments to hear the discussion.
In summary, SSRIs and SNRIs are commonly chosen for long-term management of panic disorder due to their efficacy and safety profiles. Benzodiazepines are effective for rapid relief but are limited to short-term use due to dependence risks. Other options like buspirone and hydroxyzine provide alternatives with varied side effect profiles.
- Beyond pills, treatments for panic disorder involve cognitive behavioral therapy, relaxation techniques, various types of therapy, physical activity, a balanced diet, herbal supplements, and a doctor's guidance on alternative diagnoses.
- In the context of health-and-wellness and mental-health, an individual might benefit from acting on anxiety-reducing strategies besides medication, such as practicing mindfulness, yoga, and engaging in protective social relationships.
- Following a diagnosis of panic disorder, one should be aware that the condition can predict a higher risk of obesity, as anxiety and panic attacks can lead to unhealthy eating habits and sedentary behavior.
- Medical science continues to explore predictive patterns for various health issues, linking panic attacks to long-term mental well-being consequences, such as increased rates of anxiety, depression, and decreased quality of life.
