What is panic disorder?
Panic disorder is a mental
condition in which you have repeated, unexpected panic attacks and constantly
worry about having another attack. A panic attack is a sudden feeling of
extreme anxiety along with intense and frightening, but not life-threatening,
physical symptoms. An attack usually lasts from 5 to 20 minutes but may last
even longer, up to a few hours. You feel most anxious about 10 minutes into the
For more information, see the topic
Panic Attacks and Panic Disorder.
What are the risks of panic disorder?
disorder can reduce your quality of life and interfere with your relationships
and your ability to work. If you have panic disorder, you are more likely to
other conditions such as depression or
agoraphobia, which is a fear of being in public places
or of being in situations from which it might be difficult to escape (such as
crossing a bridge or standing in line).
What types of medicines are used to treat panic disorder?
The two types of medicines that are generally used to
treat panic disorder are antidepressants and benzodiazepines. Sometimes a
combination of both may be prescribed.
The most common medicines
used to treat panic disorder are
selective serotonin reuptake inhibitors (SSRIs), such
as fluoxetine (Prozac), sertraline (Zoloft), or paroxetine (Paxil). Other
antidepressants such as
tricyclic antidepressants (TCAs) or
monoamine oxidase inhibitors (MAOIs) can also be
effective. Antidepressants with mixed neurotransmitter effects, such as
venlafaxine (Effexor), may also be used to treat panic disorder.
benzodiazepines such as alprazolam (Xanax), diazepam
(Valium), lorazepam (Ativan), or clonazepam (Klonopin) are prescribed, either
alone or combined with an antidepressant. Benzodiazepines are most commonly
used for rapid, short-term relief of symptoms and may also be used as a part of
ongoing treatment either alone or combined with an antidepressant.
Benzodiazepines work quickly to treat anxiety and may be especially helpful if
you have agoraphobia. Unlike antidepressants, they can be taken as needed. But
symptoms often recur when you stop taking them, and they have the potential to
What to expect if you take medicines to treat panic disorder
Antidepressants can help balance the chemicals in your
brain (neurotransmitters) and reduce the intensity of your symptoms. You may
start to feel better within 1 to 3 weeks of taking antidepressant medicine. But
it can take as many as 6 to 8 weeks to see more improvement. If you have
questions or concerns about your medicines, or if you do not notice any
improvement by 3 weeks, talk to your doctor. Benzodiazepines provide more
immediate relief for symptoms of anxiety and may be prescribed alone or
combined with an antidepressant such as an SSRI.
It is important
to remember that people respond differently to medicines, and the first
medicine you try may or may not be effective in relieving your symptoms of
panic disorder. If the medicine is not effective after several weeks, you may
need to try another medicine.
Although antidepressant medicines
have potential side effects, these side effects are usually mild and may
diminish after several weeks of therapy.
What to expect if you DO NOT take medicines to treat panic disorder
Even if you decide not to take medicine, it is wise to
try professional counseling, such as cognitive-behavioral therapy, which
focuses on modifying certain thinking and behavior patterns. Therapy can help
you deal with immediate problems and learn ways to better cope with future
anxiety and panic attacks. Other treatments, such as support groups, relaxation
exercises, or mindfulness activities, can also be helpful. Untreated panic
disorder may get worse or may be unmanageable without help, especially if you
also have another condition that commonly occurs along with panic disorder such
as agoraphobia or depression.
If you do not take medicines to
treat panic disorder, continuing to monitor how much your symptoms interrupt
your life and the lives of those around you can be helpful. Some people are
able to overcome panic disorder without taking medicine. But if other methods
aren't effective enough, medicines can be added to your treatment.