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Insight into the Best Medication for Panic Attacks

written by: Jean Scheid • edited by: Jacqueline Chinappi • updated: 11/13/2010

If you suffer from a panic attack disorder, do you know the best medication for panic attacks? Over the past decades, science has offered many, some good and some not so great. Here’s a breakdown on what’s available.

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    Don’t Panic – Find the Right Meds

    Don't Panic on Arm As a panic attack sufferer myself, I’ve tried many different medications and combos of meds. Often, the best medication for panic attacks depends upon the severity of your disorder, if you are receiving any sort of individual or group therapy, and if you’re willing to last through the trial and error of panic attack medication side-effects.

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    Top Medications for Panic Attacks

    According to the American Psychiatric Association (APA), there are a few drug classes that are currently used to fight panic disorders and reduce anxiety attacks. They include:

    • Benzodiazepines – This include medications that produce a calming effect such as Xanax, Ativan, Valium and Klonopin. Benzodiazepines calm the brain and body to immediately reduce the effects of a panic attack.
    • SSRIs – Also known as selective serotonin reuptake inhibitors, SSRIs include Prozac, Zoloft, and Paxil. SSRIs help serotonin levels remain steady to prevent panic attacks.
    • Antidepressants – These neurotransmitter meds include some new panic attack medications on the market like Effexor and some newer ones such as Cymbalta and Pristiq. Antidepressants are often used in conjunction with SSRIs to help the brain stay even more steady.
    • MAOIs – Monoamine oxidase inhibitors or MAOIs include Marplan, Parnate, and Nardil. In rare or severe cases of panic disorder, sometimes MAOIs are utilized, however, some sufferers report these leave a blank or no-feeling effect so these are considered a last resort.
    • TCAs – Tricyclic antidepressants include Norpramin, Anafranil and Tofranil. Again, Tricyclic antidepressants are stronger than SSRIs and the average antidepressant and are used in those who can find no relief with other medications.

    While these are many of the drugs used to treat generalized anxiety disorder, which are the best medications for panic attacks?

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    Trial & Error

    Trial and Error For panic attack sufferers, Benzodiazepines will offer fast relief, especially Xanax, Valium, and Ativan. Klonopin, on the other hand, is taken regularly (not just when needed) and as my psychiatrist Dr. Robert Franklin says, “Take a Klonopin and tell me how you feel in an hour, not 15 minutes.”

    All such medications in this class are considered to be addictive if abused, but with smart control and doctor therapy, they are very effective, especially when combined with SSRIs.

    When benzodiazepines are combined with SSRIs such as Zoloft or Prozac, the benefits that SSRIs offer is to maintain a balance serotonin level and if needed, a benzodiazepine can be taken during difficult times or in uneasy situations to alleviate the panic attack.

    Over the years, I have tried a combo of all types of these medications for my panic disorder and have found that benzodiazepines mixed with a body-accepted SSRI are the best medications for panic attacks. Some SSRIs such as Paxil, however, have been improved upon and drugs like Effexor, although in the antidepressant class, are also being used. Many reach top dose levels and if the meds aren’t working, doctors often change the type of drug combo to find the best result.

    Often, however, one person may suffer the side effects from SSRIs such as drowsiness, sleeplessness, and dry mouth or a jittery feeling. While Zoloft may work for one, Prozac may work for another. This is where the trial and error of panic attack medications comes into play because as we all know, if you’ve tried these types medications, SSRIs often take up to 4 to 6 weeks to reap the reward.

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    When Panic Disorder Causes Depression

    Often generalized anxiety disorder (GAD) and fear of having panic attacks in public can bring on depression episodes—some severe, some not. Even those with panic disorders alone can experience depression. When panic and depression come together, often the use of cognitive behavior therapy and a combo of benzodiazepines with SSRIs and an antidepressant are used. Again, however, finding the best medications for panic attacks mixed with depression depends upon how well your body accepts medication side-effects.

    More and more, therapists, psychologists, and psychiatrists are working with family doctors to help prescribe the right meds for panic attacks and if you begin a new regime of drugs, do give it time until you can reap the full effects, unless the side effects are devastating. In cases like these, it’s best to work with your doctor to determine the best medications for panic attacks.

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    References

    • American Psychiatric Association - http://www.psych.org/
    • Dr. Robert Franklin, Taos, New Mexico

    Image Credits:

    • Don't Panic - Flickr/nevermindtheend
    • Trial & Error - Flickr/Esthr.