Treatment of Panic Disorder; Tips for Panic Attacks

Drug treatment:

We can use either a fast acting benzodiazepine (like alprezolam, Xanor, etc.) usually for a short period only, or a tricyclic antidepressant (TRCAs), which are well tolerated but have a much slower onset of action. One can also use selective serotonin reuptake inhibitors (Fontex Prozac, Fluoxetin, Cipramil, Seroscand, etc.) at doses similar to those used in depression. TRCAs and SSRIs may exacerbate (increase the severity of) anxiety initially. Monoamine oxidase inhibitors are also effective (phenelzine up to 105 mg/day).

Benzodiazepines often lose their effect after some weeks, and quitting using them can give abstention symptoms for several weks or months.

Because of the risks with benzodiazepines, they are not recommended as first choice in anxiety treatment.

Psychological treatment:

Cognitive-behavior therapy, Gestalt-therapy, as well as other forms of psychotherapy, seem effective against some or all symptoms of panic disorder.

It is best to start with only psychotherapy, since it is often effective and then you will not have to use medicines for a long time. But sometimes SSRI-medicines can make psychotherapy more effective. Benzodizepines, on the other hand, may make psychotherapy less effective. Some doctors prescripe drug treatment combined with psychotherapy. Drug treatment should be timed to produce a "window" of responsiveness to psychological intervention.