The article describes the role of medications in controlling panic attacks. Medication control anxiety and regulate mood in differing ways, and all work best in combination with therapy and/or behavioral methods.
Introduction to Medication Treatment for Panic Attacks
Panic attacks are short bursts of overwhelming fear and apprehension that occur suddenly. They can be incapacitating and seriously disrupt the lives of those who experience them. Such attacks often come unexpectedly and often while the person is asleep. They are accompanied by strong physical sensations such as chest pain that that further increase fear. More people going to an emergency room fearing a heart attack are actually experiencing panic than anything cardiac in origin.
Medication plays an important role in the management of panic attacks, addressing both their underlying causes and symptoms. The principle classes of medication used are
- Benzodiazepines, e.g,:
- alprazolam (Xanax)
- lorazepam (Ativan)
- clonazepam (Klonopin)
- beta-blockers, e.g.,
- propranolol (Inderal)
- atenolol (Tenormin)
- metoprolol (Lopressor)
- antidepressants, e.g.,
- SSRIs such as escitalopram (Lexapro), sertraline (Zoloft), fluoxetine (Prozac)
- SNRIs such as venlafaxine (Effexor), duloxetine (Cymbalta), desvenlafaxine (Pristiq)
- Others such as bupropion (Bupropion)
By understanding their working principles and potential side effects, patient and physician can develop a working treatment plan tailored to individual needs.
Understanding Medication for Panic Attacks and Its Role
Panic attacks are accompanied by various physical sensations typical of the fight-or-fight response. This can include any form of perspiration, dizziness, a pounding heart, tingling of the hands or feet or mouth, nausea and vomiting. A panic attack typically lasts about four minutes. Which make the person experience an acute disaster if only for about four minutes.
Kinds of Panic Attack Medications
There are various families of medication that can be used to treat panic attacks. Benzodiazepines such as alprazolam and clonazepam are the most well-known and most sought after for their quick and reliable effect. But they should be used with caution as they quickly induce habituation (waning effect at a stable dose), dependency and in many cases true addiction (the craving for higher and higher doses).
Beta-blockers such as propranolol (Inderal) are an important alternative to benzodiazepines. They directly reduce all of the physical symptoms of panic attacks such as elevated heart rate, trembling and increased blood pressure. By targeting the body’s response to stress, beta-blockers mitigate a panic attack almost immediately. One must work with a physician closely to insure that they do not lower blood pressure too much or induce exercise intolerance. But they do not induce habituation, dependence, or addiction and once an effective dose is found it remains stable.
Medications in the antidepressant classes are the definitive treatment for panic. Whereas benzodiazepines and beta-blockers work quickly in the moment to suppress anxiety, antidepressants take a long time to become effective but re-regulate anxiety making it function in a way that is more accurately coupled to reality. They therefore prevent panic from even starting. They are the optimal choice of pharmacological intervention for panic disorder.
(Note: antidepressants are so-named by an accident of history. When Eli Lily first sought approval from the FDA for the first SSRI, Prozac (fluoxetine),they requested an indication for depression. A year later they also received an indication for anxiety. But by then Prozac and all the other emerging SSRIs and SNRIs were called “antidepressants.”)
In sum, these medications work in different ways to address the underlying mechanisms contributing to panic attacks, highlighting the importance of personalized treatment plans tailored to each individual’s unique needs and preferences. The range of medications available underscores the significance of a comprehensive approach to managing panic attacks effectively.
What side effects can I expect from the drugs prescribed for panic attacks?
It depends on the individual medication. To give one example, both selective serotonin reuptake inhibitors (SSRIs) and venlafaxine extended-release (ER) have been known to trigger such complaints as sexual dysfunction, increased appetite or excessive sweating. It’s important to know that most patients have no side effects and for those that do they go away as soon as the medication is stopped. In order to continue using a medication it must meet two common-sense criteria:
- It works
- It has no unacceptable side effects
Side effects can have a material impact on an individual’s quality of life, and should be closely watched by healthcare professionals to ensure that the best outcome occurs for all patients. Any appropriate and recommended medication should be tried and if it fails, or if there are side effects, it should be discontinued in favor of something else.
Conclusion
In summary, different families of medication work in different ways to address the underlying mechanisms contributing to panic attacks, highlighting the importance of personalized treatment plans tailored to each individual’s unique needs and preferences. The range of medications available underscores the significance of a comprehensive approach to managing panic attacks effectively.
In addition to medication, incorporating therapy into the treatment approach can significantly enhance the outcomes for individuals struggling with panic attacks. For instance, cognitive behavioral therapy (CBT) has been shown to be particularly effective in conjunction with medication, offering patients coping strategies, stress management techniques, and tools to challenge negative thought patterns associated with panic attacks. This combined approach not only targets the physiological aspects of panic attacks through medication but also addresses the psychological components through therapy, providing a more holistic and comprehensive treatment solution for individuals with panic disorder.
At the Sterling Institute, those who suffer panic attacks can get the specialized care they need to improve this condition and start on their way back to mental health. For more on our services, visit the Sterling Institute website at https://sterlinginstitute.org/.