Panic disorder is a type of anxiety disorder where the patient has "repeated, unexpected attacks of intense fear," according to the National Institutes of Health (NIH). When a patient is having an anxiety attack, she can have chest pain, dizziness, palpitations, sweating or tremors. Medications are prescribed to reduce the symptoms and the number of panic attacks; however, only therapy treats the underlying causes of a panic disorder and is often combined with medication.
Reuptake Inhibitor Antidepressants
Reuptake inhibitor antidepressants, like selective serotonin reuptake inihibitors (SSRIs) and serotonin and norepinephrine reuptake inhibitors (SNRIs), prevent serotonin and/or norepinephrine from being recycled in the brain, resulting in a decrease of anxiety symptoms. The Mayo Clinic states that SSRIs are the first choice for treating a panic disorder, because SSRIs do not have as many severe side effects as other antidepressants. Examples of SSRIs for panic disorders are sertraline, paroxetine, fluoxetine, escitalopram and citalopram. Duloxetine and venlafaxine are SNRI options.
Older Antidepressants
If an SSRI or SNRI does not work for a patient, an older antidepressant, like a tricyclic antidepressant or a monoamine oxidase inhibitor (MAOI), may be prescribed; phenelzine, selegiline, tranylcypromine and isocarboxazid are MAOIs, while desipramine, imipramine and nortriptyline are tricyclic antidepressants. Both tricyclic antidepressants and MAOIs can cause serious side effects, like heart and blood sugar problems; in addition, patients who take MAOIs have to follow a restrictive diet. The NIH notes that despite the side effects, MAOIs are the most effective for a panic disorder.
Benzodiazepines
Another medication option for a panic disorder is a benzodiazepine, a type of central nervous system depressant; examples are lorazepam, alprazolam and clonazepam. The NIH notes that a benzodiazepine is prescribed if an SSRI is not effective in treating the patient's symptoms. Benzodiazepines can be addictive, so a doctor will not prescribe it for a patient if she had a history of drug dependence and tolerance.
