Panic Disorder Treatment
1 AnswerBipolar patients with panic disorder are treated with a type of cognitive behavioral therapy and sometimes benzodiazepines, as well as the beta blocker Propanolol. In my practice, I usually don't have to medicate people for panic disorder. Instead, I use a technique that I learned from Aaron Beck, the inventor of cognitive therapy. In this technique, the patient is taught in the office to intentionally induce panic attacks through hyperventilation, and then to terminate those panic attacks with breathing techniques that raise the serum carbon dioxide levels. These techniques include breathing into a paper bag with a hole in it; breathing through a tunnel created by making a loose fist with one's hand; and skip breathing, a less obvious but harder to learn technique in which one "skips" every 4th breath, just exhaling a second time instead.
1 AnswerHealthwise answered
Medicines for panic disorder are used to control the symptoms of panic attacks, reduce their number and severity and reduce the anxiety and fear linked with having another attack.
Your symptoms of panic disorder should start to improve within a few weeks after you start taking medicines. If improvement is not seen within 6 to 8 weeks, a higher dose or another medicine may be needed.
Some medicines used to treat panic attacks need to be continued for a year or longer and then may be decreased gradually over several weeks. If you have panic attacks again while medicines are being stopped, the medicines may be continued for at least a few months more. Some people may need to stay on medicines for a long time to keep symptoms under control.
Taking medicines for panic disorder during pregnancy may increase the risk of birth defects. If you are pregnant or thinking of becoming pregnant, talk to your doctor. You may need to keep taking medicines if your panic disorder is severe. Your doctor can help weigh the risks of treatment against the risk of harm to your pregnancy.
Medicines used most often to treat panic attacks include:
- Selective serotonin reuptake inhibitors (SSRIs), such as Paxil, Prozac or Zoloft.
- Benzodiazepines, such as Ativan, Valium or Xanax.
Medicines sometimes used to treat panic disorder include:
- Antidepressants with mixed neurotransmitter effects, such as Effexor.
- Tricyclic antidepressants (TCAs), such as Anafranil, Norpramin or Tofranil.
- Monoamine oxidase inhibitors (MAOIs), such as Marplan, Nardil or Parnate.
© Healthwise, Incorporated.
2 AnswersTamar Chansky, Psychology, answered
Anxiety varies from person to person, so there's no one-size-fits-all approach to treating it, according to psychologist Dr. Tamar Chansky, who specializes in anxiety. Watch the video to learn about treatment options for panic attacks.
2 AnswersJennifer Hartstein, PsyD, Psychology, answered
When you feel a panic attack coming on, a simple breathing exercise can bring instant relief. Learn more about this natural treatment for panic attacks, watch this video featuring psychologist Dr. Jennifer Hartstein.
1 AnswerRobert Hedaya, Psychiatry, answeredPhobia induced panic responds preferentially to alprazolam (Xanax), and benzodiazepines such as clonazepam (Klonopin), since these medications work on the anxiety (raphe nucleus), GABA and glutamate receptors, and the norepinephrine induced terror (locus coeruleus). Beta blockers (e.g. propranolol [Inderal]) block the physical symptoms of panic very quickly, but have no effect on the cognitive experience. They can be very useful for specific situations (e.g. public speaking), or with other forms of panic. Cognitive therapy and behavioral exposure should be effective in this group. Buspirone (Buspar) works on the serotonin neurons in the raphe nucleus to reduce anticipatory anxiety, but does not have any effect on the norepinephrine induced terror (locus coeruleus).
1 AnswerRobert Hedaya, Psychiatry, answeredSpontaneous, nonphobic panic attacks, marked by respiratory distress, respond better to SSRIs (e.g., fluoxetine [Prozac]), SNRIs (e.g., venlafaxine [Effexor]), and imipramine (Tofranil) than benzodiazepines such as alprazolam (Xanax). It is thought that imipramine as well as the SSRIs (selective serotonin reuptake inhibitors) such as fluoxetine (Prozac), sertraline (Zoloft), paroxetine (Paxil),and fluvoxamine (Luvox) decrease the sensitivity of the suffocation alarm (the solitary nucleus), and perhaps the locus ceruleus.
Cognitive therapy should be of limited value in this group, since the panic is unrelated to cognitions, but education about the lack of danger, a search for cause, and the treatable nature of the disorder can be very helpful. Relaxation training would be harmful, since it would slow respiration and increase CO2. This would lead to panic. Exercise, and the premenstrual and postpartum period would also increase vulnerability to these panic attacks.
1 AnswerChallenge America answered
Panic disorder is a type of anxiety disorder, and anxiety disorders in general are treated with either psychotherapy, medication, or preferably a combination of both. The psychotherapy approach most recommended for panic disorder is CBT, or cognitive-behavioral therapy. The cognitive part of CBT focuses on the patterns of thinking behind your fears, and the behavioral part works on changing how you react to the situations or triggers that create anxiety for you. The type of medication most often prescribed for panic disorder are the SSRIs, or serotonin reuptake inhibitors. Brand names of SSRIs include Prozac, Zoloft, Paxil, Celexa, and Lexapro. SSRIs relieve anxiety symptoms by blocking the reabsorption (reuptake) of serotonin in the brain. This makes more serotonin available in the brain, which improves your mood. However, keep in mind that medications do not “cure” panic disorder. They help control the symptoms of anxiety to make psychotherapy more effective for you.
There are several prescription medications available to lessen and control the symptoms of panic disorder. Your doctor may prescribe medications such as selective serotonin reuptake inhibitors (SSRIs), benzodiazepines, or tricyclic antidepressants. These medications can help improve symptoms.
There are no overthecounter medications for panic disorder. Panic disorder is treated by prescribed medications and psychotherapy. Prescribed medications, such as serotonin, help to decrease the occurrences of panic attacks. Other panic disorder medications, such as benzodiazepines, act as a calming tranquilizer.
There is no medical cure for panic disorder; however, the disorder can be controlled with medication and psychotherapy. You can manage this disorder with lifestyle changes, such as avoiding drugs, caffeine, and alcohol, exercising regularly, and making sure that you get proper rest and relaxation. Avoiding stressful situations is also important.