Treatment:

The goal of treatment is to help you function well during everyday life. A combination of medication and cognitive-behavioral therapy (CBT) works best.

Antidepressant medications called selective serotonin reuptake inhibitors (SSRIs) are most commonly prescribed for panic disorder. These include:

• Fluoxetine (Prozac)
• Sertraline (Zoloft)
• Paroxetine (Paxil)
• Other SSRIs

Other medications that may be used include:

• Other types of antidepressants, such as serotonin-norepinephrine reuptake inhibitors (SNRIs)
• Antiseizure drugs in severe cases
• Benzodiazepines, including diazepam (Valium), alprazolam (Xanax), clonazepam (Klonopin), and lorazepam (Ativan) may be used for a short time.
• Monoamine oxidase inhibitors (MAOIs) are only used when the other drugs do not work, however they can have serious side effects.

Your symptoms should slowly get better over a few weeks. Talk to your doctor if they do not. Do not stop taking your medications without talking with your health care provider.

Cognitive-behavioral therapy helps you understand your behaviors and how to change them. You should have 10 to 20 visits over a number of weeks. During therapy you will learn how to:

• Understand and control distorted views of life stressors, such as other people's behavior or life events.
• Recognize and replace panic-causing thoughts, and decrease the sense of helplessness.
• Manage stress and relax when symptoms occur.
• Imagine the things that cause the anxiety, starting with the least fearful. Slowly become involved in the real-life situation may help you overcome the fears.

The following may also help reduce the number or severity of panic attacks:

• Regular exercise
• Getting enough sleep
• Regularly scheduled meals
• Reduce or avoid caffeine, certain cold medicines, and stimulants

Expectations (prognosis):

Panic disorders may be long-lasting and difficult to treat. Some people with this disorder may not be cured with treatment. However, most people get better with a combination of medicine and behavioral therapy.

Complications:

Substance abuse can occur when people who have panic attacks try to cope with their fear by using alcohol or illegal drugs.

People with panic disorder are more likely to be unemployed, less productive at work, and to have difficult personal relationships, including marital problems.

Agoraphobia is when the fear of future panic attacks causes someone to avoid situations or places that are thought to cause the attacks. This can lead a person to place severe restrictions on where they go or who they are around. See: Panic disorder with agoraphobia

Dependence on anti-anxiety medications is a possible complication of treatment. Dependence involves needing a medication to be able to function and to avoid withdrawal symptoms. It is not the same as addiction.

Calling your health care provider:

Call for an appointment with your health care provider if panic attacks are interfering with your work, relationships, or self-esteem.