There are two major classes of medications that are equally effective in blocking panic attacks. These are antidepressants and benzodiazepines. Each has its advantages and disadvantages.
The advantage of the antidepressants is that they will treat a coexisting depression if a person has depression in addition to panic disorder. A disadvantage of this class is that these medications take two to four weeks to begin working. In addition, one group of antidepressants (monoamine oxidase inhibitors, MAOIs) has dietary restrictions. The MAOIs have become much less popular since new medications without such restrictions have become available.
The advantage of the benzodiazepines is that they work immediately and panic can be blocked within hours to days of starting the medication. A disadvantage is that they do not treat coexisting depression. Another disadvantage is that they induce chemical dependency, requiring them to be slowly reduced when discontinued. They pose a risk for abuse in individuals with a history of alcohol or substance abuse.
Psychotherapy for Panic Disorder
Cognitive-behavioral therapy (CBT) is a type of psychotherapy that helps people relearn how to interpret the body’s physical signals, such as heart rate and breathing. This type of therapy teaches people how to become tuned into physical sensations related to panic attacks that they may never have noticed before.
The cognitive part of this therapy teaches people to once again ignore appropriately normal signals from the body, so that they can refocus on their life. The therapist helps people with panic disorder to change the interpretation of physical symptoms from catastrophic to realistic. The behavioral part of this therapy reintroduces people to places that they have learned to avoid as a natural consequence of having panic attacks. This may start with just being able to leave the house, drive the car at night or travel more than a few miles from an emergency room.
Often a combination of medication and psychotherapy is recommended when treating panic disorder. If thinking errors about safety or phobic avoidance of situations continues after a person’s panic attacks have been blocked with medication, there is more work to be done. CBT is specifically designed to address this component of panic disorder
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