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Medications for Panic Disorder

Here are the basics about each of the medicines below. Only the most common reactions are listed. Ask your doctor if you need to take any special steps. Use each of these drugs as advised by your doctor or the booklet they came with. If you have any questions, call your doctor.

Panic disorder symptoms can be eased with anti-anxiety medicines or antidepressants. The length of time needed with medicine depends on the person. They are often used with counseling, which can help find the cause of problems.

Prescription Medications

Selective Serotonin Reuptake Inhibitors (SSRIs)

  • Citalopram
  • Fluvoxamine
  • Paroxetine
  • Fluoxetine
  • Sertraline
  • Escitalopram

Benzodiazepines

  • Lorazepam
  • Prazepam
  • Flurazepam
  • Clonazepam
  • Triazolam
  • Chlordiazepoxide
  • Halazepam
  • Temazepam
  • Oxazepam
  • Clorazepate
  • Diazepam
  • Alprazolam

Tricyclic Antidepressants

  • Doxepin
  • Clomipramine
  • Nortriptyline
  • Amitriptyline
  • Imipramine
  • Maprotiline
  • Desipramine
  • Trimipramine
  • Protriptyline

Atypical Antidepressants

  • Trazodone
  • Venlafaxine
  • Nefazodone

Monoamine Oxidase Inhibitors (MAOIs)

  • Isocarboxazid
  • Phenelzine
  • Tranylcypromine

Prescription Medications

 

Selective Serotonin Reuptake Inhibitors (SSRIs)

Common names:

  • Citalopram
  • Fluvoxamine
  • Paroxetine
  • Fluoxetine
  • Sertraline
  • Escitalopram

Serotonin plays a role in anxiety. These antidepressants are helpful in treating panic and other anxiety disorders as well.

Some problems are:

  • Nausea
  • Diarrhea
  • Sleeping problems
  • Changes in your level of hunger
  • Weight gain or loss
  • Nervousness
  • Lightheadedness
  • Problems having sex such as decreased arousal, erectile dysfunction, and delayed time to orgasm
  • Mood and behavior changes, such as thoughts of self-harm—young adults may be at a higher risk for this problem
 

Benzodiazepines

Common names:

  • Lorazepam
  • Prazepam
  • Flurazepam
  • Clonazepam
  • Triazolam
  • Chlordiazepoxide
  • Halazepam
  • Temazepam
  • Oxazepam
  • Clorazepate
  • Diazepam
  • Alprazolam

These drugs have help you relax and ease tense muscles. Your doctor will watch you if you have these because they can be addictive. They are used best on a short-term basis.

Some problems are:

  • Sleepiness
  • Lightheadedness, particularly in older adults
  • Problems thinking clearly
  • Problems with balance
 

Tricyclic Antidepressants

Common names:

  • Doxepin
  • Clomipramine
  • Nortriptyline
  • Amitriptyline
  • Imipramine
  • Maprotiline
  • Desipramine
  • Trimipramine
  • Protriptyline

These drugs affect the levels of serotonin, norepinephrine, and dopamine, which ease anxiety. They are not addictive.

Some problems are:

  • Lightheadedness
  • Dry mouth
  • Constipation
  • Problems passing urine
  • Weight gain
  • Problems having sex
  • Mood and behavior changes, such as thoughts of self-harm—young adults may be at a higher risk for this problem
 

Atypical Antidepressants

Common names:

  • Trazodone
  • Venlafaxine
  • Nefazodone

These drugs affect the levels of serotonin, which ease anxiety.

Some problems are:

  • Nausea
  • Feeling nervous
  • Lower sex drive
  • Mood and behavior changes, such as thoughts of self-harm—young adults may be at a higher risk for this problem
 

Monoamine Oxidase Inhibitors (MAOIs)

Common names:

  • Isocarboxazid
  • Phenelzine
  • Tranylcypromine

MAOIs will keep brain chemicals from being broken down. These may help people who haven't had success with other drugs.

MAOIs can cause problems when mixed with many other types of drugs, even other antidepressants. Ask your doctor about what you will need to avoid.

When taking MAOIs, you will have to avoid:

  • Alcohol
  • Certain types of cheeses
  • Pickled, marinated, smoked, cured, or fermented foods
  • Organ meats
  • Nuts and peanut butter
  • Certain kinds of beans
  • Onions
  • Avocados
  • Canned figs
  • Chocolate
  • Caffeine
  • Monosodium glutamate (MSG)

Some problems are:

  • Changes in blood pressure—including hypertensive crisis
  • Weight gain
  • Problems having sex
  • Sleeping problems
  • Mood and behavior changes, such as thoughts of self-harm—young adults may be at a higher risk for this problem

When to Contact Your Doctor

Call your doctor if your medicine doesn't seem to be working. You should also call if you have any reactions.

Call for emergency medical services right away if you have thoughts of hurting yourself or others.

Special Considerations

If you are taking medicines:

  • Take the medicine as directed. Do not change the amount or the schedule.
  • Ask what side effects could occur. Report them to your doctor.
  • Talk to your doctor before you stop taking any prescription medicine.
  • Do not share your prescription medicine.
  • Medicines can be dangerous when mixed. Talk to your doctor or pharmacist if you are taking more than one medicine. This includes over-the-counter products and supplements.
  • Plan for refills as needed.
REFERENCES:

Anxiety disorders. National Institute of Mental Health website. Available at: https://www.nimh.nih.gov/health/topics/anxiety-disorders/index.shtml. Updated July 2018. Accessed February 25, 2019.

Panic attacks and panic disorder. Merck Manual Professional Version website. Available at: https://www.merckmanuals.com/professional/psychiatric-disorders/anxiety-and-stressor-related-disorders/panic-attacks-and-panic-disorder. Updated July 2018. Accessed February 25, 2019.

Panic disorder. EBSCO DynaMed Plus website. Available at:http://www.dynamed.com/topics/dmp~AN~T115030/Panic-disorder. Updated September 21, 2018. Accessed February 25, 2019.

Ravindran LN, Stein MB. The pharmacologic treatment of anxiety disorders: a review of progress. J Clin Psychiatry. 2010;71(7):839-854.

Suicidality in children and adolescents bring treated with antidepressant medications. US Food & Drug Administration website. Available at: https://www.fda.gov/Drugs/DrugSafety/PostmarketDrugSafetyInformationforPatientsandProviders/ucm161679.htm. Updated February 5, 2018. Accessed February 25, 2019.

2/18/2011 DynaMed Plus Systematic Literature Surveillancehttp://www.dynamed.com/topics/dmp~AN~T921683/Adverse-effects-of-antidepressant-medication: Serretti A, Mandelli L. Antidepressants and body weight: a comprehensive review and meta-analysis. J Clin Psychiatry. 2010;71(10):1259-1272.

Last reviewed December 2018 by EBSCO Medical Review Board Adrian Preda, MD  Last Updated: 2/25/2019