What can be done for Panic Attacks?


Firstly, it is very important that you speak to your doctor or medical practitioner. You should be checked out to get a proper diagnosis. What happens after that will be for you and your physician to decide together.

Treatment Options


There are three treatment options for PA's

1) Medication
2) Non-drug therapy
3) Self-Help.

1) Medication


The drugs of choice here are those from the SSRI group of antidepressant drugs. (Occasionally some older style drugs (Tricylic antidepressants) are used and rarely some anxiolytic drugs such as diazepam.)

Selective serotonin re-uptake Inhibitors (SSRIs)

Of the six or so drugs in this group, Citalopram, escitalopram, paroxetine and sertraline are strictly licensed for use in panic disorder.

All of the drugs in this class take a while to kick in so patience is needed. The other problem with these drugs is that the side effects are often worse at the beginning of treatment although they tail off as the beneficial effects start.

This process can take up to two months in some cases but the switch from side effects to benefit usually occurs from 2 - 4 weeks into treatment.

You can expect to be on this type of medicine for at least 6 months and often longer for example 18 months to two years is not unusual.

They are not addictive although a carefully monitored withdrawal is needed and unfortunately it is not uncommon for symptoms to recur once the drug is withdrawn.

Tricyclics

The older tri-cyclic antidepressant drugs for example imipramine or clomipramine have lots of side effects and drug interactions and so are used for stubborn cases or where there is a good reason not to use an SSRI. 

Anxiolytics

Fast acting anxiolytics like Diazepam have also been used for Panic Disorder and although they work well to alleviate the high anxiety associated with the problem they are not fast enough to prevent the onset of a PA. Diazepam and other drugs in this class are also addictive, cause sedation and have multiple drug interactions.


2) Non-drug therapy


Phychotherapy has been shown to be very effective at reducing the frequency and intensity of PAs. The technique is called Cognitive behavioural therapy or CBT for short. Many one to one sessions are needed with the sufferer and sometimes medication is prescribed at least in the early stages.

3) Self Help


Simply talking to others who suffer from the same condition may help understanding. Remember the old saying - "A problem shared is a problem halved ! ". (Note is doesn't say - " a problem solved but it will definitely help.

Being aware of trigger situations may help head off an attack.

The problem with this is that people often will go out of their way to avoid trigger situations which means that their condition is still in control of their lives.

If the sufferer is aware of the trigger situations and is aware of how placing oneself in the situation may cause a PA, it is sometimes possible by being aware of the danger, to prepare oneself and at least diminish the intensity.

Relaxation and breathing techniques can be hugely useful strategies for controlling PAs. These are particularly useful if you know your triggers so that you have time to prepare.