By Dr Ananya Mandal, MD
The aim of panic disorder treatment is to reduce the frequency and severity of panic attacks. The two main treatment approaches include medication and psychotherapy and a combination of the two is normally used.
Outline of panic disorder treatment
Treatment often begins with cognitive behavioral therapy (CBT). This may provide long term benefits to the person with panic disorder by helping them to cope with symptoms and reducing the negative impact the condition has on their life. During CBT, a therapist talks to the patient about their experience of a panic attack and its consequences. Once these thoughts and feelings are identified and understood, any subsequent negative or destabilizing impact on the patient's emotions can be addressed and hopefully rebalanced through counselling.
The sufferer is also informed about behavioral changes and breathing exercises that can help to curb the panic attacks. Usually, around one to two hour CBT sessions per week over a period of four months is recommended.
Group therapy that helps a person share their experiences of anxiety can help individuals cope with symptoms and reduce the anxiety associated with the fear of further panic attacks.
Antidepressants have been found to be useful in treating panic disorders. Selective serotonin reuptake inhibitors (SSRIs) including sertraline and escitalopram are commonly used as are tricyclic antidepressants such as imipramine and clomipramine.
On starting SSRIs, the symptoms of anxiety may worsen for a while and then start to subside, after around four weeks of use. The patient's progress is closely monitored for symptoms and any adverse side effects of medication such as headache, nausea and loss of appetite and sleep. SSRIs are usually continued for a period of six to twelve months and should not be stopped abruptly so as to avoid causing a flare-up of symptoms.
Anti-anxiety medications such as benzodiazepines can also treat panic disorder. One example, clonazepam, helps calm a patient by reducing their anxiety.
Beta blockers such as propranolol can also be used, not to reduce anxiety but rather the effects of panic attacks such as rapid heart rate, sweating, tremors and dizziness.
Reviewed by Sally Robertson, BSc