Panic attack disorder medications
Pro Research Analysisby 
Searched over 200M research papers
Medications for Panic Attack Disorder: An Overview
Introduction to Panic Attack Disorder
Panic attack disorder is characterized by sudden episodes of intense fear or discomfort that peak within minutes. Symptoms include a racing heart, chest pain, sweating, shaking, dizziness, and breathlessness, often accompanied by fearful thoughts such as fear of dying or losing control1 2. The disorder affects 1% to 4% of the general population and can significantly impair daily functioning1 2.
Pharmacological Treatments for Panic Disorder
Antidepressants for Panic Disorder
Antidepressants are a cornerstone in the treatment of panic disorder. Various classes of antidepressants, including selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), tricyclic antidepressants (TCAs), and monoamine oxidase inhibitors (MAOIs), have been shown to be effective1 2 9. SSRIs, such as paroxetine and fluoxetine, are often recommended as the first-line treatment due to their favorable side effect profile compared to TCAs and MAOIs2 9. Studies have shown that paroxetine and fluoxetine are particularly effective among SSRIs1.
Benzodiazepines for Panic Disorder
Benzodiazepines, including diazepam, alprazolam, and clonazepam, are also widely used for their rapid onset of action, which can provide quick relief from acute panic symptoms1 2 5. These medications are often preferred for short-term use due to the risk of dependence and withdrawal symptoms associated with long-term use5. Benzodiazepines have been found to be more effective than placebo in reducing panic symptoms and are generally well-tolerated, with lower dropout rates compared to other medications1 5.
Comparative Efficacy and Tolerability
Comparative studies have shown that both antidepressants and benzodiazepines are effective in treating panic disorder, with little difference in efficacy between the classes1 2. However, benzodiazepines tend to have a slight advantage in terms of tolerability, with fewer patients discontinuing treatment due to side effects1 2. For instance, alprazolam and diazepam have been associated with lower dropout rates compared to placebo1.
Novel Therapeutics and Future Directions
Despite the effectiveness of current treatments, there is a need for more effective, faster-acting, and better-tolerated medications. Research is ongoing into novel therapeutics targeting different molecular pathways, such as glutamate and orexin systems, as well as corticotrophin-releasing factor (CRF) antagonists3. These novel treatments are still in the early stages of investigation, and more research is needed to determine their clinical utility3.
Conclusion
In summary, both antidepressants and benzodiazepines are effective in the treatment of panic disorder, with SSRIs often recommended as the first-line treatment due to their favorable side effect profile. Benzodiazepines are useful for their rapid onset of action but are generally recommended for short-term use due to the risk of dependence. Ongoing research into novel therapeutics holds promise for more effective and better-tolerated treatments in the future.
Sources and full results
Most relevant research papers on this topic
Pharmacological treatments in panic disorder in adults: a network meta-analysis.
Antidepressants and benzodiazepines are effective and acceptably treated for panic disorder, with benzodiazepines showing the highest effectiveness and acceptability.
Meta-AnalysisAntidepressants and benzodiazepines for panic disorder in adults.
Antidepressants and benzodiazepines show no significant difference in response rates for panic disorder in adults, with SSRIs being the first-line treatment.
Systematic Review
Very Rigorous JournalNovel investigational therapeutics for panic disorder
Novel anti-panic drugs targeting glutamate and orexin show promising potential, but more research is needed to overcome barriers in clinical development.
Literature ReviewClonazepam and imipramine in the treatment of panic attacks: a double-blind comparison of efficacy and side effects.
Low doses of both clonazepam and imipramine effectively eliminate panic attacks, with mild side effects.
RCT
Highly CitedBenzodiazepines versus placebo for panic disorder in adults.
Benzodiazepines show a possible advantage in efficacy and acceptability over placebo in treating panic disorder in adults, but guidelines recommend antidepressants as first-line treatment due to lower dependence and withdrawal reactions.
Meta-AnalysisVery Rigorous JournalSertraline versus paroxetine in the treatment of panic disorder: an acute, double-blind noninferiority comparison.
Sertraline is a better tolerated and less clinically worsening treatment for panic disorder than paroxetine, with equivalent efficacy and better tolerability.
RCTParoxetine, clomipramine, and cognitive therapy in the treatment of panic disorder.
Paroxetine and clomipramine are consistently more effective than cognitive therapy for treating panic disorder and agoraphobia, with cognitive therapy showing only limited benefits.
RCTHighly CitedAre there advances in pharmacotherapy for panic disorder? A systematic review of the past five years
Expanding personalized approaches to existing medications and utilizing new technologies can potentially improve pharmacotherapy outcomes for panic disorder.
Systematic ReviewThe use of newer antidepressants for panic disorder.
Newer antidepressants like SSRIs and venlafaxine may be more effective than older drugs for treating panic disorder, when combined with cognitive-behavioral therapy.
What are evidence-based medications for the treatment of panic attacks?
Antidepressants and benzodiazepines effectively reduce symptoms and attacks in panic disorder, with varying effectiveness depending on the antidepressant and benzodiazepine class.
Meta-Analysis