Panic Disorder: Should I Take Medicine?
Panic Disorder: Should I Take Medicine?Skip to the navigationYou may want to have a say in this decision, or you may simply want to follow your doctor's recommendation. Either way, this information will help you understand what your choices are so that you can talk to your doctor about them. Panic Disorder: Should I Take Medicine?Get the factsYour options- Take medicines, along with counseling or not.
- Get counseling for treatment of panic disorder.
Key points to remember- Two types of medicines work well for treating panic disorder.
Benzodiazepines can help you feel better right away. You can take
antidepressants for long-term treatment.
- Counseling works at least as well as medicines, and the effects may last longer.
- If you take
medicines, follow your doctor's directions with care. You may have side effects
such as headaches or trouble sleeping. Some medicines can treat both
depression and panic attacks.
- For some
people, taking medicines along with getting counseling works best.
- Don't feel bad about taking medicines. Panic
disorder is a medical problem, not a weakness. The medicines won't change your
personality.
FAQs When you have panic
disorder, you have repeated, unexpected panic attacks. And you worry all the
time about having another attack. A panic attack is a sudden
feeling of very bad anxiety. It may make you feel short of breath or dizzy or
make your heart pound. An attack may last from 5 to 20 minutes or up to a few
hours. You feel most anxious about 10 minutes into the attack. Panic
disorder can lower your quality of life. It can get in the way of your daily
life and work. If you have panic disorder, you are more likely to have
other problems, including: The two types of medicines used most often are antidepressants and benzodiazepines. Some people use both. - Antidepressants. These
include:
- Selective serotonin reuptake inhibitors (SSRIs), such
as citalopram, paroxetine, or sertraline. These are
the most common medicines for panic disorder.
- Tricyclic antidepressants (TCAs), such as clomipramine or imipramine.
- Monoamine oxidase inhibitors (MAOIs), such as isocarboxazid or phenelzine.
- Antidepressants with mixed
neurotransmitter effects, such as venlafaxine.
- Benzodiazepines, such as alprazolam or clonazepam. They are sometimes used for panic disorder. They may be
used alone or with an antidepressant.
- These drugs can help you feel better
right away. They may also be used as a part of long-term treatment, either
alone or with an antidepressant.
- They may be especially helpful if
you have
agoraphobia.
- They can be taken as needed.
But they can cause
addiction (dependence). Symptoms often come back when
you stop taking them.
Antidepressants should help you
start to feel better within 1 to 3 weeks. But it can take as many as 6 to 8
weeks to see more improvement. Talk with your doctor if: - You don't notice any improvement by 3
weeks.
- You have concerns or questions about your medicines.
The medicines may cause side effects, but these are
usually mild. They may get better after a few weeks. Benzodiazepines help relieve symptoms right away. You may have to try more than one medicine to find one that works. Your
doctor may have you switch to another medicine if the first one doesn't
help. Some people use counseling, such as
cognitive-behavioral therapy, to treat panic disorder. It can help you
to: - Deal with problems you are having right now.
- Learn how to deal with future anxiety and panic attacks.
Other treatments include support groups and exercises that
help you relax, such as progressive muscle relaxation or meditation. Your doctor might advise you to take medicines if: - You have not been able to control your
symptoms with other treatment, such as counseling with cognitive-behavioral therapy.
- You have other problems linked to
panic disorder that could benefit from medicine, such as
depression or problems with drugs or alcohol.
Compare your options | |
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What is usually involved? |
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What are the benefits? |
| |
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What are the risks and side effects? |
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Take medicines for panic
disorder Take medicines for panic
disorder - For antidepressants, you take
pills or liquids every day or on certain days of the month, for months or
years.
- For benzodiazepines, you take pills or liquids as
needed.
- You may also try counseling along with taking
medicine.
- Medicines for panic disorder work
well.
- Medicine may cause
side effects such as:
- Nausea.
- Headaches.
- Nervousness.
- Tiredness.
- Trouble
sleeping.
- Benzodiazepines can lead to addiction.
(Antidepressants do NOT lead to addiction.)
Don't take medicines
Don't take medicines
- You try counseling, such as cognitive-behavioral therapy, to control your symptoms.
- Counseling works as well as medicine for many people who have panic disorder.
- You don't have
side effects from taking medicine.
- Your panic
disorder may get worse if you have no treatment.
I was having
lunch with some friends and suddenly began to feel strange-like I couldn't
breathe and my heart was pounding. I didn't know what was happening; I thought
I was having a heart attack. Although the symptoms began to go away after about
10 minutes, I went to the emergency room, where they did some tests and didn't
find anything wrong. A week later, the same thing happened in the middle of the
night. I went to see my doctor, and she suggested I may have had a panic
attack. Since then, the attacks have been occurring at least once a week, and I
have been diagnosed with panic disorder. Although each attack is still a
horrible experience, I now know what is happening and that I will get through
it. I have been going to therapy for several weeks and am learning how to deal
with the symptoms of panic attacks. They are less frequent now and less
intense. I think I can get through this without taking any medicine.
As an executive, I have to travel a lot for
my job. A few months ago, I was boarding a plane for a business trip, and I
began to feel very apprehensive. I felt trapped and got off the plane because I
was shaking and sweating and my heart was pounding. I wasn't sure exactly what
was wrong, but I felt like I was dying. I had a drink at the bar and was still
shaky but took a later flight. After that I began to feel nervous if I even
thought about flying, and I had several more similar attacks. Then I had an
attack on the subway. I felt like everyone was watching me and there was no
escape. I didn't even want to go to the office after that because I was afraid
I could have an attack at any moment. My doctor says I have panic disorder and
agoraphobia. I can hardly function, so I am going to take antidepressants and
try exposure therapy. My doctor says a benzodiazepine would make the symptoms
go away sooner. But I am worried they will make me too drowsy and they may be
too hard for me to quit. When I divorced my wife, Celia, I began to
feel down and very anxious. As a contractor, I have to deal with people every
day, and it seemed very hard to do my job when I felt so stressed out and
depressed. I had my first panic attack when my dog got lost at a job. I knew he
was probably fine and would soon come back, but with the stress of everything
else it just seemed like more than I could handle. I felt awful; I was choking
and had bad stomach cramps. Since then, I have had attacks like this nearly
every day and a lot of the time I feel down in the dumps. I have been diagnosed
with panic disorder and depression. I am going to therapy, and it seems to help
a little, but I still have panic attacks and often feel like life is not worth
living, and I feel anxious about interacting with people at all. At first I
didn't want to take any medicine. But after reading about it and talking it
over with my doctor, I decided to start taking an antidepressant.
What matters most to you?
Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.
Reasons to take medicines for panic disorder Reasons not to take medicines for panic disorder I am willing to take medicine for at least several months, or longer if I need to. I don't want to take medicines if at all possible. More important Equally important More important My panic disorder is not improving enough with counseling alone. I want to continue counseling, without medicine, at least for a while. More important Equally important More important I think my symptoms may be worse than the possible side effects of the medicine. I think the side effects of the medicine would be worse than my symptoms. More important Equally important More important My other important reasons: My other important reasons: More important Equally important More important Where are you leaning now?
Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.
Taking medicines NOT taking medicines Leaning toward Undecided Leaning toward What else do you need to make your decision?1.
How sure do you feel right now about your decision? Not sure at all Somewhat sure Very sure Your SummaryHere's a record of your answers. You can use it to talk with your doctor or loved ones about your decision. Next stepsWhich way you're leaningHow sure you areYour commentsKey concepts that you understoodKey concepts that may need reviewCredits Author | Healthwise Staff |
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Primary Medical Reviewer | Anne C. Poinier, MD - Internal Medicine |
---|
Primary Medical Reviewer | Kathleen Romito, MD - Family Medicine |
---|
Specialist Medical Reviewer | Lisa S. Weinstock, MD - Psychiatry |
---|
You may want to have a say in this decision, or you may simply want to follow your doctor's recommendation. Either way, this information will help you understand what your choices are so that you can talk to your doctor about them. Panic Disorder: Should I Take Medicine?Here's a record of your answers. You can use it to talk with your doctor or loved ones about your decision. - Get the facts
- Compare your options
- What matters most to you?
- Where are you leaning now?
- What else do you need to make your decision?
1. Get the FactsYour options- Take medicines, along with counseling or not.
- Get counseling for treatment of panic disorder.
Key points to remember- Two types of medicines work well for treating panic disorder.
Benzodiazepines can help you feel better right away. You can take
antidepressants for long-term treatment.
- Counseling works at least as well as medicines, and the effects may last longer.
- If you take
medicines, follow your doctor's directions with care. You may have side effects
such as headaches or trouble sleeping. Some medicines can treat both
depression and panic attacks.
- For some
people, taking medicines along with getting counseling works best.
- Don't feel bad about taking medicines. Panic
disorder is a medical problem, not a weakness. The medicines won't change your
personality.
FAQs What is panic disorder?When you have panic
disorder, you have repeated, unexpected panic attacks. And you worry all the
time about having another attack. A panic attack is a sudden
feeling of very bad anxiety. It may make you feel short of breath or dizzy or
make your heart pound. An attack may last from 5 to 20 minutes or up to a few
hours. You feel most anxious about 10 minutes into the attack. What are the risks of panic disorder?Panic
disorder can lower your quality of life. It can get in the way of your daily
life and work. If you have panic disorder, you are more likely to have
other problems, including: What types of medicines are used for panic disorder?The two types of medicines used most often are antidepressants and benzodiazepines. Some people use both. - Antidepressants. These
include:
- Selective serotonin reuptake inhibitors (SSRIs), such
as citalopram, paroxetine, or sertraline. These are
the most common medicines for panic disorder.
- Tricyclic antidepressants (TCAs), such as clomipramine or imipramine.
- Monoamine oxidase inhibitors (MAOIs), such as isocarboxazid or phenelzine.
- Antidepressants with mixed
neurotransmitter effects, such as venlafaxine.
- Benzodiazepines, such as alprazolam or clonazepam. They are sometimes used for panic disorder. They may be
used alone or with an antidepressant.
- These drugs can help you feel better
right away. They may also be used as a part of long-term treatment, either
alone or with an antidepressant.
- They may be especially helpful if
you have
agoraphobia.
- They can be taken as needed.
But they can cause
addiction (dependence). Symptoms often come back when
you stop taking them.
What can you expect if you take medicines for panic disorder?Antidepressants should help you
start to feel better within 1 to 3 weeks. But it can take as many as 6 to 8
weeks to see more improvement. Talk with your doctor if: - You don't notice any improvement by 3
weeks.
- You have concerns or questions about your medicines.
The medicines may cause side effects, but these are
usually mild. They may get better after a few weeks. Benzodiazepines help relieve symptoms right away. You may have to try more than one medicine to find one that works. Your
doctor may have you switch to another medicine if the first one doesn't
help. What can you expect if you DO NOT take medicines for panic disorder?Some people use counseling, such as
cognitive-behavioral therapy, to treat panic disorder. It can help you
to: - Deal with problems you are having right now.
- Learn how to deal with future anxiety and panic attacks.
Other treatments include support groups and exercises that
help you relax, such as progressive muscle relaxation or meditation. Why might your doctor recommend taking medicines?Your doctor might advise you to take medicines if: - You have not been able to control your
symptoms with other treatment, such as counseling with cognitive-behavioral therapy.
- You have other problems linked to
panic disorder that could benefit from medicine, such as
depression or problems with drugs or alcohol.
2. Compare your options | Take medicines for panic
disorder | Don't take medicines
|
---|
What is usually involved? | - For antidepressants, you take
pills or liquids every day or on certain days of the month, for months or
years.
- For benzodiazepines, you take pills or liquids as
needed.
- You may also try counseling along with taking
medicine.
| - You try counseling, such as cognitive-behavioral therapy, to control your symptoms.
|
---|
What are the benefits? | - Medicines for panic disorder work
well.
| - Counseling works as well as medicine for many people who have panic disorder.
- You don't have
side effects from taking medicine.
|
---|
What are the risks and side effects? | - Medicine may cause
side effects such as:
- Nausea.
- Headaches.
- Nervousness.
- Tiredness.
- Trouble
sleeping.
- Benzodiazepines can lead to addiction.
(Antidepressants do NOT lead to addiction.)
| - Your panic
disorder may get worse if you have no treatment.
|
---|
Personal storiesPersonal stories about people deciding whether to take medicine to treat panic disorder
These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.
"I was having lunch with some friends and suddenly began to feel strange-like I couldn't breathe and my heart was pounding. I didn't know what was happening; I thought I was having a heart attack. Although the symptoms began to go away after about 10 minutes, I went to the emergency room, where they did some tests and didn't find anything wrong. A week later, the same thing happened in the middle of the night. I went to see my doctor, and she suggested I may have had a panic attack. Since then, the attacks have been occurring at least once a week, and I have been diagnosed with panic disorder. Although each attack is still a horrible experience, I now know what is happening and that I will get through it. I have been going to therapy for several weeks and am learning how to deal with the symptoms of panic attacks. They are less frequent now and less intense. I think I can get through this without taking any medicine." "As an executive, I have to travel a lot for my job. A few months ago, I was boarding a plane for a business trip, and I began to feel very apprehensive. I felt trapped and got off the plane because I was shaking and sweating and my heart was pounding. I wasn't sure exactly what was wrong, but I felt like I was dying. I had a drink at the bar and was still shaky but took a later flight. After that I began to feel nervous if I even thought about flying, and I had several more similar attacks. Then I had an attack on the subway. I felt like everyone was watching me and there was no escape. I didn't even want to go to the office after that because I was afraid I could have an attack at any moment. My doctor says I have panic disorder and agoraphobia. I can hardly function, so I am going to take antidepressants and try exposure therapy. My doctor says a benzodiazepine would make the symptoms go away sooner. But I am worried they will make me too drowsy and they may be too hard for me to quit." "When I divorced my wife, Celia, I began to feel down and very anxious. As a contractor, I have to deal with people every day, and it seemed very hard to do my job when I felt so stressed out and depressed. I had my first panic attack when my dog got lost at a job. I knew he was probably fine and would soon come back, but with the stress of everything else it just seemed like more than I could handle. I felt awful; I was choking and had bad stomach cramps. Since then, I have had attacks like this nearly every day and a lot of the time I feel down in the dumps. I have been diagnosed with panic disorder and depression. I am going to therapy, and it seems to help a little, but I still have panic attacks and often feel like life is not worth living, and I feel anxious about interacting with people at all. At first I didn't want to take any medicine. But after reading about it and talking it over with my doctor, I decided to start taking an antidepressant." 3. What matters most to you?
Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.
Reasons to take medicines for panic disorder Reasons not to take medicines for panic disorder I am willing to take medicine for at least several months, or longer if I need to. I don't want to take medicines if at all possible. More important Equally important More important My panic disorder is not improving enough with counseling alone. I want to continue counseling, without medicine, at least for a while. More important Equally important More important I think my symptoms may be worse than the possible side effects of the medicine. I think the side effects of the medicine would be worse than my symptoms. More important Equally important More important My other important reasons: My other important reasons: More important Equally important More important 4. Where are you leaning now?
Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.
Taking medicines NOT taking medicines Leaning toward Undecided Leaning toward 5. What else do you need to make your decision?
Check the facts
1.
Taking medicine is the only way I can treat my panic disorder. You're right. Counseling works just as well for many people. 2.
There are two different kinds of medicines that I can take to help my panic disorder. That's right. Antidepressants are taken every day for long-term treatment. Benzodiazepines are taken as needed to help relieve your symptoms. Decide what's next1.
Do you understand the options available to you? 2.
Are you clear about which benefits and side effects matter most to you? 3.
Do you have enough support and advice from others to make a choice? Certainty1.
How sure do you feel right now about your decision? Not sure at all Somewhat sure Very sure 2.
Check what you need to do before you make this decision. Credits By | Healthwise Staff |
---|
Primary Medical Reviewer | Anne C. Poinier, MD - Internal Medicine |
---|
Primary Medical Reviewer | Kathleen Romito, MD - Family Medicine |
---|
Specialist Medical Reviewer | Lisa S. Weinstock, MD - Psychiatry |
---|
Note: The "printer friendly" document will not contain all the information available in the online document some Information (e.g. cross-references to other topics, definitions or medical illustrations) is only available in the online version.Current as of:
May 3, 2017 Last modified on: 8 September 2017
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