Medication for panic attacks and anxiety: Which is best? 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Anxiety involves feelings of panic, fear, and nervousness that arise when a person feels stressed, threatened, and under pressure. Medication for panic and anxiety disorders aims to alleviate symptoms. Panic attacks and disproportionate anxiety levels can be symptoms of panic disorder, an anxiety disorder that causes a person to have frequent, abrupt feelings of panic, stress, and fear. Usually, symptoms occur with no clear cause. Treatment involves alleviating symptoms and reducing the amount of anxiety and panic attacks a person experiences. Depending on the symptoms and severity, a person may use a combination of medication and other treatments, such as talk therapy. This article will cover the best medications for panic attacks and anxiety, common symptoms, additional treatment options, and getting support. Medications for panic attacks and anxiety Share on PinterestDesign by MNT; Photography by Jonathan Knowles/Getty Images & Jordan Lye/Getty ImagesMedication does not cure panic attacks or anxiety disorders but may help alleviate symptoms. A healthcare professional will prescribe medication based on the severity and frequency of symptoms and a person’s medical history. Learn more about medications to treat panic attacks. Antidepressants Antidepressants may help boost a person’s mood and reduce stress. A 2018 review of 41 clinal trials found that antidepressants were more effective than a placebo at treating panic disorder in adults. However, the study only assessed short-term outcomes. Common antidepressants include:Selective serotonin reuptake inhibitors (SSRIs): These medications are typically the first line of treatment for panic disorder. They increase the level of serotonin — a neurotransmitter that plays a role in mood — in the brain, which may improve anxiety symptoms. Types of SSRIs include sertraline (Zoloft), escitalopram (Lexapro), and paroxetine (Paxil).Serotonin-norepinephrine reuptake inhibitors (SNRIs): These medications increase the levels of serotonin and norepinephrine in the brain, which may also improve anxiety symptoms. Norepinephrine is a neurotransmitter that influences emotions, energy, and alertness. Types of SNRIs include venlafaxine (Effexor) and duloxetine (Cymbalta).Tricyclic antidepressants (TCAs): This kind of medication also increases the levels of serotonin and norepinephrine in the brain but causes more side effects than SSRIs and SNRIs. Types of TCAs include imipramine (Tofranil) and clomipramine (Anafranil). Learn more about different types of antidepressants. Side effects Antidepressants may take 2–4 weeks to begin working and up to 8 weeks to work fully. Side effects of antidepressants can include: headachesnauseasleep difficultiesdiarrhea or constipation Antidepressant medications may also cause increased suicidal thoughts and behavior in children, teenagers, and adults under 25. These side effects are more common during the first several weeks of taking them. Suicide prevention If you know someone at immediate risk of self-harm, suicide, or hurting another person:Ask the tough question: “Are you considering suicide?”Listen to the person without judgment.Call 911 or the local emergency number, or text TALK to 741741 to communicate with a trained crisis counselor.Stay with the person until professional help arrives.Try to remove any weapons, medications, or other potentially harmful objects. If you or someone you know is having thoughts of suicide, a prevention hotline can help. The 988 Suicide and Crisis Lifeline is available 24 hours a day at 988. During a crisis, people who are hard of hearing can use their preferred relay service or dial 711 then 988. Click here for more links and local resources. Withdrawal If a person wishes to reduce their antidepressant dosage, a healthcare professional can help them do so slowly and safely, as stopping these medications suddenly can lead to withdrawal symptoms. Learn more about antidepressant withdrawal. Anti-anxiety medications Anti-anxiety medications may help alleviate symptoms of panic attacks and anxiety disorders, including intense fear and worry. The most common anti-anxiety medications are benzodiazepines, which are sometimes the first-line treatment for generalized anxiety disorder but often second-line due to their potential for creating dependency. This risk of dependency increases with long-term use. Benzodiazepines may work faster than antidepressants. However, a person may develop a tolerance to benzodiazepines, requiring higher doses to achieve the same effect. For these reasons, healthcare professionals often only prescribe benzodiazepines for brief periods. They may also avoid prescribing them to people with a history of substance misuse. Examples of benzodiazepines include:alprazolam (Xanax)diazepam (Valium)clonazepam (Klonopin) A 2019 review of 24 clinical trials found consistent evidence for a possible advantage of benzodiazepines in improving panic symptoms compared with a placebo. However, a major limitation was that the studies only measured short-term effects and did not reflect the risks of dependence and withdrawal. Side effects Common side effects of benzodiazepines include: drowsinesslightheadednessconfusionimpaired coordination and an increased risk of falls, especially among older peopledizzinessslurred speechmemory problemsconstipationnauseadry mouthblurred visionmuscle weakness Less common side effects include:headachestremorschanges in sexual desiredigestive disturbanceslow blood pressurerashessight problems A person may also experience paradoxical effects, where the medication does the opposite of what it is supposed to. These include:depressionincreased anxietyirritabilityaggressive behaviorthe loss of inhibitions Withdrawal If a person abruptly stops taking benzodiazepines, they may experience withdrawal symptoms, and their anxiety symptoms may resurface. A healthcare professional can provide guidance on how to slowly and safely decrease their dose. Learn more about benzodiazepine withdrawal. Beta-blockers Healthcare professionals typically prescribe beta-blockers to reduce high blood pressure. However, this kind of medication can also help reduce physical symptoms of panic attacks and anxiety, including: a rapid heartbeatsweatingshaking or trembling People may take beta-blockers for short periods or as necessary to alleviate acute anxiety, including performance anxiety. A 2016 review found no significant differences between the efficacy of propranolol (Inderal), a beta-blocker, and benzodiazepines in treating panic disorders, with or without agoraphobia. However, the review suggested that the quality of evidence is currently insufficient to support the routine use of propranolol in treating anxiety disorders. A 2020 study suggests that the beta-blocker atenolol (Tenormin) may be more effective and better tolerated than propranolol in people with anxiety disorders. More studies are necessary to investigate its efficacy. Learn more about beta-blockers for anxiety. Symptoms Panic attacks and anxiety have many similar symptoms. However, anxiety symptoms are more common and less intense than those of panic attacks. Panic attack symptoms According to the United Kingdom’s National Health Service (NHS), a panic attack can cause sudden, severe mental and physical symptoms for no apparent reason. It states that symptoms last around 5–20 minutes. During this time, a person may feel out of control and not connected to their body or experience a feeling of impending doom. Panic attack symptoms also include: a rapid or pounding heartbeat feeling fainthot flashessweating chillsstomach painnausea weaknessdizzinesschest painshortness of breatha sensation of chokingtrembling or shaking tinglingdry moutha need to go to the toiletringing in the earsa feeling of dreada fear of dyingsevere worry about another panic attack Anxiety symptoms The main symptom of anxiety is uneasiness. A person may experience mild to severe feelings of worry and fear. Anxiety symptoms also include: a rapid heartbeata feeling of dread fearing the worstfeeling on edge or panickydifficulty concentrating restlessnessirritabilityfeeling detached from the self or the worldfeeling dizzy or lightheadedwobbly legstingling in your hands and feet shortness of breath or hyperventilationnauseaneeding to use the toilet more or less oftensweatingsleep issues panic attacks Other treatment options In addition to medications, treatment options for anxiety disorders and panic attacks include psychotherapy, which aims to teach people to modify their behavior and stay calm when they feel anxious and fearful. Cognitive behavioral therapy is a common type of psychotherapy that focuses on helping people learn to adjust their thoughts, feelings, and reactions to minimize anxiety symptoms and reduce panic attacks. The process may involve methods such as exposure therapy, which may help a person address the fears underlying their anxiety by participating in activities or situations they usually avoid. Acceptance and commitment therapy is a newer type of psychotherapy that may help alleviate discomfort and anxiety through mindfulness and goal setting. The technique involves learning to accept negative emotions, thoughts, and events. Additional treatment options include:stress management techniques, including exercise, mindfulness, and meditationmassagearomatherapyyogaPilatesbreathing techniques What to do during a panic attack If a person senses the onset of a panic attack, it is best to resist the urge to fight it. It may help to remember that the feeling will pass, is not dangerous or life threatening, and will not harm them physically. Finding a peaceful spot may help if possible, as sights and sounds can intensify a panic attack. A person can also try some relaxation techniques, such as:taking long, slow, deep breaths smelling a soothing scent, such as lavenderfocusing on a physical object in the environment to help them feel more groundedrepeating a mantra, which is a word, phrase, or sound that may help shift their focus away from fear Learn more about ways to stop a panic attack. Diagnosis A person may wish to consult a healthcare or mental health professional if they regularly experience panic attacks and anxiety without a clear cause. This is especially important if they have severe symptoms that affect their daily life. The healthcare or psychiatric professional will evaluate a person’s symptoms and may perform a physical exam to check for any underlying conditions before making a diagnosis and offering advice. Visit our dedicated hub for more in-depth resources on anxiety symptoms and management. Getting support The Substance Abuse and Mental Health Services Administration is an online resource that offers a search tool for finding mental health treatment centers across the United States. The National Institute of Mental Health offers further resources for finding support. People can also join an in-person or online support group if they wish. However, this is not a replacement for treatment from a healthcare professional. Summary Anxiety and panic attacks share similar symptoms, though anxiety is more common and less intense. Medication and treatment options for anxiety disorders and panic attacks depend on the duration, frequency, and severity of a person’s symptoms. Last medically reviewed on August 30, 2022Mental HealthAnxiety / StressPsychology / PsychiatryDrugs 12 sourcescollapsedMedical News Today has strict sourcing guidelines and draws only from peer-reviewed studies, academic research institutions, and medical journals and associations. We avoid using tertiary references. We link primary sources — including studies, scientific references, and statistics — within each article and also list them in the resources section at the bottom of our articles. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.Airagnes, G., et al. (2019). Prevalence of prescribed benzodiazepine long-term use in the French general population according to sociodemographic and clinical factors: Findings from the CONSTANCES cohort.https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-019-6933-8Anxiety. (2022).https://www.mentalhealth.org.uk/explore-mental-health/a-z-topics/anxietyAnxiety disorders. (2022).https://www.nimh.nih.gov/health/topics/anxiety-disordersArmstrong, C., et al. (2020). A preliminary investigation on the effects of atenolol for treating symptoms of anxiety.https://academic.oup.com/milmed/article/185/11-12/e1954/5874725Bighelli, I., et al. (2018). Antidepressants versus placebo for panic disorder in adults.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6494573/Breilmann, J., et al. (2019). Benzodiazepines versus placebo for panic disorder in adults.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6438660/Panic disorder. (2020).https://www.nhs.uk/mental-health/conditions/panic-disorder/Panic disorder: The symptoms. (2022).https://www.nimh.nih.gov/news/media/2022/panic-disorder-the-symptomsPanic disorder: When fear overwhelms. (2022).https://www.nimh.nih.gov/health/publications/panic-disorder-when-fear-overwhelmsSide effects of benzodiazepines. (2021).https://www.mind.org.uk/information-support/drugs-and-treatments/sleeping-pills-and-minor-tranquillisers/side-effects-of-benzodiazepines/Steenan, S. A., et al. (2016). Propranolol for the treatment of anxiety disorders: Systematic review and meta-analysis.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4724794/Treatment: Generalised anxiety disorder in adults. 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