From the Guidelines
Panic attacks should be managed with a combination of cognitive behavioral therapy (CBT) and medication, such as selective serotonin reuptake inhibitors (SSRIs), as this approach has been shown to be effective in reducing symptoms of anxiety and panic disorder.
Management Options
- Cognitive Behavioral Therapy (CBT): CBT is a helpful approach in managing panic attacks, as it teaches patients to identify and change negative thought patterns and behaviors that contribute to their anxiety 1.
- Medication: SSRIs are commonly used to treat panic disorder and can be effective in reducing symptoms of anxiety and panic attacks 1.
- Relaxation Techniques: Techniques such as deep breathing, progressive muscle relaxation, and mindfulness can help reduce symptoms of anxiety and panic attacks 1.
Treatment Approach
- Combination Therapy: Combination therapy, which includes both CBT and medication, may be more effective than monotherapy (either CBT or medication alone) in managing panic attacks 1.
- Culturally Sensitive Treatment: Treatment should be tailored to the individual's cultural background and needs, as this can improve treatment outcomes and increase patient engagement 1.
Follow-Up and Reassessment
- Regular Follow-Up: Regular follow-up appointments with a mental health professional are important to assess treatment response, identify potential obstacles to treatment, and make adjustments to the treatment plan as needed 1.
- Treatment Adjustment: If symptoms persist or worsen, the treatment plan should be adjusted, which may include adding or changing medications, referring to individual psychotherapy, or trying alternative interventions 1.
From the Research
Management of Panic Attacks
The management of panic attacks typically involves a combination of pharmacological and psychological treatments.
- Selective serotonin reuptake inhibitors (SSRIs) are often considered the first-line treatment for panic disorder, as they have a beneficial side-effect profile and are relatively safe 2, 3, 4, 5.
- Other effective pharmacological treatments include tricyclic antidepressants, monoamine oxidase inhibitors, and benzodiazepines, although the latter should be reserved for short-term use or treatment-resistant patients due to the risk of dependence and tolerance 2, 3, 4, 5.
- Cognitive-behavioral therapy (CBT) is also a highly effective treatment for panic disorder, and can be used alone or in combination with pharmacotherapy 2, 3, 6, 4, 5.
- An integrated treatment approach that combines pharmacotherapy with CBT may provide the best treatment outcomes, with long-term efficacy and ease of use being important considerations in treatment selection 2, 5.
Treatment Selection
The choice of treatment for panic disorder depends on various factors, including the patient's medical history, preferences, and the presence of comorbid conditions.
- SSRIs are generally well-tolerated and effective, making them a popular choice for first-line treatment 2, 3, 4, 5.
- Tricyclic antidepressants are equally effective, but may have more side effects and be less well-tolerated than SSRIs 2, 6, 4, 5.
- Benzodiazepines may be used for short-term treatment or in treatment-resistant patients, but should be used with caution due to the risk of dependence and tolerance 3, 4, 5.
- CBT is a highly effective treatment that can be used alone or in combination with pharmacotherapy, and is often recommended as the psychologic treatment of first choice 2, 3, 6, 4, 5.