Medication for Panic Disorders and Antianxiety

According to the most current edition of the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), an anxiety attack is an episode of intense fear where four or more of the following symptoms develop suddenly and peak within 10 minutes:

    * pounding heart, palpitations
    * sweating
    * trembling or shaking
    * sensations of shortness of breath or smothering
    * feeling of choking
    * chest pain or discomfort
    * nausea or abdominal distress
    * dizziness, lightheadedness, faintness
    * feelings of unreality or depersonalization
    * fear of losing control or going crazy
    * fear of dying
    * numbness or tingling sensations
    * chills or hot flushes

           In Case of Anxiety Attack...

If you think you're having an anxiety attack, Mark Pollack, M.D., Director of the Anxiety Disorders Program at the Massachusetts General Hospital, Boston, offers the following advice:

    * Remind yourself that no matter how uncomfortable the anxiety attack feels, it will pass. This is critical to preventing thoughts about dying or losing control which lead to a cycle of escalating anxiety.
    * Try taking deep breaths, from the diaphragm, rather than short rapid breaths.
    * If you've been prescribed a benzodiazepine (see chart) take some in the appropriate dose for you.

Anti Anxiety Medication For treating Panic Disorder:

Legend for Chart:

A - Drug Class
B - Indications/Contraindications

A
B

Selective Serotonin Reuptake Inhibitors (SSRIs)
     * Paroxetine (Paxil)
     * Sertraline (Zoloft)
     * Fluoxetine (Prozac)
     * Citalopram (Celexa)
     * Nefazodone (Serzone)

Preferred for treatment of panic disorder. Relieves depression,
 anxiety, obsessional thoughts, compulsive acts, and
 posttraumatic stress. Side effects include nausea, loss of
 sexual functioning, sedation or activation, headaches, weight
 gain, more vivid dreaming. dry mouth, sweating.

Tricyclic Antidepressants
     * Imipramine (Tofranil)* Clomipramine (Anafanil)
     * Amitriptyline (Elavil)
     * Desipramine (Norpramin)

Effective for panic disorder, but with more side effects than
 SSRIs: fry mouth, blurred vision, rapid heartbeat,
 lighteadedness, weight gain, altered libido, sun sensitivity,
 blood pressure changes.

Benzodiazepines
     * Alprazolam (Xenax)
     * Clonazepam (Klonopin)
     * Diazepam (Valium)

Used in combination with antidepressants. Faster acting than
 antidepressants. May cause drowsiness, cognitive impairment,
 dizziness. Physical dependance a risk.

Monoamine Oxidase Inhibitors
     * Phenelzine (Nardil)
     * Tranylcypromine (Parnate)
     * Isocaboxazid (Marplan)

Because of the seriousness of their many side effects, generally
 used only when other approaches don't work. Can cause dangerous
 rise in blood pressure if taken with certain drugs and foods.