Benzodiazepines, Tricyclics, and MAOIs Used for Panic Attacks
Similarly, antidepressant medications called tricyclics are started at low doses and gradually increased. Tricyclics have been around longer than SSRIs and have been more widely studied for as a panic attack medication.
Many physicians and patients prefer the newer drugs because the tricyclics sometimes cause:
- Dry mouth
- Weight gain.
When these problems persist or are bothersome, a change in dosage or a switch in medications may be needed.
Monoamine Oxidase Inhibitors
Monoamine oxidase inhibitors, or MAOIs, are the oldest class of antidepressant medications. The most commonly prescribed MAOI for panic attack treatment is phenelzine.
People who take MAOIs are put on a restrictive diet because these medications can interact with some foods and beverages, including cheese and red wine, which contain a chemical called tyramine. MAOIs also interact with some other medications, including SSRIs. Interactions between MAOIs and other substances can cause dangerous elevations in blood pressure or other potentially life-threatening reactions.
A few different anti-anxiety medications are used for panic attacks. These most commonly include benzodiazepines.
High-potency benzodiazepines relieve anxiety symptoms quickly and have few side effects, although drowsiness can be a problem. Because people can develop a tolerance to them -- and would have to continue increasing the dosage to get the same effect -- benzodiazepines are generally prescribed for just a short time.
One exception is panic disorder, for which they may be used for six months to a year. People who have had problems with drug or alcohol abuse are not usually good candidates for these medications, however, because they may become dependent on them.
Some people experience withdrawal symptoms when they stop taking benzodiazepines, although reducing the dosage gradually can diminish those symptoms. In certain instances, the symptoms of panic attack can rebound after these medications are stopped. Potential problems with benzodiazepines have led some physicians to shy away from using them or to use them in inadequate doses, even when they are of potential benefit to the patient.
A specific type of benzodiazepine, lorazepam, is particularly useful for panic disorder.