The goal of treatment is to help you function well during everyday life. Cognitive-behavioral therapy (CBT) and medications are the mainstays of treatment.

Medications are an important part of treatment. Once you start taking them, do not suddenly stop without talking with your health care provider.

Medications that may be used include:

• Antidepressants called SSRIs (selective serotonin reuptake inhibitors) are the most commonly used medications for panic disorder. They include fluoxetine (Prozac), sertraline (Zoloft), paroxetine (Paxil), fluvoxamine (Luvox), citalopram (Celexa), and escitalopram (Lexapro).
• Serotonin-norepinephrine reuptake inhibitors (SNRIs) and other antidepressants.
• If SSRIs or SNRIs do not help, benzodiazepines may be used. They include alprazolam (Xanax), clonazepam (Klonopin), and lorazepam (Ativan). However, people can become dependant on or addicted to drugs in this class of medications. Ideally, these drugs should be used only on a temporary basis.
• Other antidepressants and some anti-seizure drugs may be used for severe cases.
• Monoamine oxidase inhibitors (MAOIs), such as phenelzine (Nardil), tranylcypramine (Parnate), and isocarboxazid (Marplan), are only used when the other drugs do not work. Although they can be very helpful for treating panic disorders, MAOIs have serious side effects and can interact with other drugs and foods.

Cognitive-behavioral therapies should be used together with drug therapy. Ten to 20 visits with a mental health professional should take place over a number of weeks. Common parts of this therapy include:

• Gaining understanding of and control over distorted views of life stressors, such as other people's behavior or life events.
• Learning to recognize and replace panic-causing thoughts to decrease the sense of helplessness.
• Learning stress management and relaxation techniques to help when symptoms occur.
• Practicing systematic desensitization and exposure therapy, in which you are asked to relax, then imagine the things that cause the anxiety, working from the least fearful to the most fearful. Gradual exposure to the real-life situation also has been used with success to help people overcome their fears.

Behavioral treatment appears to have long-lasting benefits.

Regular exercise, adequate sleep, and regularly scheduled meals may help reduce the frequency of the attacks. Reduce or avoid the use of caffeine, some over-the-counter cold medicines, and other stimulants, because they may make symptoms worse.

Panic disorders may be long-lasting and difficult to treat. Some people with this disorder may not be cured with treatment. However, most people can expect rapid improvement with drug and behavioral therapies.

Substance abuse can occur when people who have panic attacks try to cope with their fear by using alcohol or illegal drugs.

People with panic disorder are more likely to be unemployed, less productive at work, and to have difficult personal relationships, including marital problems. Work, social, and family function are all disrupted.

Agoraphobia is when the fear of future panic attacks causes someone to avoid situations or places that are thought to cause the attacks. This can lead a person to place severe restrictions on where they go or who they are around. See: Panic disorder with agoraphobia

Dependence on anti-anxiety medications is a possible complication of treatment. Dependence involves needing a medication to be able to function and to avoid withdrawal symptoms. It is not the same as addiction.

Call for an appointment with your health care provider if panic attacks are interfering with your work, relationships, or self-esteem.