Patient information from BMJ

Panic attacks: what treatments work?

Last published:Apr 25, 2022

If you've ever had a panic attack you'll know how frightening it is. But, no matter how alarming your feelings are, it's important to know that nothing will happen to you. The feelings usually fade away after a few minutes.

Some people never have a second panic attack, while others find that they happen again. If this happens to you there are treatments that can help you cope.

You can use our information to talk to your doctor and decide which treatments are right for you.

What treatments work?

If you have a panic attack you suddenly feel terrified, possibly for no reason. You may even feel as though the world is going to end or that you're going to die. Your heart may pound and you may feel sweaty or find it hard to catch your breath. You may also feel dizzy and start to tremble.

Doctors aren't certain why some people get panic attacks. People who get panic attacks tend to start getting them in their late teens or early 20s. Women get them more often than men.

If you have just started having panic attacks, and especially if you have only had one panic attack, you may not need any treatment.

Your doctor should reassure you that panic attacks are common (they affect about one-third of people at some point in their lives), they are not dangerous, and they might never happen to you again.

Your doctor might also suggest you try self-help techniques to help you cope with feelings of panic: for example, through books or online resources.

Research suggests that many people who try self-help techniques for panic attacks find that they help a lot.

Learning as much as you can about panic attacks and what doctors call panic disorder can also be a huge help. For example, many people feel less anxious and more in control once they understand that while panic attacks can be really scary, they are not dangerous in themselves.

But if you feel you would like more help there are treatments available.

The main treatments for panic disorder are:

• talking treatments (psychotherapy)

• medicines, and

• a combination of psychotherapy and medicines.

Talking treatments

A talking treatment called cognitive behaviour therapy (CBT) can help you feel better and cope with situations that make you panic.

CBT can also be helpful for people who have a condition where they are afraid of certain situations or places (agoraphobia). But CBT can take a while to start working.

When you have CBT you usually see a therapist for about 50 minutes once a week. CBT can last from several weeks to up to six months. You and your therapist will work together to:

• look at what brings on a panic attack

• understand what happens to your body to cause your symptoms, and

• help you cope with anxious feelings or thoughts.

You might be given homework to do between sessions.

CBT can work well for people who have other conditions alongside panic attacks: for example, depression or anxiety. If you have one of these problems as well as panic attacks you might be referred to a psychiatrist for extra help.

Medicines

The medicines most commonly offered to people who have panic attacks or panic disorder are antidepressants.

As the name suggests, these medicines are usually used to treat depression. But these medicines can help prevent panic attacks in many people.

There are many types of antidepressant. If you decide you would like to try this treatment you can talk with your doctor about which one might suit you.

Some people get side effects from antidepressants, such as dry mouth, dizziness, stomach upsets, or problems sleeping. If side effects bother you you could try switching to a different drug.

Some antidepressants can occasionally cause more serious side effects. Your doctor should discuss these with you and tell you what to look out for.

Some antidepressants can cause withdrawal symptoms if you stop taking them suddenly or if your dose is reduced. Talk to your doctor first if you decide you want to stop taking antidepressants.

Some people might be offered medicines called benzodiazepines to help reduce panic attacks. But these medicines are usually only offered to people with severe symptoms, as for most people they don't seem to work as well as other treatments.

Benzodiazepines can also cause serious side effects and people may become dependent on them. In some countries benzodiazepines are no longer used to treat panic attacks. For example, they are rarely, if ever, used in the UK.

For more background information on panic attacks see our leaflet Panic attacks: what are they?