Medication may ease panic attacks

DEAR DOCTOR K: In the past year I’ve had five panic attacks. Now I’m always worried I’m going to have another, at any moment. Is there anything I can do to prevent them?

DEAR READER: Panic attacks can be very unsettling. All of a sudden, you are filled with extreme fear or terror. You may be short of breath, have palpitations, have chest pain, sweat or feel a smothering sensation. You probably fear that you are losing control. You might even think you are about to die.

A panic attack usually lasts five to 30 minutes. But it can continue for several hours. Sometimes the attacks occur in stressful situations, but often they begin for no apparent reason.

For my patients who suffer from panic attacks, the worst part about them is their unpredictability. If certain things seem to trigger panic attacks – like dining in crowded restaurants – they avoid them.

Various imaging studies have found that the parts of the brain that control fear are different in people who suffer from panic attacks. In other words, some people are born with a higher risk of suffering panic attacks. At the same time, stressful situations (the external environment) often trigger the attacks.

Treatment often eliminates panic attacks or makes them less intense. Antidepressants known as selective serotonin reuptake inhibitors (SSRIs) are very effective for panic disorder. The SSRIs fluoxetine (Prozac), sertraline (Zoloft) and paroxetine (Paxil) are commonly prescribed.

Medication often works best when combined with cognitive and/or behavior therapy. Cognitive therapy teaches patients to recognize the unreasonableness of the fears that cause panic. Behavior therapy may include gradual exposure to fear-provoking situations or using breath control as a way to fight panic.