US Pharm. 2018;43(11):11-12.

Episodes of Intense Anxiety

A panic attack is a period of sudden, intense fear combined with frightening physical symptoms that begin without warning and may end with a visit to an emergency room. Panic attacks are a manifestation of panic disorder, which is a well-recognized form of anxiety disorder affecting approximately 2% to 3% of Americans annually. They are twice as common in women as in men, and its sufferers may feel the symptoms of an attack so intensely that they believe they are going to die. To make matters worse, those experiencing panic attacks may feel ashamed and are often reluctant to tell anyone what they are experiencing, including loved ones and healthcare practitioners.

Stress Can Trigger an Attack

Although the cause of panic attacks is not thoroughly understood, there is an increased risk of developing panic attacks if another family member has a history of similar attacks. A specific genetic link, however, has not been identified. Panic attacks equally affect individuals across all cultural and socioeconomic backgrounds. Panic attacks generally begin during early adulthood, often after age 20 years, but they can also occur in young children. Many times, the first panic attack happens during a very stressful period in life, perhaps during a time of significant change or after the loss of a family member, but most often there is not an obvious trigger for the episode.

Symptoms Are Sudden, Mimic Other Conditions

The intensity of fear during a panic attack is remarkable, especially because panic attacks can begin for no apparent reason, often without any identifiable trigger, and reach their intensity within minute; however, they are usually over within an hour. The classic symptoms of a panic attack include an intense feeling of loss of control, impending death, detachment, unreality, or “going crazy.” Along with these psychological symptoms, the physical symptoms of pounding heart, dizziness, choking, shortness of breath, chest pain, chills, sweating, shaking, numbness or tingling, and nausea are common. Panic disorder is clinically defined by repeated panic attacks along with an intense fear of future attacks. It can become a disabling condition that interferes with normal life activities unless treatment is sought.

Although many people seek medical attention during or shortly after an initial panic attack, it may take many visits to a variety of healthcare professionals before the correct diagnosis is made. Medical conditions such as heart or lung diseases or disorders of the endocrine or nervous system can cause symptoms similar to those of a panic attack, so a doctor must first rule those out before treatment can begin. Often, persons with panic disorder seek to quell their anxiety by self-medicating with alcohol and drugs. For these people, successful management of panic disorder will also include treatment for substance abuse.

Treatment Options

With the appropriate treatment, people who suffer from repeated panic attacks can become well again. Treatment for panic disorder includes medications and a type of psychotherapy known as cognitive behavioral therapy, which teaches the patient how to view panic attacks differently and demonstrates ways to reduce anxiety. Prescription antidepressants and antianxiety medications are most commonly used to treat the symptoms of acute anxiety. Along with medications, weekly cognitive behavioral therapy sessions over several months can guide people who suffer from panic disorder how to deal with stress, replacing panic with positive self-talk and relaxation techniques.

Desensitization, or exposure therapy, has been shown to be effective in significantly reducing general anxiety and the frequency and intensity of panic attacks. In exposure therapy, the patient is exposed to—either physically or through introduction to mental images—fearful situations and taught to relax through them without panic. Gradually, fears can be overcome through these exercises, and panic attacks can be controlled.

If you have panic attacks, it is essential to seek medical care and discuss this health problem with your doctor. If you have questions about medications prescribed to treat panic disorder, be sure to ask your pharmacist.