Counseling

• Learning to cope with a panic disorder may help reduce the onset of future attacks or their severity as the patient begins to understand the nature of her condition. Cognitive behavioral therapy encourages the patient to monitor her thoughts.
  The therapist may lead the patient through a mental scene of a panic attack and assist her in rationalizing the situation while in the safe setting of the therapist's office. The patient learns to detect specific mental patterns that may precede an attack and to deliberately refocus her thoughts before a full-blown panic attack occurs.
  The patient may experience benefits from counseling within a few weeks, and the benefits may increase over a period of months while her physical and emotional symptoms gradually decrease. However, panic attacks may return in the future and require additional counseling.
  
  

Medication

• A psychiatrist may prescribe medications to treat depression, a condition that sometimes coincides with a panic disorder. Selective serotonin reuptake inhibitors (SSRIs), including Prozac, Lexapro and Celexa are relatively safe and may boost the patient's mood, reducing attacks. Trycyclic antidepressants (TCAs), such as Norpramin, may be beneficial but they also carry the risk of blood sugar side effects.
  Sometimes, the patient receives benzodiazepines, mild sedatives that affect the central nervous system. These drugs include Xanax, Klonopin and lorazepam.
  Monoamine oxidase inhibitors (MAOIs), another group of drugs used in the treatment of panic disorders are strong antidepressants but their use must be strictly monitored due to the risk of serious side effects. In addition, a patient taking MAOIs must follow dietary guidelines, making the use of these drugs less common.