Key points
- Panic disorder involves frequent, unexpected panic attacks, and worry about having more.
- Antidepressants on this list and benzodiazepines on this list carry different boxed warnings.
- NIMH says SSRI and SNRI antidepressants can help treat panic disorder symptoms, and may take several weeks to work.
- NIMH says beta-blockers may help in some situations but are not commonly prescribed for panic disorder.
- CBT is commonly used for panic disorder and can sit alongside medicine.
What panic disorder is
The National Institute of Mental Health (NIMH) says people with panic disorder have frequent and unexpected panic attacks: a sudden wave of fear or discomfort, or a sense of losing control, even when there is no clear danger. Physical symptoms can include a pounding heart, sweating, trembling, trouble breathing and chest pain.
A single panic attack is not panic disorder. NIMH says panic disorder may be diagnosed when attacks are recurrent and unexpected, along with ongoing worry or behavior changes because of fear of future attacks. Chest pain and trouble breathing also deserve urgent medical attention when you are unsure of the cause, so call 911 if you are worried it could be a medical emergency.
Medicines with an FDA panic disorder indication
These are the medicines on our list whose current FDA labels include panic disorder. It is not a ranking, and being on this list does not mean a medicine is right for you. If a medicine you take is not here, it may still be used off-label, which is a question for your prescriber.
- Sertraline (Zoloft), an SSRI.
- Paroxetine (Paxil), an SSRI, labeled in adults.
- Fluoxetine (Prozac), an SSRI: the label lists acute treatment of panic disorder, with or without agoraphobia.
- Venlafaxine extended-release (Effexor XR), an SNRI, labeled in adults.
- Alprazolam (Xanax), a benzodiazepine: labeled for panic disorder, with or without agoraphobia, in adults.
- Clonazepam (Klonopin), a benzodiazepine: labeled for panic disorder, with or without agoraphobia. Details are on its medicine page.
SSRIs and venlafaxine: what to know
NIMH says SSRI and SNRI antidepressants can help treat the symptoms of panic disorder. It says they may take several weeks to work and may cause headaches, nausea or difficulty sleeping, which are usually not severe, especially if the dose starts low and is increased slowly.
The sertraline, paroxetine, fluoxetine and venlafaxine labels all carry the same boxed warning. In short-term studies, antidepressants raised the risk of suicidal thoughts and behavior in children, teens and young adults, so anyone taking one, at any age, should be monitored closely for worsening mood or new suicidal thoughts. If you are in crisis, call or text 988, or call 911. Locascio Wellness does not provide emergency services.
These labels say the medicines must not be taken with MAOIs, because of serotonin syndrome. They also advise reducing the dose gradually and not stopping suddenly. The venlafaxine label adds a warning about elevated blood pressure.
Alprazolam and clonazepam: what to know
NIMH says benzodiazepines can be very effective in rapidly decreasing panic attack symptoms, but some people build up tolerance and some become dependent, so a provider may prescribe them only for brief periods. Both are Schedule IV controlled substances.
Boxed warning: taking a benzodiazepine with opioids may cause profound sedation, slowed breathing, coma and death. Use also exposes people to risks of abuse, misuse and addiction, which can lead to overdose or death, and continued use may lead to physical dependence. Stopping suddenly or reducing quickly after continued use can cause withdrawal reactions that can be life-threatening. Please never stop one on your own.
As of November 2026, a temporary federal rule (Federal Register, Fourth Temporary Extension) allows DEA-registered practitioners to prescribe Schedule II to V medicines by audio-video telemedicine without a prior in-person evaluation, under set conditions, through December 31, 2026. Rules may change after that date. Our guide on whether benzodiazepines can be prescribed online explains more.
Beta-blockers: off-label and less common
NIMH says beta-blockers can help control some of the physical symptoms of panic disorder, such as rapid heart rate, sweating and tremors. It also says providers do not commonly prescribe them for panic disorder, though they may help in certain situations that come before a panic attack. This use is off-label, meaning panic disorder is not on the label.
Therapy alongside medicine
NIMH says treatment typically involves psychotherapy, medication or both. Cognitive behavioral therapy (CBT) is commonly used for panic disorder. It teaches different ways of thinking, behaving and reacting to the feelings around a panic attack, and NIMH says attacks can become less frequent once a person learns to react differently to those physical sensations.
Exposure therapy is a common CBT method, and interoceptive exposure involves practicing with the body sensations linked to panic, sometimes with relaxation and breathing training. A therapist guides this at a pace you agree on.
Questions to bring to a prescriber
- Which of these medicines are labeled for my diagnosis, and which are off-label for me?
- How would we know whether it is helping?
- What side effects should I report right away?
- How would therapy fit in?
How we can help
If panic attacks are affecting your life, a licensed psychiatrist on our team can talk them through with you by secure video, as long as you are physically located in Pennsylvania or New York during each visit. Whether any of these medicines is an option for you is a decision for you and your prescriber. Ask us whether our psychiatrist can help: contact us about medication care, or read about online anxiety treatment.
Our anxiety therapy is online in Pennsylvania, West Virginia, Arizona, Colorado and Florida, not New York. Many people find panic becomes more manageable with the right support.
Common questions
Are panic attacks dangerous?
NIMH says panic attacks themselves are not life-threatening and the physical symptoms usually resolve with time, though they can be very distressing. Symptoms like chest pain can also come from other causes. If you are unsure or symptoms feel severe, call 911 or seek emergency care, and let a clinician help you sort out the cause later.
How long do panic disorder medicines take to work?
It depends on the type. NIMH says SSRI and SNRI antidepressants may take several weeks to start working, and that benzodiazepines can rapidly decrease panic attack symptoms, with risks of tolerance and dependence. NIMH also says finding the right treatment may take trial and error, so your prescriber will review how things are going over time.
Can I take a panic medicine only during an attack?
It depends on the medicine, so follow your prescriber's directions. Antidepressants on this list are taken as a regular plan and may take several weeks to work. NIMH says benzodiazepines can rapidly decrease panic symptoms, with risks of tolerance and dependence. Ask how your plan is meant to work before relying on it.
Does medicine replace therapy for panic disorder?
Not necessarily. NIMH says treatment typically involves psychotherapy, medication or both, and CBT is commonly used for panic disorder. A medicine may ease symptoms, while therapy teaches you new ways to respond. Our therapists work in Pennsylvania, West Virginia, Arizona, Colorado and Florida, so New York readers would need a therapist elsewhere.
Sources
Published by Locascio Wellness. Published November 5, 2026. Clinically reviewed by Kenneth M. Levy, DO, Psychiatrist (Pennsylvania license OS007464L). This page is general information, not medical advice or a diagnosis.