During the pandemic, mental health has been adversely affected. In addition, COVID-19, a new infectious disease, has propagated worldwide, triggering a myriad of mental disorder cases such as anxiety and panic attacks.
Additionally, as several countries start to move back to a pre-pandemic life, many people may experience increased anxiety about reopening. Even though fear, stress, and worry are normal, we can’t ignore mental health implications.
Although there hasn’t been a lot of research regarding the impact of the pandemic on panic attacks, surveys show that adult Americans are having elevated levels of anxiety and stress, which could lead to panic attacks. The good news is that you can manage the panic disorder with therapies and medications.
Available Medications
Panic disorder medications that are FDA-approved fall into three classes: benzodiazepines, serotonin-norepinephrine reuptake inhibitors (SNRIs), and selective serotonin reuptake inhibitors (SSRIs).
Benzodiazepines
Benzodiazepines, also known as “benzos,” are used to medicate a couple of conditions such as seizures, panic disorder, and anxiety disorder. These psychoactive drugs work by calming the brain and spinal cord (central nervous system).
Clonazepam (Klonopin) and alprazolam (Xanax) are the two FDA-approved benzodiazepines to treat panic disorders. Benzos are generally used to medicate active panic attacks because they start to work immediately in the body.
Even so, these medications are usually less favored than SSRIs and bear a risk of physical dependence. As such, benzos are best used only for at least two to four weeks. The shorter the period of time, the better.
SNRIs
SNRIs affect the neurotransmitters or chemical messengers used to intercommunicate between brain cells. Like any antidepressants, SNRIs work by changing brain communication and chemistry in brain nerve cell circuitry to relieve depression.
SNRIs also elevate the levels of serotonin that help in controlling your mood. But, aside from that, SNRIs raise norepinephrine brain level that’s connected with anxiety, as well. Extended-release venlafaxine (Effexor XR) is the only SNRI FDA-approved for panic disorder.
This medication comes as an ER capsule, ER tablet, and fast-release tablet. Take note that only the ER capsule is FDA-approved.
SSRIs
When it comes to treating panic disorders, SSRIs are deemed as the front runner medication. That is because they have fewer side effects compared to other medications. SSRIs primarily work by increasing serotonin brain levels, just like SNRIs. Even though the connection between serotonin and anxiety disorders is still unsure, SSRIs are adept at minimizing panic disorder symptoms.
What’s more, SSRIs can be used to treat depression and other mental health conditions. As of now, there are three FDA-approved SSRIs to treat panic disorders. These are Sertraline (Zoloft), Paroxetine (Pexeva, Paxil), and Fluoxetine (Prozac).
Primary health care providers often prescribe other SSRIs even if the FDA does not approve them for panic disorder. This action is known as off-label use. However, regulations suggest other SSRIs are similarly effective for panic disorder. Make sure to use a discount app for medication not on your plan.
Side Effects
Although benzodiazepines, SNRIs, and SSRIs work differently, they usually have several similar side effects. For instance, benzos, venlafaxine ER, and SSRIs can cause drowsiness, nausea, and diarrhea. Nevertheless, there are still major differences between them.
Benzodiazepines
As mentioned, benzos bear a risk of physical dependence. With that said, if you’ve been taking benzodiazepines regularly, you may suffer from withdrawal symptoms if you try to stop taking them or lower your dose.
The symptoms can include anxiety, shaking, and nausea. Bear in mind that withdrawal symptoms are different for everyone. However, some people may feel similar panic attack symptoms.
So, if you feel more panic attack symptoms after lowering your dose, be sure to let your provider know because they might need to change your dose. Never change your benzodiazepine dose or stop taking them without informing your healthcare provider.
Venlafaxine ER And SSRIs
Venlafaxine ER and SSRIs usually take a long time to start working compared to benzos. These medications can take four to six weeks to kick in and must be taken every day. What’s more, these drugs are known to cause irritating side effects like sexual dysfunction and sweating.
They also carry a risk of contracting a severe and rare complication called serotonin syndrome. This side effect is primarily caused by the excessive presence of serotonin in the body. It may require urgent medical attention.
If you experience the following side effects, seek immediate help:
- Tremors
- Vomiting
- Rigid muscles
- Fever
- Excessive sweating
- Restlessness
Final Thoughts
Panic disorder is a common medical diagnosis and an emerging consequence of the COVID-19 pandemic. Unemployment, social isolation, lockdowns, working from home while caring for family members, and economic losses are some of the stressors adding to the emotional burden of an individual. Thus, encouragement and support from a therapist or psychiatrist are crucial to relieving the symptoms’ severity. Find ways to cope, and don’t be afraid to call for help if needed. Don’t allow your fear of the disorder to control you.