Panic Attack Treatment: Are Meds Or CBT Best For The Disorder?

The very best panic attack treatment is revealed by large studies that compare meds and CBT.

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The very best panic attack treatment is revealed by large studies that compare meds and CBT.

Cognitive behavioural therapy (CBT) is the best treatment for panic disorders, multiple studies finds.

In addition, most people prefer therapy over taking anti-anxiety medication.

Panic attacks involve an extreme feeling of anxiety and fear, sometimes for no apparent reason.

Dr. Barbara Milrod, a professor of psychiatry at Weill Cornell Medical College, said:

“Panic disorder is really debilitating — it causes terrible healthcare costs and interference with functioning.

We conducted this first ever large panic disorder study to compare therapy types and see if one type of therapy is preferable over another.”

Panic attacks involve suffering from an extreme feeling of anxiety and fear, sometimes for no apparent reason.

Panic attacks can also be triggered by many things, including irrational fears such as phobias.

During panic attacks people can tremble, become sweaty, feel sick and may experience heart palpitations.

Panic attack treatment studies

One panic attack treatment study randomised around 200 people with panic disorders to various different commonly-used therapies (Mildrod et al., 2015).

Therapy lasted for around three months and involved one 45-minute session each week.

Across the two different sites where the therapies were tested, cognitive behavioural therapy was the most effective, and only one-quarter of people dropped out.

Professor Milrod said:

“If patients stick it out and continue with therapy rather than drop out, they have a far greater chance of seeing positive results or getting better.”

The best therapy for panic attacks

Another panic attack treatment study has found that two different types of psychotherapy are effective at treating panic disorder, (Svensson et al., 2021).

People with panic disorder showed marked improvements after some received psychodynamic psychotherapy and others cognitive-behavioural therapy (CBT).

Psychodynamic styles focus more on revealing the unconscious conflicts in the person’s mind that are causing the problems.

In contrast, treatment with cognitive-behavioural therapy does not delve into the unconscious, focussing more on conscious thoughts and behaviours.

Panic disorders involve suffering from an extreme feeling of anxiety and fear, sometimes for no apparent reason.

Panic attacks can also be triggered by many things, including irrational fears such as phobias.

During panic attacks people can tremble, become sweaty, feel sick and may experience heart palpitations.

These disorder often begin in adolescence or early adulthood and can leave people isolated.

Mr Thomas Nilsson, study co-author, said:

“Many people adapt to their panic disorder by various restrictions in their daily living.

Treatment is crucial as the disorder often leads to a downward spiral in which the margin for everyday life activities becomes increasingly narrow.”

The panic attack treatment study included 221 people with panic disorder who were tracked over 10 years.

The results showed that two years after treatment, 70 percent of patients had improved and 45 percent were in total remission.

The researchers also tested whether people did better if they chose the therapy they preferred rather than being randomly assigned to it.

The results were somewhat confusing, showing that this worked for psychodynamic therapy but not for CBT.

In other words, people did better if they specifically chose psychodynamic treatment but worse if they specifically chose CBT treatment.

Mr Nilsson said:

“Perhaps those who chose psychodynamic therapy had a more accurate perception of what they needed.”

Overall, though, whichever treatment they chose, they improved, said Dr Martin Svensson, the study’s first author:

“The patients felt better in many ways.

For instance depressive symptoms, that often accompany panic disorder, were significantly reduced and quality of life improved.”

→ Read on about panic attacks:

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This site is all about scientific research into how the mind works.

It’s mostly written by psychologist and author, Dr Jeremy Dean.

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Author: Jeremy Dean

Psychologist, Jeremy Dean, PhD is the founder and author of PsyBlog. He holds a doctorate in psychology from University College London and two other advanced degrees in psychology. He has been writing about scientific research on PsyBlog since 2004. He is also the author of the book "Making Habits, Breaking Habits" (Da Capo, 2013) and several ebooks.