Which class of medications is commonly used to treat panic disorder?

• A. Benzodiazepines
• B. SSRIs
• C. Antihypertensives
• D. Antipsychotics

Answer: (D)

Selective serotonin reuptake inhibitors are the go-to pharmacologic option for panic disorder because they effectively reduce the frequency and severity of panic attacks when used over weeks to months, providing sustained symptom control with a favorable safety profile for long-term use. They work by increasing serotonin in the synapse, helping to dampen the overactive fear circuitry in brain regions like the amygdala and prefrontal cortex, which underlie panic and anticipatory anxiety. It typically takes several weeks to notice meaningful benefits, which is why clinicians may use a short-term benzodiazepine for rapid relief or an SNRI as an alternative if SSRIs aren’t tolerated. Benzodiazepines can be effective for immediate relief but carry risks of dependence, sedation, and cognitive impairment, making them less suitable as the sole long-term treatment. Antihypertensives like propranolol might help with some physical symptoms (racing heart, tremor) in specific situations, but they don’t address the core panic disorder symptoms. Antipsychotics aren’t indicated for panic disorder and are not used as standard treatment.