Does Fluoxetine help with panic attacks? (3 solutions)

In this article, we will explore whether Fluoxetine helps with panic attacks. Furthermore, we will discuss the mechanism through which Fluoxetine helps with panic attacks, the research findings, the time taken by Fluoxetine, what to do if it does not help panic attacks, and alternatives to Fluoxetine. 

Does Fluoxetine help with panic attacks?

Yes, Fluoxetine helps with panic attacks. Fluoxetine, also known as Prozac, is FDA-approved to treat panic disorder. Fluoxetine should be started at low doses to increase its adaptability in the patients, as higher doses may pose an increased risk of side effects.

Fluoxetine is a selective serotonin reuptake inhibitor (SSRI) antidepressant, used to treat depression (children of 8 years and above), eating disorders, premenstrual dysphoric disorder, panic disorder, and other related conditions (1).

Panic disorder is a psychological condition characterized by episodes of intense fear and anxiety, which are termed “panic attacks”. Patients with panic attacks may experience fast heart rate and breathing difficulties (2). 

How does Fluoxetine help with panic attacks?

Fluoxetine helps with panic attacks through its mechanism of inhibiting the reuptake of serotonin in the synaptic regions of the brain. Serotonin, a neurotransmitter, regulates mood, sleep, appetite, emotions, and the body’s stress response. 

By blocking the reuptake of serotonin, Fluoxetine increases the serotonin levels in the brain cells. Serotonin remains in the synaptic region for a longer period, and due to this prolonged persistence, serotonin controls the symptoms of panic attacks (1). 

What does research suggest about Fluoxetine’s effectiveness for panic attacks?

According to a research study, participants were given Fluoxetine for about 12 months to monitor their response towards the treatment. Patients with panic disorder were administered Fluoxetine in low doses of 5mg per day to reduce the incidence of side effects that were previously observed with higher doses. 

The study suggested that approximately 76% of patients got better while using Fluoxetine for panic attacks; however, 16% of patients discontinued Fluoxetine due to side effects. Therefore, it is recommended to start Fluoxetine treatment at lower doses to prevent discontinuation due to the occurrence of side effects (3,4).

How long does Fluoxetine take to treat panic attacks?

Fluoxetine may take 6 to 8 weeks to treat panic attacks. A clinical trial was conducted on 30 participants with panic disorder while using Fluoxetine. A few patients experienced anxiety in the initial phase of Fluoxetine treatment. Most of the patients had a significant reduction in the frequency of panic attacks and reduced anxiety levels after 8 weeks of Fluoxetine treatment. 

The majority of patients were panic-free at the end of 8 weeks of Fluoxetine treatment. However, some of the patients discontinued Fluoxetine as their anxiety levels increased, or it did not help with their panic attacks. Therefore, the time taken by Fluoxetine for panic attacks may vary from person to person (5). 

What to do if Fluoxetine does not help your panic attacks?

If you suspect that Fluoxetine does not help your panic attacks, you should at least wait for 8 weeks before making any changes to your Fluoxetine treatment. Some patients may respond earlier or later, compared to others due to variations in pharmacological responses. 

However, if panic attacks persist even after 8 weeks, you should consult your healthcare provider. They may examine you for your current condition, your family history, and any other underlying health condition.

Your doctor may try to adjust the dose of Fluoxetine and suggest some management therapies such as cognitive behavioural therapy (CBT) along with antidepressant treatment. These adjustments in the dose of Fluoxetine along with therapy, may help to control your panic attacks (6). 

What are the alternatives to Fluoxetine for panic attack treatment?

The alternatives to Fluoxetine for panic disorders may be considered if you do not notice any improvements in your panic attacks after dose adjustment along with behavioural therapy. Your doctor may gradually discontinue Fluoxetine as sudden discontinuation may lead to withdrawal symptoms.

However, withdrawal effects of Fluoxetine are rare and mild due to the prolonged half-life of the medication (7). After successful discontinuation of Fluoxetine, your doctor may switch you to an alternative antidepressant that might suit you better, such as tricyclic antidepressants (TCAs).

TCAs have similar efficacy as Fluoxetine and may help to control panic attacks in non-responder patients to Fluoxetine. Other medications can also be used to treat panic attacks, such as Benzodiazepines (Alprazolam and Clonazepam) (6,8). 

In my opinion, Fluoxetine helps with panic attacks by reducing the frequency of attacks and even making patients panic-free. Fluoxetine may take about 8 weeks to treat panic disorder, however, this timeline may vary among individuals.

Fluoxetine success rates are higher for panic disorder, but if it does not help you, please consult your healthcare provider. They will examine all the aspects of your condition, and take necessary actions according to your specific needs.  

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