Zoloft, Xanax for Panic Attacks – An Overview

Zoloft and Xanax are two different medications that can be prescribed for panic attacks. Each works using different mechanisms of action and can be used in different ways and at different times for those with panic disorders. Here we will examine each and look at whether you should use either or both in treatment of the condition.

What Is Zoloft?

Zoloft (sertraline) is an SSRI or ‘Selective Serotonin Reuptake Inhibitor’. What this means, is that it blocks the serotonin transporters in the brain, whose job it is to ‘clear up’ excess amounts of the neurotransmitter. This essentially results in greater quantities of active serotonin in the brain which is desirable as serotonin is the ‘feel good’ neurotransmitter that is largely responsible for feelings of happiness and contentment.

In treatment of panic attacks then, Zoloft can potentially help the patient to be generally happier and more easy going and modulate their reaction to stressful events. SSRIs are predominantly used as antidepressants (rather than anxiolytics) meaning that it is particularly effective for those who experience depressive symptoms alongside their anxiety disorder. It may be particularly effective for those who are going through difficult life transitions therefore.


Xanax (alprazolam) meanwhile, is a benzodiazepine. This is an anti-anxiety medication that works by increasing the action of a substance called GABA. GABA, or gamma-aminobutyric acid is an inhibitory neurotransmitter which suppresses neural activity throughout the brain. In other words, it ‘quietens’ the ‘noise’ in the brain and makes the individual feel more sedate and relaxed.

Xanax is particularly effective in the immediate treatment of panic attack. This is because benzodiazepines actually work very quickly and thus are able to inhibit the excitement of firing neurons even during an attack to prevent it reaching its full severity.

Side Effects and Risks

Unfortunately, both benzodiazepines and SSRIs carry potential risks and side effects. As well as potentially causing feelings of detachment, confusion and even depression – both medications can lead to ‘tolerance’ and ‘dependence’.

Here, the brain responds to alterations in the levels of specific neurotransmitters by developing less sensitivity or by producing less naturally. The result is that you then need to use said medication just to achieve normal levels of GABA or of serotonin and as such you end up dependent on the medication to survive. Worse, you need more and more of the medication just to achieve this healthy equilibrium. Ultimately this can lead to an addiction.

Fortunately, benzodiazepines are used more infrequently and so this can help to reduce the chances of addiction. Meanwhile, SSRIs are slightly less harmful to begin with.

Nevertheless though, it is preferable to avoid these methods or to use them only in the short term in order to manage symptoms. For longer term solutions, it is better to use cognitive behavioral therapy or other psychotherapeutic intervention and to this way help address the underlying thought patterns or fears that are leading to the anxiety attacks.

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