In the acute treatment of a panic attack, which medication is most appropriate?

• A. SSRI
• B. Buspirone
• C. Benzodiazepine (lorazepam)
• D. Beta-blocker

Answer: (C)

In the acute treatment of a panic attack, the most appropriate medication is a benzodiazepine, such as lorazepam. Benzodiazepines are fast-acting anxiolytics that provide quick relief from the intense anxiety and physiological symptoms associated with panic attacks. They work by enhancing the effect of the neurotransmitter gamma-aminobutyric acid (GABA) at the GABA-A receptor, leading to a rapid calming effect. This makes them particularly suitable for immediate intervention during an acute panic episode.

While selective serotonin reuptake inhibitors (SSRIs) are effective for long-term management of anxiety disorders, they typically take weeks to exert their therapeutic effects and are not intended for acute relief. Buspirone, while useful for generalized anxiety disorder, does not provide the immediate relief required during a panic attack as it also takes time to work. Beta-blockers can help with some symptoms like tremors and palpitations but do not address the underlying anxiety or panic directly and are not the standard choice for acute episodes.

Therefore, lorazepam and other benzodiazepines are preferred for their rapid action and efficacy in reducing acute panic symptoms.