What is the first-line medication for acute management of panic attacks?

Benzodiazepines are considered the first-line medication for the acute management of panic attacks due to their rapid onset of action. When individuals experience a panic attack, they often require immediate relief from symptoms such as intense anxiety, palpitations, and feelings of impending doom. Benzodiazepines, such as lorazepam or alprazolam, can provide quick alleviation of these symptoms, typically within 30 minutes of administration.

In contrast, selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) are more commonly used for long-term management of anxiety disorders, including panic disorder, but they take several weeks to exert their full therapeutic effects and are not suitable for immediate relief. Buspirone, while useful for generalized anxiety disorder, is not effective in the acute setting and has a slower onset of action as well. Thus, for immediate treatment of panic attacks, benzodiazepines are the most effective option.