A 20 year old lady, Maya, frequently experiences palpitations, breathlessness, sweating and a fear of impending death. She has one episode of such attacks every week. There are no identifiable triggers for the episodes Which among the following is the best drug options for her long term treatment?

The lady in the question experiences frequent panic attacks and hence the diagnosis is panic disorder. Alprazolam and Lorazepam may be used for sho term treatment of panic attacks. However SSRIs are the long term treatment options along with psychotherapy. Olanzapine is an anti-psychotic. Diazepam is useful to reduce anxiety but it is not as fact acting as Lorazepam. Betablockers are good to reduce the physical symptoms like palpitations and sweating. However it cannot reduce the psychological symptoms of panic attack like the fear of death and severe anxiety.