Best med for "breakthrough" panic attacks

[murf7777]

I know they have epi-pens for severe allergies, and similar emergency intervention drugs like inhalers for other emergencies, but what can augment clonazapam for those really really freaky panic attacks, the type that leave you feeling like you ran 2 marathons?  The clonazepam is 1mg 3xs/day and works well to prevent them, but some slip through and can be brutal.  I am 58 and do not want the last period of my life to be miserable.

Any thoughts?

[Paxiled]

First question would be if you're in therapy with a specialist in anxiety treatment, particularly CBT.  Drugs for anxiety and depression are symptom relieving drugs because there is no consensus on why these illnesses occur.  The drugs you're talking about are for asthma, and we know what's happening when you have an asthma attack, but not exactly what's happening when you have a panic attack.  Antidepressants, when they work, work all the time, whereas the benzos you've been relying on only work for periods of time and then wear off, so you're stuck taking repeated doses of addictive drugs that your brain eventually gets used to.  Given you say the klonopin is preventing most of your attacks, it also sounds like you're giving a lot of power to a problem that is mostly controlled in those few times it isn't.  But if you can find a therapist you can work with and change the way you're thinking about anxiety, then the problem is gone and you can go on your merry way.  There's no guarantee that will work, but it's worth the try.  You might also learn some breathing techniques and meditation and other relaxation techniques that might work for you.  Now, other benzos tend to be more powerful than klonopin but work for shorter periods of time but they also go to work more quickly, but any time you take them regularly you run into the addictive drug problem and then the eventual tolerance problem.  Antidepressants also can poop out, but again, if you find one that works, it works all the time.