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Conditions
PanicAttacks
Sudden episodes of intense fear with physical symptoms - racing heart, breathlessness, chest pain, dizziness, and a feeling of losing control. Terrifying but not dangerous.
Get support
From $24.95 · No appointment needed
6 min
avg cert turnaround
13 min
avg doctor review
2
days a week
30%
refund if declined
Symptoms
CommonsymptomsofPanicAttacks
An AHPRA-registered doctor assesses these symptoms online - no in-person visit required.
Rapid or pounding heartbeat
Chest pain or tightness
Shortness of breath or hyperventilation
Dizziness or feeling faint
Trembling or shaking
Sweating
Feeling of unreality or detachment
Fear of dying or losing control
Tingling in hands, feet, or face
Our Scope
Howwecanhelp
InstantMed handles many common conditions entirely online. Here's what fits our service.
What we can help with
- Assessment and reassurance after a first panic attack
- Medical certificates for mental health days
- Discussion of management strategies (CBT, breathing techniques)
- Referrals to mental health professionals
- Medication discussion if appropriate
What needs in-person care
- Emergency assessment of first-episode chest pain (call 000)
- Ongoing psychological therapy (we can refer)
- In-person cardiac assessment
Depending on your situation, an AHPRA-registered doctor may be able to issue a medical certificate or arrange a repeat prescription after reviewing your request online.
Clinical Guidance
Whentoseeadoctor
These indicators suggest you should seek professional medical advice promptly.
Signs you need a doctor
- 1First panic attack (to rule out cardiac causes)
- 2Panic attacks becoming more frequent
- 3Avoiding situations due to fear of panic attacks
- 4Panic attacks affecting work or daily life
- 5You need a mental health day
Seek emergency care if
- First episode of chest pain with breathlessness (could be cardiac - call 000)
- Symptoms that don't resolve within 30 minutes
- Loss of consciousness
- Chest pain with exertion (not at rest)
Call 000 or go to your nearest emergency department
Clinical Insight
Adoctor'sperspectiveonPanicAttacks
InstantMed Clinical Team
AHPRA-registered medical team · Reviewed 2026-03
Panic attacks are one of the most frightening experiences a person can have - the combination of chest pain, breathlessness, racing heart, and a sense of impending doom genuinely mimics a heart attack. The first clinical priority is ruling out cardiac causes, which is why I always take a first-ever panic attack seriously. Once cardiac causes are excluded (based on age, risk factors, and symptom pattern), the focus shifts to management. The most important thing I tell patients is: panic attacks are terrifying but not dangerous. Your body is activating its fight-or-flight response inappropriately - the adrenaline surge causes every symptom you feel, but it cannot harm you. CBT for panic disorder has one of the highest success rates of any psychological treatment - around 80%. The key technique is learning to ride the wave of panic rather than fighting it, combined with addressing the catastrophic thoughts that fuel the cycle.
Treatment
TreatingPanicAttacks
Panic disorder is highly treatable. Cognitive Behavioural Therapy (CBT) has the strongest evidence base and achieves significant improvement in 70-80% of cases. Pharmacological treatment is used alongside CBT when attacks are frequent or severe. SSRIs are first-line agents per Australian and international guidelines -- specifically sertraline and escitalopram due to their evidence in panic disorder and tolerability. Benzodiazepines are sometimes used short-term for acute distress but are not recommended for long-term management due to dependence risk and tolerance.
Sertraline
Zoloft, Sertraline Sandoz, Xydep
Class:Selective serotonin reuptake inhibitor (SSRI)
Typical dose:25mg daily for 1-2 weeks (start low to reduce initial side effects), then increase to 50mg daily; therapeutic range 50-200mg daily
PBS:PBS listed for panic disorder; $25.00 general / $7.70 concession (PBS, 2026)
- First-line pharmacotherapy for panic disorder per eTG and RACGP guidelines
- Full effect takes 4-8 weeks; initial anxiety increase possible in weeks 1-2 (start at low dose to minimise this)
- Continue for at least 12 months after symptom remission to reduce relapse risk
- A telehealth consult can initiate sertraline with a clear review plan
Escitalopram
Lexapro, Escitalopram Sandoz
Class:Selective serotonin reuptake inhibitor (SSRI)
Typical dose:5mg daily for 1 week, then 10mg daily; maximum 20mg daily
PBS:PBS listed for panic disorder; $25.00 general / $7.70 concession (PBS, 2026)
- Comparable efficacy to sertraline for panic disorder; well tolerated
- Often preferred for patients who find sertraline causes too much initial activation
- Maximum 20mg daily due to QT interval prolongation at higher doses
- Can be initiated via telehealth consult with appropriate history review
Propranolol
Inderal, Deralin
Class:Non-selective beta-blocker
Typical dose:10-40mg taken 30-60 minutes before a known triggering situation (situational use)
PBS:PBS listed for various indications; $25.00 general / $7.70 concession (PBS, 2026)
- Used situationally to reduce physical symptoms of panic (racing heart, tremor) before known triggers
- Not recommended as regular daily treatment for panic disorder
- Contraindicated in asthma, heart block, and bradycardia
- Does not address the psychological component -- should be used alongside CBT, not instead of it
Source: Therapeutic Guidelines -- Psychotropic, 2023; RACGP guidelines for anxiety disorders; Australian Psychological Society clinical practice guidelines for panic disorder. This information is educational only and does not replace clinical assessment.
Specialist referral: Refer to a psychologist for CBT via a Medicare Mental Health Care Plan (10 subsidised sessions per year) -- first-line treatment. Refer to a psychiatrist if: panic disorder is severe or refractory, there is significant comorbid depression, SSRIs are not tolerated, or complex medication management is required.
Panic Attacks in Australia
Panic disorder affects approximately 2-3% of Australians in any given year
Women are twice as likely to experience panic attacks as men
Panic disorder typically develops between ages 15-25
CBT achieves significant improvement in 70-80% of panic disorder patients within 12-16 sessions
Recovery
Whattoexpect
Typical recovery timeline and return-to-work guidance for most patients.
Typical recovery
Individual panic attacks peak within 10 minutes and resolve within 20-30 minutes. Panic disorder (recurrent attacks) typically improves significantly within 8-16 sessions of CBT. Medication effects begin within 2-4 weeks.
Return to work
After a panic attack, most people can return to work the same day or next day once the acute symptoms pass. If panic attacks are frequent and affecting your ability to function, discuss a Mental Health Care Plan with your GP for structured therapy.
When to reassess
Seek emergency care if chest pain is severe, occurred during exertion, or radiates to the arm/jaw (possible cardiac cause). See your GP if panic attacks are increasing in frequency, if you are avoiding situations due to fear of attacks, or if panic is significantly affecting your quality of life.
Self-Care
ManagingPanicAttacksathome
Evidence-based tips to support your recovery alongside medical treatment.
During a panic attack: slow your breathing. In for 4 seconds, hold for 4, out for 6. Focus on the out-breath
Remind yourself: 'This is a panic attack. It is unpleasant but not dangerous. It will pass within minutes'
Ground yourself with the 5-4-3-2-1 technique: name 5 things you see, 4 you feel, 3 you hear, 2 you smell, 1 you taste
Reduce caffeine - it mimics and triggers the physical symptoms of panic in sensitive individuals
Regular exercise significantly reduces the frequency of panic attacks - it burns off excess adrenaline
Consider CBT - it is the gold-standard treatment for panic disorder and can be accessed through a Mental Health Care Plan (10 Medicare-subsidised sessions)
FAQ
CommonquestionsaboutPanicAttacks
Answers to the most common questions from patients.
Panic attacks and heart attacks share symptoms (chest pain, breathlessness). Key differences: panic attacks peak within 10 minutes and resolve in 20-30 minutes, often involve tingling and a feeling of unreality. Heart attacks typically involve crushing chest pressure, pain with exertion, and pain radiating to the arm or jaw. If unsure, always call 000.
Yes. Panic attacks are a genuine medical condition and can be debilitating. If a panic attack or anxiety is preventing you from working safely, a certificate is appropriate.
Yes, with treatment. Cognitive Behavioural Therapy (CBT) is highly effective - up to 80% of people with panic disorder improve significantly with CBT. Medication can also help. Untreated panic disorder tends to worsen over time.
Triggers include stress, caffeine, sleep deprivation, alcohol withdrawal, and specific phobias. Many panic attacks occur without an obvious trigger - this is normal for panic disorder.
Ready to get help with Panic Attacks?
Australian-registered doctors review your request when available.
Full refund if the doctor declines.