Since you have been taking this medication for a number of months, it would be unlikely to suddenly start causing problems like
panic attacks. Most of the problems with side effects from medications occur early in treatment, and then become less likely over time.
As a 'psychodynamic psychiatrist', I don't generally consider
panic attacks to come for no reason; I assume that there are things that you have repressed-- fears, feelings, thoughts, etc that you don't want to experience-- that are leading to episodes of panic that 'break through' your ability to repress them. This is the thought behind using psychotherapy for
anxiety or panic; you cannot access your 'unconscious', but by talking about your life you may be able to express some of the repressed feelings, or get an idea about what might be bothering you.
Short of psychotherapy there are a couple things to consider. You could, of course, see your doctor about increasing or changing the medication. The
SSRI's are generally a first line, and if they are ineffective a person would move to SNRI medications. I recommend avoiding 'benzodiazepines'; Xanax or alprazolam, valium or
diazepam, Klonopin or clonazepam, etc... as they cause tolerance and 'rebound
anxiety' that can often trap a person in a cycle of use/withdrawal. Other medications for
anxiety and panic include buspirone, quetiapine, and hydroxyzine.
Beyond medication, you can do your own 'mini-psychotherapy' by keeping an open mind about what might be bothering you. If you do experience fears (not the
panic attacks, but appropriate fear) over things in your life, take the time to consider what you are afraid of, and deal with it. As an example, if there is something you need to do but that you have been putting off, consider getting it done. And stop for 10-15 minutes every morning and evening and 'check in' with yourself; reflect on the day, consider how things went, and think about your plans for the next day. Stop rushing and get more in touch with yourself.
Finally, avoid substances that will make panic worse-- caffeine, alcohol, smoking pot,
pain pills, etc. Some of them will help for a short time, but they all will increase your discomfort long term.
