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As in your previous ER visits panic attacks had been diagnosed. It is usually diagnosed when symptoms (like yours) occur with out cardiac illness.
SSRIs are very effective treatment for panic attacks. But few patient do not responds due to some of the following reasons:
imbalance (like low cortisol
in your case)
-Medical illness (like pituitary microadenoma in your case)
(possible in your case so get it investigated)
So continue SSRIs and get concurrent management of above issues for solution.
I hope this information has been both informative and helpful for you.
Wish you Good Health.
Dr. Ashish Mittal