The long-term treatment of panic disorder
by
Davidson JR
Department of Psychiatry and Behavioral Science,
Duke University Medical Center,
Durham, NC 27710, USA.
J Clin Psychiatry 1998; 59 Suppl 8:17-21; discussion 22-3

ABSTRACT

Panic disorder is a chronic and recurring condition, and there is therefore a need for long-term therapy. This paper reviews data from long-term studies of drug treatment for panic disorder to address issues of whether medication benefits persist, whether improvement can continue over several months or years, the tolerability of long-term treatment, patient selection for long-term treatment, and when and how to stop medication. The main conclusion is that long-term drug treatment of panic disorder is necessary, effective, and safe. Serotonin selective reuptake inhibitors offer benefits of ease of dosing, good tolerability, and no safety or dependence problems; TCAs are often poorly tolerated, and benzodiazepines are associated with dependence problems. Withdrawal from all types of medication should be considered, slow, planned, and individualized; some patients require an indefinite duration of treatment.

GAD
TCAs
SSRIs
Anxiety
Inositol
Pagoclone
Sertraline
Fluoxetine
Paroxetine
Fluvoxamine
Benzodiazepines
SSRI interactions
SSRIs and panic disorder
Citalopram and panic disorder
Alprazolam and panic disorder
Escitalopram in the treatment of panic disorder
Panic disorder and the serotonin 5-HT1a receptor
Panic disorder: imipramine (Tofranil) v sertraline (Zoloft)

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