Medication discontinuation in panic disorder.
Current pharmacotherapy for panic disorder generally consists of a trial of antidepressants or benzodiazepines for at least 3 months, with continuation for 6 to 12 months when patients respond favorably. However, the most appropriate time to discontinue medication has not yet been determined. The author discusses reasons for discontinuation, both appropriate and inappropriate; optimal timing for discontinuation; outcomes of discontinuation (i.e., remaining well, relapse, rebound, and withdrawal); strategies, including dosage taper, to avoid or minimize unfavorable outcomes; and long-term outcomes in patients treated for panic disorder. The author concludes from the data available on long-term outcomes that, although there is preliminary understanding of the course of acutely treated panic disorder patients, additional data from long-term follow-up studies are needed.
Ballenger
J C
JC
Department of Psychiatry and Behavioral Sciences, Institute of Psychiatry, Medical University of South Carolina, Charleston.
D000928:Antidepressive Agents / Q000008:administration & dosage* / Q000009:adverse effects; D001569:Benzodiazepines / Q000008:administration & dosage* / Q000009:adverse effects; D004334:Drug Administration Schedule; D005500:Follow-Up Studies; D006801:Humans; D016584:Panic Disorder / Q000188:drug therapy* / Q000523:psychology; D010352:Patient Dropouts; D010358:Patient Participation; D012008:Recurrence; D013375:Substance Withdrawal Syndrome / Q000209:etiology; D016312:Treatment Refusal
D000928:Antidepressive Agents; D001569:Benzodiazepines