The long-term treatment of panic disorder.
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.
Department of Psychiatry and Behavioral Science, Duke University Medical Center, Durham, NC 27710, USA.
J R
JR
Davidson
D000929:Antidepressive Agents, Tricyclic / Q000627:therapeutic use; D002986:Clinical Trials as Topic; D002997:Clomipramine / Q000627:therapeutic use; D015928:Cognitive Behavioral Therapy; D004334:Drug Administration Schedule; D005500:Follow-Up Studies; D006801:Humans; D008134:Long-Term Care; D016584:Panic Disorder / Q000188:drug therapy* / Q000523:psychology / Q000628:therapy; D017374:Paroxetine / Q000627:therapeutic use; D012008:Recurrence; D012064:Relaxation Therapy; D016896:Treatment Outcome
D000929:Antidepressive Agents, Tricyclic; D017374:Paroxetine; D002997:Clomipramine