Panic disorder: the place of benzodiazepines and selective serotonin reuptake inhibitors.
This article reviews the efficacy of the benzodiazepines and the selective serotonin reuptake inhibitor class of antidepressant in the treatment of panic disorder. The benzodiazepine alprazolam has been used successfully in the treatment of panic disorder, but its long-term use presents problems with dependence. Since panic may be mediated by a dysfunction of serotonin neuronal pathways, there is a rationale for treatment with antidepressants that modulate serotonergic systems. In clinical trials, members of the SSRI class of antidepressant reduced panic attack frequency to zero in 36-86% of patients and were well tolerated over long-term administration, all important factors in ensuring patient compliance. In addition, antidepressants are preferable to benzodiazepines in the treatment of panic and comorbid depression, of which there is a high prevalence among panic disorder patients. This review emphasises the need for long-term treatment of this chronic and disabling condition with a therapy that is well tolerated and provides complete and sustained recovery from panic attacks, and resolution of anticipatory anxiety.
Kasper
S
S
Department of General Psychiatry, University of Vienna, Währinger Gürtel 18-20, A-1090, Vienna, Austria. sk@akh-wien.ac.at
Resinger
E
E
D000818:Animals; D000928:Antidepressive Agents / Q000627:therapeutic use; D001569:Benzodiazepines / Q000627:therapeutic use*; D015897:Comorbidity; D003865:Major Depressive Disorder / Q000188:drug therapy / Q000523:psychology; D006801:Humans; D016584:Panic Disorder / Q000188:drug therapy* / Q000523:psychology; D016032:Randomized Controlled Trials as Topic / Q000706:statistics & numerical data; D012701:Serotonin / Q000378:metabolism; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use*
D000928:Antidepressive Agents; D001569:Benzodiazepines; D012701:Serotonin; D017367:Selective Serotonin Reuptake Inhibitors