Management of panic disorder.
Selective serotonin reuptake inhibitors are the first-line treatment for panic disorder. They are effective and well tolerated. Although tricyclic antidepressants are equally effective, they are less well tolerated than the selective serotonin reuptake inhibitors. Monoamine oxidase inhibitors can be efficacious but have a range of unwanted effects that preclude their use as first-line treatments. Benzodiazepines should be reserved for short-term use and for treatment-resistant patients who do not have a history of dependence and tolerance. Also, they can be combined with selective serotonin reuptake inhibitors in the first weeks of treatment to tide the patient over before the onset of the response. Cognitive behavioral therapy is the psychologic treatment of first choice. The methods of combining drug and nondrug treatments need careful and thorough exploration.
Lader
Malcolm
M
Institute of Psychiatry, Denmark Hill, London, SE5 8AF, UK. m.lader@iop.kcl.ac.uk
D000928:Antidepressive Agents / Q000627:therapeutic use*; D001569:Benzodiazepines / Q000627:therapeutic use; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D005104:Expert Testimony; D006801:Humans; D008996:Monoamine Oxidase Inhibitors / Q000627:therapeutic use; D016584:Panic Disorder / Q000175:diagnosis / Q000628:therapy*; D017410:Practice Guidelines as Topic; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use; D016896:Treatment Outcome
D000928:Antidepressive Agents; D001569:Benzodiazepines; D008996:Monoamine Oxidase Inhibitors; D017367:Selective Serotonin Reuptake Inhibitors