title: Clonazepam for the treatment of panic disorder.
abstract: Clonazepam was initially licensed as an anti-epileptic agent, but its use in a wide variety of psychiatric conditions, including panic disorder (PD) has now been well established. This overview evaluates the current role of clonazepam alone or in combination with antidepressants and/or behavioral therapy in the treatment of PD. We review the data establishing the use of clonazepam in the treatment of PD as well as new information, particularly confirmation of longterm efficacy and safety. We also discuss a regimen for safely tapered withdrawal of clonazepam, the characteristics of the respiratory subtype of PD, and CO2-induced panic attacks as a diagnostic measure and predictor for therapeutic success. It has been shown that panic attacks can more readily be induced by CO2 in PD patients with the respiratory subtype than those with the non-respiratory subtype. More than 25 years after the first report of efficacy in PD in 1984, clonazepam, alone or combined with selective serotonin reuptake inhibitors (SSRIs) and/or behavioral therapy, remains an important therapeutic modality for the management of PD.
authors.affiliation: Panic and Respiration Laboratory, Institute of Psychiatry, Federal University of Rio de Janeiro, National Institute for Translational Medicine (INCT-TM), Rio de Janeiro, Brazil.
authors.forename: Antonio E
authors.initials: AE
authors.lastname: Nardi
authors.forename: Sergio
authors.initials: S
authors.lastname: Machado
authors.forename: Leonardo Ferreira
authors.initials: LF
authors.lastname: Almada
authors.forename: Flávia
authors.initials: F
authors.lastname: Paes
authors.forename: Adriana Cardoso
authors.initials: AC
authors.lastname: Silva
authors.forename: Ricardo José
authors.initials: RJ
authors.lastname: Marques
authors.forename: Roman
authors.initials: R
authors.lastname: Amrein
authors.forename: Rafael C
authors.initials: RC
authors.lastname: Freire
authors.forename: Rocío
authors.initials: R
authors.lastname: Martin-Santos
authors.forename: Fiammeta
authors.initials: F
authors.lastname: Cosci
authors.forename: Jaime E
authors.initials: JE
authors.lastname: Hallak
authors.forename: José A
authors.initials: JA
authors.lastname: Crippa
authors.forename: Oscar
authors.initials: O
authors.lastname: Arias-Carrión
mesh_terms: D000818:Animals; D002998:Clonazepam / Q000009:adverse effects / Q000493:pharmacokinetics / Q000494:pharmacology / Q000627:therapeutic use*; D018849:Controlled Clinical Trials as Topic; D004347:Drug Interactions; D018757:GABA Modulators / Q000627:therapeutic use*; D006801:Humans; D016584:Panic Disorder / Q000188:drug therapy*; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use
chemical_list: D002998:Clonazepam; D018757:GABA Modulators; D017367:Selective Serotonin Reuptake Inhibitors