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Pharmacotherapy for panic disorder in adults

Author
Peter P Roy-Byrne, MD
Section Editor
Murray B Stein, MD, MPH
Deputy Editor
Richard Hermann, MD

INTRODUCTION

Panic disorder is a chronic illness characterized by recurrent panic attacks, at least some of which are unexpected, accompanied either by anxiety about having future attacks or about the implications of attacks (eg, undiscovered medical illness, possible sudden death or insanity), or by a change in behavior due to attacks (eg, avoidance of certain situations, recurrent requests for medical tests) [1].

With the revision of DSM-IV to DSM-5, agoraphobia is diagnosed independently of panic disorder [1]. Agoraphobia frequently but not always accompanies panic disorder.

While up to a third of the population will have a panic attack in their lifetime, only about 10 percent of this group (about 3 percent of the population) will go on to develop panic disorder [2]. Clinical trials have found that both pharmacologic and psychotherapeutic approaches are efficacious for panic disorder.

Pharmacotherapy for panic disorder is discussed here. The epidemiology, pathogenesis, clinical manifestations, course and diagnosis of panic disorder are discussed separately, as is psychotherapy for panic disorder. (See "Panic disorder in adults: Epidemiology, pathogenesis, clinical manifestations, course, assessment, and diagnosis" and "Psychotherapy for panic disorder in adults".)

MEDICATIONS

Several classes of medication have shown comparable efficacy for panic disorder, including the selective serotonin reuptake inhibitors (SSRIs), the serotonin-norepinephrine reuptake inhibitors (SNRIs), tricyclic antidepressants (TCADs), monoamine oxidase inhibitors (MAOIs), and benzodiazepines. However, these drugs differ in the extent of supporting evidence, side effect profile, and in the case of benzodiazepines, their potential for abuse. These issues are discussed below [3-6].

                       

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Literature review current through: Nov 2016. | This topic last updated: Thu Oct 20 00:00:00 GMT+00:00 2016.
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