Management of panic disorder

Expert Rev Neurother. 2005 Mar;5(2):259-66. doi: 10.1586/14737175.5.2.259.


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.

Publication types

  • Review

MeSH terms

  • Antidepressive Agents / therapeutic use*
  • Benzodiazepines / therapeutic use
  • Cognitive Behavioral Therapy / methods*
  • Expert Testimony
  • Humans
  • Monoamine Oxidase Inhibitors / therapeutic use
  • Panic Disorder / diagnosis
  • Panic Disorder / therapy*
  • Practice Guidelines as Topic
  • Serotonin Uptake Inhibitors / therapeutic use
  • Treatment Outcome


  • Antidepressive Agents
  • Monoamine Oxidase Inhibitors
  • Serotonin Uptake Inhibitors
  • Benzodiazepines