The use of newer antidepressants for panic disorder

Antidepressants are frequently prescribed to treat panic disorder. Although tricyclic antidepressants and monoamine oxidase inhibitors both block panic attacks, they have many adverse effects such as orthostatic hypotension and weight gain. High potency benzodiazepines such as alprazolam are also efficacious but carry the risk of physical dependency. Data from research trials as well as clinical experience are accumulating to indicate that the serotonin selective reuptake inhibitors (SSRIs)--fluoxetine, fluvoxamine, paroxetine, and sertraline--and perhaps venlafaxine, which inhibits both serotonergic and noradrenergic reuptake, are useful antipanic medications. The possibility also exists that these newer antidepressants such as SSRIs and venlafaxine are superior in effectiveness to the previously available drugs and, when combined with cognitive-behavioral therapy, might provide the best treatment outcome for patients with panic disorder.