Antidepressants in panic disorder: clinical and preclinical mechanisms

Advances have been made in understanding the biology of panic disorder and the role of the underlying serotonergic dysfunction. This review summarizes the biological evidence for the involvement of serotonin in the pathogenesis of panic disorder and considers the 2 opposing theories that are currently prevalent (5-HT excess and 5-HT deficit). The serotonin selective reuptake inhibitors are increasingly considered as first-line treatment for panic disorder, and the interaction of these agents with the serotonergic system is considered.