Pharmacotherapy of panic disorder: differential efficacy from a clinical viewpoint

Antidepressants and high-potency benzodiazepines have been used to treat patients with panic disorder. This review considers the efficacy of these treatments in reducing panic attack frequency and in addition considers their ability to attenuate global anxiety, depressive symptomatology, agoraphobic avoidance, and overall impairment. An extensive database is available for the tricyclic antidepressants imipramine and clomipramine, the serotonin selective reuptake inhibitor paroxetine, and the benzodiazepine alprazolam. The antidepressants are more effective than the benzodiazepines in reducing associated depressive symptomatology and are at least as effective for improving anxiety, agoraphobia, and overall impairment.