Current Pharmacological Interventions in Panic Disorder
Rafael C. Freire, Sergio Machado, Oscar Arias-Carrion and Antonio E. Nardi
Affiliation: Laboratory of Panic and Respiration, Federal University of Rio de Janeiro, Address: Rua Visconde de Piraja 407/702, Rio de Janeiro, Zip code: 22410-003, RJ, Brazil.
Keywords: Anti-anxiety agents, antidepressive agents, antipsychotic agents, benzodiazepines, clinical trial, cognitive therapy,
comparative study, panic disorder.
The aim of this review was to summarize the recent evidences regarding the pharmacological treatment of
panic disorder (PD). The authors performed a review of the literature regarding the pharmacological treatment of PD since
the year 2000. The research done in the last decade brought strong evidences of effectiveness for paroxetine, venlafaxine,
sertraline, fluvoxamine, citalopram, fluoxetine, clonazepam, and the relatively novel agent escitalopram. There are
evidences indicating that the other new compounds inositol, duloxetine, mirtazapine, milnacipran, and nefazodone have
antipanic properties and may be effective compounds in the treatment of PD. The effectiveness of reboxetine and
anticonvulsants is a subject of controversy. In addition to selective serotonin reuptake inhibitors and serotonin and
noradrenaline reuptake inhibitors, tricyclic antidepressants, monoamine oxidase inhibitors, benzodiazepines and atypical
antipsychotics may be valid alternatives in the treatment of PD. Recent data indicate that augmentation strategies with
aripiprazole, olanzapine, pindolol or clonazepam may be effective. D-cycloserine is a promising agent in the augmentation
of cognitive behavioral therapy.
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