Clonazepam for the treatment of panic disorder

• Published in: Current drug targets Vol. 14; no. 3; p. 353
• Main Authors: Nardi, Antonio E, Machado, Sergio, Almada, Leonardo Ferreira, Paes, Flávia, Silva, Adriana Cardoso, Marques, Ricardo José, Amrein, Roman, Freire, Rafael C, Martin-Santos, Rocío, Cosci, Fiammeta, Hallak, Jaime E, Crippa, José A, Arias-Carrión, Oscar
• Format: Journal Article
• Language: English
• Published: United Arab Emirates 01-03-2013
• Subjects: Animals; Clonazepam - adverse effects; Clonazepam - pharmacokinetics; Clonazepam - pharmacology; Clonazepam - therapeutic use; Controlled Clinical Trials as Topic; Drug Interactions; GABA Modulators - therapeutic use; Humans; Panic Disorder - drug therapy; Serotonin Uptake Inhibitors - therapeutic use
• ISSN: 1873-5592
• DOI: 10.2174/1389450111314030007

Clonazepam was initially licensed as an anti-epileptic agent, but its use in a wide variety of psychiatric conditions, including panic disorder (PD) has now been well established. This overview evaluates the current role of clonazepam alone or in combination with antidepressants and/or behavioral therapy in the treatment of PD. We review the data establishing the use of clonazepam in the treatment of PD as well as new information, particularly confirmation of longterm efficacy and safety. We also discuss a regimen for safely tapered withdrawal of clonazepam, the characteristics of the respiratory subtype of PD, and CO2-induced panic attacks as a diagnostic measure and predictor for therapeutic success. It has been shown that panic attacks can more readily be induced by CO2 in PD patients with the respiratory subtype than those with the non-respiratory subtype. More than 25 years after the first report of efficacy in PD in 1984, clonazepam, alone or combined with selective serotonin reuptake inhibitors (SSRIs) and/or behavioral therapy, remains an important therapeutic modality for the management of PD.