Risks and benefits of medications for panic disorder: a comparison of SSRIs and benzodiazepines

• Published in: Expert opinion on drug safety Vol. 17; no. 3; p. 315
• Main Authors: Quagliato, Laiana A, Freire, Rafael C, Nardi, Antonio E
• Format: Journal Article
• Language: English
• Published: England 04-03-2018
• Subjects: Benzodiazepines - administration & dosage; Benzodiazepines - adverse effects; Benzodiazepines - therapeutic use; Drug Tolerance; Humans; Panic Disorder - drug therapy; Panic Disorder - physiopathology; Serotonin Uptake Inhibitors - administration & dosage; Serotonin Uptake Inhibitors - adverse effects; Serotonin Uptake Inhibitors - therapeutic use; Substance-Related Disorders - epidemiology; Time Factors; alprazolam; fluoxetine; paroxetine; escitalopram; clonazepam; adverse events; fluvoxamine; Citalopram; sertraline
• ISSN: 1744-764X
• DOI: 10.1080/14740338.2018.1429403

Panic disorder (PD) is a prevalent and disabling anxiety disorder that can be treated effectively. Selective serotonin reuptake inhibitors (SSRIs) and benzodiazepines are among the most frequently prescribed drugs for PD. In this article, the authors review the current evidence on efficacy, adverse events, and limitations of these two treatment options.
MEDLINE/Pubmed and Web of Science databases were searched for open or placebo-controlled trials on SSRIs and/or benzodiazepines in PD treatment.
The literature search yielded 4,957 articles related to the theme. Of these, 24 articles were included in this review. Despite their usefulness in PD, SSRIs are associated with a delay of several weeks in onset of therapeutic effect and have the potential to exacerbate anxiety and panic early in the treatment course. Benzodiazepines present rapid onset of action, but can cause tolerance and dependence. Despite strong evidence of the effectiveness of SSRIs and benzodiazepines in the treatment of PD, few trials have performed head-to-head comparisons of these two drug classes. Future studies on the pharmacological treatment of PD should make direct comparisons of risks, benefits, and limitations of each group. This could help improve the evidence-based pharmacotherapy of PD.