Evidence-based pharmacotherapy of panic disorder: an update

Batelaan, Neeltje M.; Van Balkom, Anton J. L. M.; Stein, Dan J.

doi:10.1017/s1461145711000800

Cited by 67Anxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesTreatment of Major DepressionMaternal Mental Health During Pregnancy and Postpartum

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Evidence-based pharmacotherapy of panic disorder: an update

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Batelaan, Neeltje M., Van Balkom, Anton J. L. M., Stein, Dan J.·2012·The International Journal of Neuropsychopharmacology

DOI 10.1017/s1461145711000800

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Abstract

The evidence-based pharmacotherapy of panic disorder continues to evolve. This paper reviews data on first-line pharmacotherapy, evidence for maintenance treatment, and management options for treatment-refractory patients. A Medline search of research on pharmacotherapy was undertaken, and a previous systematic review on the evidence-based pharmacotherapy of panic disorder was updated. Selective serotonin reuptake inhibitors remain a first-line pharmacotherapy of panic disorder, with the serotonin noradrenaline reuptake inhibitor venlafaxine also an acceptable early option. Temporary co-administration of benzodiazepines can be considered. Maintenance treatment reduces relapse rates, but further research to determine optimal duration is needed. For patients not responding to first-line agents several pharmacotherapy options are available, but there is a notable paucity of data on the optimal choice.

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Current guidelines do not offer clear indications for choosing among available options for treatment-refractory panic disorder patients, including dosage modifications, switching medications or treatment modalities, or augmentation strategies.
“Current guidelines do not offer clear indications to choose from available options for treatment-refractory patients, such as dosage modifications for current pharmacotherapy, switching within or between classes of medications or to other treatment modalities, or augmentation strategies for the use of additional medications or other treatment modalities [2, 5].”
From Management of Treatment-Resistant Panic Disorder (2017) · cites this paper as [2]

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Clonazepam in the Treatment of Panic Disorder and Agoraphobia
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“In addition, augmentation of antidepressants with an antipsychotic has been suggested for refractory panic disorder patients (Hoge et al. 2008; Saito & Miyaoka, 2007 ; Sepede et al. 2006; Simon et al. 2006).”
Background
Potential effectiveness and safety of olanzapine in refractory panic disorder
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“1998) or by the cardiologist at the emergency unit is common (Harvison et al. 2004; Kuijpers et al. 2000).”
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Long-term drug treatment of panic disorder
Burrows, G. D., Judd, F. K., & Norman, T. R. (1993) · Journal of Psychiatric Research · doi:10.1016/0022-3956(93)90022-t · Cited by 19
[Panic disorder in patients with chest pain and palpitations: an often unrecognized relationship].
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Baldwin, D. S., Anderson, I. M., Nutt, D. J., Allgulander, C., Bandelow, B., den Boer, J. A., Christmas, D. M., Davies, S., Fineberg, N., Lidbetter, N., et al. (2014) · Journal of Psychopharmacology · doi:10.1177/0269881114525674 · Cited by 676
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Pharmacological treatment of eating disorders, comorbid mental health problems, malnutrition and physical health consequences
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Reporting Bias in Clinical Trials Investigating the Efficacy of Second-Generation Antidepressants in the Treatment of Anxiety Disorders: A Report of 2 Meta-analyses
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Benzodiazepines versus placebo for panic disorder in adults
Breilmann, J., Girlanda, F., Guaiana, G., Barbui, C., Cipriani, A., Castellazzi, M., Bighelli, I., Davies, S., Furukawa, T. A., & Koesters, M. (2019) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd010677.pub2 · Cited by 100
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CO2 exposure as translational cross-species experimental model for panic
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Bridging the gap between education and appropriate use of benzodiazepines in psychiatric clinical practice
Fiorillo, A., Dell’Osso, B. M., Albert, U., Atti, A. R., Carmassi, C., Carrà, G., Cosci, F., Vecchio, V. D., Nicola, M. D., Ferrari, S., et al. (2015) · Neuropsychiatric Disease and Treatment · doi:10.2147/ndt.s83130 · Cited by 69
Antidepressants and benzodiazepines for panic disorder in adults
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“PD is associated with psychiatric/medical comorbidity; significant impairment of daily functioning, work performance, and quality of life; and relevant social costs [2, 3].”
Background
Effects of chronic treatment with corticosterone and imipramine on fos immunoreactivity and adult hippocampal neurogenesis
Diniz, L., Santos, T. B., Britto, L. R. G., Céspedes, I. C., Garcia, M. C., Spadari-Bratfisch, R. C., Medalha, C. C., de Castro, G. M., Montesano, F. T., & Viana, M. D. B. (2012) · Behavioural Brain Research · doi:10.1016/j.bbr.2012.10.024 · Cited by 37
Pharmacological Therapy in Panic Disorder: Current Guidelines and Novel Drugs Discovery for Treatment-resistant Patient
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Azapirones versus placebo for panic disorder in adults
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A 6-Year Posttreatment Follow-up of Panic Disorder Patients
Freire, R. C. R., Amrein, R., Mochcovitch, M. D., Dias, G. P., Machado, S. E. D. C., Versiani, M., Arias-Carrión, Ó., Carta, M. G., & Nardi, A. E. (2017) · Journal of Clinical Psychopharmacology · doi:10.1097/jcp.0000000000000740 · Cited by 20
No Effects of D-Cycloserine Enhancement in Exposure With Response Prevention Therapy in Panic Disorder With Agoraphobia
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Authors: Batelaan, N. M., Van Balkom, A. J. L. M., & Stein, D. J.
Affiliations: Amsterdam Public Health (NL)
Stellenbosch University (ZA)
Corresponding author: Batelaan, Neeltje M.
ORCID: Batelaan, Neeltje M.
Stein, Dan J.
Venue: The International Journal of Neuropsychopharmacology
Publisher: Oxford University Press (OUP)
Published: 2011-06-09
Volume: 15
Issue: 03
Pages: 403-415
ISSN: 1461-1457 (ISSN-L)
1469-5111
DOI: 10.1017/s1461145711000800
OpenAlex: W2166402651
Cited by: 67
References: 154
Citations by year: 2026: 1 · 2025: 2 · 2024: 4 · 2023: 7 · 2022: 4 · 2021: 2 · 2020: 6 · 2019: 4 · 2018: 6 · 2017: 6 · 2016: 6 · 2015: 4 · 2014: 8 · 2013: 4 · 2012: 3
FWCI: 0.64
Type: journal article
Language: en
Open access: green
research.vumc.nl
Licence: other-oa
Locations: The International Journal of Neuropsychopharmacology (publishedVersion)
PubMed (publishedVersion)
Amsterdam UMC (VU Amsterdam) - Institutional Repository (publishedVersion, other-oa)
Pure Amsterdam UMC (submittedVersion, other-oa)
Digital Academic REpository of VU University Amsterdam (Vrije Universiteit Amsterdam) (submittedVersion)
SUNScholar (Stellenbosch University) (submittedVersion)
Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
Funders: Eli Lilly and Company
Pfizer
AstraZeneca
GlaxoSmithKline
Jazz Pharmaceuticals
Servier
H. Lundbeck A/S
Topics: Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
Health Sciences › Medicine › Pharmacology (medical) › Treatment of Major Depression
Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
Keywords: panic disorder, pharmacotherapy, selective serotonin reuptake inhibitors, venlafaxine, serotonin-norepinephrine reuptake inhibitors, benzodiazepines, maintenance therapy, relapse prevention, first-line therapy
MeSH terms: Antidepressive Agents, Benzodiazepines, Humans, Tranquilizing Agents, Panic Disorder, Evidence-Based Medicine

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Evidence-based pharmacotherapy of panic disorder: an update

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