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The Long-Term Treatment of Panic Disorder

Jonathan R. T. Davidson, M.D.

Published: April 1, 1998

Article Abstract

Panic disorder is a chronic and recurring condition, and there is therefore a need for long-termtherapy. This paper reviews data from long-term studies of drug treatment for panic disorder to addressissues of whether medication benefits persist, whether improvement can continue over severalmonths or years, the tolerability of long-term treatment, patient selection for long-term treatment, andwhen and how to stop medication. The main conclusion is that long-term drug treatment of panic disorderis necessary, effective, and safe. Serotonin selective reuptake inhibitors offer benefits of ease ofdosing, good tolerability, and no safety or dependence problems; TCAs are often poorly tolerated, andbenzodiazepines are associated with dependence problems. Withdrawal from all types of medicationshould be considered, slow, planned, and individualized; some patients require an indefinite durationof treatment.

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Volume: 59

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