Which medications in the drug class Antidepressants, Others are used in the treatment of Panic Disorder?

Updated: Mar 21, 2018
  • Author: Mohammed A Memon, MD; Chief Editor: Randon S Welton, MD  more...
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Answer

Antidepressants, Others

Other antidepressants are those that are unique and not categorized into the classification of selective serotonin reuptake inhibitors (SSRIs), serotonin and norepinephrine reuptake inhibitors (SSNIs), tricyclic antidepressants (TCAs), and monoamine oxidase inhibitors (MAOIs).

Trazodone (Desyrel, Desyrel Dividose, Oleptro)

Trazodone is useful in the treatment of panic disorder and agoraphobia with panic attacks. It is an antagonist at the 5-HT2 receptor and inhibits the reuptake of 5-HT. Trazodone also has a negligible affinity for cholinergic and histaminergic receptors.

In animals, this drug selectively inhibits serotonin uptake by brain synaptosomes and potentiates the behavioral changes induced by the serotonin precursor, 5-hydroxytryptophan.

Mirtazapine (Remeron, Remeron SolTab)

Mirtazapine is an alpha-2 adrenergic antagonist that increases synaptic norepinephrine and serotonin, while also blocking some postsynaptic serotonergic receptors that conceptually mediate excessive anxiety when stimulated with serotonin. This agent causes significant sedation which generally reduces its potential to aggravate initial anxiety and may cause residual morning sedation that often improves with continued therapy.

Sedating antidepressants such as mirtazapine are usually prescribed for use only at night before bed to help improve sleep, but they should include a warning for patients not to operate a motor vehicle or machinery if they are feeling sedated or directly after the dose.

Mirtazapine may also cause an increase in appetite or weight gain.


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