Which medications in the drug class Antidepressants, SSRIs 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, SSRIs

Selective serotonin reuptake inhibitors (SSRIs) are first-line agents for the long-term management of anxiety disorders. Control is gradually achieved over a 2- to 4-week course, depending on the required dosage increases.

All commonly used SSRIs appear to have a role in the treatment of panic disorder. Fluoxetine is covered here, because it has a very long half-life; this makes it well suited for patients who have difficulty remembering to take all of their medications each day. The longer half-life also minimizes the risk and severity of SSRI withdrawal that can occur when patients exhaust or abruptly discontinue their SSRI.

Fluoxetine (Prozac)

Fluoxetine selectively inhibits presynaptic serotonin reuptake, with minimal or no effect on reuptake of norepinephrine or dopamine. It has a long half-life and therefore a lower risk of withdrawal symptoms. However, fluoxetine does require slower titration and has CNS stimulating effects.

Paroxetine (Paxil, Paxil CR, Pexeva)

Paroxetine is the least stimulating SSRI. This agent is a potent selective inhibitor of neuronal serotonin reuptake. Paroxetine also has a very weak effect on norepinephrine and dopamine neuronal reuptake. It does not significantly bind to muscarinic, alpha-adrenergic, or histamine receptors and therefore has fewer adverse effects than do tricyclic antidepressants (TCAs).

Sertraline (Zoloft)

Sertraline selectively inhibits presynaptic serotonin reuptake. It also has a very weak inhibitory effect on norepinephrine and dopamine neuronal reuptake.

Fluvoxamine (Luvox, Luvox CR)

Fluvoxamine is a potent selective inhibitor of neuronal serotonin reuptake. It does not significantly bind to alpha-adrenergic, histamine, or cholinergic receptors and therefore has fewer adverse effects than do tricyclic antidepressants.

Citalopram (Celexa)

Citalopram enhances serotonin activity due to selective reuptake inhibition at the neuronal membrane. SSRIs are the antidepressants of choice due to minimal anticholinergic effects.

Escitalopram (Lexapro)

Escitalopram is an SSRI and an S-enantiomer of citalopram. Its mechanism of action is thought to be potentiation of serotonergic activity in the CNS resulting from the inhibition of CNS neuronal reuptake of serotonin.


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