The Management of Panic Disorder

The evidence for benzodiazepines in panic disorder is compelling; along with the selective serotoninreuptake inhibitors (SSRIs), they are a standard treatment for panic and other anxiety disorders. However,extended-release formulations of these agents may prove to be as effective as the immediate-releaseformulations, and extended-release agents have clinical benefits that may make them moreattractive treatments than the currently available, shorter-acting benzodiazepines. Because of theirlonger duration of action, extended-release benzodiazepines can protect against breakthrough anxietyand need to be taken only once or twice a day, which may improve compliance in some patients. Becausethe other standard treatments of panic disorder, the SSRIs, have a slow onset of action, adding anextended-release benzodiazepine to the treatment regimen for the initial 6 to 8 weeks could serve as aneffective bridge until the desired SSRI effect is realized.