The Long-Term Treatment of Panic Disorder

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.