The Successful Use of Meclizine in Panic Disorder

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Sir: A variety of pharmacologic treatments have been recommended in panic disorder, including the selective serotonin reuptake inhibitors (SSRIs), tricyclic antidepressants, benzodiazepines, and monoamine oxidase inhibitors.¹ This does not exclude the effectiveness of other medications (e.g., venlafaxine, gabapentin) that may not have been formally studied for the disorder. Meclizine, an H1 receptor antagonist, has not undergone empirical study as a pharmacologic intervention in panic disorder, although Jacob2 indicates its potential effectiveness among individuals with both panic disorder and vestibular symptoms. We present the case of a female patient, seen in a primary care setting, who had been treated with the traditional pharmacotherapies for panic disorder (SSRIs, tricyclic antidepressants, benzodiazepines), but responded well only to meclizine.