Treatment Guidelines for Panic Disorder

Drug of choice

SSRIs

Sertraline is recommended first-line per NICE Stepped Care Model

Second-line

MAOIs, Mirtazapine, Imipramine, Clomipramine, Venlafaxine

Experimental

Gabapentin, Inositol, Pindolol as augmentation

Psychotherapy

CBT, Anxiety management

Canadian Mood and Anxiety Network Guidelines

First-line

Citalopram
Escitalopram
Fluoxetine
Fluvoxamine
Paroxetine
Paroxetine CR
Sertraline
Venlafaxine XR

Second-Line

Alprazolam
Clomipramine
Clonazepam
Diazepam
Imipramine
Lorazepam
Mirtazapine
Reboxetine

Third-line

Bupropion SR, Divalproex, duloxetine, gabapentin, levetiracetam, milnacipran, moclobemide, olanzapine, phenelzine, quetiapine, risperidone, tranylcypromine

Adjunctive Therapy

Second-line: alprazolam ODT, clonazepam, Third-line: aripiprazole, Divalproex, olanzapine, pindolol, risperidone

Not Recommended

Buspirone, propranolol, tiagabine, trazodone

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