Saturday, 9 January 2021

Treatment Guidelines for Panic Disorder

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

  1. Alprazolam
  2. Clomipramine 
  3. Clonazepam
  4. Diazepam
  5. Imipramine
  6. Lorazepam
  7. Mirtazapine
  8. 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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