Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2005;7(1):5-11.
doi: 10.4088/pcc.v07n0101.

The Role of High-Potency Benzodiazepines in the Treatment of Panic Disorder

Jeffrey Susman  1 , Brian Klee
Affiliations

The Role of High-Potency Benzodiazepines in the Treatment of Panic Disorder

Jeffrey Susman et al. Prim Care Companion J Clin Psychiatry. 2005.

Abstract

Medication plays a central role in the treatment of panic disorder, with the goal of eliminating panic attacks and restoring normal function (i.e., achieving full remission). Four drug classes have similar efficacy (tricyclic antidepressants, selective serotonin reuptake inhibitors [SSRIs], benzodiazepines, and monoamine oxidase inhibitors). Nonetheless, benzodiazepines remain the most prescribed medication for panic disorder in the United States. The high-potency benzodiaze-pines alprazolam (available as immediate- and extended-release tablets) and clonazepam (available as tablets and orally disintegrating wafers) are the only benzodiazepines approved by the U.S. Food and Drug Administration for the treatment of panic disorder. High-potency benzodiaze-pines, with their proven efficacy in panic disorder exerted through control of the central nervous system excitability by a selective and potent enhancement of inhibitory gamma-aminobutyric acid-mediated neurotransmission, are also a safe and well-tolerated option for potentiation of rapid treatment response when initiating treatment with SSRIs. Judicious use of high-potency benzodiazepines followed by a cautious taper and discontinuation may optimize the benefits and minimize any potential risk associated with this class of drugs.

PubMed Disclaimer

Figures

Figure 1.
Figure 1.
Mean Steady-State Plasma Concentrations After the Administration of Alprazolam XR 6 mg q.d. and Alprazolam IR 1.5 mg q.i.d.a
Figure 2.
Figure 2.
Mean Frequency of Panic Attacks at Endpoint (LOCF) Analysis Treated With Alprazolam XR Compared With Placeboa
Figure 3.
Figure 3.
Change in Panic Disorder Severity Scale (PDSS) Score During 12 Weeks of Treatment by Treatment Group (LOCF)a
See this image and copyright information in PMC

References

    1. Eaton WW, Kessler RC, and Wittchen HU. et al. Panic and panic disorder in the United States. Am J Psychiatry. 1994 151:413–420. - PubMed
    1. Roy-Byrne PP, Stang P, and Wittchen HU. et al. Lifetime panic-depression comorbidity in the National Comorbidity Survey: association with symptoms, impairment, course and help-seeking. Br J Psychiatry. 2000 176:229–235. - PubMed
    1. Birchall H, Brandon S, Taub N. Panic in a general practice population: prevalence, psychiatric comorbidity and associated disability. Soc Psychiatry Psychiatr Epidemiol. 2000;35:235–241. - PubMed
    1. Gorman JM, Kent JM, and Sullivan GM. et al. Neuroanatomical hypothesis of panic disorder, revised. Am J Psychiatry. 2000 157:493–505. - PubMed
    1. Horesh N, Amir M, and Kedem P. et al. Life events in childhood, adolescence and adulthood and the relationship to panic disorder. Acta Psychiatr Scand. 1997 96:373–378. - PubMed