Sertraline in the treatment of panic disorder

Abstract

Sertraline has been used as a treatment for anxiety disorders since the mid 1990s and has proven itself an effective, well-tolerated and economically viable treatment for panic disorder (PD) when used in the range of 50 to 175 mg per day. Numerous short- and long-term studies have demonstrated the efficacy of sertraline in the treatment of PD. In addition, in an 80-week relapse prevention trial, sertraline was found to reduce severity and frequency of panic attacks, baseline anxiety and to confer protection from relapse for up to 36 weeks following withdrawal from medication Data on sertraline as an alternative to tricyclic antidepressants and paroxetine in terms of tolerability is presented here. The efficacy of sertraline is shown to be comparable to cognitive behavioral therapy in one study and recent attempts at adjunctive therapy for PD with atypical antipsychotics are reviewed as well. Anxiety disorders constitute the most prevalent grouping of mental illnesses in the general population. Patients with panic disorder suffer a significant degree of medical comorbidity in addition to overlap with major depressive disorder, generalized anxiety disorder and somatization disorders. Further, PD patients experience a high degree of debility as measured by public assistance, emergency room and medical service utilization and suicide risk. Epidemiological data and studies linking significant decrease in medical, emergency service and laboratory utilization in PD patients taking sertraline are also presented. When reviewed in context with the efficacy trials, a compelling argument can be made for making sertraline a first choice among the serotonin reuptake inhibitors in the treatment of PD.