| Abstract: | Three drugs are currently licensed for the treatment of panic disorder: the benzodiazepine, alprazolam; the tricyclic antidepressant, clomipramine; and, most recently, the selective serotonin reuptake inhibitor, paroxetine. Alprazolam and clomipramine are effective in the treatment of panic disorder, but are less than ideal agents due to their tolerability profiles. An extensive clinical trial programme has been undertaken to investigate the efficacy and tolerability of paroxetine treatment in panic disorder. This article reviews the clinical evidence for the short- and long-term efficacy and tolerability of paroxetine in panic disorder, and its effect on relapse prevention and on quality of life. The results from the short-term studies indicate that paroxetine is effective in treating panic disorder (with or without agoraphobia) either alone or in combination with cognitive-behavioural therapy. The minimum effective dose is 40 mg daily. Paroxetine was equally as effective as clomipramine in reducing the frequency of panic attacks but produced an earlier improvement in symptomatology. Continued treatment with paroxetine over periods of up to 9 months provided evidence that paroxetine maintained its anti-panic effect and prevented relapse. Paroxetine was well-tolerated during both the short- and long-term studies at doses of up to 60 mg per day. © 1997 John Wiley & Sons, Ltd. |
