Which pharmacologic class is first-line for panic disorder?

Which pharmacologic class is first-line for panic disorder?

• A. Selective Serotonin Reuptake Inhibitor
• B. Serotonin-Norepinephrine Reuptake Inhibitor
• C. Benzodiazepine
• D. Tricyclic Antidepressant

Answer: (A)

Selective serotonin reuptake inhibitors are first-line for panic disorder. They gradually reduce the frequency and intensity of panic attacks and the associated anticipatory anxiety, and they do so with a favorable safety and tolerability profile compared with older antidepressants. Although they take a few weeks to work, their favorable risk-benefit balance supports their use as the initial pharmacologic choice. Benzodiazepines can provide rapid relief but carry risks of dependence, withdrawal, and cognitive side effects with long-term use, so they’re not preferred as the starting monotherapy. Tricyclic antidepressants and MAO inhibitors are effective but have more adverse effects and safety concerns, making them less favored as first-line options. Some guidelines also consider SNRIs as alternatives, but SSRIs remain the standard first choice.

Selective serotonin reuptake inhibitors are first-line for panic disorder. They gradually reduce the frequency and intensity of panic attacks and the associated anticipatory anxiety, and they do so with a favorable safety and tolerability profile compared with older antidepressants. Although they take a few weeks to work, their favorable risk-benefit balance supports their use as the initial pharmacologic choice.

Benzodiazepines can provide rapid relief but carry risks of dependence, withdrawal, and cognitive side effects with long-term use, so they’re not preferred as the starting monotherapy. Tricyclic antidepressants and MAO inhibitors are effective but have more adverse effects and safety concerns, making them less favored as first-line options. Some guidelines also consider SNRIs as alternatives, but SSRIs remain the standard first choice.