Panic Disorder Treatment

Question 1

First-line treatments for PAD

Answer 1

ADs!

Question 2

How should you dose ADs in treatment of PAD

Answer 2

1/2 the dose you would give compared to MDD treatment

Question 3

FDA-approved SSRIs for PAD

Answer 3

fluoxetine, paroxetine, sertraline

Question 4

FDA-approved SNRI for PAD

Answer 4

venlafaxine XR

Question 5

Recommended length of treatment with ADs for PAD

Answer 5

12-24 months is recommended before gradual drug D/C

Question 6

How long should you taper an AD over when D/C’ing for PAD?

Answer 6

4-6 months

Question 7

How long does it take for ADs to work in PAD?

Answer 7

8-12 weeks for full effect, may take 4 weeks for “anti-panic” effect

Question 8

Meds used for panic symptoms (best to worst)

Answer 8

venlafaxine > fluoxetine > citalopram > fluvoxamine > fluoxetine > paroxetine

(This is from the Canadian guidelines)

Question 9

Meds used for anxiety symptoms (best to worst)

Answer 9

mirtazapine > venlafaxine > citalopram > fluvoxamine > fluoxetine > paroxetine

(This is from the Canadian guidelines)

Question 10

PAD treatment in children and the elderly

Answer 10

SSRIs are best choice, benzos are second line due to disinhibition and increased risk of falls/hip fractures in the elderly