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Benzodiazepines in Panic Disorder

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Panic Disorder

Abstract

Benzodiazepines are efficacious and well tolerated in clinical use. Besides the anxiolytic effects, they present sedative, muscle relaxant and anticonvulsive properties. Concerns regarding their use rely on drug dependence after prolonged used and difficult to manage withdrawal symptoms during drug discontinuation. Studies show that treatment duration up to 12 weeks is insufficient to reach maximal possible therapeutic effect and relapse during or shortly after drug discontinuation is frequent. Rebound and intolerable adverse events during drug discontinuation can be avoided in most cases if the dose is slowly down titrated in small decrements over a prolonged period of time. Most recent treatment guidelines recommend selective serotonin reuptake inhibitors (SSRI) as the first choice for the treatment of PD and the benzodiazepines have the reputation to cause dependence, especially if they are taken for long-term and in high doses. However these recommendations are mainly based on expert opinions mainly supported by a large number of clinical trials with SSRI since evidence coming from direct drug comparisons in PD is sparse. The SSRI have side effects and need a gradual tapering out too. There is no doubt that every substance must be prescribed with clinical concerns and indications. The benzodiazepines are efficacious in PD and the physician can manage the concern about dependence and withdrawal. It is very important to include this class of drugs in the armamentarium for treating PD.

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Authors and Affiliations

  1. Private Practice, Basel, Switzerland

    Roman Amrein

  2. Laboratory of Panic and Respiration, Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil

    Roman Amrein, Michelle Levitan, Rafael Christophe R. Freire & Antonio E. Nardi

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  1. Roman Amrein
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  2. Michelle Levitan
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  3. Rafael Christophe R. Freire
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  4. Antonio E. Nardi
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Correspondence to Rafael Christophe R. Freire .

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Editors and Affiliations

  1. Laboratory of Panic and Respiration, Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil

    Antonio Egidio Nardi

  2. Laboratory of Panic and Respiration, Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil

    Rafael Christophe R. Freire

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Amrein, R., Levitan, M., Freire, R.C.R., Nardi, A.E. (2016). Benzodiazepines in Panic Disorder. In: Nardi, A., Freire, R. (eds) Panic Disorder. Springer, Cham. https://doi.org/10.1007/978-3-319-12538-1_16

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  • DOI: https://doi.org/10.1007/978-3-319-12538-1_16

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