THE LONG-TERM TREATMENT OF PANIC DISORDER

Panic disorder is a chronic and recurring condition,and there is there fore a need for long-term therapy. This paper reviews data from long-t erm studies of drug treatment for panic disorder to address issues of whether medication benefits persist, whether improvement can continue over several months or years, the tolerability of long-term treatment, patient selection for long-term treatment, and when and how to stop m edication. The main conclusion is that long-term drug treatment of pan ic disorder is necessary, effective, and safe. Serotonin selective reu ptake inhibitors offer benefits of ease of dosing, good tolerability, and no safety or dependence problems; TCAs are often poorly tolerated, and benzodiazepines are associated with dependence problems. Withdraw al from all types of medication should be considered, slow, planned, a nd individualized; some patients require an indefinite duration of tre atment.