Microsoft word - selective_serotonin_reuptake_inhibitors_for_panic_disorder.docx

Selective Serotonin Reuptake Inhibitors
(SSRIs) for Panic Disorder
For more information, go to: and click on "Find a Health Banks Physician" to find patient education from your physician. Examples Fluoxetine hydrochloride Prozac sertraline hydrochloride Zoloft paroxetine hydrochloride Paxil CR fluvoxamine maleate luvox How It Works Selective serotonin reuptake inhibitors (SSRIs) affect brain chemicals (neurotransmitters) and reduce the number and severity of panic attacks associated with panic disorder. SSRIs are also used to treat depression. Paxil CR is a controlled-release tablet recently approved by the U.S. Food and Drug Administration (FDA) for the treatment of panic disorder. Its unique chemical makeup allows it to release small amounts of a single dose of the medication over time, which may help keep serotonin levels more steady. Why It Is Used SSRIs are used to reduce the number and severity of panic attacks. How Well It Works SSRIs reduce the severity and number of panic attacks as well as anxiety related to anticipating a panic attack. Side Effects Side effects of SSRIs include: • Dry mouth. • Headache. • Nausea, loss of appetite, diarrhea. • Feeling irritable or anxious. • Problems sleeping. • Drowsiness. • Loss of sexual desire or ability. • Tremor or shaky hands. FDA Advisory. The US Food and Drug Administration (FDA) have issued an advisory to patients, families, and health care providers to closely monitor adults and children taking antidepressants for signs of suicide. This is especially important at the beginning of treatment or when doses are changed. The FDA also advises that patients be observed for increases in anxiety, panic attacks, agitation, irritability, insomnia, impulsivity, hostility, and mania. It is most important to watch for these behaviors in children who may be less able to control their impulsivity as much as adults and therefore may be at greater risk for suicidal impulses. The FDA has not recommended that people stop using antidepressants, but simply to monitor those taking the medications and, if concerns arise, to contact a health professional.
What to Think About
SSRIs usually are started at low doses and increased gradually.
They may take several weeks to start working. If you experience
side effects that won't go away, (such as sexual dysfunction), your
doctor may change your medication or combine it with another
medication to help reduce such side effects.
Never suddenly stop taking antidepressants. The use of any
antidepressant should be tapered off slowly and only under the
supervision of a doctor. Abruptly stopping antidepressant
medications can cause negative side effects or a relapse into a
depressive episode or panic disorder.
SSRIs generally have fewer side effects than tricyclic
antidepressants, which also are used to treat panic attacks. SSRIs
also are safer than tricyclic antidepressants in case of overdose,
which makes SSRIs a better treatment choice for people with thoughts
of suicide.
People with liver disease usually require lower doses of SSRIs.
SSRIs are also used to treat depression. SSRIs alone are not
commonly used if you have episodes of mania.
For more information on selective serotonin reuptake inhibitors, see
Drug Reference. (Drug Reference is not available in all systems.)

Kumar S, Oakley-Browne M (2002). Panic disorder. Clinical
Evidence, (7): 906-91
Medical Review: Terry Golden, DO - Family Practice


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