Use of benzodiazepines in panic disorder.

Over the past 15 years, benzodiazepines have been used successfully to treat panic disorder with agoraphobia, but not without some controversy. Efficacy and side effect data from the principal benzodiazepine outcome studies of panic disorder demonstrate that alprazolam, lorazepam, and clonazepam are all clinically effective. Clonazepam has several advantages over other benzodiazepines and can be considered a first-line agent for panic disorder. Benzodiazepines in general are therapeutically effective for a broad range of panic disorder symptoms. Their effect is rapid and maintained without dose increase over a 7- to 8-month period. Discontinuation-related difficulties can occur in a considerable number of patients, but these can be decreased in several ways.