The value of selective serotonin re-uptake inhibitors (SSRIs) in the treatment of panic disorder with and without agoraphobia.

Many promising medical and psychotherapeutic treatment approaches have been developed for panic disorder with or without agoraphobia in recent years. Previously, good results have been seen with the TCAs (imipramine, clomipramine) and alprazolam. This review represents a comprehensive survey of all existing studies of the efficacy of the selective serotonin re-uptake inhibitors (SSRIs) paroxetine and fluvoxamine. There is conclusive evidence that the effectiveness of these drugs-paroxetine in particular-can be regarded as proven. Moreover, there are indications that a quicker response and better tolerability can be achieved than with TCA. A phased therapy model demonstrates how SSRIs can amplify and therefore improve the treatment of panic disorder. Reference is also made to differential indications with regard to the severity and the duration of the disorder. (Int J Psych Clin Pract 1997; 1: 59-67).