Selective serotonin reuptake inhibitors for panic disorder
Examples
Generic Name Brand Name fluoxetine Prozac fluvoxamine maleate Luvox paroxetine Paxil sertraline Zoloft How It Works
Selective serotonin reuptake inhibitors (SSRIs) balance brain chemicals (neurotransmitters) by making more serotonin available, which reduces the number and severity of panic attacks associated with panic disorder.
Why It Is Used
SSRIs are frequently the first choice of medication for treating panic disorder and are effective in reducing the number and severity of panic attacks. SSRIs also are effective in reducing anxiety associated with panic attacks and are effective in treating depression and agoraphobia, both of which frequently occur with panic disorder.1
How Well It Works
SSRIs reduce the severity and number of panic attacks as well as anxiety related to anticipating a panic attack.2 It generally takes several weeks before an SSRI is fully effective, and some people may need to try more than one before they find one that works.
Side Effects
Side effects of SSRIs include:
- Dry mouth.
- Headache.
- Nausea, loss of appetite, and diarrhea.
- Feeling irritable or anxious.
- Problems sleeping.
- Drowsiness.
- Loss of sexual desire or ability.
- Tremor or shaky hands.
- Weight gain.
Health Canada and U.S. FDA Advisories. Health Canada and the U.S. Food and Drug Administration (FDA) have issued:
- Advisories on antidepressant medicines and the risk of suicide in children and adults. It is not recommended that people stop using these medicines. Instead, a person taking antidepressants should be watched for warning signs of suicide. This is especially important at the beginning of treatment or when doses are changed.
- Warnings about the antidepressants Paxil and Paxil CR and birth defects. Taking these medicines in the first 12 weeks of pregnancy may increase your chance of having a baby with a birth defect.
- A warning about taking triptans, used for migraines, with SSRIs (selective serotonin reuptake inhibitors) or SNRIs (selective serotonin/norepinephrine reuptake inhibitors). Taking these medicines together can cause a serious condition called serotonin syndrome.
See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)
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 who have 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, such as in bipolar disorder.
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| Author: | Douglas Dana Sabra L. Katz-Wise Ralph Poore | Last Updated: January 11, 2007 |
| Medical Review: | Adam Husney, MD - Family Medicine Andrew Swan, MD, CCFP, FCFP - Family Medicine Lisa S. Weinstock, MD - Psychiatry | |
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| Topic Contents | |
| Examples | |
| How It Works | |
| Why It Is Used | |
| How Well It Works | |
| Side Effects | |
| What To Think About | |
| References | |