What first-line pharmacological treatments are recommended for adults with panic disorder?

For adults with panic disorder, if pharmacological treatment is considered, antidepressants are the recommended intervention for longer-term management ¹. The classes of antidepressants that have an evidence base for effectiveness include selective serotonin reuptake inhibitors (SSRIs), serotonin-noradrenaline reuptake inhibitors (SNRIs), and tricyclic antidepressants (TCAs) ¹.

As of June 2020, specific antidepressants licensed for the treatment of panic disorder are escitalopram, sertraline, citalopram, paroxetine, and venlafaxine ¹. When deciding which medication to offer, factors such as the person's age, previous treatment response, risks (including likelihood of overdose or self-harm), tolerability, potential drug interactions, and patient preference should be considered ¹.

It is important to note that benzodiazepines, sedating antihistamines, and antipsychotics should not be prescribed for the treatment of panic disorder ¹.