Non-Antidepressant Pharmacologic Long-Term Treatment of Panic Disorder

Introduction: Panic disorder (PD) is a common anxiety disorder. Despite neurophysiological advances, its pathogenesis is still not well elucidated. Although the recommended pharmacological agents have demonstrated efficacy and a rather acceptable tolerability, yet many patients do not respond fully and still suffer from residual symptoms. There is a need for new pharmacological classes with better tolerability and efficacy, and faster onset of action. The purpose of this review is to illustrate the existing non-antidepressant treatment of PD as well as the recent advances in the treatment of PD. Methods: 38 articles discussing pharmacological treatment of PD were selected for this review. They were mainly openlabel studies, case-reports and review articles. Results: We reviewed the studies on anticonvulsants, benzodiazepines, gamma amino butyric acid (GABAergic) products, atypical antipsychotics, clonidine, as well as emerging drugs in the treatment of PD such as metabotropic glutamate II agonists, and D-cycloserine. Conclusion: Although most of the drugs tested were proven effective and well tolerated, the studies on the nonconventional agents are restricted to open-label trials and case reports. Further studies are required to establish their efficacy and tolerability in the treatment of panic disorder.