Antidepressants versus placebo for panic disorder in adults

Panic disorder is common in the general population. It is characterised by panic attacks, periods of fear or anxiety with a rapid onset in which other characteristic symptoms are experienced (involving bodily systems and fearful thoughts). 

The treatment of panic disorder includes psychological and pharmacological interventions, often used in combination. Among pharmacological interventions, the standard treatment suggested by guidelines is different classes of antidepressants. Evidence for their effectiveness and acceptability is unclear. This featured review assesses the effects of antidepressants for panic disorder in adults.

What does the evidence from the review tell us?

The authors found evidence showing that antidepressants are better than placebo in terms of effectiveness and number of people leaving the study early. However, their findings also showed that antidepressants are less well tolerated than placebo, producing more dropouts due to adverse effects. Results are limited in the following ways: some studies were funded by pharmaceutical companies, and only short-term outcomes were assessed. The authors found almost no data on other clinically relevant outcomes, such as functioning and quality of life. The quality of the available evidence ranged from very low to high.

Read the review in the Cochrane Library