G. Ruffolo, G. Perugi - Vol. 8, March 2002, Issue 1
Testo Immagini
Bibliografia Summary Indice
Impiego delle benzodiazepine e degli SSRI
nel trattamento del Disturbo da Panico
Use of benzodiazepines in the treatment of Panic Disorders
The paper is a review of the literature on the utilization of Benzodiazepines
(BDZ) and Selective Serotonin Reuptake Inhibitors (SSRI) in the treatment of
Panic Disorder (PD). Both classes of drugs have been demonstrated effective
in blocking panic attacks, in improving anticipatory anxiety and avoidance behavior.
SSRI resulted effective also in the treatment of the frequently coexisting depressive
simptomatology. Although BDZ have been shown to display a rapid onset of the
anti-anxiety effect, resulting quite useful from the first days of treatment,
this drugs cannot be utilized in medium- and long-term treatment for the frequent
development of tolerance and dependence phenomena. Considering that SSRI are
generally well-tolerated and effective for both anxious and depressive symptomatology,
this compounds should be considered the first choice for the medium- and long-term
pharmacological treatment of PD. The few comparative studies conducted with
various SSRI did not report significant differences in terms of efficacy; however,
the various SSRI have shown several differences from the pharmacocinetic and
tolerability point of views. Among the SSRI, those with a more favourable side
effects profile should be utilized; moreover, in the elderly as well as in patients
who are taking other medications, the compound with less pharmachological interactions
should be preferred. For what concern long-term prophylactic treatments, it
should be given precedence to SSRI less liable to produce withdrawal symptom
after abrupt discontinuation.
