Selective Serotonin Reuptake Inhibitors for Panic Disorder
How It Works
Selective serotonin reuptake inhibitors (SSRIs) balance brain chemicals (neurotransmitters) by making more serotonin available. This reduces the number and severity of panic attacks associated with panic disorder.
Why It Is Used
SSRIs are frequently the first choice of medicine for treating panic disorder and are effective in reducing the number and severity of panic attacks. SSRIs help to reduce anxiety, symptoms of depression, and agoraphobia.
How Well It Works
SSRIs reduce the severity and number of panic attacks as well as anxiety related to anticipating a panic attack. You may start to feel better 1 to 3 weeks after you start taking an SSRI. But it can take as many as 6 to 8 weeks to see more improvement. If you have questions or concerns about your medicines, or if you do not notice any improvement by 3 weeks, talk to your doctor.
All medicines have side effects. But many people don't feel the side effects, or they are able to deal with them. Ask your pharmacist about the side effects of each medicine you take. Side effects are also listed in the information that comes with your medicine.
Here are some important things to think about:
Call your doctor if you have:
Common side effects of this medicine include:
FDA Advisories. The U.S. Food and Drug Administration (FDA) has issued:
See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)
What To Think About
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 medicine can cause negative side effects or a relapse into a depressive episode or panic disorder.
SSRIs can be safer than tricyclic or tetracyclic antidepressants, because they do not cause death if taken in large quantities (overdose). SSRIs usually are well tolerated and effective. SSRIs also may be safer for older adults, because the side effects are more tolerable.
People with liver disease usually require lower doses of SSRIs.
Daily use of SSRIs may increase the risk of bone fracture in adults over age 50. Talk to your doctor about this risk before taking an SSRI.
Many medicines can interact with SSRIs, such as nonsteroidal anti-inflammatory drugs (NSAIDs) including aspirin, ibuprofen, or naproxen, which can increase bleeding or bruising. Be sure your doctors know all of the medicines that you take. This includes prescription medicine, over-the-counter medicine, vitamins, supplements, and herbal remedies.
Some people may have sexual dysfunction while taking an SSRI.
Medicine is one of the many tools your doctor has to treat a health problem. Taking medicine as your doctor suggests will improve your health and may prevent future problems. If you don't take your medicines properly, you may be putting your health (and perhaps your life) at risk.
There are many reasons why people have trouble taking their medicine. But in most cases, there is something you can do. For suggestions on how to work around common problems, see the topic Taking Medicines as Prescribed.
Advice for women
Women who take an SSRI during pregnancy have a slightly higher chance of having a baby with birth defects. If you are pregnant, you and your doctor must weigh the risks of taking an SSRI against the risks of not treating your panic disorder.
Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.
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