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Selective Serotonin Reuptake Inhibitors for Panic Disorder

Examples

Generic Name Brand Name
citalopram Celexa
fluoxetine Prozac
fluvoxamine Luvox
paroxetine Paxil
sertraline Zoloft

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.

Side Effects

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:

  • Usually the benefits of the medicine are more important than any minor side effects.
  • Side effects may go away after you take the medicine for a while.
  • If side effects still bother you and you wonder if you should keep taking the medicine, call your doctor. He or she may be able to lower your dose or change your medicine. Do not suddenly quit taking your medicine unless your doctor tells you to.

Call 911 or other emergency services right away if you have:

  • Trouble breathing.
  • Swelling of your face, lips, tongue, or throat.

Call your doctor if you have:

  • Hives.
  • Thoughts of suicide.
  • Agitation and restlessness.
  • Seizures.
  • Fast heartbeat.
  • Nausea and vomiting.

Common side effects of this medicine include:

  • Loss of sexual desire or ability.
  • Irritability.
  • Trouble sleeping or drowsiness.
  • Headache.
  • Changes in appetite.

FDA Advisories. The U.S. Food and Drug Administration (FDA) has issued:

  • An advisory on antidepressant medicines and the risk of suicide. Talk to your doctor about these possible side effects and the warning signs of suicide.
  • A warning about taking triptans, used for headaches, with SSRIs (selective serotonin reuptake inhibitors) or SNRIs (selective serotonin/norepinephrine reuptake inhibitors). Taking these medicines together can cause a very rare but serious condition called serotonin syndrome.

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.

Taking medicine

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.

Checkups

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.

Complete the new medication information form (PDF)new medication information form (PDF)(What is a PDF document?) to help you understand this medication.

Credits

By Healthwise Staff
Primary Medical Reviewer Anne C. Poinier, MD - Internal Medicine
Specialist Medical Reviewer Lisa S. Weinstock, MD - Psychiatry
Last Revised September 7, 2012

Last Revised: September 7, 2012

This information does not replace the advice of a doctor. Healthwise, Incorporated disclaims any warranty or liability for your use of this information. Your use of this information means that you agree to the Terms of Use. How this information was developed to help you make better health decisions.

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