The role of high-potency benzodiazepines in the treatment of panic disorder

Jeffrey Susman, Brian Klee

Research output: Contribution to journalReview articlepeer-review

38 Scopus citations


Medication plays a central role in the treatment of panic disorder, with the goal of eliminating panic attacks and restoring normal function (i.e., achieving full remission). Four drug classes have similar efficacy (tricyclic antidepressants, selective serotonin reuptake inhibitors [SSRIs], benzodiazepines, and monoamine oxidase inhibitors). Nonetheless, benzodiazepines remain the most prescribed medication for panic disorder in the United States. The high-potency benzodiazepines alprazolam (available as immediate- and extended-release tablets) and clonazepam (available as tablets and orally disintegrating wafers) are the only benzodiazepines approved by the U.S. Food and Drug Administration for the treatment of panic disorder. High-potency benzodiazepines, with their proven efficacy in panic disorder exerted through control of the central nervous system excitability by a selective and potent enhancement of inhibitory γ-aminobutyric acid-mediated neurotransmission, are also a safe and well-tolerated option for potentiation of rapid treatment response when initiating treatment with SSRIs. Judicious use of high-potency benzodiazepines followed by a cautious taper and discontinuation may optimize the benefits and minimize any potential risk associated with this class of drugs.

Original languageEnglish (US)
Pages (from-to)5-11
Number of pages7
JournalPrimary Care Companion to the Journal of Clinical Psychiatry
Issue number1
StatePublished - 2005
Externally publishedYes

ASJC Scopus subject areas

  • Psychiatry and Mental health


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