These drugs were better tolerated than tricyclics and benzodiazepines as they had a low risk of dependence and overdosing complications .
The serotonergic , noradrenergic and GABAergic pathways play a major role in the fear network and in the physiopathology of PD .
INTRODUCTION Panic disorder ( PD ) is a prevalent psychiatric disorder characterized by unexpected and recurrent panic attacks .
PD patients present significant psychosocial impairment and a high risk of psychiatric comorbidities and suicide .
PD should be treated effectively as soon as the symptoms emerge because the longer these patients remain without treatment , the worse the prognosis will be .
SSRIs and SNRIs are the first-line compounds in the treatment of PD .
The efficacy of reboxetine in the treatment-refractory patients with panic disorder: an open label study.
BACKGROUND AND OBJECTIVE Selective serotonin reuptake inhibitors ( SSRIs ) are currently the first-line treatment for panic disorder , although up to 30 % of patients either do not respond to SSRIs or withdraw due to adverse events . Reboxetine , a selective norepinephrine reuptake inhibitor ( selective NRI ) , is effective in treating depression and may alleviate depression-related anxiety . This study aim ed to investigate the efficacy of reboxetine in the treatment of patients with panic disorder who did not respond to SSRIs . METHOD In this 6-week , open-label study , 29 adult out patients with panic disorder who had previously failed to respond to SSRI treatment received reboxetine 2 mg/day , titrated to a maximum of 8 mg/day over the first 10 days .  Efficacy was assessed using the Panic Self- Question naire ( PSQ ) , the Hamilton Rating Scale for Anxiety ( HAM-A ) , the 17-item Hamilton Rating Scale for Depression ( HRSD ) and the Global Assessment of Functioning ( GAF ) Scale . RESULTS The 24 patients who completed the study responded well to reboxetine treatment . Significant improvement ( p < 0.001 ) was observed in the number of daily panic attacks , and on the scales measuring anxiety , depression and functioning . Reboxetine was generally well tolerated . Five patients withdrew due to  adverse events . CONCLUSIONS Reboxetine appears to be effective in the treatment of SSRI-refractory panic disorder patients and warrants further clinical investigation
These drugs were better tolerated than tricyclics and benzodiazepines as they had a low risk of dependence and overdosing complications .
The serotonergic , noradrenergic and GABAergic pathways play a major role in the fear network and in the physiopathology of PD .
INTRODUCTION Panic disorder ( PD ) is a prevalent psychiatric disorder characterized by unexpected and recurrent panic attacks .
PD patients present significant psychosocial impairment and a high risk of psychiatric comorbidities and suicide .
PD should be treated effectively as soon as the symptoms emerge because the longer these patients remain without treatment , the worse the prognosis will be .
SSRIs and SNRIs are the first-line compounds in the treatment of PD .