Two primary outcomes of efficacy and acceptability showed a possible advantage of benzodiazepines over placebo .
Low- quality evidence shows a possible superiority of benzodiazepine over placebo in the short-term treatment of panic disorders .
Due to these limitations , our results regarding the efficacy of benzodiazepines versus placebo provide only limited guidance for clinical practice .
BACKGROUND Panic disorder is characterised by recurrent unexpected panic attacks consisting of a wave of intense fear that reaches a peak within a few minutes .
Panic disorder is a common disorder , with an estimated lifetime prevalence of 1 % to 5 % in the general population and a 7 % to 10 % prevalence in primary care setting s. Its aetiology is not fully understood and is probably heterogeneous .
Panic disorder is treated with psychological and pharmacological interventions , often used in combination .
Although benzodiazepines are frequently used in the treatment of panic disorder , guidelines recommend antidepressants , mainly selective serotonin reuptake inhibitors ( SSRIs ) , as first-line treatment for panic disorder , particularly due to their lower incidence of dependence and withdrawal reaction when compared to benzodiazepines .
Despite these recommendations , benzodiazepines are widely used in the treatment of panic disorder , probably because of their rapid onset of action .
OBJECTIVES To assess the efficacy and acceptability of benzodiazepines versus placebo in the treatment of panic disorder with or without agoraphobia in adults .
The effects of clonazepam on quality of life and work productivity in panic disorder.
Although panic disorder has been associated with impaired quality of life ( QOL ) and financial dependence , no prior study has examined whether a clinical intervention will improve these outcomes . This study examines the effects of clinical ly titrated doses of clonazepam versus placebo on QOL and work productivity ( WP ) in patients with panic disorder .  QOL and WP were measured in conjunction with a r and omized , double-blind , placebo-controlled trial . The Medical Outcomes Study 36-Item Short Form Health Survey ( SF-36 ) and Work Productivity and Impairment question naire were used to assess QOL and WP , respectively . Baseline assessment s were obtained before r and omizing patients to receive clinical ly titrated doses of clonazepam or placebo . Follow-up assessment s were obtained after 6 weeks of therapy with the test drug or at premature termination from the study . Improvement on the SF-36 Mental Health Component Summary scale was more than twice as great with clonazepam than with placebo ( P = 0.03 ) . Clonazepam patients improved ( P < 0.05 ) on all five measures of mental health-related QOL , and both measures of physical health-related QOL , and both measures of WP .  Placebo patients improved on three of five measures of mental health-related QOL , but on no other measures . Patients with marked improvements on clinical measures of  panic disorder severity , especially avoidance and fear of the main phobia , showed the greatest gains on the SF-36 Mental Health Component Summary scale . Clinical ly titrated doses of clonazepam significantly improved mental health-related QOL and WP in panic disorder patients . Lesser improvements were obtained with placebo
Two primary outcomes of efficacy and acceptability showed a possible advantage of benzodiazepines over placebo .
Low- quality evidence shows a possible superiority of benzodiazepine over placebo in the short-term treatment of panic disorders .
Due to these limitations , our results regarding the efficacy of benzodiazepines versus placebo provide only limited guidance for clinical practice .
BACKGROUND Panic disorder is characterised by recurrent unexpected panic attacks consisting of a wave of intense fear that reaches a peak within a few minutes .
Panic disorder is a common disorder , with an estimated lifetime prevalence of 1 % to 5 % in the general population and a 7 % to 10 % prevalence in primary care setting s. Its aetiology is not fully understood and is probably heterogeneous .
Panic disorder is treated with psychological and pharmacological interventions , often used in combination .
Although benzodiazepines are frequently used in the treatment of panic disorder , guidelines recommend antidepressants , mainly selective serotonin reuptake inhibitors ( SSRIs ) , as first-line treatment for panic disorder , particularly due to their lower incidence of dependence and withdrawal reaction when compared to benzodiazepines .
Despite these recommendations , benzodiazepines are widely used in the treatment of panic disorder , probably because of their rapid onset of action .
OBJECTIVES To assess the efficacy and acceptability of benzodiazepines versus placebo in the treatment of panic disorder with or without agoraphobia in adults .