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  • Table 8 describes usual dosing for antidepressant and benzodiazepine pharmacotherapy for panic disorder. Important safety considerations are described in Table 9.

  • Because patients with panic disorder can be sensitive to medication side effects, low starting doses of SSRIs, SNRIs, and TCAs are recommended (approximately half of the starting doses given to depressed patients). The low dose is maintained for several days then gradually increased to a full therapeutic dose over subsequent days and as tolerated by the patient.

  • Underdosing of antidepressants (i.e., starting low and never reaching full therapeutic doses) is common in the treatment of panic disorder and is a frequent source of partial response or nonresponse.

  • When benzodiazepines are prescribed, a regular dosing schedule rather than a PRN ("as needed") schedule is preferred for patients with panic disorder. The goal is to prevent panic attacks rather than reduce symptoms once the attack has already occurred.

  • Patients are typically seen every 1–2 weeks when first starting a medication, then every 2–4 weeks until the dose is stabilized. After the dose is stabilized and symptoms have decreased, patients will most likely require less frequent visits.

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Table 8. Dosing of Antidepressants and Benzodiazepines for Panic Disorder

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Table Reference Number
Table 8. Dosing of Antidepressants and Benzodiazepines for Panic Disorder
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Table 9. Safety Considerations for Medications Used for Panic Disorder

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Table Reference Number
Table 9. Safety Considerations for Medications Used for Panic Disorder
Table Reference Number
Table 8. Dosing of Antidepressants and Benzodiazepines for Panic Disorder
Table Reference Number
Table 9. Safety Considerations for Medications Used for Panic Disorder

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