What first-line pharmacological treatments are recommended for adults with panic disorder?

Guideline-aligned answer with reasoning, red flags and references. Clinically reviewed by Dr Kola Tytler MBBS CertHE MBA MRCGP.

Posted: 14 August 2025 Guideline-Aligned (High Confidence) Clinically Reviewed
Dr Kola Tytler MBBS CertHE MBA MRCGPClinical Lead • iatroX

For adults with panic disorder, if pharmacological treatment is considered, antidepressants are the recommended intervention for longer-term management . The classes of antidepressants that have an evidence base for effectiveness include selective serotonin reuptake inhibitors (SSRIs), serotonin-noradrenaline reuptake inhibitors (SNRIs), and tricyclic antidepressants (TCAs) .

As of June 2020, specific antidepressants licensed for the treatment of panic disorder are escitalopram, sertraline, citalopram, paroxetine, and venlafaxine . When deciding which medication to offer, factors such as the person's age, previous treatment response, risks (including likelihood of overdose or self-harm), tolerability, potential drug interactions, and patient preference should be considered .

It is important to note that benzodiazepines, sedating antihistamines, and antipsychotics should not be prescribed for the treatment of panic disorder .

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