Panic attacks have an estimated lifetime prevalence of 15% ( Eaton et al 1994). Panic disorder is a chronic, recurrent illness associated with substantial functional impairment and cost to the individual and society. This paper will review the current evidence for clinical efficacy, safety, tolerability, and quality of life improvements with venlafaxine XR in the short and long-term treatment of panic disorder. Recently, venlafaxine XR has been approved for use in the treatment of panic disorder in a number of countries. Exposure helps to eliminate the anticipatory anxiety and agoraphobic avoidance, which are the most functionally disabling aspects of panic disorder with agoraphobia.Įfficacy, safety, and tolerability of venlafaxine extended release (XR) has been established for depression ( Smith et al 2002), generalized anxiety disorder ( Gelenberg et al 2000), and social anxiety disorder ( Allgulander et al 2004). Some form of exposure (individual or group CBT or self-help books) is essential to furthering the treatment response beyond cessation of panic attacks. Clearly, there remains room for improvement in the treatment of panic disorder.Ĭognitive behavioural therapy (CBT) is the other mainstay in the treatment of panic disorder.
In addition, follow-up studies of patients with panic disorder at 1 to 5 years after initiation of antidepressants or high potency benzodiazepines demonstrate that 40%–90% of patients remain at least somewhat symptomatic ( Noyes et al 1989 Nagy et al 1989, 1993).
#VENLAFAXINE ER FREE#
Treatment for panic disorder most often involves antidepressants, however, only about half of patients will become panic free on antidepressants alone ( Otto et al 2001 Bakker et al 2002). Panic disorder is a prevalent psychiatric disorder, which can significantly impact an individual’s emotional and functional wellbeing ( Sherbourne et al 1996 Roy-Byrne et al 2000 Ramage-Morin 2004 Kessler, Berglund, et al 2005 Kessler, Chiu, et al 2005). Importantly, venlafaxine XR significantly improved patient quality of life and functioning, and was generally well tolerated. Relapse rates were significantly reduced with ongoing venlafaxine XR treatment compared to switching to placebo (22% vs 50%, p≤0.001), in a 6 month study. In addition, venlafaxine XR has been shown to produce significantly higher response and remission rates than placebo. In 12-week trials, venlafaxine XR was significantly more effective than placebo in achieving a panic-free state (54%–70% vs 34%–48%, p≤0.05), and was as effective as paroxetine. Venlafaxine extended release (XR) was effective and well tolerated in both the short-term and long-term treatment of panic disorder. In fact, 40%–90% of patients in long-term follow-up studies in the late 1980s and early 1990s, treated with antidepressants or high potency benzodiazepines alone, remained somewhat symptomatic. It is associated with substantial functional impairment, and studies suggest that treatment with medication alone (and no instruction in exposure to feared and avoided situations) is less than optimal. Panic disorder is a chronic, recurrent illness, with a lifetime prevalence of about 5%.
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