The potential role of atypical antipsychotics in the treatment of panic disorder.

OBJECTIVE: Many studies have investigated the efficacy and tolerability of alternative pharmacotherapy for panic disorder. This study aims to provide a comprehensive review of the existing literature regarding the efficacy and tolerability of atypical antipsychotics for panic disorder.

METHODS: We searched for relevant published articles using Medline, the Cochrane database, and EMBASE on 19 June 2013. Prospective studies that examined the efficacy and tolerability of atypical antipsychotics in the treatment of primary panic disorder or comorbid panic disorder (or symptoms) in other psychiatric disorders were included in this review.

RESULTS: Seven prospective studies were included in this review. Among these, four were open-label studies for refractory panic disorder. Two of the seven included studies were randomized controlled trials among patients with panic symptoms comorbid with bipolar disorder. The remaining study was a randomized controlled trial for panic disorder or panic attack comorbid with major depression. Except one negative risperidone study, the reviewed studies showed the favorable efficacy results of atypical antipsychotics.

CONCLUSIONS: Although the majority of the evidence regarding the efficacy of atypical antipsychotics in the treatment of panic disorder comes from small, open-label studies, this review suggests the potential role of atypical antipsychotics in treating panic disorder.