*5.2.3 First-line pharmacotherapy of panic disorder*

SSRIs and venlafaxine should both be considered first-line agents for treatment of panic disorder. SSRIs and venlafaxine are effective in acute and long-term treatment, have an acceptable side effect profile and acceptable dropout rate [16, 48, 57].

TCAs may have a slower onset than SSRIs. In addition, TCAs have a less tolerable side effect profile than SSRIs given that they have more anticholinergic effects, and are generally less safe than SSRIs. Finally, reported dropout rates are higher for TCAs compared to SSRIs [5, 6, 62].

In summary, benzodiazepines as monotherapy should not be regarded as a firstline treatment in view of their side effect profile and in view of their lack of efficacy in treating comorbid conditions.
