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Int. J. Mol. Sci. 2016, 17(4), 551; doi:10.3390/ijms17040551

Is There Room for Second-Generation Antipsychotics in the Pharmacotherapy of Panic Disorder? A Systematic Review Based on PRISMA Guidelines

Department of Clinical Neurosciences, Hermanas Hospitalarias, Villa San Benedetto Menni Hospital, FoRiPsi, via Roma 16, Albese con Cassano, 22032 Como, Italy
Department of Psychiatry and Neuropsychology, Faculty of Health, Medicine and Life Sciences, Maastricht University, 6200 Maastricht, The Netherlands
Department of Psychiatry and Behavioral Sciences, Leonard Miller School of Medicine, Miami University, Miami, FL 33136, USA
Child Psychopathology Unit, Scientific Institute, IRCCS Eugenio Medea, Bosisio Parini, 23842 Lecco, Italy
Author to whom correspondence should be addressed.
Academic Editor: Domenico De Berardis
Received: 23 February 2016 / Revised: 31 March 2016 / Accepted: 6 April 2016 / Published: 13 April 2016
(This article belongs to the Special Issue Antipsychotics)
View Full-Text   |   Download PDF [636 KB, uploaded 25 April 2016]   |  


A role for second-generation antipsychotics (SGAs) in the treatment of panic disorders (PD) has been proposed, but the actual usefulness of SGAs in this disorder is unclear. According to the PRISMA guidelines, we undertook an updated systematic review of all of the studies that have examined, in randomized controlled trials, the efficacy and tolerability of SGAs (as either monotherapy or augmentation) in the treatment of PD, with or without other comorbid psychiatric disorders. Studies until 31 December 2015 were identified through PubMed, PsycINFO, Embase, Cochrane Library and Clinical Among 210 studies, five were included (two involving patients with a principal diagnosis of PD and three involving patients with bipolar disorder with comorbid PD or generalized anxiety disorder). All were eight-week trials and involved treatments with quetiapine extended release, risperidone and ziprasidone. Overall, a general lack of efficacy of SGAs on panic symptoms was observed. Some preliminary indications of the antipanic effectiveness of risperidone are insufficient to support its use in PD, primarily due to major limitations of the study. However, several methodological limitations may have negatively affected all of these studies, decreasing the validity of the results and making it difficult to draw reliable conclusions. Except for ziprasidone, SGAs were well tolerated in these short-term trials. View Full-Text
Keywords: panic disorder; second-generation antipsychotics; quetiapine; risperidone; ziprasidone; bipolar disorder panic disorder; second-generation antipsychotics; quetiapine; risperidone; ziprasidone; bipolar disorder

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Perna, G.; Alessandra, A.; Raffaele, B.; Elisa, M.; Giuseppina, D.; Paolo, C.; Maria, N.; Daniela, C. Is There Room for Second-Generation Antipsychotics in the Pharmacotherapy of Panic Disorder? A Systematic Review Based on PRISMA Guidelines. Int. J. Mol. Sci. 2016, 17, 551.

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