Venlafaxine extended release (XR) in the treatment of panic disorder

Panic disorder is a chronic, recurrent illness, with a lifetime prevalence of about 5%. 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. 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. Venlafaxine extended release (XR) was effective and well tolerated in both the short-term and long-term treatment of panic disorder. 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. In addition, venlafaxine XR has been shown to produce significantly higher response and remission rates than placebo. 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. Importantly, venlafaxine XR significantly improved patient quality of life and functioning, and was generally well tolerated.