Relapse prevention in panic disorder with pharmacotherapy: where are we now?

<p>Relapse prevention in panic disorder with pharmacotherapy: where are we now?</p> <p>Introduction: A substantial number of patients with PD experience relapse after the discontinuation<br> of effective pharmacotherapy, leading to detrimental effects on the individuals and considerable<br> societal costs. This suggests the need to optimize pharmacotherapy to minimize relapse risk.<br> Area covered: The present systematic review examines randomized, double-blind, placebo-controlled<br> relapse prevention studies published over the last 20 years involving recommended medications. The<br> authors aim to provide an overview of this topic and evaluate whether recent advances were achieved.<br> Only seven studies were included, providing limited results. One-year maintenance pharmacotherapy<br> with constant doses had protective effects against relapse in patients who had previously exhibited<br> satisfactory responses to the same medication at the same doses. The duration of maintenance treatment<br> did not influence relapse risk. No data were available concerning the use of lower doses or the predictors<br> of relapse.<br> Expert opinion: Relapse prevention in PD has received limited attention. Recent progress and conclusive<br> indications are lacking. Rethinking pharmacological research in PD may be productive.<br> Collecting a wide range of clinical and individual features/biomarkers in large-scale, multicenter longterm<br> naturalistic studies, and implementing recent technological innovations (e.g., electronic medical<br> records/&lsquo;big data&rsquo; platforms, wearable devices, and machine learning techniques) may help identify<br> reliable predictive models.</p>