Table 2.

Selective Serotonin Reuptake Inhibitor and Serotonin Norepinephrine Reuptake Inhibitor Antidepressant Options

Medication	Anziolytic Efficacy^*	Advantages	Disadvantages
Fluoxetine	Panic,^† PTSD^*	Generic available; long half life (no withdrawal)	Most stimulating; longer half life
Paroxetine	Panic,^† GAD,^† SAD,^† PTSD^†	Generic available; most extensively studied across these anxiety disorders; least stimulating; no P450 3A4 effects	Most sedating; shorter half life and worse withdrawal
Sertraline	Panic,^† GAD,^* SAD,^† PTSD^†	Well-studied across these 4 anxiety disorders; least P4502D6 effects; minimal P4503A4 effects; intermediate half life (less withdrawal)	Most diarrhea
Citalopram	Panic^*	Generic available; no P450 effects
Escitalopram	Panic,^* GAD,^† SAD^*	No P450 effects
Venlafaxine ER	Panic,^† GAD,^† SAD,^† PTSD	No P450 effects, pain effects	Short half life; withdrawal with missed dose or sudden discontinuation; increased blood pressure at >225 mg
Duloxetine	GAD^†	Pain effects	Unclear efficacy for other anxiety disorders; more stimulating

↵* Randomized controlled trials but no Food and Drug Administration-approved indication.
↵† Food and Drug Administration-approved indication as of January 2006.
GAD, generalized anxiety disorder; PTSD, posttraumatic stress disorder; SAD, social anxiety disorder.