Table 2.

Selective Serotonin Reuptake Inhibitor and Serotonin Norepinephrine Reuptake Inhibitor Antidepressant Options

MedicationAnziolytic Efficacy*AdvantagesDisadvantages
FluoxetinePanic, PTSD*Generic available; long half life (no withdrawal)Most stimulating; longer half life
ParoxetinePanic, GAD, SAD, PTSDGeneric available; most extensively studied across these anxiety disorders; least stimulating; no P450 3A4 effectsMost sedating; shorter half life and worse withdrawal
SertralinePanic, GAD,* SAD, PTSDWell-studied across these 4 anxiety disorders; least P4502D6 effects; minimal P4503A4 effects; intermediate half life (less withdrawal)Most diarrhea
CitalopramPanic*Generic available; no P450 effects
EscitalopramPanic,* GAD, SAD*No P450 effects
Venlafaxine ERPanic, GAD, SAD, PTSDNo P450 effects, pain effectsShort half life; withdrawal with missed dose or sudden discontinuation; increased blood pressure at >225 mg
DuloxetineGADPain effectsUnclear 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.