Treatment of panic disorder

Abstract

Panic disorder consists of recurrent, disabling attacks of panic. It is frequently complicated by agoraphobia and other anxiety disorders or depression. Panic disorder differs from an isolated panic attack, both clinically and in treatment. Many patients respond to a combination of lifestyle change, especially control of caffeine and alcohol use, and cognitive behaviour therapy. For panic disorder, high potency benzodiazepines are effective for acute and long-term treatment, but have the disadvantages of sedation, drug interactions and discontinuation problems. For long-term treatment, imipramine is effective, but a lack of tolerability substantially limits its use. Most new antidepressants are probably effective for panic disorder, but few have been approved for this indication.