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Approximately 17 to 25 percent of patients who present to emergency departments with chest pain meet the criteria for panic disorder. In addition, one in three patients with panic disorder is depressed, and one in five attempts suicide. There may also be substance abuse as well as an array of somatic and affective problems. Patients with panic disorder may be some of the most complicated and time-consuming patients in a primary care setting.
The American Family Physician Journal has published a review of Panic Disorder that assesses multiple evidence-based reviews of effective treatments for panic disorder. The article describes not only the pharmacology where the "choice of medication is based on side effect profiles and patient preferences," but it also outlines the strong evidence that supports the effectiveness of cognitive behavior therapy (CBT) in treating panic disorder. CBT can be used alone or in combination with antidepressants to treat patients with panic disorder. The review also discusses the role of benzodiazepines in treating panic disorder symptoms.
The article offers a brief overview of diagnostic criteria, a treatment algorithm, and description of the various treatment approaches including a table of currently used medications and approximate cost. Finally, the authors present a "Strength of Recommendation Taxonomy" (SORT) which offers a hierarchy of evidence that weighs the strength of clinical recommendations.
Am Fam Physician 2005;71:733-39,740
(PDF version)
Patient information handout
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