Panic Disorder
Not yet clinically reviewed
This protocol was migrated from the earlier Pharmapedia and Ward Guide apps for educational use. Follow your hospital's own policies and consult seniors when in doubt.
Introduction
Panic disorder is a diagnostic entity of recent introduction. The essential feature is a sudden attack of anxiety in which physical symptoms predominate and accompanied by a fear of a serious consequence such as a heart attack.
Symptoms
Shortness of breath and smothering sensation 2. Choking 3. Palpitation and accelerated heart rate 4. Chest discomfort or pain 5. Sweating 6. Dizziness, unsteady feelings or faintness 7. Nausea, abdominal distress 8. Numbness, tingling sensation 9. Flushes or chills 10. Trembling 11. Fear of dying, going crazy or doing something uncontrolled 12. Depersonalisation or derealisation.
Treatment
- SSRI (Citalopram, Paroxetine, Sertraline)
- Tricyclic antidepressants (Imipramine, Clomipramine) and Clonazepam are used. The dosage depends on the clinical response and needs to be tailored. Alprazolam is also effective, but the propensity to induce dependence restricts its usage.
- Cognitive therapy is also found to be effective, the aim being to reduce fears of the physical effects of anxiety on the assumption that fears prolong the disease.