Panic Disorder

Treatment

Treatment of panic disorder involves a combination of

• patient education,
• behavior therapy (exposure with response prevention), and
• medication.

Patients need to understand their condition and receive reassurance that they are not "going crazy" and that their condition can be managed. Because they may have received some explanation that their symptoms are caused by a medical disease, they need to be educated about panic disorder and accept their new diagnosis.

Exposure with response prevention is a very effective behavior therapy for people with panic disorder. In this treatment, the patient (1) is exposed to a situation that causes panic and then (2) learns to "ride out" the panic until the attack passes. This behavior therapy works best if the patient is not taking tranquilizers because tranquilizers can prevent the experience of anxiety.

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Relaxation therapy and progressive desensitization are other behavior therapies that are used. There is not much evidence, however, that they effectively treat panic disorder.

Antidepressant medications (e.g., paroxitene [Paxil®]) may be used to help reduce the occurrence of panic attacks. Benzodiazepines may help reduce anticipatory anxiety and panic attack symptoms.

Psychotherapy is rarely used to treat panic disorder, but may be useful in helping the person readjust socially as other treatments begin to take effect.

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