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Panic Disorder

Jay Winner, MD, FAAFP Reviewed 06/2020
 


BASICS

DESCRIPTION

  • A classic panic attack is characterized by rapid onset of a brief period of sympathetic nervous system hyperarousal accompanied by intense fear

  • In panic disorder, multiple panic attac...

DIAGNOSIS

  • Panic attack: an abrupt surge of intense fear, reaching a peak within minutes in which ≥4 of the following symptoms develop abruptly: (i) palpitations, pounding heart, or accelerated heart r...

TREATMENT

The two options are psychotherapy and medical therapy. Studies have shown that both have comparable results and neither has advantage over the other. Combined antidepressant therapy and psyc...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Full therapeutic effect of antidepressants often does not occur until 4–6 weeks of being at therapeutic dose. However, because of risk of suicidal ideation when s...

REFERENCES

1
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 5th ed. Arlington, VA: American Psychiatric Association; 2013.
2
Furukawa TA, Watanabe N, Churchill R...

ADDITIONAL READING

Chen MH, Tsai SJ. Treatment-resistant panic disorder: clinical significance, concept and management. Prog Neuropsychopharmacol Biol Psychiatry.  2016;70:219–226. 

SEE ALSO

Algori...

CODES

ICD10

  • F41.0 Panic disorder without agoraphobia

  • F40.01 Agoraphobia with panic disorder

  • F43.0 Acute stress reaction

ICD9

  • 300.01 Panic disorder without agoraphobia

  • 300.21 Agoraphobia with panic disorder

  • 3...

CLINICAL PEARLS

  • For medically stable patients, 10 minutes of vigorous aerobic exercise at onset of a panic attack often helps patient to feel safe during an attack.

  • Always evaluate a patient with panic...

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