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Panic Disorder

Jay Winner, FAAFP, MD Reviewed 06/2022
 


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 atta...

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

Combined antidepressant therapy and psychotherapy is superior to either alone during initial treatment for panic disorder (3)[A]. Most effective therapy includes cognitive-behavioral therap...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Full therapeutic effect of antidepressants often does not occur until 4-6 weeks. Monitor (usually within 1-2 weeks) for suicidal ideation when starting antidepres...

REFERENCES

1
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders . 5th ed. Arlington, VA: Amer...

SEE ALSO

Algorithm: Anxiety 

CODES

ICD10

  • F41.0 Panic disorder [episodic paroxysmal anxiety]

SNOMED

  • 371631005 Panic disorder

  • 35607004 Panic disorder with agoraphobia

  • 56576003 Panic disorder without agoraphobia

  • 417676004 O/E - panic atta...

CLINICAL PEARLS

Evaluate a patient with panic for suicidality because patients with panic disorder are at increased risk for suicide, particularly if depressed. 

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