Materiały źródłowe

• #1 Panic Attacks & Panic Disorder: Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/4451-panic-attack-panic-disorder

  Panic attacks are sudden, intense feelings of fear that cause physical symptoms like a racing heart, fast breathing and sweating. […] Therapy and medications can treat panic attacks and panic disorder. […] Psychotherapy, medications or a combination of both are very effective in treating panic attacks and panic disorder. How long youll need treatment depends on the severity of the condition and how well you respond to treatment. […] Specific types of psychotherapy that can help with panic attacks and panic disorder include: […] Cognitive behavioral therapy (CBT): In this type of therapy, you discuss your thoughts and emotions with a mental health professional, such as a licensed counselor or psychologist. This specialist helps identify panic attack triggers so you can change your thinking, behaviors and reactions. As you start to respond differently to triggers, the attacks may decrease and ultimately stop.

• #2 Panic Disorder – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK430973/

  Panic disorder is fairly common in the general population. […] Panic disorder is characterized by recurrent, unexpected panic attacks. […] Making an accurate diagnosis of panic disorder is not possible without a thorough awareness of what constitutes panic attacks. […] This activity reviews panic disorder and the role of the interprofessional team in the recognition and management of this condition. […] Outline the treatment options available for panic disorder. […] The main approaches to the treatment of panic disorder include both psychological and pharmacological interventions. Psychological interventions consist of cognitive-behavioral therapy. […] Antidepressants and benzodiazepines are the mainstays of pharmacologic treatment. […] SSRIs are considered the first-line treatment option for patients with panic disorder.

• #3 Panic Disorder Treatment | SunCloud

  https://suncloudhealth.com/blog/panic-disorder-treatment/

  Panic disorder is a type of anxiety disorder marked by recurrent, unexpected panic attacks. These episodes of intense fear can be overwhelming and are often accompanied by uncomfortable physical symptoms. While panic disorder can significantly impact daily life, effective treatments are available. […] Effective Treatment Options for Panic Disorder […] There are many treatment options for managing panic attacks and panic disorder. For many, a combination of therapies and lifestyle changes will lead to the best results. Some treatment options include: […] Cognitive Behavioral Therapy (CBT) and psychotherapy for panic disorder. CBT is considered the gold standard for panic disorder treatment. It helps individuals identify and change negative thoughts that contribute to panic attacks. […] Seeking help is the first step toward healing. There are several treatment options available for panic disorder. With the help of a trusted provider, those with this condition can find the balance of therapy, medications, and lifestyle changes that work best for them.

• #4 Treatment-Resistant Panic Disorder

  https://www.psychiatrictimes.com/view/treatment-resistant-panic-disorder

  Panic disorder (PD), a common and impairing anxiety syndrome, is generally readily diagnosable and treatable. Its phenomenology is diverse, including acute fear episodes (spontaneous and cued panics), anticipatory anxiety, and physical sensation sensitivity. PD is also frequently accompanied by agoraphobia and is more likely to affect women. […] Concerning the natural history of PD, approximately one-third of patients have a clinical remission with standard interventions (pharmacotherapies and cognitive behavioral therapy [CBT]), without subsequent episodes. In another third, the course of the illness is characterized by recurrent episodes, which remain treatment-sensitive. However, a third go on to have chronic, persistent symptoms-and the majority of these patients have treatment-resistant panic (TRP).

• #5 Pharmacologic Management of Acute and Chronic Panic Disorder

  https://www.uspharmacist.com/article/pharmacologic-management-of-acute-and-chronic-panic-disorder

  Panic disorder (PD) has an estimated prevalence of approximately 5% in the United States. Currently, several treatment modalities are available for the management of PD. In choosing the most effective pharmacotherapeutic regimen, practitioners should carefully consider the severity of symptoms, patient response, and comorbid conditions. […] Nonpharmacologic treatment options for panic attack include cognitive behavioral therapy (CBT), patient support groups, and panic-focused psychodynamic psychotherapy. CBT focuses on confronting stimuli and situations that have caused panic attacks in the past. It consists of weekly sessions for 3 to 4 months where the patient identifies cues that may precede panic attacks and learns techniques to control symptoms. […] Acute management of PD typically involves sedative measures in efforts to relax the patient and reduce his or her anxiety. Benzodiazepines (BZDs) increase the efficiency of the GABAA receptor via allosteric binding, resulting in reduced anxiety and sedation.

• #6 Panic Disorder Treatment & Management: Approach Considerations, Emergency Department Management, Cognitive-Behavioral Therapy

  https://emedicine.medscape.com/article/287913-treatment

  All patients with panic disorder should be referred to a psychiatrist, psychologist, or other mental health professional. Psychiatric treatment has a demonstrated effect on decreasing medical costs associated with emergency department and nonpsychiatric outpatient care. […] Pharmacotherapy, cognitive- behavioral therapy (CBT), and other psychological treatment modalities are used to manage panic disorder. The American Psychiatric Association (APA) recommends treating patients with panic disorder when symptoms cause dysfunction (eg, work, family, social, leisure activities) or significant distress. […] Treatment goals include the following: Tailoring the treatment plan to each individual, reducing frequency and intensity of panic attacks, reducing anticipatory anxiety and agoraphobic avoidance, treating co-occurring psychiatric disorders, achieving full symptomatic remission, returning to premorbid level of function.

• #7 Panic disorder in adults: Treatment overview – UpToDate

  https://www.uptodate.com/contents/panic-disorder-in-adults-treatment-overview

  Panic disorder is a relatively common disorder, most often with an adult onset and chronic course. It can lead to impairments in functioning, poor quality of life, and high health care costs. The disorder can be effectively treated with cognitive-behavioral therapy, medication, or a combination of the two modalities. […] The main objectives of treatment are to minimize attack frequency, anticipatory anxiety, and phobic avoidance, thereby improving functioning. Individuals with mild panic disorder whose symptoms do not interfere significantly with functioning may reasonably elect to forgo treatment initially.

• #8 Panic Disorder Treatment & Management: Approach Considerations, Emergency Department Management, Cognitive-Behavioral Therapy

  https://emedicine.medscape.com/article/287913-treatment

  All patients with panic disorder should be referred to a psychiatrist, psychologist, or other mental health professional. Psychiatric treatment has a demonstrated effect on decreasing medical costs associated with emergency department and nonpsychiatric outpatient care. […] Pharmacotherapy, cognitive- behavioral therapy (CBT), and other psychological treatment modalities are used to manage panic disorder. The American Psychiatric Association (APA) recommends treating patients with panic disorder when symptoms cause dysfunction (eg, work, family, social, leisure activities) or significant distress. […] Treatment goals include the following: Tailoring the treatment plan to each individual, reducing frequency and intensity of panic attacks, reducing anticipatory anxiety and agoraphobic avoidance, treating co-occurring psychiatric disorders, achieving full symptomatic remission, returning to premorbid level of function.

• #9 Panic attacks and panic disorder – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/panic-attacks/diagnosis-treatment/drc-20376027

  Treatment can help reduce the intensity and frequency of your panic attacks and improve your function in daily life. The main treatment options are psychotherapy and medications. One or both types of treatment may be recommended, depending on your preference, your history, the severity of your panic disorder and whether you have access to therapists who have special training in treating panic disorders. […] Psychotherapy, also called talk therapy, is considered an effective first choice treatment for panic attacks and panic disorder. Psychotherapy can help you understand panic attacks and panic disorder and learn how to cope with them. […] A form of psychotherapy called cognitive behavioral therapy can help you learn, through your own experience, that panic symptoms are not dangerous. Your therapist will help you gradually re-create the symptoms of a panic attack in a safe, repetitive manner. Once the physical sensations of panic no longer feel threatening, the attacks begin to resolve. Successful treatment can also help you overcome fears of situations that you’ve avoided because of panic attacks.

• #10 Panic Attacks & Panic Disorder: Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/4451-panic-attack-panic-disorder

  Panic attacks are sudden, intense feelings of fear that cause physical symptoms like a racing heart, fast breathing and sweating. […] Therapy and medications can treat panic attacks and panic disorder. […] Psychotherapy, medications or a combination of both are very effective in treating panic attacks and panic disorder. How long youll need treatment depends on the severity of the condition and how well you respond to treatment. […] Specific types of psychotherapy that can help with panic attacks and panic disorder include: […] Cognitive behavioral therapy (CBT): In this type of therapy, you discuss your thoughts and emotions with a mental health professional, such as a licensed counselor or psychologist. This specialist helps identify panic attack triggers so you can change your thinking, behaviors and reactions. As you start to respond differently to triggers, the attacks may decrease and ultimately stop.

• #11 Treatment of Panic Disorder | AAFP

  https://www.aafp.org/pubs/afp/issues/2005/0215/p733.html

  Patients with panic disorder have several treatment options. Determining which treatment is best for a given patient is done through a shared decision-making process between the patient and physician. […] Antidepressant medications have been shown to reduce panic severity, eliminate attacks, and improve overall quality-of-life measures in patients with panic disorder. […] Cognitive behavior therapy (CBT) includes many techniques, such as applied relaxation, exposure in vivo, exposure through imagery, panic management, breathing retraining, and cognitive restructuring. Meta-analyses support the efficacy of CBT in improving panic symptoms and overall disability. […] Although the evidence indicates that anti-depressants and CBT alone are effective in treating panic disorder, it remains unclear whether one treatment modality is superior to the other.

• #12 Panic Disorder | NAMI Michigan

  https://namimi.org/mental-illness/panic-disorder

  Recovery from panic disorder can be achieved either by taking medication or by cognitive behavioral therapy that is specific for panic disorder. […] Studies suggest that medication and cognitive behavioral therapy are about equally effective and the decision about which to take depends largely on the preference of the person with the panic disorder. […] Medication probably works a bit faster, but has more adverse side effects than cognitive behavioral therapy. […] Also, when successful treatment is finished, people who have had cognitive behavioral therapy tend to remain well longer than people who have taken medication. […] There is some evidence that the combination of cognitive behavioral therapy and medication may offer some benefits over either one alone. […] Cognitive therapy is used to help people think and behave appropriately.

• #13 Panic attacks and panic disorder – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/panic-attacks/diagnosis-treatment/drc-20376027

  Treatment can help reduce the intensity and frequency of your panic attacks and improve your function in daily life. The main treatment options are psychotherapy and medications. One or both types of treatment may be recommended, depending on your preference, your history, the severity of your panic disorder and whether you have access to therapists who have special training in treating panic disorders. […] Psychotherapy, also called talk therapy, is considered an effective first choice treatment for panic attacks and panic disorder. Psychotherapy can help you understand panic attacks and panic disorder and learn how to cope with them. […] A form of psychotherapy called cognitive behavioral therapy can help you learn, through your own experience, that panic symptoms are not dangerous. Your therapist will help you gradually re-create the symptoms of a panic attack in a safe, repetitive manner. Once the physical sensations of panic no longer feel threatening, the attacks begin to resolve. Successful treatment can also help you overcome fears of situations that you’ve avoided because of panic attacks.

• #14 Overcoming Panic Disorder

  https://give.brighamandwomens.org/overcoming-panic-disorder/

  Overcoming Panic Disorder […] Fortunately, anxiety sensitivity is highly treatable and can be greatly improved through certain types of therapy. […] If you think you have panic disorder, self-educate and seek professional help […] Ideally, a PCP would recommend a therapist or psychiatrist. A cognitive behavioral therapist who has experience with anxiety disorders is an ideal choice. […] Cognitive Behavioral Therapy is 70 to 90 percent effective as a treatment for panic disorder. […] Panic disorder is one of the most treatable anxiety disorders. The prevailing treatment is cognitive behavioral therapy (CBT). […] A key part of CBT in treating panic is a method called interoceptive exposure, in which the person deliberately confronts the unpleasant physical sensations that are causing anxiety.

• #15 Learn About Panic Attacks and Panic Disorder | Psychology Tools

  https://www.psychologytools.com/articles/learn-about-panic-attacks-and-panic-disorder

  Cognitive Behavioral Therapy (CBT) is an extremely effective treatment for panic disorder: about 80% of people with panic disorder who complete a course of CBT are panic-free at the end of treatment. […] Research has indicated that psychological therapy, or a combination of psychological therapy plus antidepressant medication, is the treatment of choice for panic disorder. One of the most effective psychological treatments for panic is cognitive behavioral therapy (CBT). […] The UK National Institute of Health and Care Excellence (NICE) guidelines for panic disorder recommend that the only medicines that should be used in the longer-term management of panic disorder are selective serotonin reuptake inhibitors (SSRIs) and tricyclic antidepressants (TCAs).

• #16 Panic Disorder Treatment & Management: Approach Considerations, Emergency Department Management, Cognitive-Behavioral Therapy

  https://emedicine.medscape.com/article/287913-treatment

  Cognitive-behavioral therapy (CBT) helps patients to understand how automatic thoughts and false beliefs/distortions lead to exaggerated emotional responses, such as anxiety, and how they can lead to secondary behavioral consequences. […] The American Psychiatric Association (APA) found insufficient evidence to either recommend any pharmacologic intervention as superior to others for panic disorder or to routinely recommend combination therapy over monotherapy. […] However, pharmacotherapy is recommended for patients who prefer to be managed with medication or those who don’t have the time or other resources to participate in psychosocial therapy. […] Selective serotonin reuptake inhibitors (SSRIs) are generally used as first-line pharmacologic agents in panic disorder, followed remotely by tricyclic antidepressant agents (TCAs).

• #17

  https://psychology.org.au/for-the-public/psychology-topics/panic-disorder/evidence-based-psychological-approaches-and-strate

  There are a range of treatment interventions that psychologists may use to address symptoms of panic disorder. These can be used alone or in conjunction with pharmacological therapies if needed. […] Cognitive behaviour therapy (CBT) has the most research evidence as an effective treatment for panic disorder. CBT is a type of psychological therapy that helps a person identify and modify unhelpful thoughts and behaviours that may lead to feelings of panic. […] Psychoeducation involves providing important information about how panic disorder develops in order to improve symptom awareness and empower the person to cope effectively with the disorder. […] Monitoring a persons thoughts, behaviours, and symptoms is a core feature of CBT. […] Cognitive restructuring is a CBT technique which helps a person to identify and challenge these negative thoughts and develop a more rational and helpful style of thinking.

• #18 Overcoming Panic Disorder

  https://give.brighamandwomens.org/overcoming-panic-disorder/

  Overcoming Panic Disorder […] Fortunately, anxiety sensitivity is highly treatable and can be greatly improved through certain types of therapy. […] If you think you have panic disorder, self-educate and seek professional help […] Ideally, a PCP would recommend a therapist or psychiatrist. A cognitive behavioral therapist who has experience with anxiety disorders is an ideal choice. […] Cognitive Behavioral Therapy is 70 to 90 percent effective as a treatment for panic disorder. […] Panic disorder is one of the most treatable anxiety disorders. The prevailing treatment is cognitive behavioral therapy (CBT). […] A key part of CBT in treating panic is a method called interoceptive exposure, in which the person deliberately confronts the unpleasant physical sensations that are causing anxiety.

• #19 Generalized Anxiety Disorder and Panic Disorder in Adults | AAFP

  https://www.aafp.org/pubs/afp/issues/2022/0800/generalized-anxiety-disorder-panic-disorder.html

  Psychotherapy for GAD and PD can include relaxation techniques; cognitive restructuring, including CBT; and exposure therapy. […] CBT can be as effective for PD as pharmacotherapy, but evidence is limited and lacks data on adverse effects. […] Interoceptive exposure, a technique in which patients induce the somatic symptoms of a panic attack to decouple their association with fear, is the most beneficial component of CBT for treating PD.

• #20 Overcoming Panic Disorder

  https://give.brighamandwomens.org/overcoming-panic-disorder/

  CBT sessions are usually conducted on a weekly basis and last for around 12 to 16 sessions. The treatment tends to show long-lasting results, and relapse is uncommon. […] Therapy isn’t always covered by insurance. Because of this, people with panic disorder can live with a highly treatable disorder and not know how to treat it.

• #21 Panic Attacks and How to Treat Them

  https://childmind.org/article/panic-attacks-best-treatments/

  Panic attacks develop into panic disorder when a person worries so much about having another attack that they start avoiding places or situations. […] The best treatment for panic attacks is cognitive behavioral therapy (CBT). […] Research shows that the most successful treatment for panic disorder is a combination of antidepressant medication and cognitive behavioral therapy (CBT). […] In treating someone who has panic disorder with CBT, the clinician starts by working with the patient to think more flexibly about their anxiety. […] To help the person disconnect the negative feelings associated with attacks, the therapist induces those physical sensations […] As the fear of attacks diminishes, attacks themselves grow less severe and less frequent. […] Patients who’ve been treated with CBT sometimes return for “maintenance sessions,” to refresh their skills.

• #22 Panic Disorder Treatment: Psychotherapy, Medication, and More

  https://psychcentral.com/anxiety/panic-disorder-treatment

  Other treatments for panic disorder include acceptance and commitment therapy (ACT) and mindfulness-based stress reduction (MBSR). […] Medication is sometimes used to: prevent panic attacks, reduce their frequency and severity, decrease the associated anticipatory anxiety. […] When it comes to medication, the first-line treatment for panic disorder is selective serotonin reuptake inhibitors (SSRIs). […] Sometimes healthcare providers prescribe serotonin-norepinephrine reuptake inhibitors (SNRIs). […] If your symptoms are very acute and you can’t wait 4 to 6 weeks until an SSRI or SNRI becomes effective, your healthcare provider may prescribe an additional medication: a benzodiazepine, such as clonazepam (Klonopin). […] Benzodiazepines can also interfere with CBT. They’re best used short term.

• #23 Panic Disorder Treatment – Oceans Healthcare

  https://oceanshealthcare.com/treatment-and-services/panic-disorder-treatment/

  If youve ever had a panic attack, you know what its like to feel like youre not in charge of your own body. […] Our team at Oceans Healthcare is here to empower you to reclaim your life from panic attacks. […] With treatment, you dont need to live in fear of your next panic attack. […] There are multiple methods for treating panic disorder. At Oceans Healthcare, well work with you to determine what mode of treatment works best for you. […] We use multiple tools for treating panic disorders, including: Anti-anxiety medications. Medication is an important tool for many people managing panic disorder. […] Cognitive behavioral therapy (CBT). In this type of therapy, youll work with your therapist to develop a better understanding of the relationship between your thoughts, feelings, and behaviors.

• #24 Panic attacks and panic disorder – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/panic-attacks/diagnosis-treatment/drc-20376027

  Medications can help reduce symptoms associated with panic attacks as well as depression if that’s an issue for you. Several types of medication have been shown to be effective in managing symptoms of panic attacks, including: […] Selective serotonin reuptake inhibitors (SSRIs). Generally safe with a low risk of serious side effects, SSRI antidepressants are typically recommended as the first choice of medications to treat panic attacks. […] If one medication doesn’t work well for you, your doctor may recommend switching to another or combining certain medications to boost effectiveness. Keep in mind that it can take several weeks after first starting a medication to notice an improvement in symptoms. […] All medications have a risk of side effects, and some may not be recommended in certain situations, such as pregnancy. Talk with your doctor about possible side effects and risks.

• #25 Panic Disorder Treatment & Management: Approach Considerations, Emergency Department Management, Cognitive-Behavioral Therapy

  https://emedicine.medscape.com/article/287913-treatment

  Cognitive-behavioral therapy (CBT) helps patients to understand how automatic thoughts and false beliefs/distortions lead to exaggerated emotional responses, such as anxiety, and how they can lead to secondary behavioral consequences. […] The American Psychiatric Association (APA) found insufficient evidence to either recommend any pharmacologic intervention as superior to others for panic disorder or to routinely recommend combination therapy over monotherapy. […] However, pharmacotherapy is recommended for patients who prefer to be managed with medication or those who don’t have the time or other resources to participate in psychosocial therapy. […] Selective serotonin reuptake inhibitors (SSRIs) are generally used as first-line pharmacologic agents in panic disorder, followed remotely by tricyclic antidepressant agents (TCAs).

• #26 Panic Disorder – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK430973/

  Panic disorder is fairly common in the general population. […] Panic disorder is characterized by recurrent, unexpected panic attacks. […] Making an accurate diagnosis of panic disorder is not possible without a thorough awareness of what constitutes panic attacks. […] This activity reviews panic disorder and the role of the interprofessional team in the recognition and management of this condition. […] Outline the treatment options available for panic disorder. […] The main approaches to the treatment of panic disorder include both psychological and pharmacological interventions. Psychological interventions consist of cognitive-behavioral therapy. […] Antidepressants and benzodiazepines are the mainstays of pharmacologic treatment. […] SSRIs are considered the first-line treatment option for patients with panic disorder.

• #27 Pharmacologic Management of Acute and Chronic Panic Disorder

  https://www.uspharmacist.com/article/pharmacologic-management-of-acute-and-chronic-panic-disorder

  Four primary classes of medications are used in the long-term management of PD. These agents include BZDs and several types of antidepressants, including SSRIs, serotonin-norepinephrine reuptake inhibitors (SNRIs), and tricyclic antidepressants (TCAs). No specific drug is regarded as the drug of choice; however, SSRIs and SNRIs are recommended as first-line agents according to the American Psychiatric Association (APA) treatment guidelines. […] After therapy is initiated, patients should be monitored approximately every other week until the dose can be optimized and follow-up visits may be decreased. Guidelines suggest treatment duration of 1 year or more to promote symptom reduction and prevent recurrence. […] SSRIs play a role in increasing serotonin levels, preventing recurrent panic events.

• #28 Treatment of Panic Disorder | AAFP

  https://www.aafp.org/pubs/afp/issues/2005/0215/p733.html

  Panic disorder with or without agoraphobia occurs commonly in patients in primary care settings. This article assesses multiple evidence-based reviews of effective treatments for panic disorder. Antidepressant medications successfully reduce the severity of panic symptoms and eliminate panic attacks. Selective serotonin reuptake inhibitors and tricyclic antidepressants are equally effective in the treatment of panic disorder. The choice of medication is based on side effect profiles and patient preferences. Strong evidence supports the effectiveness of cognitive behavior therapy in treating panic disorder. Family physicians who are not trained in cognitive behavior therapy may refer patients with panic disorder to therapists with such training. Cognitive behavior therapy can be used alone or in combination with antidepressants to treat patients with panic disorder. Benzodiazepines are effective in treating panic disorder symptoms, but they are less effective than antidepressants and cognitive behavior therapy.

• #29 Panic Disorder Medication: Anxiolytics, Benzodiazepines, Antidepressants, SSRIs, Antidepressants, TCA, Antidepressants, MAO Inhibitors, Antidepressants, SNRI’s, Antidepressants, Others

  https://emedicine.medscape.com/article/287913-medication

  Selective serotonin reuptake inhibitors (SSRIs) are first-line agents for the long-term management of anxiety disorders. Control is gradually achieved over a 2- to 4-week course, depending on the required dosage increases. […] All commonly used SSRIs appear to have a role in the treatment of panic disorder. […] Trazodone is useful in the treatment of panic disorder and agoraphobia with panic attacks. It is an antagonist at the 5-HT2 receptor and inhibits the reuptake of 5-HT. […] Mirtazapine is an alpha-2 adrenergic antagonist that increases synaptic norepinephrine and serotonin, while also blocking some postsynaptic serotonergic receptors that conceptually mediate excessive anxiety when stimulated with serotonin.

• #30 Drug treatment for panic disorder with or without agoraphobia: systematic review and network meta-analysis of randomised controlled trials | The BMJ

  https://www.bmj.com/content/376/bmj-2021-066084

  Objective To identify drug classes and individual selective serotonin reuptake inhibitors (SSRIs) with high rates of remission and low risk of adverse events in the treatment of panic disorder with or without agoraphobia. […] Results indicated that tricyclic antidepressants, benzodiazepines, monoamine oxidase inhibitors, SSRIs, and serotonin-noradrenaline reuptake inhibitors (SNRIs) were associated with significantly higher remission rates than placebo, with risk ratios of 1.39, 1.47, 1.30, 1.38, and 1.27, respectively. […] The findings suggest that SSRIs provide high rates of remission with low risk of adverse events for the treatment of panic disorder. […] Among SSRIs, sertraline and escitalopram were associated with high remission and low risk of adverse events. […] SSRIs were associated with high rate of remission and low risk of adverse events in the treatment of panic disorder, and among individual SSRIs, sertraline and escitalopram provided high remission with low risk of adverse events.

• #31 What treatments should I be offered for panic disorder? | Information for the public | Generalised anxiety disorder and panic disorder in adults: management | Guidance | NICE

  https://www.nice.org.uk/guidance/cg113/ifp/chapter/what-treatments-should-i-be-offered-for-panic-disorder

  Psychological treatment, medication and self-help have all been shown to be effective in treating panic disorder. Studies of different treatments found that the benefits of psychological treatment lasted the longest. […] If you decide to have psychological treatment, you should be offered cognitive behavioural therapy (which is sometimes shortened to CBT). CBT helps you to understand how your problems, thoughts, feelings and behaviour affect each other. […] If you are considering taking medication to treat your panic disorder, your healthcare professional should discuss with you the risks of the different options. […] You should be offered an antidepressant, which should be a type called a selective serotonin reuptake inhibitor (sometimes shortened to SSRI), licensed for the treatment of panic disorder.

• #32 Pharmacotherapy for Panic Disorder: What Therapists Need to Know | CARLAT PUBLISHING

  https://www.thecarlatreport.com/articles/4430-pharmacotherapy-for-panic-disorder-what-therapists-need-to-know

  For this reason, a standard pharmacologic technique is to start treatment with both an antidepressant and a benzodiazepine and then discontinue the benzodiazepine in four to six weeks when the antidepressant becomes effective. […] Understanding the landscape of medication treatment for panic disorder will help you ensure that you and your clients prescriber are working in synergy to address your clients symptoms.

• #33 Panic Disorder Treatment: Psychotherapy, Medication, and More

  https://psychcentral.com/anxiety/panic-disorder-treatment

  Other treatments for panic disorder include acceptance and commitment therapy (ACT) and mindfulness-based stress reduction (MBSR). […] Medication is sometimes used to: prevent panic attacks, reduce their frequency and severity, decrease the associated anticipatory anxiety. […] When it comes to medication, the first-line treatment for panic disorder is selective serotonin reuptake inhibitors (SSRIs). […] Sometimes healthcare providers prescribe serotonin-norepinephrine reuptake inhibitors (SNRIs). […] If your symptoms are very acute and you can’t wait 4 to 6 weeks until an SSRI or SNRI becomes effective, your healthcare provider may prescribe an additional medication: a benzodiazepine, such as clonazepam (Klonopin). […] Benzodiazepines can also interfere with CBT. They’re best used short term.

• #34 Generalized Anxiety Disorder and Panic Disorder in Adults | AAFP

  https://www.aafp.org/pubs/afp/issues/2022/0800/generalized-anxiety-disorder-panic-disorder.html

  Effective therapies for PD and GAD include cognitive behavior therapy and anti-depressants, including selective serotonin reuptake inhibitors and serotonin-norepinephrine reuptake inhibitors. […] Psychotherapy can be as effective as medication for GAD and PD; for PD, evidence of benefit is strongest for cognitive behavior therapy. […] The two main categories of treatment for GAD and PD are pharmacotherapy and psychotherapy, with cognitive behavior therapy (CBT) being the most effective and well-studied form of psychotherapy for PD. […] Antidepressants, SSRIs and SNRIs in particular, are considered first-line therapies for GAD and PD because they are effective and generally well tolerated. […] Benzodiazepines are not more effective than antidepressants for treating anxiety disorders and should not be used as first-line therapy.

• #35 Panic Disorder Medication: Anxiolytics, Benzodiazepines, Antidepressants, SSRIs, Antidepressants, TCA, Antidepressants, MAO Inhibitors, Antidepressants, SNRI’s, Antidepressants, Others

  https://emedicine.medscape.com/article/287913-medication

  First-line pharmacologic therapies for panic disorder include selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), and tricyclic antidepressants (TCAs). These 3 classes of agents are preferred over benzodiazepines as monotherapies for patients with co-occurring depression or substance use disorders. […] For patients requiring rapid symptom control, benzodiazepines can be used as adjuncts with antidepressant agents to treat residual anxiety symptoms, and they may be preferred (as monotherapies or in combination with antidepressants). Clinicians must carefully assess the benefit of more rapid response against the potential complications of benzodiazepine therapy. […] The American Psychiatric Association (APA) recommends avoiding TCAs for patients with panic disorder who also have acute narrow-angle glaucoma or clinically significant prostatic hypertrophy. TCAs may increase the risk of falls and fractures, particularly in elderly patients. In addition, owing to the potential for significant or fatal arrhythmia in patients with preexisting cardiac conduction abnormalities, it is important to obtain an electrocardiogram (ECG) in these individuals before starting TCA treatment. Use TCAs with caution in suicidal patients as overdoses with these drugs can cause cardiac toxicity and death.

• #36 Panic disorder – NHS

  https://www.nhs.uk/mental-health/conditions/panic-disorder/

  Treatment aims to reduce the number of panic attacks you have and ease your symptoms. […] Talking therapies and medicine are the main treatments for panic disorder. Your treatment will depend on your symptoms. […] You can refer yourself directly to a talking therapies service for treatment based on cognitive behavioural therapy (CBT). […] If you and your doctor think it might be helpful, you may be prescribed: a type of antidepressant called a selective serotonin reuptake inhibitor (SSRI) or, if SSRIs are not suitable, a tricyclic antidepressant (usually imipramine or clomipramine). […] If your symptoms do not improve after CBT, medicine and connecting with a support group, your GP may refer you to a mental health specialist such as a psychiatrist or clinical psychologist. […] Panic disorder is treatable so it’s best to get medical help as soon as you can.

• #37 Panic Disorder Medication: Anxiolytics, Benzodiazepines, Antidepressants, SSRIs, Antidepressants, TCA, Antidepressants, MAO Inhibitors, Antidepressants, SNRI’s, Antidepressants, Others

  https://emedicine.medscape.com/article/287913-medication

  First-line pharmacologic therapies for panic disorder include selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), and tricyclic antidepressants (TCAs). These 3 classes of agents are preferred over benzodiazepines as monotherapies for patients with co-occurring depression or substance use disorders. […] For patients requiring rapid symptom control, benzodiazepines can be used as adjuncts with antidepressant agents to treat residual anxiety symptoms, and they may be preferred (as monotherapies or in combination with antidepressants). Clinicians must carefully assess the benefit of more rapid response against the potential complications of benzodiazepine therapy. […] The American Psychiatric Association (APA) recommends avoiding TCAs for patients with panic disorder who also have acute narrow-angle glaucoma or clinically significant prostatic hypertrophy. TCAs may increase the risk of falls and fractures, particularly in elderly patients. In addition, owing to the potential for significant or fatal arrhythmia in patients with preexisting cardiac conduction abnormalities, it is important to obtain an electrocardiogram (ECG) in these individuals before starting TCA treatment. Use TCAs with caution in suicidal patients as overdoses with these drugs can cause cardiac toxicity and death.

• #38 Pharmacologic Management of Acute and Chronic Panic Disorder

  https://www.uspharmacist.com/article/pharmacologic-management-of-acute-and-chronic-panic-disorder

  Panic disorder (PD) has an estimated prevalence of approximately 5% in the United States. Currently, several treatment modalities are available for the management of PD. In choosing the most effective pharmacotherapeutic regimen, practitioners should carefully consider the severity of symptoms, patient response, and comorbid conditions. […] Nonpharmacologic treatment options for panic attack include cognitive behavioral therapy (CBT), patient support groups, and panic-focused psychodynamic psychotherapy. CBT focuses on confronting stimuli and situations that have caused panic attacks in the past. It consists of weekly sessions for 3 to 4 months where the patient identifies cues that may precede panic attacks and learns techniques to control symptoms. […] Acute management of PD typically involves sedative measures in efforts to relax the patient and reduce his or her anxiety. Benzodiazepines (BZDs) increase the efficiency of the GABAA receptor via allosteric binding, resulting in reduced anxiety and sedation.

• #39 Treatment of panic disorder – Australian Prescriber

  https://australianprescriber.tg.org.au/articles/treatment-of-panic-disorder.html

  Panic disorder consists of recurrent, disabling attacks of panic. […] Many patients respond to a combination of lifestyle change, especially control of caffeine and alcohol use, and cognitive behaviour therapy. […] For panic disorder, high potency benzodiazepines are effective for acute and long-term treatment, but have the disadvantages of sedation, drug interactions and discontinuation problems. […] Cognitive behaviour therapy is the treatment of choice, and helps many patients. It involves firstly educating the patient about panic disorder, its causes, outcome and management. […] Cognitive behaviour therapy for panic disorder involves both cognitive and behavioural elements, but the cognitive elements may be more prominent. […] Drug treatment can be added to cognitive behaviour therapy. There is the suggestion that the response to this combined approach is better than either treatment alone and there may be a lower risk of relapse when medication is discontinued.

• #40 Pharmacologic Management of Acute and Chronic Panic Disorder

  https://www.uspharmacist.com/article/pharmacologic-management-of-acute-and-chronic-panic-disorder

  BZDs are among the most commonly prescribed drugs in the treatment of PD due to their rapid onset of action. However, they are generally used in conjunction with antidepressants because SSRIs take approximately 4 to 6 weeks to become effective, or they are added on to therapy after antidepressant trials have failed or are not tolerated. […] Several small clinical studies of bupropion have shown mixed efficacy in the management of PD. Trazodone, nefazodone, mirtazapine, pregabalin, gabapentin, and second-generation antipsychotics have limited data and are not recommended as first-line treatment. […] To date, the exact pathogenesis of PD and guidelines for the treatment of this disorder have not been concretely established. Multiple lines of inquiry and research are being conducted on the mechanism of panic attacks, and as more information is revealed, the targeted treatment of PD will continue to improve.

• #41 Pharmacotherapy for Panic Disorder: What Therapists Need to Know | CARLAT PUBLISHING

  https://www.thecarlatreport.com/articles/4430-pharmacotherapy-for-panic-disorder-what-therapists-need-to-know

  Antidepressants, specifically selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs), are generally the first-line medications for panic disorder. They are effective and cause minimal side effects. […] Pharmacological treatment is often a critical component of managing panic disorder, alongside psychotherapy. The most common medications used to treat panic disorder are antidepressants and benzodiazepines, and it’s essential to know their benefits, potential side effects, and best practices for their use. […] Benzodiazepines are another treatment option for panic disorder, known for their rapid onset of action and ability to quickly target the physical symptoms of anxiety, anticipatory fear, and avoidant behavior. […] Research suggests that starting clients on both CBT and antidepressants simultaneously may yield better outcomes.

• #42 Generalized Anxiety Disorder and Panic Disorder in Adults | AAFP

  https://www.aafp.org/pubs/afp/issues/2022/0800/generalized-anxiety-disorder-panic-disorder.html

  Effective therapies for PD and GAD include cognitive behavior therapy and anti-depressants, including selective serotonin reuptake inhibitors and serotonin-norepinephrine reuptake inhibitors. […] Psychotherapy can be as effective as medication for GAD and PD; for PD, evidence of benefit is strongest for cognitive behavior therapy. […] The two main categories of treatment for GAD and PD are pharmacotherapy and psychotherapy, with cognitive behavior therapy (CBT) being the most effective and well-studied form of psychotherapy for PD. […] Antidepressants, SSRIs and SNRIs in particular, are considered first-line therapies for GAD and PD because they are effective and generally well tolerated. […] Benzodiazepines are not more effective than antidepressants for treating anxiety disorders and should not be used as first-line therapy.

• #43 Panic Disorder Treatment: Psychotherapy, Medication, and More

  https://psychcentral.com/anxiety/panic-disorder-treatment

  Other treatments for panic disorder include acceptance and commitment therapy (ACT) and mindfulness-based stress reduction (MBSR). […] Medication is sometimes used to: prevent panic attacks, reduce their frequency and severity, decrease the associated anticipatory anxiety. […] When it comes to medication, the first-line treatment for panic disorder is selective serotonin reuptake inhibitors (SSRIs). […] Sometimes healthcare providers prescribe serotonin-norepinephrine reuptake inhibitors (SNRIs). […] If your symptoms are very acute and you can’t wait 4 to 6 weeks until an SSRI or SNRI becomes effective, your healthcare provider may prescribe an additional medication: a benzodiazepine, such as clonazepam (Klonopin). […] Benzodiazepines can also interfere with CBT. They’re best used short term.

• #44 Azthena logo with the word Azthena

  https://www.news-medical.net/health/Panic-Disorder-Treatments.aspx

  Anti-anxiety medications such as benzodiazepines can also treat panic disorder. One example, clonazepam, helps calm a patient by reducing their anxiety. […] Beta blockers such as propranolol can also be used, not to reduce anxiety but rather the effects of panic attacks such as rapid heart rate, sweating, tremors and dizziness.

• #45 Panic Disorder and Panic Attack Treatment in Los Angeles

  https://cogbtherapy.com/los-angeles-panic-treatment

  Antidepressants can be safe and effective for many people. However, they may be risky for some, especially children, teens, and young adults. […] Beta-blockers, another variety of medication, can help control some of the physical symptoms of panic disorder, such as excessive sweating, a pounding heart, or dizziness.

• #46 Treatment – Agoraphobia – NHS

  https://www.nhs.uk/mental-health/conditions/agoraphobia/treatment/

  If sertraline fails to improve your symptoms, you may be prescribed an alternative SSRI or a similar type of medicine known as serotonin-norepinephrine reuptake inhibitors (SNRIs). […] If you’re unable to take SSRIs or SNRIs for medical reasons or you experience troublesome side effects, another medicine called pregabalin may be recommended.

• #47 Treatment of Panic Disorder | AAFP

  https://www.aafp.org/pubs/afp/issues/2005/0215/p733.html

  Benzodiazepines are as effective as anti-depressants in reducing panic symptoms and frequency of attacks, are well tolerated, and have a short onset of action. […] Family physicians may wish to refer patients with panic disorder to a cognitive behavior therapist for four to 15 sessions of CBT, ideally with exposure techniques. Although long-term data are lacking, it is likely that combining antidepressant therapy and CBT benefits the patient more than either treatment alone and provides the option of discontinuing the antidepressant.

• #48 Panic Disorder Treatment

  https://www.verywellmind.com/treatment-for-panic-disorder-2584322

  Therapies like CBT and PFPP are effective treatments for panic disorder. […] Your doctor may determine that a combination of therapy and medication is best suited for you. Typically, this approach involves using SSRIs together with a form of therapy like CBT. This combination has been shown to be effective at treating panic disorder. […] There are treatment options available for panic disorder. These include: Medication, like SSRIs or benzodiazepines; Therapy, like CBT or PFPP; A combination of medication and therapy.

• #49 Treatment-Resistant Panic Disorder

  https://www.psychiatrictimes.com/view/treatment-resistant-panic-disorder

  Treatment resistance in PD may be apparent or real. Apparent treatment resistance may be due to a range of clinical factors including unstable psychiatric and medical comorbidities, patient adherence problems, clinician availability (important to PD patients early in treatment), or therapeutic alliance problems, often driven by cognitive and behavioral avoidance. […] Evidence-based pharmacotherapies include SSRIs, SNRIs, TCAs, the MAOI phenelzine, and benzodiazepine agonists (eg, clonazepam and alprazolam, which are approved by the FDA for panic). Recommended psychotherapies include CBT (especially individual CBT). Data from a large meta-analysis of anxiety studies suggest that combination treatment (medication plus CBT) is likely to be superior to monotherapy and should now be routinely offered.

• #50 Pharmacotherapy for Panic Disorder: What Therapists Need to Know | CARLAT PUBLISHING

  https://www.thecarlatreport.com/articles/4430-pharmacotherapy-for-panic-disorder-what-therapists-need-to-know

  For this reason, a standard pharmacologic technique is to start treatment with both an antidepressant and a benzodiazepine and then discontinue the benzodiazepine in four to six weeks when the antidepressant becomes effective. […] Understanding the landscape of medication treatment for panic disorder will help you ensure that you and your clients prescriber are working in synergy to address your clients symptoms.

• #51 Panic Disorder and Panic Attack Treatment in Los Angeles

  https://cogbtherapy.com/los-angeles-panic-treatment

  Panic disorder is one of the most treatable of all anxiety disorders, responding in most cases to certain kinds of Cognitive Behavioral Therapy (CBT), which helps change thinking patterns that lead to fear and anxiety. […] The most effective treatments for Panic Disorder include Cognitive Behavioral Therapy (CBT), medication, or both. Cognitive Behavior Therapy is especially useful for treating panic disorder. […] Your psychologist should work with your psychiatrist to track your progress. […] Doctors also commonly prescribe medication to help treat panic disorder. The most commonly prescribed medications for panic disorder are anti-anxiety medications and antidepressants. […] Interestingly, there is evidence to suggest the combination of medication and CBT also leads to high relapse rates, indicating CBT is the treatment of choice for Panic Disorder.

• #52 Treatment of Panic Disorder | AAFP

  https://www.aafp.org/pubs/afp/issues/2005/0215/p733.html

  Patients with panic disorder have several treatment options. Determining which treatment is best for a given patient is done through a shared decision-making process between the patient and physician. […] Antidepressant medications have been shown to reduce panic severity, eliminate attacks, and improve overall quality-of-life measures in patients with panic disorder. […] Cognitive behavior therapy (CBT) includes many techniques, such as applied relaxation, exposure in vivo, exposure through imagery, panic management, breathing retraining, and cognitive restructuring. Meta-analyses support the efficacy of CBT in improving panic symptoms and overall disability. […] Although the evidence indicates that anti-depressants and CBT alone are effective in treating panic disorder, it remains unclear whether one treatment modality is superior to the other.

• #53 What treatments should I be offered for panic disorder? | Information for the public | Generalised anxiety disorder and panic disorder in adults: management | Guidance | NICE

  https://www.nice.org.uk/guidance/cg113/ifp/chapter/what-treatments-should-i-be-offered-for-panic-disorder

  If you and your healthcare professional decide on medication, your healthcare professional should discuss with you how it will work and all of its potential side effects. […] There are many things you can do yourself that can be successful in reducing panic attacks. […] If you have tried one type of treatment and it hasn’t worked, your healthcare professional should discuss with you whether to try another type of treatment. […] In specialist care you may meet with a psychiatrist, a psychiatric nurse, a clinical psychologist, an occupational therapist or a social worker. The specialist may offer psychological treatment and/or medication.

• #54 Panic attacks and panic disorder – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/panic-attacks/diagnosis-treatment/drc-20376027

  Medications can help reduce symptoms associated with panic attacks as well as depression if that’s an issue for you. Several types of medication have been shown to be effective in managing symptoms of panic attacks, including: […] Selective serotonin reuptake inhibitors (SSRIs). Generally safe with a low risk of serious side effects, SSRI antidepressants are typically recommended as the first choice of medications to treat panic attacks. […] If one medication doesn’t work well for you, your doctor may recommend switching to another or combining certain medications to boost effectiveness. Keep in mind that it can take several weeks after first starting a medication to notice an improvement in symptoms. […] All medications have a risk of side effects, and some may not be recommended in certain situations, such as pregnancy. Talk with your doctor about possible side effects and risks.

• #55 Panic Disorder Treatment: Psychotherapy, Medication, and More

  https://psychcentral.com/anxiety/panic-disorder-treatment

  Tricyclic antidepressants (TCAs) may also be effective in treating panic disorder. […] Monoamine oxidase inhibitors (MAOIs) can be effective for panic disorder too. […] Overall, before starting any medication, it’s critical to talk with your healthcare provider about possible side effects. […] Though psychotherapy and medication are considered first-line treatments for panic disorder, there are several things you can try on your own to help you feel better. […] Research has found that engaging in aerobic exercise can decrease symptoms of anxiety in people with panic disorder. […] Both breathing and relaxation techniques have been found to be effective tools when it comes to treating panic disorder. […] There are many excellent books written by anxiety experts that can help you better understand and cope with anxiety and panic.

• #56 Panic Attack Treatments: Medications & Remedies

  https://www.webmd.com/anxiety-panic/understanding-panic-attack-treatment

  Your doctor may decide that medication should be part of your therapy, to lessen your attacks physical symptoms. It might be part of the first steps, for instance. […] You and your doctor may have to try more than one medication before finding what works best. Some people do best with more than one type. […] While youre working to get better, it helps to have people around you to help. If you join a support group, you could draw strength and encouragement from others who face the same challenges. […] Conquering panic attacks takes time. If you have weekly therapy sessions, you should start to notice results in 10 to 20 weeks. Some studies show improvement after just 12 weeks. After a year, you should feel a huge improvement.

• #57 What treatments should I be offered for panic disorder? | Information for the public | Generalised anxiety disorder and panic disorder in adults: management | Guidance | NICE

  https://www.nice.org.uk/guidance/cg113/ifp/chapter/what-treatments-should-i-be-offered-for-panic-disorder

  If you and your healthcare professional decide on medication, your healthcare professional should discuss with you how it will work and all of its potential side effects. […] There are many things you can do yourself that can be successful in reducing panic attacks. […] If you have tried one type of treatment and it hasn’t worked, your healthcare professional should discuss with you whether to try another type of treatment. […] In specialist care you may meet with a psychiatrist, a psychiatric nurse, a clinical psychologist, an occupational therapist or a social worker. The specialist may offer psychological treatment and/or medication.

• #58 Treatment of panic disorder – Australian Prescriber

  https://australianprescriber.tg.org.au/articles/treatment-of-panic-disorder.html

  Alprazolam and clonazepam are effective for the acute therapy and the maintenance treatment of panic disorder. […] Several antidepressants have been used to treat panic disorder. […] If antidepressants work they should be continued for a minimum of six months. […] Cognitive behaviour therapy can be usefully helped with cognitive behaviour therapy. […] If symptoms are more marked, if the patient cannot relate to cognitive behaviour therapy, or if improvement is inadequate with the psychological approach alone, medications can be very helpful. […] After a response most patients on pharmacotherapy would be expected to continue treatment for 6-12 months usually in conjunction with cognitive behaviour therapy.

• #59 Panic Disorder and Panic Attacks | familydoctor.org

  https://familydoctor.org/condition/panic-disorder/

  Anti-anxiety medicines are another useful medication for panic disorder. As their name suggests, these medicines give relief from fear and anxiety. They should be used only for a short period of time (a few weeks to a few months) unless you absolutely can’t function without them. Never suddenly stop taking either of these medicines. If you need to stop, these medicines should be tapered off over several weeks. This should only be done under your doctor’s supervision. […] How long treatment continues depends on you. Stopping panic attacks completely is a reasonable goal. Your doctor will design a treatment plan just for you. A treatment period lasting at least 6 to 9 months is usually recommended. Some people taking medicine for panic disorder can stop treatment after only a short time. Other people need to continue treatments over a long period of time, or even for their lifetime.

• #60 Overcoming Panic Disorder

  https://give.brighamandwomens.org/overcoming-panic-disorder/

  CBT sessions are usually conducted on a weekly basis and last for around 12 to 16 sessions. The treatment tends to show long-lasting results, and relapse is uncommon. […] Therapy isn’t always covered by insurance. Because of this, people with panic disorder can live with a highly treatable disorder and not know how to treat it.

• #61 Panic Disorder Treatment: Psychotherapy, Medication, and More

  https://psychcentral.com/anxiety/panic-disorder-treatment

  Talk therapy, especially cognitive behavioral therapy (CBT), and certain medications are often recommended to treat panic disorder. […] Psychotherapy, also called talk therapy, is often recommended as a first-line treatment for panic disorder. […] While cognitive behavioral therapy (CBT) is the best known and most researched therapy for panic disorder, other psychotherapy methods are available too. […] The National Institute for Health and Care Excellence, which provides evidence-based recommendations for health and care in England, recommends CBT as the first-line treatment for panic disorder. […] CBT typically consists of 12 sessions at 60 minutes each week. […] In addition, your therapist will help you face uncomfortable sensations that normally trigger anxiety and help you learn to cope with them.

• #62 Treatment-Resistant Panic Disorder

  https://www.psychiatrictimes.com/view/treatment-resistant-panic-disorder

  Panic disorder (PD), a common and impairing anxiety syndrome, is generally readily diagnosable and treatable. Its phenomenology is diverse, including acute fear episodes (spontaneous and cued panics), anticipatory anxiety, and physical sensation sensitivity. PD is also frequently accompanied by agoraphobia and is more likely to affect women. […] Concerning the natural history of PD, approximately one-third of patients have a clinical remission with standard interventions (pharmacotherapies and cognitive behavioral therapy [CBT]), without subsequent episodes. In another third, the course of the illness is characterized by recurrent episodes, which remain treatment-sensitive. However, a third go on to have chronic, persistent symptoms-and the majority of these patients have treatment-resistant panic (TRP).

• #63 Panic disorder – NHS

  https://www.nhs.uk/mental-health/conditions/panic-disorder/

  Treatment aims to reduce the number of panic attacks you have and ease your symptoms. […] Talking therapies and medicine are the main treatments for panic disorder. Your treatment will depend on your symptoms. […] You can refer yourself directly to a talking therapies service for treatment based on cognitive behavioural therapy (CBT). […] If you and your doctor think it might be helpful, you may be prescribed: a type of antidepressant called a selective serotonin reuptake inhibitor (SSRI) or, if SSRIs are not suitable, a tricyclic antidepressant (usually imipramine or clomipramine). […] If your symptoms do not improve after CBT, medicine and connecting with a support group, your GP may refer you to a mental health specialist such as a psychiatrist or clinical psychologist. […] Panic disorder is treatable so it’s best to get medical help as soon as you can.

• #64 Treatment-Resistant Panic Disorder

  https://www.psychiatrictimes.com/view/treatment-resistant-panic-disorder

  Treatment resistance in PD may be apparent or real. Apparent treatment resistance may be due to a range of clinical factors including unstable psychiatric and medical comorbidities, patient adherence problems, clinician availability (important to PD patients early in treatment), or therapeutic alliance problems, often driven by cognitive and behavioral avoidance. […] Evidence-based pharmacotherapies include SSRIs, SNRIs, TCAs, the MAOI phenelzine, and benzodiazepine agonists (eg, clonazepam and alprazolam, which are approved by the FDA for panic). Recommended psychotherapies include CBT (especially individual CBT). Data from a large meta-analysis of anxiety studies suggest that combination treatment (medication plus CBT) is likely to be superior to monotherapy and should now be routinely offered.

• #65 Treatment-Resistant Panic Disorder

  https://www.psychiatrictimes.com/view/treatment-resistant-panic-disorder

  Although the patient has a diagnosis of TRP, the goal of treatment is still to achieve a remission state, as this protects against relapse and lowers the risk of complications. […] Benzodiazepines are similarly effective to antidepressants for panic disorder, and their panicolytic benefit is almost always sustained over the long term. […] The concern that benzodiazepines disrupt the effectiveness of evidence-based psychotherapies for panic, such as CBT, has not been confirmed in recent anxiety clinical trials. […] Effective psychotherapies for PD include CBT (strongest evidence), panic-focused psychodynamic psychotherapy, and CBT with a mindfulness component, and these are also suitable options for TRP. […] TRP should be treated vigorously with this goal in mind, as residual symptoms confer a higher risk of clinical complications.

• #66 Treatment-Resistant Panic Disorder

  https://www.psychiatrictimes.com/view/treatment-resistant-panic-disorder

  Although the patient has a diagnosis of TRP, the goal of treatment is still to achieve a remission state, as this protects against relapse and lowers the risk of complications. […] Benzodiazepines are similarly effective to antidepressants for panic disorder, and their panicolytic benefit is almost always sustained over the long term. […] The concern that benzodiazepines disrupt the effectiveness of evidence-based psychotherapies for panic, such as CBT, has not been confirmed in recent anxiety clinical trials. […] Effective psychotherapies for PD include CBT (strongest evidence), panic-focused psychodynamic psychotherapy, and CBT with a mindfulness component, and these are also suitable options for TRP. […] TRP should be treated vigorously with this goal in mind, as residual symptoms confer a higher risk of clinical complications.

• #67 Panic Disorder Treatment: Psychotherapy, Medication, and More

  https://psychcentral.com/anxiety/panic-disorder-treatment

  Tricyclic antidepressants (TCAs) may also be effective in treating panic disorder. […] Monoamine oxidase inhibitors (MAOIs) can be effective for panic disorder too. […] Overall, before starting any medication, it’s critical to talk with your healthcare provider about possible side effects. […] Though psychotherapy and medication are considered first-line treatments for panic disorder, there are several things you can try on your own to help you feel better. […] Research has found that engaging in aerobic exercise can decrease symptoms of anxiety in people with panic disorder. […] Both breathing and relaxation techniques have been found to be effective tools when it comes to treating panic disorder. […] There are many excellent books written by anxiety experts that can help you better understand and cope with anxiety and panic.

• #68 How to stop a panic attack: 11 effective methods

  https://www.medicalnewstoday.com/articles/321510

  Panic attacks can be sudden and overpowering. Steps such as deep breathing, grounding techniques, light exercise, or repeating a mantra may help relieve the symptoms of a panic attack. […] This article looks at 11 ways to stop a panic attack, general methods for reducing anxiety, and how to help when someone else is having a panic attack. […] Panic attacks can cause physical and emotional symptoms, including: sweating, rapid breathing, a racing heartbeat, feelings of fear and anxiety, intense and repetitive worrying, a sense of impending doom. […] Below are 11 methods people can use to help regain control and reduce the symptoms of a panic attack. […] Practicing muscle relaxation techniques may help limit an attack. […] A technique called progressive muscle relaxation is a popular, effective method for coping with anxiety and panic attacks.

• #69 How to stop a panic attack: 11 effective methods

  https://www.medicalnewstoday.com/articles/321510

  During a panic attack, it can help to remember that these feelings will pass and cause no physical harm, however disconcerting it feels at the time. […] Deep breathing, also known as diaphragmatic breathing, can benefit people with anxiety disorders and panic attacks. […] Grounding techniques such as this can help people experiencing panic attacks, anxiety, and trauma. […] The 5-4-3-2-1 method is a grounding technique and a type of mindfulness. It helps direct the person’s focus away from sources of stress. […] A mantra is a word, phrase, or sound that may help with focus and provide strength. […] Walking can remove a person from a stressful environment, and the rhythm of walking may also help them regulate their breathing. […] Depending on the severity of panic attacks, a doctor may prescribe a use-as-necessary medication.

• #70 Panic Disorder: MedlinePlus

  https://medlineplus.gov/panicdisorder.html

  Panic disorder is a type of anxiety disorder. It causes repeated panic attacks, which are sudden periods of intense fear, discomfort, or a sense of losing control. […] Treatment for panic disorder usually includes one or more of the following: […] Talk therapy, also called psychotherapy or counseling, which can help you understand your feelings. […] It may include cognitive-behavioral therapy (CBT), a type of talk therapy that helps you change your negative thoughts and how you react to things that cause you to feel anxiety. […] Medicines, including: Antidepressants, such as selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) […] Anti-anxiety medicines. […] Your provider may also suggest that you follow a healthy lifestyle, which may help with panic disorder. […] Joining a support group may also be helpful. Support groups can make you feel like you are not alone, and you may learn some new tips on how to cope.

• #71 Panic Attack Treatments: Medications & Remedies

  https://www.webmd.com/anxiety-panic/understanding-panic-attack-treatment

  Your doctor may decide that medication should be part of your therapy, to lessen your attacks physical symptoms. It might be part of the first steps, for instance. […] You and your doctor may have to try more than one medication before finding what works best. Some people do best with more than one type. […] While youre working to get better, it helps to have people around you to help. If you join a support group, you could draw strength and encouragement from others who face the same challenges. […] Conquering panic attacks takes time. If you have weekly therapy sessions, you should start to notice results in 10 to 20 weeks. Some studies show improvement after just 12 weeks. After a year, you should feel a huge improvement.

• #72 Panic Disorder | NAMI Michigan

  https://namimi.org/mental-illness/panic-disorder

  Patients learn to make the feared object or situation less threatening as they are exposed to, and slowly get used to, whatever is so frightening to them. […] Family members and friends help a great deal in this process when they are supportive and encouraging. […] Medication is most effective when it is used as part of an overall treatment plan that includes supportive therapy. […] Antidepressants and antianxiety medications are the most successful medications for this disorder. […] Healthy living habits may also help people overcome panic disorder. […] Exercise, a proper and balanced diet, moderate use of caffeine and alcohol, and learning how to reduce stress are all important. […] Peer support is a vital part of overcoming panic disorder. […] Family and friends can play a significant role in the treatment process and should be informed of the treatment plan and of the ways they can be most helpful.

• #73 Learn About Panic Attacks and Panic Disorder | Psychology Tools

  https://www.psychologytools.com/articles/learn-about-panic-attacks-and-panic-disorder

  Cognitive Behavioral Therapy (CBT) is an extremely effective treatment for panic disorder: about 80% of people with panic disorder who complete a course of CBT are panic-free at the end of treatment. […] Research has indicated that psychological therapy, or a combination of psychological therapy plus antidepressant medication, is the treatment of choice for panic disorder. One of the most effective psychological treatments for panic is cognitive behavioral therapy (CBT). […] The UK National Institute of Health and Care Excellence (NICE) guidelines for panic disorder recommend that the only medicines that should be used in the longer-term management of panic disorder are selective serotonin reuptake inhibitors (SSRIs) and tricyclic antidepressants (TCAs).

• #74 Panic Disorder

  https://www.massgeneral.org/condition/panic-disorder

  Panic disorder is when you have repeated, unexpected panic attacks and worry constantly about when the next one might happen. Medicines and therapy can help. […] Treatment may include: Anti-anxiety and antidepressant medicines, Counseling, such as cognitive behavioral therapy or group therapy. […] Treatment for panic disorders is often very effective. Treatment will help you learn to recognize that the symptoms are not life-threatening. You will also learn coping skills and ways to relax. This can help decrease the intensity and length of the panic attack. […] Treatment is effective. It includes anti-anxiety medicines and antidepressants along with cognitive behavioral therapy.

• #75 Learn About Panic Attacks and Panic Disorder | Psychology Tools

  https://www.psychologytools.com/articles/learn-about-panic-attacks-and-panic-disorder

  Cognitive Behavioral Therapy (CBT) is an extremely effective treatment for panic disorder: about 80% of people with panic disorder who complete a course of CBT are panic-free at the end of treatment. […] Research has indicated that psychological therapy, or a combination of psychological therapy plus antidepressant medication, is the treatment of choice for panic disorder. One of the most effective psychological treatments for panic is cognitive behavioral therapy (CBT). […] The UK National Institute of Health and Care Excellence (NICE) guidelines for panic disorder recommend that the only medicines that should be used in the longer-term management of panic disorder are selective serotonin reuptake inhibitors (SSRIs) and tricyclic antidepressants (TCAs).

• #76 Panic Disorder – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK430973/

  In patients with co-existing conditions or where the patients are having severe symptoms, it is preferred that a benzodiazepine such as alprazolam is used until the anti-depressants take effect. […] Pharmacotherapy and cognitive-behavioral therapy should be discussed with the patients so that they can understand the treatment options for the condition that they have. […] A team approach to the care of these patients will lead to the best outcomes. […] The currently available pharmacological therapy and cognitive behavior therapy does work in about 80% of patients, but relapses are common.

• #77 Cognitive behavioral group therapy for panic disorder in a general clinical setting: a prospective cohort study with 12 to 31-years follow-up | BMC Psychiatry | Full Text

  https://bmcpsychiatry.biomedcentral.com/articles/10.1186/s12888-020-02679-w

  The effect size of the long-term change (mean change/ pooled SD) in the PARS-total score was (1.6, p0.001) and was stable over time. A PARS-total score reduction of 50% was found in 98% of patients at the long-term follow-up. […] Of the patients, 95% reported high to very high satisfaction with the CBT, and 93% reported large treatment benefits. […] To the best of our knowledge, this study has the longest follow-up after group CBT for panic disorder and agoraphobia, showing a good prognosis in 93% of the participating patients. […] The patients HRQoL and QoL were similar to the expected scores for the general Norwegian population. […] The positive benefits of regular physical activity were emphasized, and the ways in which physical activity influences health in general and anxiety specifically were explained.

• #78 Cognitive behavioral group therapy for panic disorder in a general clinical setting: a prospective cohort study with 12 to 31-years follow-up | BMC Psychiatry | Full Text

  https://bmcpsychiatry.biomedcentral.com/articles/10.1186/s12888-020-02679-w

  The main strength of this study is its length of follow-up. […] Our study suggests that CBT in groups is feasible and that the therapeutic gains last for a very long period of time. This finding is good news for a common mental health problem. However, further studies are needed to establish a robust body of evidence on this matter.

• #79 Anxiety Disorders: Causes, Symptoms, Treatment & Types

  https://my.clevelandclinic.org/health/diseases/9536-anxiety-disorders

  Anxiety disorders can make it difficult to get through the day. Fortunately, there are several effective treatments for these conditions. […] An anxiety disorder is like any other health condition that requires treatment. You cant will it away. Its not a matter of self-discipline or attitude. Researchers have made a lot of progress in the last few decades in treating mental health conditions. Your healthcare provider will tailor a treatment plan that works for you. Your plan may include a combination of medication and psychotherapy (talk therapy). […] Medications cant cure an anxiety disorder. But they can improve the symptoms and help you function better. Medications for anxiety disorders often include: […] Psychotherapy, also called talk therapy, is a term for a variety of treatment techniques that aim to help you identify and change unhealthy emotions, thoughts and behaviors. A mental health provider talks through strategies to help you better understand and manage an anxiety disorder. Approaches include:

• #80 Anxiety Disorders: Causes, Symptoms, Treatment & Types

  https://my.clevelandclinic.org/health/diseases/9536-anxiety-disorders

  Treatment is effective. The right treatment can help improve your quality of life, relationships and productivity. It can also support your overall well-being. […] If you notice symptoms of an anxiety disorder, talk to a healthcare provider. Its best to get diagnosed and treated as soon as possible. Doing so can limit the problems that anxiety disorders can cause. Often, a combination of medications and counseling for anxiety can help you feel your best.

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