Pharmacological Treatment Of Panic Disorder Research Articles

Long-Term Pharmacologic Treatment of Panic Disorder

Acute and follow-up studies of these pharmacotherapeutic agents suggest that many patients, though improved, remain symptomatic despite treatment.

Pharmacologic treatment of panic disorder

Several pharmacologic agents, including tricyclic antidepressants, monoamine oxidase inhibitors, selective serotonin reuptake inhibitors, and benzodiazepines, have proven effective in the treatment of panic disorder. Complicating factors, such as comorbid conditions and inappropriate diagnosis and treatment, can interfere with the effective management of this illness. An educational model developed at the University of Pisa for treating panic disorder divides the treatment process into eight consecutive phases, which are independent of the type of antipanic agent used. The model provides the clinician with an orderly and logical method for adjusting treatment measures according to the needs of the patient. The first three phases of the treatment model involve the initiation and dose titration of antipanic medication to a level sufficient for the elimination of panic attacks. Treatment is continued during the next three phases, and any adjustments required to maintain efficacy are made. Pharmacologic treatment is slowly and gradually tapered off during the last two phases.

A meta-analysis of treatments for panic disorder.

In a meta-analysis, the authors compared the effectiveness of psychological and pharmacological treatments for panic disorder. Percentage of agoraphobic subjects in the sample and duration of the illness were unrelated to effect size (ES). Type of dependent variable was generally unrelated to treatment outcome, although behavioral measures yielded significantly smaller ESs. Dependent measures of general anxiety, avoidance, and panic attacks yielded larger ESs than did depression measures. Choice of control was related to ES, with comparisons with placebo controls greater than comparisons with exposure-only or "other treatment" controls. Psychological coping strategies involving relaxation training, cognitive restructuring, and exposure yielded the most consistent ESs; flooding and combination treatments (psychological and pharmacological) yielded the next most consistent ESs. Antidepressants were the most effective pharmacological intervention.

A meta-analysis of treatments for panic disorder.

In a meta-analysis, the authors compared the effectiveness of psychological and pharmacological treatments for panic disorder. Percentage of agoraphobic subjects in the sample and duration of the illness were unrelated to effect size (ES). Type of dependent variable was generally unrelated to treatment outcome, although behavioral measures yielded significantly smaller ESs. Dependent measures of general anxiety, avoidance, and panic attacks yielded larger ESs than did depression measures. Choice of control was related to ES, with comparisons with placebo controls greater than comparisons with exposure-only or "other treatment" controls. Psychological coping strategies involving relaxation training, cognitive restructuring, and exposure yielded the most consistent ESs; flooding and combination treatments (psychological and pharmacological) yielded the next most consistent ESs. Antidepressants were the most effective pharmacological intervention.

A meta-analysis of treatments for panic disorder with agoraphobia: Imipramine, alprazolam, and in vivo exposure

The most common pharmacological treatments for panic disorder with agoraphobia (PDA) include the use of imipramine and alprazolam while the most common behavior therapy is the use of graded in vivo exposure. Several studies have found these treatments to be superior to placebo in the treatment of PDA, but it has not been clear if there are differences among these three treatments. It has also not been clear for what aspects of PDA each treatment is the most effective. The purpose of this study was to conduct a meta- analysis of the results of relevant treatment outcome studies on a number of dependent variables (e.g., panic attack severity, dysphoria, avoidance behavior). Few studies satisfied the minimum criteria for inclusion and the final data pool consisted of 34 treatments studies. Imipramine was found to be generally ineffective for most variables. Alprazolam was significantly effective for panic and anxiety variables in PDA, while exposure was significantly effective for phobia variables. Exposure had the most consistently strong effect sizes.

Pharmacological Treatment of Panic Disorder

Panic disorder has recently been recognized as a distinct sub-type of anxiety which may occur with or without phobic avoidance. Controlled prospective trials have demonstrated the efficacy of the tricyclic antidepressants and monoamine oxidase inhibitors in the treatment of this disorder. The use of benzodiazepines and beta-blockers has been more controversial. Some preliminary studies assessing other pharmacological agents are available. Methodological problems limit the conclusions which may be drawn from available data.