Panic disorder: clinical phenomena and treatment options

Sivolap Iu.P.

doi:https://doi.org/10.17116/jnevro20171174112-116

Close metadata

Recommended articles:

The state of mental health of migrant workers and citizens of the Russian Federation: A comparative analysis as illustrated by the Moscow region. S.S. Korsakov Journal of Neurology and Psychiatry. 2025;(4):95-101

Factors of depression according to actigraphy in the fall season. S.S. Korsakov Journal of Neurology and Psychiatry. 2025;(5-2):27-32

Identification of depression biomarkers: Prospects for use in clinical practice. S.S. Korsakov Journal of Neurology and Psychiatry. 2025;(5):51-55

Depression Anxiety Stress Scale (russian language version). S.S. Korsakov Journal of Neurology and Psychiatry. 2025;(5):103-107

Investigation of the relationship of individual characteristics of the brain bioelectrical activity with levels of mental stress, aggression, anxiety, and depression. S.S. Korsakov Journal of Neurology and Psychiatry. 2025;(5):108-117

Modern concepts of sleep disturbances associated with mental disorders. S.S. Korsakov Journal of Neurology and Psychiatry. 2025;(6):7-12

Validation of the Snaith—Hamilton Pleasure Scale to assess anhedonia in patients with unipolar depression In Russia. S.S. Korsakov Journal of Neurology and Psychiatry. 2025;(7):110-121

Sore throat and panic attacks: is a relationship possible? Clinical example. Russian Bulletin of Otorhinolaryngology. 2025;(2):69-73

Gender characteristics of cardiovascular diseases psychosocial risk factors associations with sleep quality in an open urban population. Russian Journal of Preventive Medicine. 2025;(6):67-73

Dysfunctional pelvic pain in women. Russian Journal of Pain. 2025;(2):32-37

Abstract:

Panic disorder is a common mental disease with high psychiatric comorbidity. It is considered that a combination of genetic predisposition and a special psychic vulnerability plays a key role in the occurrence of panic disorder. Clinically proven efficacy in the treatment of panic disorder have benzodiazepines, tricyclic antidepressants, monoamine oxidase inhibitors, selective serotonin reuptake inhibitors and selective serotonin and norepinephrine reuptake inhibitors; antidepressants from other pharmaceutical groups are also used. Selective serotonin reuptake inhibitors are the first line medicines in the treatment of panic disorder. Atypical antipsychotics may be used for the therapy augmentation in addition to first line drugs. Psychotherapy is used along with medications, and a combination of pharmacotherapy and cognitive behavioral therapy is the best method of treatment.

Keywords:

panic attack; panic disorder; agoraphobia; depression; benzodiazepines; tricyclic antidepressants; monoamine oxidase inhibitors; selective serotonin reuptake inhibitors; selective serotonin and norepinephrine reuptake inhibitors; cognitive-behavioral therapy

Authors:

Sivolap Iu.P.

Moskovskaia meditsinskaia akademiia im. I.M. Sechenova

Close metadata

References:

Semple D, Smyth R. Oxford Handbook of Psychiatry (Third Edition). Oxford: Oxford University Press; 2013.
de Jonge P, Roest AM, Lim CC, Florescu SE, Bromet EJ, Stein DJ, Harris M, Nakov V, Caldas-de-Almeida JM, Levinson D, Al-Hamzawi AO, Haro JM, Viana MC, Borges G, O'Neill S, de Girolamo G, Demyttenaere K, Gureje O, Iwata N, Lee S, Hu C, Karam A, Moskalewicz J, Kovess-Masfety V, Navarro-Mateu F, Browne MO, Piazza M, Posada-Villa J, Torres Y, Ten Have ML, Kessler RC, Scott KM. Cross-national epidemiology of panic disorder and panic attacks in the world mental health surveys. Depress Anxiety. 2016. doi:10.1002/da.22572
Kessler RC, Chiu WT, Jin R, Ruscio AM, Shear K, Walters EE. The epidemiology of panic attacks, panic disorder, and agoraphobia in the National Comorbidity Survey Replication. Arch Gen Psychiatry. 2006;63(4):415-424. doi:10.1001/archpsyc.63.4.415
Black DW, Andreasen NC. Introductory Textbook of Psychiatry (Sixth Edition). Arlington: American Psychiatric Publishing; 2014.
Carleton RN. The intolerance of uncertainty construct in the context of anxiety disorders: theoretical and practical perspectives. Expert Rev Neurother. 2012;12(8):937-947. doi:10.1586/ern.12.82
Michel NM, Rowa K, Young L, McCabe RE. Emotional distress tolerance across anxiety disorders. J Anxiety Disord. 2016;40:94-103. doi:10.1016/j.janxdis.2016.04.009
Osma López J, Barrada González JR, García-Palacios A, Botella Arbona C. Influence of vulnerability factors in panic disorder severity. Psicothema. 2016;28(2):167-173. doi:10.7334/psicothema2015.223
Shihata S, McEvoy PM, Mullan BA. Pathways from uncertainty to anxiety: an evaluation of a hierarchical model of trait and disorder-specific intolerance of uncertainty on anxiety disorder symptoms. J Anxiety Disord. 2016;45:72-79. doi:10.1016/j.janxdis.2016.12.001
Diagnostic and Statistical Manual of Mental Disorders: DSM-5. Fifth Edition. Washington, D.C.: American Psychiatric Association; 2013.
den Boer JA, Slaap BR. Review of current treatment in panic disorder. Int Clin Psychopharmacol. 1998;13(suppl 4):25-30.
Lader M. Management of panic disorder. Expert Rev Neurother. 2005;5(2):259-266. doi:10.1586/14737175.5.2.259
Schatzberg A, DeBattista C. Manual of Clinical Psychopharmacology (Eight Edition). Washington, DC: American Psychiatric Publishing; 2015.
Anxiety Disorders: Panic Disorder and Social Anxiety Disorder (Edited by D. Nutt and J. Ballenger). Oxford: Wiley-Blackwell; 2005.
Taylor D, Paton C, Kapur S. The Maudsley Prescribing Guidelines in Psychiatry (Eleventh Edition). Chichester: Wiley-Blackwell; 2012.
Hirsh A, Proescholdbell SK, Bronson W, Dasgupta N. Prescription histories and dose strengths associated with overdose deaths. Pain Med. 2014;15(7):1187-1195.
Syunyakov S.A., Teleshova E.S. Fenazepam — effektivnyi benzodiazepinovyi anksiolitik pri terapii psikhicheskikh narushenii pogranichnogo urovnya. Psikhiatriya i psikhofarmakoterapiya. 2013;6:42-47.
Pribytkov A.A. Effektivnost' benzodiazepinov i nizkopotentnykh antipsikhotikov v kachestve ad"yuvantnoi terapii somatoformnykh rasstroistv. Zhurnal nevrologii i psikhiatrii im. S.S. Korsakova. 2016;116(5):52-56. doi:10.17116/jnevro20161165152-56
Batelaan NM, Van Balkom AJ, Stein DJ. Evidence-based pharmacotherapy of panic disorder: an update. Int J Neuropsychopharmacol. 2012;15(3):403-415. doi:10.1017/S1461145711000800
Andrisano C, Chiesa A, Serretti A. Newer antidepressants and panic disorder: a meta-analysis. Int Clin Psychopharmacol. 2013;28(1):33-45. doi:10.1097/YIC.0b013e32835a5d2e
Serretti A, Chiesa A, Calati R, Perna G, Bellodi L, De Ronchi D. Novel antidepressants and panic disorder: evidence beyond current guidelines. Neuropsychobiology. 2011;63(1):1-7. doi:10.1159/000321831
Freire RC, Machado S, Arias-Carrión O, Nardi AE. Current pharmacological interventions in panic disorder. CNS Neurol Disord Drug Targets. 2014;13(6):1057-1065.
Perna G, Alciati A, Riva A, Micieli W, Caldirola D. Long-term pharmacological treatments of anxiety disorders: an updated systematic review. Curr Psychiatry Rep. 2016;18(3):23. doi:10.1007/s11920-016-0668-3
Montgomery S, Emir B, Haswell H, Prieto R. Long-term treatment of anxiety disorders with pregabalin: a 1 year open-label study of safety and tolerability. Curr Med Res Opin. 2013;29(10):1223-1230. doi:10.1185/03007995.2013.820694
Zwanzger P. Pharmacotherapy of Anxiety Disorders. Fortschr Neurol Psychiatr. 2016;84(5):306-314. doi:10.1055/s-0042-106764
Hoge EA, Worthington JJ 3rd, Kaufman RE, Delong HR, Pollack MH, Simon NM. Aripiprazole as augmentation treatment of refractory generalized anxiety disorder and panic disorder. CNS Spectr. 2008;13(6):522-527.
Simon NM, Hoge EA, Fischmann D, Worthington JJ, Christian KM, Kinrys G, Pollack MH. An open-label trial of risperidone augmentation for refractory anxiety disorders. J Clin Psychiatry. 2006;67(3):381-385.
Imai H, Tajika A, Chen P, Pompoli A, Furukawa TA. Psychological therapies versus pharmacological interventions for panic disorder with or without agoraphobia in adults. Cochrane Database Syst Rev. 2016;10:CD011170. doi:10.1002/14651858.CD011170.pub2
van Apeldoorn FJ, Timmerman ME, Mersch PP, van Hout WJ, Visser S, van Dyck R, den Boer JA. A randomized trial of cognitive-behavioral therapy or selective serotonin reuptake inhibitor or both combined for panic disorder with or without agoraphobia: treatment results through 1-year follow-up. J Clin Psychiatry. 2010;71(5):574-586. doi:10.4088/JCP.08m04681blu
Pollack MH, Allgulander C, Bandelow B, Cassano GB, Greist JH, Hollander E, Nutt DJ, Okasha A, Swinson RP. World Council of Anxiety. WCA recommendations for the long-term treatment of panic disorder. CNS Spectr. 2003;8(8 suppl 1):17-30.
Bandelow B, Baldwin DS, Zwanzger P. Pharmacological treatment of panic disorder. Mod Trends Pharmacopsychiatri. 2013;29:128-143. doi:10.1159/000351953
Foldes-Busque G, Marchand A, Landry P. Early detection and treatment of panic disorder with or without agoraphobia: update. Can Fam Physician. 2007;53(10):1686-1693.