INTEGRATED TREATMENT OF PANIC DISORDER

The purpose of this article is to provide the nonpsychiatric physician with a practical approach to the treatment of panic disorder by reviewing the literature on treatment efficacy. The author reviews studies and uncontrolled case series on pharmacologic and nonpharmacologic treatment of panic disorder and presents a clinical approach based on these. Setting the stage for treatment by educating patients and obtaining a detailed description of their particular clinical syndrome is a vital, but frequently neglected, precursor to treatment. Treatment selection is based on a risk-benefit analysis of the individual treatment and the particular exigencies of the patient's clinical presentation. Both pharmacologic and nonpharmacologic therapies are highly effective for acute treatement. Because panic disorder is a chronic illness, long-term treatment or reinitiation of acute treatment at a later date is often required.