A Medline search of research on pharmacotherapy was undertaken , and a previous systematic review on the evidence -based pharmacotherapy of panic disorder was up date d. Selective serotonin reuptake inhibitors remain a first-line pharmacotherapy of panic disorder , with the serotonin noradrenaline reuptake inhibitor venlafaxine also an acceptable early option .
Temporary co-administration of benzodiazepines can be considered .
For patients not responding to first-line agents several pharmacotherapy options are available , but there is a notable paucity of data on the optimal choice
The evidence -based pharmacotherapy of panic disorder continues to evolve .
This paper review s data on first-line pharmacotherapy , evidence for maintenance treatment , and management options for treatment-refractory patients .
Increased Risk of Acute Myocardial Infarction for Patients With Panic Disorder: A Nationwide Population-Based Study
Objective : To examine prospect ively the relationship between a diagnosis of panic disorder and the risk of acute myocardial infa rct ion within 1 year of follow-up . Panic disorder is associated prospect ively with coronary artery disease , but the risk of acute myocardial infa rct ion associated with panic disorder has not been specifically investigated . Method : This nationwide population -based study used data from the Taiwan National Health Insurance Research Data base covering the years 2000 to 2005 . A total of 9641 patients diagnosed with panic disorder in 2004 were included , together with 28,923 matched nonpanic disorder enrollees as a comparison cohort . Cox proportional hazard regressions were conducted to compute hazard ratios , after adjustment for comorbid medical disorders and sociodemographic characteristics . Results : Results indicated that 4.77 % of patients with panic disorder ( approximately one in 21 ) experienced an acute myocardial infa rct ion episode within a year , compared with 2.73 % of patients in the comparison cohort . The adjusted hazard of acute myocardial infa rct ion was significantly higher ( 1.75 times , 95 % Confidence Interval = 1.55 - 1.97 ) for patients with panic disorder , relative to the comparison cohort . The association persisted in further analyses stratified by hypertension , coronary heart diseases , and age . Conclusion : Panic disorder was identified as an independent risk factor for subsequent acute myocardial infa rct ion . Comprehensive multidisciplinary approaches are needed to optimize primary and secondary prevention of acute myocardial infa rct ion among patients with panic disorder . PD = panic disorder ; CHD = coronary heart disease ; AMI = acute myocardial infa rct ion ; MI = myocardial infa rct ion ; NHIRD = National Health Insurance Research Data base ; NHI = National Health Insurance program ; HR = hazard ratio ; CI = Confidence Interval ; HRV = heart rate variability
A Medline search of research on pharmacotherapy was undertaken , and a previous systematic review on the evidence -based pharmacotherapy of panic disorder was up date d. Selective serotonin reuptake inhibitors remain a first-line pharmacotherapy of panic disorder , with the serotonin noradrenaline reuptake inhibitor venlafaxine also an acceptable early option .
Temporary co-administration of benzodiazepines can be considered .
For patients not responding to first-line agents several pharmacotherapy options are available , but there is a notable paucity of data on the optimal choice
The evidence -based pharmacotherapy of panic disorder continues to evolve .
This paper review s data on first-line pharmacotherapy , evidence for maintenance treatment , and management options for treatment-refractory patients .