Quetiapine extended-release augmentation has not been found to be beneficial , in comparison to placebo , in non-responders to previously recommended pharmacotherapy .
In non-responders to cognitive behavioral therapy ( CBT ) , switching to paroxetine/citalopram has been found to be more effective than continuing CBT .
Acceptance and commitment therapy ( ACT ) has shown some improvement in patients ’ resistance to previous psychological/pharmacological interventions compared with a waiting-list condition .
Prolonged pharmacotherapy may produce significant improvement in patients with unsatisfactory response to short-term pharmacotherapy  , while switching to pharmacotherapy may help non-responders to CBT .
Purpose of Review Purpose of Review Management of treatment-resistant ( TR ) panic disorder ( PD ) is an unresolved issue .
In this paper , we provide a brief summary of previous findings , an up date d ( 2015–2017 ) systematic review of pharmacological/non-pharmacological studies , and our personal perspective on this topic .
Paroxetine Decreases Respiratory Irregularity of Linear and Nonlinear Measures of Respiration in Patients with Panic Disorder
Previous studies indicate that serotonin reuptake inhibitors do not appear to have serious cardiac side effects . However , the effects of these agents on respiratory measures have not been studied in detail . Several studies indicate that patients with anxiety exhibit irregular breathing patterns as measured by tidal volume and respiratory rate . In this study , we evaluated the effects of a serotonin reuptake inhibitor , paroxetine , on respiratory variability in patients with panic disorder ( n = 13 ) , using linear and nonlinear measures of regularity , approximate entropy ( APEN ) and a measure of chaos , the largest Lyapunov exponent ( LLE ) , with pre- and posttreatment lung volume time series ( 256 s long sample d at 4 Hz ) . Our results show that paroxetine significantly decreases some of the linear measures of variability and supine APEN and st and ing LLE of lung volume series after successful treatment . The implication s of these findings on respiratory and cardiovascular function have been discussed
Quetiapine extended-release augmentation has not been found to be beneficial , in comparison to placebo , in non-responders to previously recommended pharmacotherapy .
In non-responders to cognitive behavioral therapy ( CBT ) , switching to paroxetine/citalopram has been found to be more effective than continuing CBT .
Acceptance and commitment therapy ( ACT ) has shown some improvement in patients ’ resistance to previous psychological/pharmacological interventions compared with a waiting-list condition .
Prolonged pharmacotherapy may produce significant improvement in patients with unsatisfactory response to short-term pharmacotherapy  , while switching to pharmacotherapy may help non-responders to CBT .
Purpose of Review Purpose of Review Management of treatment-resistant ( TR ) panic disorder ( PD ) is an unresolved issue .
In this paper , we provide a brief summary of previous findings , an up date d ( 2015–2017 ) systematic review of pharmacological/non-pharmacological studies , and our personal perspective on this topic .