Cognitive behavioral therapy is a symptom-oriented approach to the treatment of panic disorder. Some components contained in this approach include psychoeducation, continuous panic monitoring, breathing retraining, cognitive restructuring focused on correction of catastrophic misinterpretation of bodily sensations, and exposure to fear cues. Effective medications include selective serotonin reuptake inhibitors, tricyclic antidepressants and monoamine oxidase inhibitors, and benzodiazepines. The goals, efficacy, side effects and implementation issues for each class of medications are discussed. The APA guideline strongly recommends that patients suspected of having panic disorder be thoroughly evaluated with special attention to the presence of other illnesses frequently associated with panic disorder, such as depression and substance use disorders.
Alcohol consumption promotes inflammation, cell death and scarring in the liver.
Susceptibility to alcohol-induced liver disease differs considerably among individuals, making it difficult to predict who will develop liver disease by how much they drink. Abstinence is the cornerstone of management for alcohol-induced liver disease. Fatty liver and alcoholic hepatitis are frequently reversible, and survival is improved among patients who abstain from alcohol, including those with cirrhosis. Liver transplantation is the only effective treatment for terminally ill patients. It is indicated for patients who are already receiving and who can tolerate opioid therapy for their underlying persistent cancer pain.