The author states that infrequent panic attacks rarely lead to disability. This contradicts a growing body of research showing that although patients with infrequent attacks are not as disabled as those with panic disorder, such patients have a poorer quality of life and level of function than panic-free patients. The book offers a good discussion on agoraphobia, but it should emphasize the fact that all patients with agoraphobia need behavioral therapy such as systematic desensitization. One significant omission is the lack of information on the role of diet and exercise in treatment. The book should address the need for avoidance of cardiac stimulants in all patients, not just those receiving treatment with monoamine oxidase inhibitors.
New evidence suggests that inositol can reduce the frequency of panic attacks.
In addition, exercise may help to decrease levels of anxiety and to improve the patient's ability to cope with stress. Two years ago, I had the privilege of reviewing the second edition of this book. At that time, I noted six areas of concern. This edition has corrected three of those deficiencies. In addition to presenting criteria from the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders instead of those from the third revised edition, the book clearly states that medication is used to prevent panic attacks rather than to abort them.