The pharmacotherapy of panic disorder Introduction Panic disorder is characterised by recurrent paroxysmal attacks of intense anxiety accompanied by cardiopulmonary, gastrointestinal and neurologic symptoms, autonomic arousal and psychological symptoms, including fears of losing control, going crazy, or dying. Patients may experience anticipatory anxiety and have persistent concerns about additional attacks occurring. Agoraphobia may develop when patients fear or avoid situations in which they previously experienced an attack, from which escape may be difficult or embarrassing, or when help is not readily available.
Panic disorder is common in primary care.
In the USA, over three quarters of patients present for initial evaluation of their symptoms to the general medical setting, and close to half continue to be treated exclusively in such settings. However, panic disorder is often unrecognised, mis-diagnosed, or inappropriately managed in primary care. Panic disorder can cause considerable emotional distress and lead to social and occupational disability. Patients with panic disorder are at increased risk of premature mortality from cardiovascular complications and suicide. Given that panic disorder is so prevalent, with a potential for serious complications, it is vitally important that primary care physicians are familiar with its diagnosis and treatment.