However, in these settings, the correct diagnosis is often not made. Some persons with recurrent panic attacks, anticipatory anxiety, and avoidance recover without treatment, particularly if they continue to go into situations in which panic attacks have occurred. For others, especially without treatment, panic disorder follows a chronic waxing and waning course. Treatment Patients should be told that their disorder results from both biologic and psychologic dysfunction and that pharmacotherapy and behavior therapy usually help control symptoms. In addition to information about the disorder and its treatment, a physician can provide realistic hope for improvement and support based on a trusting physician-patient relationship.
Supportive psychotherapy is an integral part of treatment of all anxiety disorders.
Individual, group, and family therapy may help resolve problems associated with a long-standing disorder. Drugs, such as antidepressants and benzodiazepines, can prevent or greatly reduce anticipatory anxiety, phobic avoidance, and the number and intensity of panic attacks. Newer antidepressants, such as mirtazapine, nefazodone, and venlafaxine, show promise for treating panic disorder. Drug treatment may have to be long-term because panic attacks often recur when drugs are discontinued. Exposure therapy, a form of behavior therapy in which the patient is confronted with what he fears, often helps diminish that fear.