Highlights & Basics
- Frequency of panic attacks may vary considerably in panic disorder, with some individuals reporting brief clusters of several panic episodes in a short period of time, weekly panic attacks, or periodic attacks over the course of several months.
- Higher risk among first-degree relatives; onset of attacks triggered by stress; often comorbid with other anxiety, mood, and substance-use disorders.
- Assessment is made through ruling out organic causes; self-report; clinical interview; and behavioral observation.
- Self-help, cognitive behavioral therapy, selective serotonin-reuptake inhibitors and serotonin-norepinephrine reuptake inhibitors are first-line treatments.
- Long-term management includes relapse prevention after treatment discontinuation.
Quick Reference
History & Exam
Key Factors
Other Factors
Diagnostics Tests
Treatment Options
Definition
Epidemiology
Etiology
Pathophysiology
Citations
American Psychiatric Association. Diagnostic and statistical manual of mental disorders, 5th ed., text revision, (DSM-5-TR). Washington, DC: American Psychiatric Publishing; 2022.
Andrews G, Bell C, Boyce P, et al. Royal Australian and New Zealand College of Psychiatrists clinical practice guidelines for the treatment of panic disorder, social anxiety disorder and generalised anxiety disorder. Australian & New Zealand Journal of Psychiatry. 2018;52(12):1109-172.[Full Text]
Penninx BW, Pine DS, Holmes EA, et al. Anxiety disorders. Lancet. 2021 Mar 6;397(10277):914-27.[Abstract][Full Text]
Katzman MA, Bleau P, Blier P, et al; Canadian Anxiety Guidelines Initiative Group on behalf of the Anxiety Disorders Association of Canada and McGill University. Canadian clinical practice guidelines for the management of anxiety, posttraumatic stress and obsessive-compulsive disorders. BMC Psychiatry. 2014;14 Suppl 1:S1.[Abstract][Full Text]
Roy-Byrne P, Craske MG, Sullivan G, et al. Delivery of evidence-based treatment for multiple anxiety disorders in primary care: a randomized controlled trial. JAMA. 2010 May 19;303(19):1921-8.[Abstract]
1. American Psychiatric Association. Diagnostic and statistical manual of mental disorders, 5th ed., text revision, (DSM-5-TR). Washington, DC: American Psychiatric Publishing; 2022.
2. Olaya B, Moneta MV, Miret M, et al. Epidemiology of panic attacks, panic disorder and the moderating role of age: results from a population-based study. J Affect Disord. 2018 Dec 1;241:627-33.[Abstract]
3. de Jonge P, Roest AM, Lim CC, et al. Cross-national epidemiology of panic disorder and panic attacks in the world mental health surveys. Depress Anxiety. 2016 Dec;33(12):1155-77.[Abstract][Full Text]
4. Andrews G, Bell C, Boyce P, et al. Royal Australian and New Zealand College of Psychiatrists clinical practice guidelines for the treatment of panic disorder, social anxiety disorder and generalised anxiety disorder. Australian & New Zealand Journal of Psychiatry. 2018;52(12):1109-172.[Full Text]
5. Goodwin RD, Eaton WW. Asthma and the risk of panic attacks among adults in the community. Psychol Med. 2003;33:879-885.[Abstract]
6. Zvolensky MJ, Feldner MT, Leen-Feldner EW, et al. Smoking and panic attacks, panic disorder, and agoraphobia: a review of the empirical literature. Clin Psychol Rev. 2005;25:761-789.[Abstract]
7. Kessler RC, Chiu WT, Jin R, et al. The epidemiology of panic attacks, panic disorder, and agoraphobia in the National Comorbidity Survey Replication. Arch Gen Psychiatry. 2006 Apr;63(4):415-24.[Abstract][Full Text]
8. Grant BF, Hasin DS, Stinson FS, et al. The epidemiology of DSM-IV panic disorder and agoraphobia in the United States: results from the National Epidemiologic Survey on Alcohol and Related Conditions. J Clin Psychiatry. 2006 Mar;67(3):363-74.[Abstract]
9. Goodwin RD, Faravelli C, Rosi S, et al. The epidemiology of panic disorder and agoraphobia in Europe. Eur Neuropsychopharmacol. 2005 Aug;15(4):435-43.[Abstract]
10. Kroenke K, Spitzer RL, Williams JB, et al. Anxiety disorders in primary care: prevalence, impairment, comorbidity, and detection. Ann Intern Med. 2007 Mar 6;146(5):317-25.[Abstract]
11. Roy-Byrne PP, Wagner AW, Schraufnagel TJ. Understanding and treating panic disorder in the primary care setting. J Clin Psychiatry. 2005;66 Suppl 4:16-22.[Abstract]
12. Penninx BW, Pine DS, Holmes EA, et al. Anxiety disorders. Lancet. 2021 Mar 6;397(10277):914-27.[Abstract][Full Text]
13. Clayton AH, Stewart RS, Fayyad R, et al. Sex differences in clinical presentation and response in panic disorder: pooled data from sertraline treatment studies. Arch Womens Ment Health. 2006 May;9(3):151-7.[Abstract]
14. Hammerness P, Harpold T, Petty C, et al. Characterizing non-OCD anxiety disorders in psychiatrically referred children and adolescents. J Affect Disord. 2008 Jan;105(1-3):213-9.[Abstract]
15. Goodwin RD, Lieb R, Hoefler M, et al. Panic attack as a risk factor for severe psychopathology. Am J Psychiatry. 2004 Dec;161(12):2207-14.[Abstract]
16. Lamers F, van Oppen P, Comijs HC, et al. Comorbidity patterns of anxiety and depressive disorders in a large cohort study: the Netherlands Study of Depression and Anxiety (NESDA). J Clin Psychiatry. 2011 Mar;72(3):341-8.[Abstract]
17. Cosci F, Knuts IJ, Abrams K, et al. Cigarette smoking and panic: a critical review of the literature. J Clin Psychiatry. 2010 May;71(5):606-15.[Abstract]
18. Rodriguez BF, Bruce SE, Pagano ME, et al. Relationships among psychosocial functioning, diagnostic comorbidity, and the recurrence of generalized anxiety disorder, panic disorder, and major depression. J Anxiety Disord. 2005;19(7):752-66.[Abstract]
19. Roy-Byrne PP, Stein MB, Russo J, et al. Panic disorder in the primary care setting: comorbidity, disability, service utilization, and treatment. J Clin Psychiatry. 1999 Jul;60(7):492-9.[Abstract]
20. Penninx BW, Nolen WA, Lamers F, et al. Two-year course of depressive and anxiety disorders: results from the Netherlands Study of Depression and Anxiety (NESDA). J Affect Disord. 2011 Sep;133(1-2):76-85.[Abstract][Full Text]
21. Teismann T, Lukaschek K, Hiller TS, et al. Suicidal ideation in primary care patients suffering from panic disorder with or without agoraphobia. BMC Psychiatry. 2018 Sep 24;18(1):305.[Abstract][Full Text]
22. Hettema JM, Neale NC, Kendler KS. A review and meta-analysis of the genetic epidemiology of anxiety disorders. Am J Psychiatry. 2001 Oct;158(10):1568-78.[Abstract]
23. Kendler KS, Neale MC, Kessler RC, et al. Panic disorder in women: a population-based twin study. Psychol Med. 1993 May;23(2):397-406.[Abstract]
24. Meier SM, Deckert J. Genetics of anxiety disorders. Curr Psychiatry Rep. 2019 Mar 2;21(3):16.[Abstract]
25. Roy-Byrne PP, Craske MG, Stein M. Panic disorder. Lancet. 2006 Sep 16;368(9540):1023-32.[Abstract]
26. Howe AS, Buttenschøn HN, Bani-Fatemi A, et al. Candidate genes in panic disorder: meta-analyses of 23 common variants in major anxiogenic pathways. Mol Psychiatry. 2016 May;21(5):665-79.[Abstract]
27. Deckert J, Weber H, Villmann C, et al. GLRB allelic variation associated with agoraphobic cognitions, increased startle response and fear network activation: a potential neurogenetic pathway to panic disorder. Mol Psychiatry. 2017 Oct;22(10):1431-9[Abstract]
28. Schartner C, Ziegler C, Schiele MA, et al. CRHR1 promoter hypomethylation: An epigenetic readout of panic disorder? Eur Neuropsychopharmacol. 2017 Apr;27(4):360-71.[Abstract][Full Text]
29. Barlow DH. Anxiety and its disorders. 2nd ed. New York: Guilford Press; 2002.
30. Leskin GA, Sheikh JI. Lifetime trauma history and panic disorder: findings from the National Comorbidity Survey. J Anxiety Disord. 2002;16(6):599-603.[Abstract]
31. Niccolai V, van Duinen MA, Griez EJ. Respiratory patterns in panic disorder reviewed: a focus on biological challenge tests. Acta Psychiatr Scand. 2009;120:167-177.[Abstract]
32. Schmidt NB, Lerew DR, Jackson RJ. Prospective evaluation of anxiety sensitivity in the pathogenesis of panic: replication and extension. J Abnorm Psych. 1999;108:532-537.[Abstract]
33. LeDoux J, Daw ND. Surviving threats: neural circuit and computational implications of a new taxonomy of defensive behaviour. Nat Rev Neurosci. 2018 May;19(5):269-82.[Abstract]
34. Clark DA, Beck AT. Cognitive therapy of anxiety disorders: science and practice. New York, NY: The Guilford Press; 2010.
35. Hirshfeld DR, Smoller JW, Fredman SJ, et al. Early antecedents of panic disorder: genes, childhood, and the environment. In: Rosenbaum JF, Pollack MH, eds. Panic disorder and its treatment. New York, NY: Marcel Dekker Inc; 1998:93-152.
36. Pine DS, Fox NA. Childhood antecedents and risk for adult mental disorders. Annu Rev Psychol. 2015 Jan 3;66:459-85.[Abstract]
37. Schmidt NB, Lerew DR, Jackson RJ. Prospective evaluation of anxiety sensitivity in the pathogenesis of panic: replication and extension. J Abnorm Psychol. 1999 Aug;108(3):532-7.[Abstract]
38. Naragon-Gainey K. Meta-analysis of the relations of anxiety sensitivity to the depressive and anxiety disorders. Psychol Bull. 2010 Jan;136(1):128-50.[Abstract]
39. Gorman JM, Kent JM, Sullivan GM, et al. Neuroanatomical hypothesis of panic disorder, revised. Am J Psychiatry. 2000 Apr;157(4):493-505.[Abstract]
40. Roy-Byrne PP, Cowley DS. Search for pathophysiology of panic disorder. Lancet. 1998 Nov 21;352(9141):1646-7.[Abstract]
41. Wu Y, Zhong Y, Ma Z, et al. Gray matter changes in panic disorder: A voxel-based meta-analysis and meta-analytic connectivity modeling. Psychiatry Res Neuroimaging. 2018 Dec 30;282:82-89.[Abstract]
42. Abelson JL, Khan S, Liberzon I, et al. HPA axis activity in patients with panic disorder: review and synthesis of four studies. Depress Anxiety. 2007;24(1):66-76.[Abstract][Full Text]
43. Marin MF, Hammoud MZ, Klumpp H, et al. Multimodal categorical and dimensional approaches to understanding threat conditioning and its extinction in individuals with anxiety disorders. JAMA Psychiatry. 2020 Jun 1;77(6):618-27.[Abstract][Full Text]
44. Janiri D, Moser DA, Doucet GE, et al. Shared neural phenotypes for mood and anxiety disorders: a meta-analysis of 226 task-related functional imaging studies. JAMA Psychiatry. 2020 Feb 1;77(2):172-9.[Abstract][Full Text]
45. Kircher T, Arolt V, Jansen A, et al. Effect of cognitive-behavioral therapy on neural correlates of fear conditioning in panic disorder. Biol Psychiatry. 2013 Jan 1;73(1):93-101.[Abstract]
46. Reinecke A, Thilo K, Filippini N, et al. Predicting rapid response to cognitive-behavioural treatment for panic disorder: the role of hippocampus, insula, and dorsolateral prefrontal cortex. Behav Res Ther. 2014 Nov;62:120-8.[Abstract]
47. Kessler RC, Chiu WT, Jin R, et al. The epidemiology of panic attacks, panic disorder, and agoraphobia in the National Comorbidity Survey Replication. Arch Gen Psychiatry. 2006;63:415-424.[Abstract][Full Text]
48. Grant BF, Hasin DS, Stinson FS, et al. The epidemiology of DSM-IV panic disorder and agoraphobia in the United States: results from the National Epidemiologic Survey on Alcohol and Related Conditions. J Clin Psychiatry. 2006;67:363-374.[Abstract]
49. Goodwin RD, Lieb R, Hoefler M, et al. Panic attack as a risk factor for severe psychopathology. Am J Psychiatry. 2004;161:2207-2214.[Abstract]
50. Goodwin RD, Eaton WW. Asthma and the risk of panic attacks among adults in the community. Psychol Med. 2003 Jul;33(5):879-85.[Abstract]
51. Niccolai V, van Duinen MA, Griez EJ. Respiratory patterns in panic disorder reviewed: a focus on biological challenge tests. Acta Psychiatr Scand. 2009 Sep;120(3):167-77.[Abstract]
52. Zvolensky MJ, Feldner MT, Leen-Feldner EW, et al. Smoking and panic attacks, panic disorder, and agoraphobia: a review of the empirical literature. Clin Psychol Rev. 2005 Sep;25(6):761-89.[Abstract]
53. Vilarim MM, Rocha Araujo DM, Nardi AE. Caffeine challenge test and panic disorder: a systematic literature review. Expert Rev Neurother. 2011 Aug;11(8):1185-95.[Abstract]
54. Moreno-Peral P, Conejo-Cerón S, Rubio-Valera M, et al. Effectiveness of psychological and/or educational interventions in the prevention of anxiety: a systematic review, meta-analysis, and meta-regression. JAMA Psychiatry. 2017 Oct 1;74(10):1021-9.[Abstract][Full Text]
55. Craske MG, Tsao JC. Assessment and treatment of nocturnal panic attacks. Sleep Med Rev. 2005 Jun;9(3):173-84.[Abstract]
56. Isensee B, Wittchen HU, Stein MB, et al. Smoking increases the risk of panic: findings from a prospective community study. Arch Gen Psychiatry. 2003 Jul;60(7):692-700.[Abstract][Full Text]
57. Lewis-Fernández R, Hinton DE, Laria AJ, et al. Culture and the anxiety disorders: recommendations for DSM-V. Depress Anxiety. 2010 Feb;27(2):212-29.[Abstract][Full Text]
58. Hollifield M, Finley MR, Skipper B. Panic disorder phenomenology in urban self-identified Caucasian-Non-Hispanics and Caucasian-Hispanics. Depress Anxiety. 2003;18(1):7-17.[Abstract]
59. Hinton DE, Chhean D, Pich V, et al. Neck-focused panic attacks among Cambodian refugees: a logistic and linear regression analysis. J Anxiety Disord. 2006;20(2):119-38.[Abstract]
60. Hinton DE, Chhean D, Fama JM, et al. Gastrointestinal-focused panic attacks among Cambodian refugees: associated psychopathology, flashbacks, and catastrophic cognitions. J Anxiety Disord. 2007;21(1):42-580.[Abstract]
61. Smith LC, Friedman S, Nevid J. Clinical and sociocultural differences in African American and European American patients with panic disorder and agoraphobia. J Nerv Ment Dis. 1999 Sep;187(9):549-60.[Abstract]
62. Seguí J, Salvador-Carulla I, García I, et al. Semiology and subtyping of panic disorders. Acta Psychiatr Scand. 1998 Apr;97(4):272-7.[Abstract]
63. Neerakal I, Srinivasan K. A study of the phenomenology of panic attacks in patients from India. Psychopathology. 2003 Mar-Apr;36(2):92-7.[Abstract]
64. Shiori T, Someya T, Murashita S, et al. The symptom structure of panic disorder: a trial using factor and cluster analysis. Acta Psychiatr Scand. 1996 Feb;93(2):80-6.[Abstract]
65. Deacon B, Lickel J, Abramowitz JS. Medical utilization across the anxiety disorders. J Anxiety Disord. 2008;22(2):344-50.[Abstract]
66. Comer JS, Blanco C, Hasin DS, et al. Health-related quality of life across the anxiety disorders: results from the national epidemiologic survey on alcohol and related conditions (NESARC). J Clin Psychiatry. 2011 Jan;72(1):43-50.[Abstract][Full Text]
67. Nepon J, Belik SL, Bolton J, et al. The relationship between anxiety disorders and suicide attempts: findings from the National Epidemiologic Survey on Alcohol and Related Conditions. Depress Anxiety. 2010 Sep;27(9):791-8.[Abstract][Full Text]
68. de Graaf R, Tuithof M, van Dorsselaer S, et al. Comparing the effects on work performance of mental and physical disorders. Soc Psychiatry Psychiatr Epidemiol. 2012 Nov;47(11):1873-83.[Abstract]
69. National Institute for Health and Care Excellence. Generalised anxiety disorder and panic disorder in adults: management. Jun 2020 [internet publication].[Full Text]
70. Katzman MA, Bleau P, Blier P, et al; Canadian Anxiety Guidelines Initiative Group on behalf of the Anxiety Disorders Association of Canada and McGill University. Canadian clinical practice guidelines for the management of anxiety, posttraumatic stress and obsessive-compulsive disorders. BMC Psychiatry. 2014;14 Suppl 1:S1.[Abstract][Full Text]
71. Weber BE, Kapoor WN. Evaluation and outcomes of patients with palpitations. Am J Med. 1996 Feb;100(2):138-48.[Abstract]
72. Katerndahl DA. Chest pain and its importance in patients with panic disorder: an updated literature review. Prim Care Companion J Clin Psychiatry. 2008;10(5):376-83.[Abstract][Full Text]
73. Spitzer RL, Kroenke K, Williams JB; Patient Health Questionnaire Primary Care Study Group. Validation and utility of a self-report version of PRIME-MD: the PHQ primary care study. JAMA. 1999 Nov 10;282(18):1737-44.[Abstract][Full Text]
74. Furukawa TA, Katherine Shear M, Barlow DH, ET AL. Evidence-based guidelines for interpretation of the Panic Disorder Severity Scale. Depress Anxiety. 2009;26(10):922-9.[Abstract][Full Text]
75. Spitzer RL, Kroenke K, Williams JB, et al. A brief measure for assessing generalized anxiety disorder: the GAD-7. Arch Intern Med. 2006 May 22;166(10):1092-7.[Abstract][Full Text]
76. US Preventive Services Task Force, Barry MJ, Nicholson WK, et al. Screening for anxiety disorders in adults: US Preventive Services Task Force recommendation statement. JAMA. 2023 Jun 27;329(24):2163-70.[Abstract][Full Text]
77. US Preventive Services Task Force, Mangione CM, Barry MJ, et al. Screening for anxiety in children and adolescents: US Preventive Services Task Force recommendation statement. JAMA. 2022 Oct 11;328(14):1438-44.[Abstract][Full Text]
78. Gregory KD, Chelmow D, Nelson HD, et al. Screening for anxiety in adolescent and adult women: a recommendation from the Women's Preventive Services Initiative. Ann Intern Med. 2020 Jul 7;173(1):48-56.[Abstract][Full Text]
79. Barsky AJ, Delamater BA, Orav JE. Panic disorder patients and their medical care. Psychosomatics. 1999 Jan-Feb;40(1):50-6.[Abstract]
80. Imai H, Tajika A, Chen P, et al. Psychological therapies versus pharmacological interventions for panic disorder with or without agoraphobia in adults. Cochrane Database Syst Rev. 2016 Oct 12;10(10):CD011170.[Abstract][Full Text]
81. Roy-Byrne P, Craske MG, Sullivan G, et al. Delivery of evidence-based treatment for multiple anxiety disorders in primary care: a randomized controlled trial. JAMA. 2010 May 19;303(19):1921-8.[Abstract]
82. Sullivan G, Craske MG, Sherbourne C, et al. Design of the Coordinated Anxiety Learning and Management (CALM) study: innovations in collaborative care for anxiety disorders. Gen Hosp Psychiatry. 2007 Sep-Oct;29(5):379-87.[Abstract][Full Text]
83. Craske MG, Stein MB, Sullivan G, et al. Disorder-specific impact of coordinated anxiety learning and management treatment for anxiety disorders in primary care. Arch Gen Psychiatry. 2011 Apr;68(4):378-88.[Abstract][Full Text]
84. Rollman BL, Belnap BH, Mazumdar S, et al. Telephone-delivered stepped collaborative care for treating anxiety in primary care: a randomized controlled trial. J Gen Intern Med. 2017 Mar;32(3):245-55.[Abstract][Full Text]
85. Rollman BL, Herbeck Belnap B, Abebe KZ, et al. Effectiveness of online collaborative care for treating mood and anxiety disorders in primary care: a randomized clinical trial. JAMA Psychiatry. 2018 Jan 1;75(1):56-64.[Abstract][Full Text]
86. Munjack DJ, Crocker B, Cabe D, et al. Alprazolam, propranolol, and placebo in the treatment of panic disorder and agoraphobia with panic attacks. J Clin Psychopharmacol. 1989 Feb;9(1):22-7.[Abstract]
87. Febbraro GA. An investigation into the effectiveness of bibliotherapy and minimal contact interventions in the treatment of panic attacks. J Clin Psychol. 2005 Jun;61(6):763-79.[Abstract]
88. Sharp DM, Power KG, Swanson V. Reducing therapist contact in cognitive behaviour therapy for panic disorder and agoraphobia in primary care: global measures of outcome in a randomised controlled trial. Br J Gen Pract. 2000 Dec;50(461):963-8.[Abstract][Full Text]
89. Febbraro GA, Clum GA, Roodman AA, et al. The limits of bibliotherapy: a study of the differential effectiveness of self-administered interventions in individuals with panic attacks. Beh Ther. 1999;30(2):209-22.
90. The Reading Agency (UK). Reading Well Books on Prescription scheme. 2018 [internet publication].[Full Text]
91. Lewis C, Pearce J, Bisson JI. Efficacy, cost-effectiveness and acceptability of self-help interventions for anxiety disorders: systematic review. Br J Psychiatry. 2012 Jan;200(1):15-21.[Abstract]
92. Andrisano C, Chiesa A, Serretti A. Newer antidepressants and panic disorder: a meta-analysis. Int Clin Psychopharmacol. 2013 Jan;28(1):33-45.[Abstract]
93. Hofmann SG, Sawyer AT, Korte KJ, et al. Is it beneficial to add pharmacotherapy to cognitive-behavioral therapy when treating anxiety disorders? A meta-analytic review. Int J Cogn Ther. 2009 Jan 1;2(2):160-75.[Abstract][Full Text]
94. Bandelow B, Reitt M, Röver C, et al. Efficacy of treatments for anxiety disorders: a meta-analysis. Int Clin Psychopharmacol. 2015 Jul;30(4):183-92.[Abstract][Full Text]
95. Barlow DH, Gorman JM, Shear MK, et al. Cognitive-behavioral therapy, imiprimine, or their combination for panic disorder: a randomized controlled trial. JAMA. 2000 May 17;283(19):2529-36.[Abstract]
96. Otto MW, Deveney C. Cognitive-behavioral therapy and the treatment of panic disorder: efficacy and strategies. J Clin Psychiatry. 2005;66 Suppl 4:28-32.[Abstract]
97. Sánchez-Meca J, Rosa-Alcázar AI, Marín-Martínez F, et al. Psychological treatment of panic disorder with or without agoraphobia: a meta-analysis. Clin Psychol Rev. 2010 Feb;30(1):37-50.[Abstract]
98. Carlbring P, Bohman S, Brunt S, et al. Remote treatment of panic disorder: a randomized trail of internet-based cognitive behavior therapy supplemented with telephone calls. Am J Psychiatry. 2006;163:2119-2125.[Abstract]
99. Cuijpers P, Marks IM, van Straten A, et al. Computer-aided psychotherapy for anxiety disorders: a meta-analytic review. Cogn Behav Ther. 2009;38:66-82.[Abstract]
100. Hedman E, Ljótsson B, Lindefors N. Cognitive behavior therapy via the Internet: a systematic review of applications, clinical efficacy and cost-effectiveness. Expert Rev Pharmacoecon Outcomes Res. 2012;12:745-764.[Abstract]
101. Andrews G, Basu A, Cuijpers P, et al. Computer therapy for the anxiety and depression disorders is effective, acceptable and practical health care: An updated meta-analysis. J Anxiety Disord. 2018 Apr;55:70-8.[Abstract][Full Text]
102. Andrews G, Cuijpers P, Craske MG, et al. Computer therapy for the anxiety and depressive disorders is effective, acceptable and practical health care: a meta-analysis. PLoS One. 2010 Oct 13;5(10):e13196.[Abstract][Full Text]
103. Olthuis JV, Watt MC, Bailey K, et al. Therapist-supported internet cognitive behavioural therapy for anxiety disorders in adults. Cochrane Database Syst Rev. 2015;(3):CD011565.[Abstract][Full Text]
104. Ruwaard J, Broeksteeg J, Schrieken B, et al. Web-based therapist-assisted cognitive behavioral treatment of panic symptoms: a randomized controlled trial with a three-year follow-up. J Anxiety Disord. 2010 May;24(4):387-96.[Abstract]
105. Marchand A, Roberge P, Primiano S, et al. A randomized, controlled clinical trial of standard, group and brief cognitive-behavioral therapy for panic disorder with agoraphobia: a two-year follow-up. J Anxiety Disord. 2009 Dec;23(8):1139-47.[Abstract]
106. Roy-Byrne PP, Craske MG, Stein MB, et al. A randomized effectiveness trial of cognitive-behavioral therapy and medication for primary care panic disorder. Arch Gen Psychiatry. 2005 Mar;62(3):290-8.[Abstract][Full Text]
107. Gloster AT, Wittchen HU, Einsle F, et al. Psychological treatment for panic disorder with agoraphobia: a randomized controlled trial to examine the role of therapist-guided exposure in situ in CBT. J Consult Clin Psychol. 2011 Jun;79(3):406-20.[Abstract]
108. de Beurs E, van Balkom AJ, Lange A, et al. Treatment of panic disorder with agoraphobia: comparison of fluvoxamine, placebo, and psychological panic management combined with exposure and of exposure in vivo alone. Am J Psychiatry. 1995 May;152(5):683-91.[Abstract]
109. van Apeldoorn FJ, van Hout WJ, Mersch PP, et al. Is a combined therapy more effective than either CBT or SSRI alone? Results of a multicenter trial on panic disorder with or without agoraphobia. Acta Psychiatr Scand. 2008 Apr;117(4):260-70.[Abstract]
110. Rosenbaum JF, Fredman SJ, Pollack MH. The pharmacotherapy of panic disorder. In: Rosenbaum JF, Pollack MH, eds. Panic disorder and its treatment. New York, NY: Marcel Dekker Inc.; 1998:153-80.
111. Furukawa TA, Watanabe N, Churchill R. Psychotherapy plus antidepressant for panic disorder with or without agoraphobia: systematic review. Br J Psychiatry. 2006 Apr;188:305-12.[Abstract]
112. Bandelow B, Seidler-Brandler U, Becker A, et al. Meta-analysis of randomized controlled comparisons of psychopharmacological and psychological treatments for anxiety disorders. World J Biol Psychiatry. 2007;8(3):175-87.[Abstract]
113. Furukawa TA, Watanabe N, Churchill R. Combined psychotherapy plus antidepressants for panic disorder with or without agoraphobia. Cochrane Database Syst Rev. 2007 Jan 24;(1):CD004364.[Abstract][Full Text]
114. Otto MW, Pollack MH, Sachs GS, et al. Discontinuation of benzodiazepine treatment: efficacy of cognitive-behavioral therapy for patients with panic disorder. Am J Psychiatry. 1993 Oct;150(10):1485-90.[Abstract]
115. Spiegel DA, Bruce TJ. Benzodiazepines and exposure-based cognitive-behavior therapies for panic disorder: conclusions from combined treatment trials. Am J Psychiatry. 1997 Jun;154(6):773-81.[Abstract]
116. Bakker A, van Balkom AJ, Stein DJ. Evidence-based pharmacotherapy of panic disorder. Int J Neuropsychopharmacol. 2005 Sep;8(3):473-82.[Abstract]
117. Bradwejn J, Ahokas A, Stein DJ, et al. Venlafaxine extended-release capsules in panic disorder: flexible-dose, double-blind, placebo-controlled study. Br J Psychiatry. 2005 Oct;187:352-9.[Abstract][Full Text]
118. Batelaan NM, Van Balkom AJ, Stein DJ. Evidence-based pharmacotherapy of panic disorder: an update. Int J Neuropsychopharmacol. 2012 Apr;15(3):403-15.[Abstract][Full Text]
119. Freire RC, Hallak JE, Crippa JA, et al. New treatment options for panic disorder: clinical trials from 2000 to 2010. Expert Opin Pharmacother. 2011 Jun;12(9):1419-28.[Abstract]
120. Bighelli I, Castellazzi M, Cipriani A, et al. Antidepressants versus placebo for panic disorder in adults. Cochrane Database Syst Rev. 2018 Apr 5;4(4):CD010676.[Abstract][Full Text]
121. Chawla N, Anothaisintawee T, Charoenrungrueangchai K, et al. Drug treatment for panic disorder with or without agoraphobia: systematic review and network meta-analysis of randomised controlled trials. BMJ. 2022 Jan 19;376:e066084.[Abstract][Full Text]
122. Bighelli I, Trespidi C, Castellazzi M, et al. Antidepressants and benzodiazepines for panic disorder in adults. Cochrane Database Syst Rev. 2016 Sep 12;9(9):CD011567.[Abstract][Full Text]
123. Kimmel RJ, Roy-Byrne PP, Cowley DS. Pharmacological treatments for panic disorder, generalized anxiety disorder, specific phobia, and social anxiety disorder. In: Nathan PE, Gorman JM, eds. A guide to treatments that work. 4th ed. New York, NY: Oxford University Press; 2015:463-506.
124. Ballenger JC, Davidson JR, Lecrubier Y, et al. Consensus statement on panic disorder from the International Consensus Group on Depression and Anxiety. J Clin Psychiatry. 1998;59 Suppl 8:47-54.[Abstract]
125. Pollack MH, Otto MW, Worthington JJ, et al. Sertraline in the treatment of panic disorder: a flexible-dose multicenter trial. Arch Gen Psychiatry. 1998 Nov;55(11):1010-6.[Abstract][Full Text]
126. Michelson D, Allgulander C, Dantendorfer K, et al. Efficacy of usual antidepressant dosing regimens of fluoxetine in panic disorder: randomized, placebo-controlled trial. Br J Psychiatry. 2001 Dec;179:514-8.[Abstract][Full Text]
127. Backish D, Hooper CL, Filteau MJ, et al. A double-blind placebo-controlled trial comparing fluvoxamine and imiprimine in the treatment of panic disorder with or without agoraphobia. Psychopharmacol Bull. 1996;32(1):135-41.[Abstract]
128. Leinonen E, Lepola U, Koponen H, et al. Citalopram controls phobic symptoms in patients with panic disorder: randomized controlled trial. J Psychiatry Neurosci. 2000 Jan;25(1):24-32.[Abstract][Full Text]
129. Stahl SM, Gergel I, Li D. Escitalopram in the treatment of panic disorder: a randomized, double-blind, placebo-controlled trial. J Clin Psychiatry. 2003 Nov;64(11):1322-7.[Abstract]
130. Mochcovitch MD, Nardi AE. Selective serotonin-reuptake inhibitors in the treatment of panic disorder: a systematic review of placebo-controlled studies. Expert Rev Neurother. 2010 Aug;10(8):1285-93.[Abstract]
131. Breilmann J, Girlanda F, Guaiana G, et al. Benzodiazepines versus placebo for panic disorder in adults. Cochrane Database Syst Rev. 2019 Mar 28;3:CD010677.[Abstract][Full Text]
132. Balon R, Chouinard G, Cosci F, et al. International task force on benzodiazepines. Psychother Psychosom. 2018;87(4):193-4.[Abstract][Full Text]
133. Silberman E, Balon R, Starcevic V, et al. Benzodiazepines: it's time to return to the evidence. Br J Psychiatry. 2021 Mar;218(3):125-7.[Abstract][Full Text]
134. Royal Australian College of General Practitioners. Prescribing drugs of dependence in general practice, Part B - benzodiazepines. Jun 2015 [internet publication]. [Full Text]
135. Moylan S, Giorlando F, Nordfjærn T, et al. The role of alprazolam for the treatment of panic disorder in Australia. Aust N Z J Psychiatry. 2012 Mar;46(3):212-24.[Abstract]
136. Moylan S, Staples J, Ward SA, et al. The efficacy and safety of alprazolam versus other benzodiazepines in the treatment of panic disorder. J Clin Psychopharmacol. 2011 Oct;31(5):647-52.[Abstract]
137. Kennedy KM, O'Riordan J. Prescribing benzodiazepines in general practice. Br J Gen Pract. 2019 Mar;69(680):152-153.[Abstract][Full Text]
138. Hermos JA, Young MM, Lawler EV, et al. Characterizations of long-term anxiolytic benzodiazepine prescriptions in veteran patients. J Clin Psychopharmacol. 2005 Dec;25(6):600-4.[Abstract]
139. Hermos JA, Young MM, Lawler EV, et al. Long-term, high-dose benzodiazepine prescriptions in veteran patients with PTSD: influence of preexisting alcoholism and drug-abuse diagnoses. J Trauma Stress. 2007 Oct;20(5):909-14.[Abstract]
140. Means-Christensen AJ, Roy-Byrne PP, Sherbourne CD, et al. Relationships among pain, anxiety, and depression in primary care. Depress Anxiety. 2008;25(7):593-600.[Abstract]
141. Caillard V, Rouillon F, Viel JF, et al. Comparative effects of low and high doses of clomipramine and placebo in panic disorder: a double-blind controlled study. Acta Psychiatr Scand. 1999 Jan;99(1):51-8.[Abstract]
142. Ogawa Y, Takeshima N, Hayasaka Y, et al. Antidepressants plus benzodiazepines for adults with major depression. Cochrane Database Syst Rev. 2019 Jun 3;6(6):CD001026.[Abstract][Full Text]
143. Rush AJ. STAR*D: what have we learned? Am J Psychiatry. 2007 Feb;164(2):201-4.[Abstract]
144. Rathgeb-Fuetsch M, Kempter G, Feil A, et al. Short- and long- term efficacy of cognitive behavioral therapy for DSM-IV panic disorder in patients with and without severe psychiatric comorbidity. J Psychiatr Res. 2011 Sep;45(9):1264-8.[Abstract]
145. Emmrich A, Beesdo-Baum K, Gloster AT, et al. Depression does not affect the treatment outcome of CBT for panic and agoraphobia: results from a multicenter randomized trial. Psychother Psychosom. 2012;81(3):161-72.[Abstract]
146. Bystritsky A. Treatment-resistant anxiety disorders. Mol Psychiatry. 2006 Sep;11(9):805-14.[Abstract]
147. Batelaan NM, Bosman RC, Muntingh A, et al. Risk of relapse after antidepressant discontinuation in anxiety disorders, obsessive-compulsive disorder, and post-traumatic stress disorder: systematic review and meta-analysis of relapse prevention trials. BMJ. 2017 Sep 13;358:j3927.[Abstract][Full Text]
148. DeGeorge KC, Grover M, Streeter GS. Generalized anxiety disorder and panic disorder in adults. Am Fam Physician. 2022 Aug;106(2):157-64.[Abstract][Full Text]
149. Doyle A, Pollack MH. Long-term management of panic disorder. J Clin Psychiatry. 2004;65 Suppl. 5:24-28.[Abstract]
150. Cloos JM. The treatment of panic disorder. Curr Opin Psychiatry. 2005;18:45-50.[Abstract]
151. Van Leeuwen E, van Driel ML, Horowitz MA, et al. Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults. Cochrane Database Syst Rev. 2021 Apr 15;4(4):CD013495.[Abstract][Full Text]
152. van Dis EAM, van Veen SC, Hagenaars MA, et al. Long-term outcomes of Cognitive behavioral therapy for anxiety-related disorders: A systematic review and meta-analysis. JAMA Psychiatry. 2020 Mar 1;77(3):265-73.[Abstract][Full Text]
153. Bandelow B, Sagebiel A, Belz M, et al. Enduring effects of psychological treatments for anxiety disorders: meta-analysis of follow-up studies. Br J Psychiatry. 2018 Jun;212(6):333-8.[Abstract]
154. Goddard AW, Brouette T, Almai A, et al. Early coadministration of clonazepam with sertraline for panic disorder. Arch Gen Psychiatry. 2001 Jul;58(7):681-6.[Abstract][Full Text]
155. Sheehan DV, Raj AB, Harnett-Sheehan K, et al. The relative efficacy of high-dose buspirone and alprazolam in the treatment of panic disorder: a double-blind placebo-controlled study. Acta Psychiatr Scand. 1993 Jul;88(1):1-11.[Abstract]
156. Moroz G, Rosenbaum JF. Efficacy, safety, and gradual discontinuation of clonazepam in panic disorder: a placebo-controlled, multicenter study using optimized dosages. J Clin Psychiatry. 1999 Sep;60(9):604-12.[Abstract]
157. Schweizer E, Fox I, Case G, et al. Lorazepam vs. alprazolam in the treatment of panic disorder. Psychopharmacol Bull. 1988;24(2):224-7.[Abstract]
158. Otto MW, Tolin DF, Nations KR, et al. Five sessions and counting: considering ultra-brief treatment for panic disorder. Depress Anxiety. 2012 Jun;29(6):465-70.[Abstract]
159. Lessard MJ, Marchand A, Pelland MÈ, et al. Comparing two brief psychological interventions to usual care in panic disorder patients presenting to the emergency department with chest pain. Behav Cogn Psychother. 2012 Mar;40(2):129-47.[Abstract]
160. Gallo KP, Chan PT, Buzzella BA, et al. The impact of an 8-day intensive treatment for adolescent panic disorder and agoraphobia on comorbid diagnoses. Behav Ther. 2012 Mar;43(1):153-9.[Abstract][Full Text]
161. Firth J, Torous J, Nicholas J, et al. Can smartphone mental health interventions reduce symptoms of anxiety? A meta-analysis of randomized controlled trials. J Affect Disord. 2017 Aug 15;218:15-22.[Abstract][Full Text]
162. Van Singer M, Chatton A, Khazaal Y. Quality of smartphone apps related to panic disorder. Front Psychiatry. 2015 Jul 14;6:96.[Abstract][Full Text]
163. Pande AC, Pollack MH, Crockatt J, et al. Placebo-controlled study of gabapentin treatment of panic disorder. J Clin Psychopharmacol. 2000 Aug;20(4):467-71.[Abstract]
164. Mula M, Pini S, Cassano GB. The role of anticonvulsant drugs in anxiety disorders: a critical review of the evidence. J Clin Psychopharmacol. 2007 Jun;27(3):263-72.[Abstract]
165. Croom KF, Perry CM, Plosker GL. Mirtazapine: a review of its use in major depression and other psychiatric disorders. CNS Drugs. 2009;23(5):427-52.[Abstract]
166. Serretti A, Chiesa A, Calati R, et al. Novel antidepressants and panic disorder: evidence beyond current guidelines. Neuropsychobiology. 2011;63(1):1-7.[Abstract][Full Text]
167. Fava GA, Zielezny M, Savron G, et al. Long-term effects of behavioural treatment for panic disorder with agoraphobia. Br J Psychiatry. 1995 Jan;166(1):87-92.[Abstract]
168. Brown TA, Barlow DH. Long-term outcome in cognitive-behavioral treatment of panic disorder: clinical predictors and alternative strategies for assessment. J Consult Clin Psychol. 1995 Oct;63(5):754-65.[Abstract]
169. Ballenger JC, Pecknold J, Rickels K, et al. Medication discontinuation in panic disorder. J Clin Psychiatry. 1993 Oct;54 Suppl:15-21.[Abstract]
170. Doyle A, Pollack MH. Long-term management of panic disorder. J Clin Psychiatry. 2004;65 Suppl 5:24-8.[Abstract]
171. Reisman Y. Post-SSRI sexual dysfunction. BMJ. 2020 Feb 27;368:m754.[Abstract]
172. Reisman Y. Sexual Consequences of Post-SSRI Syndrome. Sex Med Rev. 2017 Oct;5(4):429-433.[Abstract]
173. Cloos JM. The treatment of panic disorder. Curr Opin Psychiatry. 2005 Jan;18(1):45-50.[Abstract]
174. Serretti A, Porcelli S. Antidepressant induced weight gain. BMJ. 2018 May 23;361:k2151.[Abstract]
