Panic Disorder
last authored:
last reviewed:
Introduction
Panic disorder is a discrete period of intense fear or discomfort that comes on unexpectedly and recurrently. Its peak onset is from 15-19 years, with a prevalence 3.5%.
The Case of...
a simple case introducing clincial presentation and calling for a differential diagnosis to get students thinking.
Causes and Risk Factors
Pathophysiology
Signs and Symptoms
- history
- physical exam
History
- tachycardia/palpitations
- tembling/shaking
- choking
- nausea
- sweating
- shortness of breath/hyperventilation
- chest pain/discomfort
- dizzy
- fear of losing control or going crazy
- paresthesias
- chills/hot flushes
- there is persistent worry that things could happen again
- recurrent unexpected panic attacks, including at least four of the above symptoms, which develop abruptly and peak within 10 minutes
- there needs to be changes in behaviour or persistent fear of future attacks or health implications
can be with or without agoraphobia
Physical Exam
Investigations
- lab investigations
- diagnostic imaging
Lab Investigations
Diagnostic Imaging
Differential Diagnosis
Treatments
mild PD can be treated with behavioural therapy
moderate PD can benefit from antidepressants (except bupriopion)
severe PD indicates additions of benzodiazepines (clonazepam, lorazepam)
- benzodiazepines can be used immediately during an episode or before a stressful situation
combination therapy alone may actually worsen long-term outcomes, compared with CBT (Foa et al, 2002)
Consequences and Course
Resources and References
Topic Development
created:
authors:
editors:
reviewers:
 |