EBMH Notebook What are the effects of drug treatments for panic disorder?

This article is part of a new initiative in Evidence-based Mental Health, namely the serialisation of chapters of Clinical Evidence (a summary of the best available evidence on common clinical interventions updated regularly by the BMJ Publishing Group). This article is based on material presented in: Kumar S, Oakley-Browne M. Panic disorder. Clinical Evidence 2002; 8: 1003–9. For this review, Clinical Evidence searched and appraised material published until May 2002. Studies with follow up periods of less than 6 months were excluded. A panic attack is a period in which there is sudden onset of intense apprehension, fearfulness or terror, often associated with feelings of impending doom. Panic disorder occurs when there are recurrent, unpredictable attacks followed by at least 1 month of persistent concern about having another panic attack; worry about the possible implications or consequences of the panic attacks, or a significant behavioural change related to the attacks. The term “panic disorder” excludes panic attacks attributable to the direct physiological effects of a general medical condition, substance or another mental disorder. Panic disorder is sometimes categorised as “with” or “without agoraphobia.” Alternative categorisations focus on phobic anxiety disorders and specify agoraphobia with or without panic disorder.