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Abstract
Panic disorder is characterized by acute panic attack accompanied by autonomic symptoms such as tachycardia, sweating, dyspnea, chest pain, dizziness, and tremors, as well as anticipatory anxiety and avoidant behaviors. 30% of the general population may have suffered isolated episodes of panic attack, and epidemiologic studies have demonstrated that the lifetime prevalence of panic disorder is around 4.8%. Panic disorder is commonly comorbid with the other psychiatric disorders, and 30% of patients with panic disorder show treatment resistance and a chronic waxing and waning course. Therefore, adequate treatment guidelines and strategies for panic disorder by evidence-based pharmacotherapy are needed and some treatment guidelines for panic disorder have already been developed in foreign countries. In this article, among the foreign guidelines for the pharmacological treatment of panic disorder, those by World Federation of Societies of Biological Psychiatry (WFSBP) in particular were reviewed. Also, the recently developed Korean Medication Algorithm Project for Panic Disorder 2008 by the Korean Academy of Anxiety Disorder was reviewed.
Figures and Tables
Figure 1
Korean medication algorithm flow for panic disorder. This figure was adapted from [11].
Abbreviations: SSRI, selective serotonin reuptake inhibitor; SNRI, serotonin and norepinephrine reuptake inhibitor; BZD, benzodiazepine; TCA, tricyclic antidepressant; NaSSA, noradrenergic and specific serotonergic antidepressant.
Table 2
Recommendations for the drug treatment of panic disorder
Abbreviations: SSRIs, selective serotonin reuptake inhibitor; SNRI, serotonin norepinephrine reuptake inhibitor; TCA, tricyclic antidepressant; MAOI, monoamine oxidase inhibitor.
This table was adapted from [13].
a)Categories of evidence are only based on efficacy without regard to other properties (e.g., side effects).
Table 4
Dose of anti-panic drugs for initial treatment of panic disorder (Mean±SD)
This table was adapted from [11].
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