Anxiety disorder: panic disorder

Question 1

Define panic disorder. What is it often comorbid with?

Answer 1

• Intermittent anxiety NOT triggered by a specific stimulus
• Unpredictable
• Aka episodic paroxysmal anxiety
• Often comorbid with agoraphobia

Question 2

How common is panic disorder? When is it most common? Who is most affected?

Answer 2

• F>M (2:1)
• lifetime prevalence = 1.5-3 %
• age range 25-44

Question 3

What are the symptoms of panic disorder?

Answer 3

• Panic attacks
  
  • Fear of suffocating / dying
  • Hyperventilation
  • Sweating
  • Dizziness
  • Palpitations
  • Chest discomfort
  • Desire to flee

Question 4

What investigations should be done for panic disorder?

Answer 4

• Rule out organic causes (incl. thyroid), alcohol, drug withdrawal
• Urine drug screen
• Bloods e.g. TFTs
• ECG

Question 5

What is the management of panic disorder? What treatment is NOT recommended?

Answer 5

• CBT / Relaxation training e.g. breathing techniques
• SSRI / Venlafaxine MR

Benzos are not recommended due to risk of tolerance and dependence (NICE)