Antidepressants, such as tricyclic antidepressants and selective serotonin reuptake inhibitors (SSRIs) also have antianxiety and antipanic effects, in addition to their antidepressant effects (Surgeon General, 2003). According to the Surgeon Generals report (2003), current practices are to prefer SSRI use because they are better tolerated, have antiobsessional effects, and are safer to use than tricyclic antidepressants and monoamine oxidate inhibitors (MAOIs); however, both tricyclic antidepressants and MAOIs are considered after SSRIs fail to produce the desired results (Surgeon General, 2003). There are six drugs within the SSRI class: fluoxetine (Prozac), sertraline (Zoloft), fluvoxamine (Luvox), paroxetine (Paxil) and citalopram; however, only sertraline (Zoloft) and paroxetine (Paxil) are approved for use with panic disorders. When these drugs are used for panic disorder, low initial doses are used with a slow increase in dosage. According to the Surgeon General, (2003), antidepressant use for the treatment of anxiety should have a duration of at least 4 to 6 months, with slow tapering to avoid reemergence of anxiety symptoms; however, it is likely that treatment of anxiety disorders may require longer term indefinite treatment to prevent relapse.
Conclusion
Panic disorder is a condition that affects 1.7% of the adult population in any given year (NIMH, 2003). The central feature of panic disorder is the presence of repeated unexpected panic attacks, which often leads to a cycle where the individual anticipates having another panic attack and either misinterprets or exaggerates the somatic symptoms of everyday events and situations as signs that predict another panic attack is about to occur, which then predisposes that individual to have another panic attack in the near future. The co-morbidity of other conditions associated with panic disorder often make distinguishing of this condition difficult, as symptoms of this disorder may appear as life-threatening medical issues or as other mental disorders. Further confounding this issue is that about 17% of individuals attempt to self-medicate with the use of drugs or alcohol (NIMH, 2003) and that certain prescription and non-prescription substances can cause presentation symptoms similar to panic disorder.
The exact causes of panic disorder are unknown, but current research and theories indicate that an interaction of genetic, biological, and conditioned factors in causing certain individuals to be more likely to develop this disorder is present. Initial panic attacks generally occur when a person has been placed under considerable stress and the presence of panic disorder tends to run in families (NIMH, 2001). Somehow, people with panic attacks are more prone to biological provocation of a panic attack through direct manipulation of the bodys physiological response within a controlled laboratory setting than are people without the disorder, which suggests that their body is more prone to set off a false alarm under normal conditions.
Treatment generally is through the use of medications, such as benzodiazepines and/or antidepressants, and cognitive-behavioral psychotherapy. Though other approaches to psychotherapy (e.g. psychodynamic, interpersonal, etc.) have been used with this group of individuals there is little empirical support currently. Typically, cognitive-behavioral psychotherapy focuses on providing education to bring the client to view their situations in a more realistic manner, teaching breathing and relaxation strategies to calm themselves, and through repeated and systematic exposure to in vivo events and situations and successfully maintaining their composure through these situations. According to Barlow et al. (2000), the Panic Control Treatment based on the cognitive-behavioral model yielded normative levels of functioning in 85% of the individuals are panic-free at the end of the program.
References
American Psychiatric Association. (2000). Diagnostic and statistical manual of
mental disorders (4th ed., text rev.). Washington, DC: Author.
Barlow, D. H., Craske, M., G., & Meadows, E. A. (2000). Mastery of your
anxiety and panic (3rd ed.). San Antonio, TX: The Psychological Corporation.
Butcher, J. N, Carson, R. C. & Mineka, S. (2002). Fundamentals of abnormal
psychology and modern life. Boston, MA: Allyn and Bacon.
McLean, P. D., & Woody, S. R. (2001). Anxiety disorders in adults: An
evidence-based approach to psychological treatment. New York, NY: Oxford
University Press, Inc.
National Institute of Mental Health (2003). Facts about panic disorder.
Publication No. OM-99 4155 (Revised). Printed September 1999, Updated
February 21, 2003. Bethesda, MD: Author. Web-site reference
www.nimh.gov/anxiety/panicfacts.cfm
National Institute of Mental Health (1995). Understanding panic disorder.
Publication No 95-3509 (Revised). Printed 1993, Reprinted 1995 and Updated
June 21, 2001. Bethesda, MD: Author. Web-site reference
www.nimh.nih.gov/anxiety/upd.cfm
National Institute of Mental Health (2001). Panic disorder treatment and referral:
information for health care professionals. Publication No 94-3642. Printed
1994, Updated June 1, 1999. Bethesda, MD: Author. Web-site reference
www.nimh.nih.gov/anxiety/pdtr.cfm
Surgeon General (2003). Mental health: a report of the surgeon general. U.S.
Government Online Bookstore, Washington, DC, GPO Order No.
2003040901540. Web-site reference
Conclusion
Panic disorder is a condition that affects 1.7% of the adult population in any given year (NIMH, 2003). The central feature of panic disorder is the presence of repeated unexpected panic attacks, which often leads to a cycle where the individual anticipates having another panic attack and either misinterprets or exaggerates the somatic symptoms of everyday events and situations as signs that predict another panic attack is about to occur, which then predisposes that individual to have another panic attack in the near future. The co-morbidity of other conditions associated with panic disorder often make distinguishing of this condition difficult, as symptoms of this disorder may appear as life-threatening medical issues or as other mental disorders. Further confounding this issue is that about 17% of individuals attempt to self-medicate with the use of drugs or alcohol (NIMH, 2003) and that certain prescription and non-prescription substances can cause presentation symptoms similar to panic disorder.
The exact causes of panic disorder are unknown, but current research and theories indicate that an interaction of genetic, biological, and conditioned factors in causing certain individuals to be more likely to develop this disorder is present. Initial panic attacks generally occur when a person has been placed under considerable stress and the presence of panic disorder tends to run in families (NIMH, 2001). Somehow, people with panic attacks are more prone to biological provocation of a panic attack through direct manipulation of the bodys physiological response within a controlled laboratory setting than are people without the disorder, which suggests that their body is more prone to set off a false alarm under normal conditions.
Treatment generally is through the use of medications, such as benzodiazepines and/or antidepressants, and cognitive-behavioral psychotherapy. Though other approaches to psychotherapy (e.g. psychodynamic, interpersonal, etc.) have been used with this group of individuals there is little empirical support currently. Typically, cognitive-behavioral psychotherapy focuses on providing education to bring the client to view their situations in a more realistic manner, teaching breathing and relaxation strategies to calm themselves, and through repeated and systematic exposure to in vivo events and situations and successfully maintaining their composure through these situations. According to Barlow et al. (2000), the Panic Control Treatment based on the cognitive-behavioral model yielded normative levels of functioning in 85% of the individuals are panic-free at the end of the program.
References
American Psychiatric Association. (2000). Diagnostic and statistical manual of
mental disorders (4th ed., text rev.). Washington, DC: Author.
Barlow, D. H., Craske, M., G., & Meadows, E. A. (2000). Mastery of your
anxiety and panic (3rd ed.). San Antonio, TX: The Psychological Corporation.
Butcher, J. N, Carson, R. C. & Mineka, S. (2002). Fundamentals of abnormal
psychology and modern life. Boston, MA: Allyn and Bacon.
McLean, P. D., & Woody, S. R. (2001). Anxiety disorders in adults: An
evidence-based approach to psychological treatment. New York, NY: Oxford
University Press, Inc.
National Institute of Mental Health (2003). Facts about panic disorder.
Publication No. OM-99 4155 (Revised). Printed September 1999, Updated
February 21, 2003. Bethesda, MD: Author. Web-site reference
www.nimh.gov/anxiety/panicfacts.cfm
National Institute of Mental Health (1995). Understanding panic disorder.
Publication No 95-3509 (Revised). Printed 1993, Reprinted 1995 and Updated
June 21, 2001. Bethesda, MD: Author. Web-site reference
www.nimh.nih.gov/anxiety/upd.cfm
National Institute of Mental Health (2001). Panic disorder treatment and referral:
information for health care professionals. Publication No 94-3642. Printed
1994, Updated June 1, 1999. Bethesda, MD: Author. Web-site reference
www.nimh.nih.gov/anxiety/pdtr.cfm
Surgeon General (2003). Mental health: a report of the surgeon general. U.S.
Government Online Bookstore, Washington, DC, GPO Order No.
2003040901540. Web-site reference
