PANIC DISORDER

What is panic disorder? 

A severe attack of anxiety which reaches peak instantly and settles down within 15-30 minutes is called panic attack. It invariably is accompanied by a feeling of impending doom. Panic attack can occur in all physical as well as mental conditions but to be classified as panic disorder it should be independent of those conditions.

Panic disorder is present in approximately 3% of population. It is 3 times more common in women than in men.

Causes of panic attacks

Certain neurochemicals like serotonin are implicated in this disorder

Panic inducing substances are known to occur in these people

Brain imaging may show certain minute abnormalities.

Risk factors for panic disorder is family history

Mitral valve prolapse might mimic panic attack

For panic attack to be classified as panic disorder the frequency of panic attack should be once/ week for 4 weeks.

Types of panic disorder

     1.      Panic disorder without agoraphobia

     2.      Panic disorder with agoraphobia

Agoraphobia is defined as fear of occurrence of panic disorder in places from where immediate escape is not possible like open fields, cinema halls etc. If accompanied by some person the patient feels safe.

Symptoms of panic attack include-

     1.      Dryness of mouth

     2.      Palpitations

     3.      Sweating

     4.      Coldness of skin

     5.      Tremors

     6.      Chest discomfort

     7.      Headache

     8.      Feeling of impending doom

Treatment of panic disorder

Differentiating panic attack caused by other medical and psychiatric conditions from true panic disorder.

Pharmacological treatment includes

SSRI’S particularly Paroxetine is the mainstay of treatment of panic disorder.

TCA’S can also be used

Benzodiazepines are for the initial symptomatic control of panic attack till the SSRI’S or other drugs act. Long term use of these for panic disorder should be avoided as they cause dependence

MAOI’S are to be used with caution.

SNRI’S

Lithium

Carbamazepine

Valproate

Buspirone

Verapamil

Non pharmacological treatment includes cognitive behavioraltherapy.

Wishing you a long and healthy life

Dr Hitesh Sharma

MBBS, MD (Psychiatry)
For asking a query or phone/video consultation with me visit-  https://www.icliniq.com/hitesh