Panic Disorder

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Panic disorder is a type of anxiety disorder in which you have repeated attacks of intense fear that something bad will occur when not expected. And that triggers severe physical reactions.
Panic disorder may occur in children, it is often not diagnosed until they are older.

*Causes, incidence, and risk factors

The cause is unknown. Genetics may play a role. Studies suggest that if one identical twin has panic disorder, the other twin will also develop the condition 40% of the time. However, panic disorder often occurs when there is no family history.

A panic attack begins suddenly, and most often peaks within 10 - 20 minutes. Some symptoms may continue for an hour or more. A panic attack may be mistaken for a heart attack.
Panic attacks may include anxiety about being in a situation where an escape may be difficult (such as being in a crowd or traveling in a car or bus).
A person with panic disorder often lives in fear of another attack, and may be afraid to be alone or far from medical help.

People with panic disorder have at least four of the following symptoms during an attack:
  • Chest pain or discomfort
  • Dizziness or faintness
  • Fear of dying
  • Fear of losing control or impending doom
  • Feeling of choking
  • Feelings of detachment
  • Feelings of unreality
  • Nausea or upset stomach
  • Numbness or tingling in the hands, feet, or face
  • Palpitations, fast heart rate, or pounding heart
  • Sensation of shortness of breath or smothering
  • Sweating, chills, or hot flashes
  • Trembling or shaking

People with panic disorder may have symptoms of:
  • Alcoholism
  • Depression
  • Drug abuse

*Signs and tests

Many people with panic disorder first seek treatment in the emergency room, because the panic attack feels like a heart attack.
The health care provider will perform a physical examination, including a psychiatric evaluation.
Blood tests will be done. Other medical disorders must be ruled out before panic disorder can be diagnosed. Disorders related to substance abuse should be considered, because symptoms can mimic panic attacks.


The goal of treatment is to help you function well during everyday life. A combination of medication and cognitive-behavioral therapy (CBT) works best.
Antidepressant medications called selective serotonin reuptake inhibitors (SSRIs) are most commonly prescribed for panic disorder. These include:
  • Fluoxetine (Prozac)
  • Sertraline (Zoloft)
  • Paroxetine (Paxil)
  • Other SSRIs
Other medications that may be used include:
  • Other types of antidepressants, such as serotonin-norepinephrine reuptake inhibitors (SNRIs)
  • Antiseizure drugs in severe cases
  • Benzodiazepines, including diazepam (Valium), alprazolam (Xanax), clonazepam (Klonopin), and lorazepam (Ativan) may be used for a short time.
  • Monoamine oxidase inhibitors (MAOIs) are only used when the other drugs do not work, however they can have serious side effects.

Symptoms should slowly get better over a few weeks.
The following may also help reduce the number or severity of panic attacks:
  • Regular exercise
  • Getting enough sleep
  • Regularly scheduled meals
  • Reduce or avoid caffeine, certain cold medicines, and stimulants


  • If you get panic attacks, avoid the following:
  • Alcohol
  • Stimulants such as caffeine and cocaine
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These substances may trigger or worsen the symptoms.

Page made by:
Kevin Marchant