PHARMACOLOGICAL TREATMENT OF PANIC DISORDER

Several pharmacologic agents, including tricyclic antidepressants, mon oamine oxidase inhibitors, selective serotonin reuptake inhibitors, an d benzodiazepines, have proven effective in the treatment of panic dis order. Complicating factors, such as comorbid conditions and inappropr iate diagnosis and treatment, can interfere with the effective managem ent of this illness. An educational model developed at the University of Pisa for treating panic disorder divides the treatment process into eight consecutive phases, which are independent of the type of antipa nic agent used. The model provides the clinician with an orderly and l ogical method for adjusting treatment measures according to the needs of the patient. The first three phases of the treatment model involve the initiation and dose titration of antipanic medication to a level s ufficient for the elimination of panic attacks. Treatment is continued during the next three phases, and any adjustments required to maintai n efficacy are made. Pharmacologic treatment is slowly and gradually t apered off during the last two phases.