PANIC DISORDER - THE ULTIMATE ANXIETY

Panic disorder, an intense exacerbation of anxiety accompanied by a va riety of physical symptoms, is twice as common among women as among me n. Onset is bimodal (teens/20s and mid-30s/40s), 50% of cases are acco mpanied by agoraphobia, and the etiology is probably multifactorial. T reatment in the primary care setting includes pharmacologic (selective serotonin reuptake inhibitors) and cognitive-behavioral intervention. Medication is initiated at low doses, and the drug-evaluation trial i s of 6 weeks duration. Psychiatric referral is helpful in nonresponder s and in those with comorbid psychiatric conditions. Outcome varies, w ith most patients experiencing relief with treatment. For some people, however, the disorder is chronic, with ongoing exacerbations and remi ssions.