Panic disorder behavioral therapy

Ost, L. A., Westling, B. E. (1995). Applied relaxation vs. cognitive behavior therapy in the treatment of panic disorder. Behavior Research and Therapy, 33, 145-158. 

Beginning in the 1960s, ben2odia2epiae anxiolytics and hypnotics rapidly became the standard prescription dmg treatment. In the 1980s, buspkone [36505-84-7] (3), which acts as a partial agonist at the serotonin [50-67-9] (5-hydroxytryptamine, 5-HT) type lA receptor, was approved as treatment for generali2ed anxiety. More recently, selective serotonin reuptake inhibitors (SSRIs) have been approved for therapy of panic disorder and obsessive—compulsive behavior. 

In two studies in which benzodia2epines were gradually tapered, concurrent cognitive-behavioral therapy (CBT) did not increase the proportion of patients who were able to successfully discontinue their use of these agents (Oude Voshaar et al. 2003 Vorma et al. 2003). On the other hand, other studies of patients with panic disorder found that CBT facilitated the discontinuation of benzodiazepine use (Otto et al. 1993). Similarly, CBT may be superior to supportive medical management in preventing the reoccurrence of panic attacks in panic disorder patients in whom alprazolam has been tapered (Bruce etal. 1999). 

Bruce TJ, Spiegel DA, Hegel MT Cognitive-behavioral therapy helps prevent relapse and recurrence of panic disorder following alprazolam discontinuation a longterm follow-up of the Peoria and Dartmouth studies. J Consult Clin Psychol 67 151-156, 1999... 

Otto MW, Pollack MH, Sachs GS, et al Discontinuation of benzodiazepine treatment efficacy of cognitive-behavioral therapy for patients with panic disorder. Am J... 

Fitzpatrick, K. K., St Schmidt, N. B. (2000, November). The Discomfort Intolerance Scale (DIS) Psychometric properties and clinical utility in patients with panic disorder. Poster session presented at the annual meeting of the Association for Advancement of Behavior Therapy, New Orleans, LA. 

Standardized cognitive behavioral therapy manuals, which ensure adherence to a treatment protocol, have been developed for many different anxiety disorders, including phobias, generalized anxiety, panic, social anxiety, Agoraphobia,... 

The hrst-line treatments for panic disorder are (1) cognitive-behavioral therapy (CBT), (2) benzodiazepines, and (3) SSRIs/SNRls. Each of these three treatment modalities can be nsed independently or in combination. The selection of the primary treatment depends on several factors inclnding severity and frequency of the panic attacks, comorbid illnesses, and patient preference. 

Barlow DH, Gorman JM, Shear MK, Woods SW (2000) Cognitive-behavioral therapy, imipramine, or their combination for panic disorder a randomized controlled trial. JAMA 283 2529-2536... 

As with panic disorder, cognitive-behavioral therapy is an important part of the treatment program for social anxiety disorder. Some evidence suggests that in some cases, drug treatment did not improve the effects of receiving cognitive-behavior therapy. 

Welko vit2. L.A.. Papp, L.A., Cloitre. M., et aL . Cognitive-behavior therapy for panic disorder delivered by psychopharmacologically oriented clinicians J. Nerv. AJent. Dis. 179, 473-477, 1991. 

This syndrome often develops in patients in their twenties, and some, with the more severe form, rarely leave home for periods of many years, or until they are effectively treated by medication, cognitive behavior therapy, or other behavior/psychological therapies. Family studies of panic disorder (PD) find an increased occurrence of attacks in first-degree relatives (2). 

Klosko JS, Barlow DH, Tassinari RB, et al. Alprazolam vs. cognitive behavior therapy for panic disorder a preliminary report. In Hand I, Witchen HU, eds. Panic and phobias. New York Springer Verlag, 1988 54-65. 

Martinsen EW, Olsen T, Tonset E, et al. Cognitive-behavioral group therapy for panic disorder in the general clinical setting a naturalistic study with 1-year follow-up. J Clin Psychiatry 1998 59 437-442. 

Spiegel DA, Bruce TJ. Benzodiazepines and exposure-based cognitive behavior therapies for panic disorder conclusions from combined treatment trials. Am J Psychiatry 1997 154 773-781. 

Loerch B, Graf-Morgenstern M, Hautzineger M, et al. Randomised placebo-controlled trial of moclobemide, cognitive-behavioral therapy and their combination in panic disorder with agoraphobia. Br J Psychiatry 1999 174 205-212. 

Otto MW, Pollack MH, Penava SJ, et al. Group cognitive-behavior therapy for patients failing to respond to pharmacotherapy for panic disorder a clinical case series. Behav Res Ther 1999 37 763-770. 

To review the drug treatments of panic disorder, including benzodiazepines, serotonin selective reuptake inhibitors, cognitive behavioral therapy and other treatments. 

Behavioral therapies and cognitive therapies are commonly less effective for the treatment of panic disorder and obsessive compulsive disorder than are the SSRIs. 

Although anxiety disorders, when untreated, can be the cause of substantial personal suffering, disability, and marital and family disruption, the progress made in the therapeutic area for conditions like panic disorder, OCD, and GAD, among other anxiety disorders, makes these conditions very gratifying to treat. Indeed, the skillful use of psychotherapies—cognitive-behavioral therapies appear to be most effective—and medications can produce dramatic and lasting improvement in many patients. 

Craske, M. G., Brown, T. A., Barlow, D. H. (1991). Behavioral treatment of panic disorder A two-year follow-up. Behavior Therapy, 22, 289-304. 

It is used in the therapy of chronic anxiety or panic disorder, in the absence of a behavioral disorder. 

Pharmacotherapy is only one of several treatment options for PTSD, especially in view of the great success of cognitive-behavioral therapy (CBT). Medication may be a good choice when patient acceptability of such an approach is high, when comorbid conditions are present that are responsive to pharmacotherapy (e.g. depression, panic disorder, social phobia, and obsessive-compulsive disorder), or when CBT is not applicable. ... 

PD and its related symptoms can be quite disabling. The recognition that specific drug therapies can effectively block the panic episodes has brought new found hope for thousands of patients. Optimal outcome, however, often requires the addition of various behavioral techniques to manage all related components of the disorder (e.g., panic attack, anticipatory anxiety, phobic avoidance). 

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