Panic disorder relapse after

Maintenance Phase Treatment. Because panic disorder tends to be a chronic condition, the appropriate duration of therapy is a critically important question. Conventional practice is to continue treatment for 6-9 months after remission has been achieved and then to taper medicines gradually over several weeks to months. The relapse rate is extremely high with over one-half of those treated with medications alone experiencing a relapse within a few months of discontinuing treatment. There is some evidence that CBT may reduce this relapse rate. When relapse occurs, it is usually advisable to restart the medication that was previously used. 

Panic disorder typically starts in the third decade of life, although it may start in childhood or late in life as well. It is a recurrent, chronic, and disabling condition, in which relapses after remission are common. Panic disorder affects females twice as often as males, and after remission, women are more likely to relapse than men. The long duration of illness and the presence of agoraphobia portend a less favorable prognosis. Suicide risk is comparable to that seen among patients with major depression. 

Unfortunately a large percentage of patients relapse when medications are discontinued—as many as 70 percent have a return of panic symptoms if medications are withdrawn a year after treatment is initiated. Panic disorder, thus, appears to be an often chronic condition. To date, there are no very long-term follow-up studies tracking the course of this disorder. However, for practical purposes, the clinician should anticipate medication treatment lasting at least one year. Then a trial discontinuation or medication reduction can be implemented to determine if continued treatment is necessary. 

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