Panic disorder without agoraphobia

Panic disorder Agoraphobia with panic disorder Agoraphobia without panic disorder Specific phobia Social phobia Generalised anxiety disorder Mild anxiety and depression disorder Obsessive compulsive disorder Acute stress disorder Post-traumatic stress disorder (PTSD) Adjustment disorder Panic disorder without agoraphobia Panic disorder with agoraphobia Agoraphobia Specific phobia Social phobia (also called social anxiety disorder) Generalised anxiety disorder Obsessive compulsive disorder Acute stress disorder Post-traumatic stress disorder (PTSD)... 

F40.0 Agoraphobia. 00 Without panic disorder. 01 With panic disorder... 

PHOBIC DISORDERS profound fear of, and avoidance of, a dreaded object or situation. Agoraphobia. Fear of places or situations from which escape is difficult—can occur with or without a history of panic disorder Social phobia. Fear of social or performance situations Specific phobia. Fear of a specific object or situation... 

Panic disorder Treatment of panic disorder, with or without agoraphobia (alprazolam immediate-release, extended-release, and orally disintegrating clonazepam). 

Because many antidepressant compounds are also effective in panic disorder, we performed a trial of inositol in panic (Benjamin et al. 1995). Twenty-one patients with panic disorder with or without agoraphobia completed a double-blind, random assignment crossover treatment trial of inositol 12 g/ day versus placebo, with 4 weeks in each treatment phase. Frequency of panic attacks and severity of panic disorder and of agoraphobia declined significantly more on inositol than on placebo the effect was comparable to that of imipramine in previous studies. Side effects were minimal. 

One analysis (Angst and Wicki 1993) showed agoraphobia in 2.6% of control subjects, 2.8% of subjects with major depression, 7.4% of subjects with pure panic, and 28.0% of subjects with both panic disorder and major depression. Similarly, the attempted suicide rate was 3.5% among control subjects, 5.0% in subjects with pure panic, 13.0% in subjects with depression without panic, and 28.9% in patients with both panic disorder and major depression. These data underline the importance of recognizing and treating comorbid depression in patients with panic disorder. 

G. The fear or avoidance is not due to the direct physiological effects of a substance [e.g., a drug of abuse, a medication) or a general medical condition and is not better accounted for by another mental disorder [e.g., panic disorder with or without agoraphobia, separation anxiety disorder, body dysmorphic disorder, a pervasive developmental disorder, or schizoid personality disorder). 

Bakish D, Hooper CL, Filteau MJ, et al A double-blind placebo-controlled trial comparing fluvoxamine and imipramine in the treatment of panic disorder with or without agoraphobia. Psychopharmacol Bull 32 135-141, 1996 Bakish D, Hooper CL, Thorton MD, et al Fast onset an open study of the treatment of major depressive disorder with nefazodone and pindolol combination therapy. Int Clin Psychopharmacol 12 91-97, 1997 Baldwin DS Depression and sexual function. J Psychopharmacol 10 (suppl l) 30-34, 1996... 

It is used in the management of generalised anxiety disorder or the short term relief of symptoms of anxiety. It is also indicated for the treatment of panic disorders with or without agoraphobia. 

It is also indicated for the treatment of panic disorder with or without agoraphobia. 

Goisman RM, Warshaw MG, Steketee GS, et al. DSM-IV and the disappearance of agoraphobia without a history of panic disorder new data on a controversial diagnosis. Am J Psychiatry 1995 152 1438-1443. 

Rosenbaum JF, Moroz G, Bowden CL. Clonazepam in the treatment of panic disorder with or without agoraphobia a dose-response study of efficacy, safety, and discontinuance. Clonazepam Panic Disorder Dose-Response Study Group. J Clin Psychopharmacol 1997 17 390-400. 

Anxiety disorders include a range of diagnoses in which panic or disabling anxiety is a prominent feature. These include panic disorder with and without agoraphobia, specific phobias, PTSD, social phobia, OCD, and generalized anxiety disorder (GAD) (Table 4.1). 

The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision classifies anxiety disorders into several categories GAD, panic disorder (with or without agoraphobia), agoraphobia, SAD, specific phobia, obsessive-compulsive disorder, posttraumatic stress disorder, and acute stress disorder. The characteristic features of these illnesses are anxiety and avoidance behavior. 

Bruce SE, Vasile RG, Goisman RM, et al. Are benzodiazepines still the medication of choice for patients with panic disorder with or without agoraphobia Am J Psychiatry 2003 160 1432-1438. 

Panic disorders, with or without agoraphobia, affect 1.6% of the adult population (>3,000,000 people) in the United States at some time in their lives. In panic disorder, brief episodes of fear are accompanied by multiple physical symptoms, such as terror, fear of dying, heart palpitations, difficulty in breathing, and dizziness. Panic attacks recur and the victim develops an intense fear of having another attack, which is termed anticipatory anxiety. In addition, the victim may develop irrational fears, called phobias, that relate to situations in which a panic attack has occurred. This condition may coexist with other phobias (agoraphobia, simple phobia, social phobia), depression, obsessive-compulsive disorder, alcohol and drug abuse, suicidal tendencies and irritable bowel syndrome. 

In agoraphobia with or without panic or with a history of panic disorder, there is a desperate habitual attempt to avoid the specific anxiety-producing stimulus (Nordenberg, 1999). Many times these attempts at avoidance include characteristic patterns and cluster around situations such as being outside the home, in a crowd, in an automobile or other mode of transportation, or being on a bridge (American Psychiatric Press, 1994). 

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