Long-Term Management of Panic Disorder

Panic disorder is a chronic, disabling condition that is often associated with a need for long-termclinical treatment. While a variety of pharmacotherapy options, including tricyclic antidepressants,selective serotonin reuptake inhibitors, and benzodiazepines, are effective in reducing symptoms inthe acute phase, a significant number of patients do not fully respond to initial treatment, and a largemajority of patients experience relapse after medication discontinuation. Optimal long-term treatmentof panic disorder involves attention to adequate medication dosing and adequate duration of treatmentto achieve maximum improvement before discontinuing. Recent reports suggest the efficacy of adjunctivepharmacotherapies and combining pharmacotherapy with behavioral therapy to improve treatmentresponse. Further research is necessary to determine the long-term effectiveness of these multifacetedtreatment strategies among patients suffering from refractory panic disorder.