PHARMACOTHERAPY VERSUS PSYCHOTHERAPY IN PANIC DISORDER. REVIEW

PHARMACOTHERAPY VERSUS PSYCHOTHERAPY IN PANIC DISORDER.REVIEW (Abstract) Panic disorder is one of the most frequent psychiatric conditions and the incidence is increasing. More worrying than the number of patients is the major negative impact over personal, social and economic functioning. Due to the increasing risk of death, whether by suicide or by cardiovascular disease, in patients suffering of panic disorder a prompt, adequate intervention is essential. This condition has a chronic evolution, with low rates of remission and a significant negative impact over quality of life and over social and economic aspects. In this article we presented different aspects related to the therapeutic management of panic disorder, with special reference to pharmacotherapy and its specific classes and psychotherapy, particularly Cognitive-Behavioral Therapy. These two therapeutic categories proved to be the most efficient in both acute and long-term symptomatology, with improvement of anxiogenic rumination, avoidance behavior or agoraphobia. Pharmacotherapy, whether with antidepressants or benzodiazepines, is recommended to be followed by psychotherapy. SSRIs and SSNRs are recommended as first-line medication, while benzodiazepines are necessary only in acute phases or until the therapeutic effect of the above-mentioned medicines is obtained. In treatment-resistant patients at patients who do not respond sufficiently to any first-line treatments it is necessary to use other classes of medicines, such as atypical antipsychotics.