Panic Disorder
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28 terms
Terms | Definitions |
|---|---|
 What is the DSM-IV criteria for panic attack? | Intense fear for discrete period of time: 20-30 minutes (peak 10 minutes) Associated with four charactersitics? |
| What are some psychiatric symptoms of panic attack? | Fear of going crazy Fear of dying Derealization Depersonalization |
| What are some cardiopulmonary symptoms of panic attacks? | Chest pain Palpitations SOB Tachycardia |
| What are some neurological symptoms of panic attacks? | Trembling Dizziness Numbness Faint |
| What are some GI symptoms of panic attacks? | Abdominal pain Autonomic Hot flashes Sweating |
| What are the three DSM-IV-TR criteria for panic disorder? | 1. recurrent panic attacks 2. followed by a period of at least 1 month associated with: *fear of having another panic attack or *behavioral changes due to panic attack or *fear of consequences of having the panic attack 3. May be present with or without agoraphobia |
| What are the risk factors for panic disorder? | personality type parenting technique family history medications (same as GAD) medical conditions (same as GAD) |
| What is the rating scale used to determine panic disorder? | Panic Disorder Severity Scale (with or without agrophobia) |
| What are the nonpharmacological treatments for Panic attack? | CBT Relaxation techniques Education |
| What are the mainstay of therapy for panic attacks? | SSRI (all) SNRI (venlafaxine, duloxetine) |
| What do you not want to use but can for refractory cases of panic attack? | phenelzine (Nardil) |
| What are other options besides SSRI or SNRI that you can use for pantic attacks? | TCA: imipramine (Tofranil), clomipramine (Anafranil) BZD: alprozolam (xanax), clonazepam (klonopin), diazepam (valium), lorazepam (ativan) |
| What is the brand name of imipramine? | Tofranil |
| What is the brand name of clomipramine? | Anafranil |
| Do GAD and PD have the same criteria for what is considered adequate response? | Yes: adequate dose for six weeks with 25% symptoms reduction with SSRI or SNRI |
| Like GAD for PD should you bridge the gap with BZD? | yes for 2-3 weeks and slowly taper. |
| What are the SSRI and SNRI FDA approved for PD? | SSRI: fluoxetine, paroxetine, sertraline (FPS) SNRI: venlafaxine |
| What is the BZD approved for PD? | alprazolam clonazepam |
| What are the dose for the SSRI? | fluoxetine: 10-40 paroxetine: 20-60 sertraline: 50-200 |
| What are the dose for SNRI? | venlafaxine: 75-225 duloxetine: 60-120 |
| What are the dose of BZD alprazolam and clonzaepam? | alprazolam: 4-10 clonazepam: 1-4 diazepam: 5-20 lorazepam: 2-8 |
| What is the follow up for PD? | Every 1-2 weeks initially Every 2-4 weeks to adjust dose Once stabilized on a dose every other month |
| What is generally the treatment length for PD? | 12-24 months |
| You should taper if the medication is to be discontinued over how many months? | 4-6 months |
| What is considered a response in treatment? | reduction in 40% of baseline score |
| What is considered remission? | PDSS score of 3 or less with no anxiety symptoms |
| What is considered severe panic disorder with agrophobia in PDSS? | ≥16 |
| What is considered severe panic disorder without agrophobia in PDSS? | ≥14 |
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