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
What are some cardiopulmonary symptoms of panic attacks?
What are some neurological symptoms of panic attacks?
What are some GI symptoms of panic attacks?
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?
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?
What are the mainstay of therapy for panic attacks?
SNRI (venlafaxine, duloxetine)
What do you not want to use but can for refractory cases of panic attack?
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?
What is the brand name of clomipramine?
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)
What is the BZD approved for PD?
What are the dose for the SSRI?
What are the dose for SNRI?
What are the dose of BZD alprazolam and clonzaepam?
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?
You should taper if the medication is to be discontinued over how many 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?
What is considered severe panic disorder without agrophobia in PDSS?