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Treatmentstrategies in refractory panic disorder

Published online by Cambridge University Press:  18 September 2015

Summary

A considerable amount of patients with panic disorder (25 – 30%) is refractory for the first line of treatment, mostly antidepressants, and for psychotherapy. Augmentation and combination strategies are discussed; and a protocol for the treatment of refractory patients with panic disorder is proposed with consists of five steps.

No patients is considered treatment refractory until they have had a trial with monoamine oxidase inhibitors.

Type
Research Article
Copyright
Copyright © Scandinavian College of Neuropsychopharmacology 1996

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References

Literatuur

1.Katerndahl, DA, Realinie, IP. Lifetime prevalence of panic states. Am J Psychiatr 1993; 150:246–9.Google Scholar
2.Timmerman, LPanic Disorder, a specific clinical entity? Rotterdam, Thesis (Erasmus University) 1995.Google Scholar
3.Clark, DM, Salkovskis, PM, Hackmann, A, Middleton, H, Anastasiades, P, Gelder, MA, comparison of cognitive therapy, applied relaxation and Imipramine in the treatment of panic disorder. Br J Psychiat 1994; 164: 759–69.Google Scholar
4.Black, DW, Wesner, RB, Gabel, J, Bowers, W, Monahan, P. Predictors of short-term treatment respons in 66 patients with panic disorder. J affect Disord 1994; 30: 233–41.Google Scholar
5.Klein, DF, Fink, W. Psychiatric reaction patterns to Imipramine. Am J Psychiat 1994; 119: 432–38.Google Scholar
6.Boer Den, JA. Serotonergic mechanisms in anxiety disorders. Utrecht: Thesis (RU Utrecht), 1988.Google Scholar
7.Modigh, K, Westberg, P, Eriksson, E. Superiority of clomipramine over Imipramine in the treatment of panic disorder. J clin Psychopharm 1992; 12: 251-61.CrossRefGoogle ScholarPubMed
8.Westenberg, HGM. Developments in the drugtreatment of panic disorder: What is the place of the selective serotonin reuptake inhibitors? J affect Disord 1996; 40: 8593.Google Scholar
9.Boyer, W. Serotonin uptake inhibitors are superior to Imipramine and alprazolam in alleviating panic attracks: a meta analysis. Int clin Psychopharmacol 1995; 10: 45–9.Google Scholar
10.Barlow, DHAdvances in the psychosocial treatment of anxiety disorders. Arch gen Psychiat 1996; 53: 727–35.CrossRefGoogle ScholarPubMed
11.De Beurs, E, van Balkom, AJLM, Lange, A, Koele, P, van Dijck, R. Treatment of panic disorder with agoraphobia: comparison of fluvoxamine, placebo and psychological panic management combined with exposure and of exposure in vivo alone. Am J Psychiat 1995; 152: 683–96.Google ScholarPubMed
12.Practical approaches to the treatment of panic disorder. Academic Highlights. J clin Psychiat 1996; 57: 45–8.Google Scholar