Panic disorders: differential diagnosis and care in emergencies
Damsa, C.; Lazignac, C.; Iancu, R.; Niquille, M.; Miller, N.; Mihai, A.; Virgillito, S.; Adam, E.
Revue Medicale Suisse 4(144): 404-406; 408-409
2008
ISSN/ISBN: 1660-9379 PMID: 18320769 Document Number: 627573
Despite the high prevalence of panic disorders in patients in primary-care settings, this condition is frequently under-recognised and under-treated. After the description of DSM-IV diagnosis criteria of panic disorders, this paper underline the importance of an adequate somatic and psychiatric differential diagnosis. Even if cognitive-behavioural therapy is the best studied psychotherapeutical approach, several efficacious psychodynamic psychotherapies were also described. High-potency benzodiazepines provide a rapid efficacy with beneficial effects during the first days of treatment. However, benzodiazepines should be avoided in the long term, because of the development of tolerance and dependence. Antidepressants (SSRI, venlafaxine) are effective in preventing panic attacks, especially in improving anticipatory anxiety and avoidance behaviour.