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panic disorder treatment

Aline Iannone, Antonio Pedro de Mello Cruz, Joaquim Pereira Brasil-Neto, Raphael Boechat-Barros
Transcranial magnetic stimulation (TMS) has recently been investigated as a possible adjuvant treatment for many neuropsychiatric disorders, and has already been approved for the treatment of drug-resistant depression in the United States and in Brazil, among other countries. Although its use in other neuropsychiatric disorders is still largely experimental, many physicians have been using it as an off-label add-on therapy for various disorders. More recently, another technique, transcranial direct current stimulation (tDCS), has also become available as a much cheaper and portable alternative to TMS, although its mechanisms of action are different from those of TMS...
October 2016: Arquivos de Neuro-psiquiatria
Luara A Batista, Andrea S Haibara, Luiz C Schenberg, Fabricio A Moreira
Selective stimulation of carotid chemoreceptors by intravenous infusion of low doses of potassium cyanide (KCN) produces short-lasting escape responses that have been proposed as a model of panic attack. In turn, preclinical studies suggest that facilitation of the endocannabinoid system attenuate panic-like responses. Here, we compared the effects of cannabinoid-related compounds to those of alprazolam, a clinically effective panicolytic, on the duration of the escape reaction induced by intravenous infusion of KCN (80μg) in rats...
October 11, 2016: Behavioural Brain Research
Hissei Imai, Aran Tajika, Peiyao Chen, Alessandro Pompoli, Toshi A Furukawa
BACKGROUND: Panic disorder is common and deleterious to mental well-being. Psychological therapies and pharmacological interventions are both used as treatments for panic disorder with and without agoraphobia. However, there are no up-to-date reviews on the comparative efficacy and acceptability of the two treatment modalities, and such a review is necessary for improved treatment planning for this disorder. OBJECTIVES: To assess the efficacy and acceptability of psychological therapies versus pharmacological interventions for panic disorder, with or without agoraphobia, in adults...
October 12, 2016: Cochrane Database of Systematic Reviews
Ekaterina Ivanova, Philip Lindner, Kien Hoa Ly, Mats Dahlin, Kristofer Vernmark, Gerhard Andersson, Per Carlbring
Acceptance and Commitment Therapy (ACT) can be effective in treating anxiety disorders, yet there has been no study on Internet-delivered ACT for social anxiety disorder (SAD) and panic disorder (PD), nor any study investigating whether therapist guidance is superior to unguided self-help when supplemented with a smartphone application. In the current trial, n=152 participants diagnosed with SAD and/or PD were randomized to therapist-guided or unguided treatment, or a waiting-list control group. Both treatment groups used an Internet-delivered ACT-based treatment program and a smartphone application...
September 30, 2016: Journal of Anxiety Disorders
Craig N Sawchuk, Peter Roy-Byrne, Carolyn Noonan, Julia R Craner, Jack Goldberg, Spero Manson, Dedra Buchwald
Panic disorder is a common mental health condition, but little is known about panic disorder in non-Caucasian populations. The purpose of this study is to describe the epidemiology, clinical features, and comorbidities of panic attacks and panic disorder in two large American Indian (AI) tribes (N=3084). A culturally-adapted version of the Composite International Diagnostic Interview assessed panic attacks, panic disorder, and various psychiatric comorbidities. After adjusting for age, gender, and tribe, linear and logistic regression analyses were conducted to compare AIs with panic disorder to those with panic attacks only on clinical characteristics and panic symptoms...
October 5, 2016: Journal of Anxiety Disorders
M Dieterich, J P Staab, T Brandt
Functional and psychiatric disorders that cause vestibular symptoms (i.e., vertigo, unsteadiness, and dizziness) are common. In fact, they are more common than many well-known structural vestibular disorders. Neurologists and otologists are more likely to encounter patients with vestibular symptoms due to persistent postural-perceptual dizziness or panic disorder than Ménière's disease or bilateral vestibular loss. Successful approaches to identifying functional and psychiatric causes of vestibular symptoms can be incorporated into existing practices without much difficulty...
2017: Handbook of Clinical Neurology
Pim Cuijpers, Ioana A Cristea, Eirini Karyotaki, Mirjam Reijnders, Marcus J H Huibers
We report the current best estimate of the effects of cognitive behavior therapy (CBT) in the treatment of major depression (MDD), generalized anxiety disorder (GAD), panic disorder (PAD) and social anxiety disorder (SAD), taking into account publication bias, the quality of trials, and the influence of waiting list control groups on the outcomes. In our meta-analyses, we included randomized trials comparing CBT with a control condition (waiting list, care-as-usual or pill placebo) in the acute treatment of MDD, GAD, PAD or SAD, diagnosed on the basis of a structured interview...
October 2016: World Psychiatry: Official Journal of the World Psychiatric Association (WPA)
Bruce L Rollman, Bea Herbeck Belnap, Sati Mazumdar, Kaleab Z Abebe, Jordan F Karp, Eric J Lenze, Herbert C Schulberg
BACKGROUND: Collaborative care for depression is more effective in improving treatment outcomes than primary care physicians' (PCPs) usual care (UC). However, few trials of collaborative care have targeted anxiety. OBJECTIVE: To examine the impact and 12-month durability of a centralized, telephone-delivered, stepped collaborative care intervention (CC) for treating anxiety disorders across a network of primary care practices. DESIGN: Randomized controlled trial with blinded outcome assessments...
October 6, 2016: Journal of General Internal Medicine
Adrian R Allen, Jill M Newby, Anna Mackenzie, Jessica Smith, Matthew Boulton, Siobhan A Loughnan, Gavin Andrews
BACKGROUND: Internet cognitive-behavioural therapy (iCBT) for panic disorder of up to 10 lessons is well established. The utility of briefer programmes is unknown. AIMS: To determine the efficacy and effectiveness of a five-lesson iCBT programme for panic disorder. METHOD: Study 1 (efficacy): Randomised controlled trial comparing active iCBT (n=27) and waiting list control participants (n=36) on measures of panic severity and comorbid symptoms...
March 2016: BJPsych Open
Mehmet Asoglu, Mehmet Aslan, Okan Imre, Yuksel Kivrak, Oznur Akil, Emin Savik, Hasan Buyukaslan, Ulker Fedai, Abdurrahman Altındag
BACKGROUND: As the relationship between psychological stress and platelet activation has been widely studied in recent years, activated platelets lead to certain biochemical changes, which occur in the brain in patients with mental disorders. However, data relating to the mean platelet volume (MPV) in patients with panic disorder (PD) are both limited and controversial. Herein, we aimed to evaluate, for the first time, the red cell distribution width (RDW) levels combined with MPV levels in patients with PD...
2016: Neuropsychiatric Disease and Treatment
Panayota Flevari, Dionyssios Leftheriotis, Evangelos Repasos, Dimitrios Katsaras, Andreas Katsimardos, John Lekakis
AIMS: The optimal medical therapy of patients with vasovagal syncope (VVS) remains controversial. Fluoxetine is effective against anxiety and panic disorders, while its use has shown promising results for VVS. Anxiety sensitivity is a personality trait observed in a considerable proportion of patients with VVS, associated with predisposition to anxiety and panic disorders. Our aim was to examine whether fluoxetine exerts beneficial effects regarding VVS prevention in the subset of patients with anxiety sensitivity...
October 4, 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Diane Warden, Katherine Sanchez, Tracy Greer, Thomas Carmody, Robrina Walker, Adriane Dela Cruz, Marisa Toups, Chad Rethorst, Madhukar H Trivedi
This study aimed to determine if current comorbid psychiatric disorders differ in adults with cocaine use disorder, other stimulant (primarily methamphetamine) use disorder, or both, and identify demographic and clinical characteristics in those with increasing numbers of comorbid disorders. Baseline data from a randomized controlled trial beginning in residential settings (N=302) was used. Mood disorders were present in 33.6%, and anxiety disorders in 29.6%, with no differences among stimulant use disorder groups...
September 15, 2016: Psychiatry Research
Camilla Gesi, Claudia Carmassi, Katherine M Shear, Theresa Schwartz, Angela Ghesquiere, Julie Khaler, Liliana Dell'Osso
INTRODUCTION: Complicated grief (CG) has been the subject of increasing attention in the past decades but its relationship with separation anxiety disorder (SEPAD) is still controversial. The aim of the current study was to explore the prevalence and clinical significance of adult SEPAD in a sample of help-seeking individuals with CG. METHODS: 151 adults with CG, enrolled in a randomized controlled trial comparing the effectiveness of (CG) treatment to that of interpersonal therapy, were assessed by means of the Inventory of Complicated Grief (ICG), the Structured Clinical Interview for DSM-IV, the Hamilton Rating Scale for Depression (HAM-D), the Work and Social Adjustment Scale (WSAS), the Adult Separation Anxiety Questionnaire (ASA-27), the Grief Related Avoidance Questionnaire (GRAQ), the Peritraumatic Dissociative Experiences Questionnaire (PDEQ), and the Impact of Events Scale (IES)...
September 10, 2016: Comprehensive Psychiatry
Jonathan M Feldman, Lynne Matte, Alejandro Interian, Paul M Lehrer, Shou-En Lu, Bari Scheckner, Dara M Steinberg, Tanya Oken, Anu Kotay, Sumita Sinha, Chang Shim
Confusion between panic and asthma symptoms can result in serious self-management errors. A cognitive behavior psychophysiological therapy (CBPT) intervention was culturally adapted for Latinos consisting of CBT for panic disorder (PD), asthma education, differentiation between panic and asthma symptoms, and heart rate variability biofeedback. An RCT compared CBPT to music and relaxation therapy (MRT), which included listening to relaxing music and paced breathing at resting respiration rates. Fifty-three Latino (primarily Puerto Rican) adults with asthma and PD were randomly assigned to CBPT or MRT for 8 weekly sessions...
September 17, 2016: Behaviour Research and Therapy
Jon E Grant, Sarah A Redden, Eric W Leppink, Samuel R Chamberlain
BACKGROUND: Trichotillomania appears to be a fairly common disorder, with high rates of co-occurring anxiety disorders. Many individuals with trichotillomania also report that pulling worsens during periods of increased anxiety. Even with these clinical links to anxiety, little research has explored whether trichotillomania with co-occurring anxiety is a meaningful subtype. METHODS: One hundred sixty-five adults with trichotillomania were examined on a variety of clinical measures including symptom severity, functioning, and comorbidity...
September 16, 2016: Comprehensive Psychiatry
P Cuijpers, I A Cristea, E Weitz, C Gentili, M Berking
BACKGROUND: The effects of cognitive behavioural therapy of anxiety disorders on depression has been examined in previous meta-analyses, suggesting that these treatments have considerable effects on depression. In the current meta-analysis we examined whether the effects of treatments of anxiety disorders on depression differ across generalized anxiety disorder (GAD), social anxiety disorder (SAD) and panic disorder (PD). We also compared the effects of these treatments with the effects of cognitive and behavioural therapies of major depression (MDD)...
September 23, 2016: Psychological Medicine
G Dorard, C Bungener, O Phan, Y Edel, M Corcos, S Berthoz
BACKGROUND: The use of illicit substances, in particular cannabis, among French adolescents and young adults has become an important public health concern. A better understanding of the mechanisms involved in pathological substance use is nowadays critical. Psychiatric comorbidities have been previously reported in adult substance abusers but are less documented in adolescents, especially regarding cannabis dependence. OBJECTIVES: We investigated mental health problems in adolescents and young adults, seeking treatment for their problematic cannabis use, comparatively to healthy controls, taking into account the participant's gender and age...
September 13, 2016: L'Encéphale
Pim Cuijpers, Claudio Gentili, Rosa M Banos, Javier Garcia-Campayo, Cristina Botella, Ioana A Cristea
Although cognitive and behavioral therapies are effective in the treatment of anxiety disorders, it is not clear what the relative effects of these treatments are. We conducted a meta-analysis of trials comparing cognitive and behavioral therapies with a control condition, in patients with social anxiety disorder (SAD), generalized anxiety disorder (GAD) and panic disorder. We included 42 studies in which generic measures of anxiety were used (BAI, HAMA, STAI-State and Trait). Only the effects of treatment for panic disorder as measured on the BAI (13...
October 2016: Journal of Anxiety Disorders
Wiede Vissers, Ger P J Keijsers, Mirjam Kampman, Gert-Jan Hendriks, Paul Rijnders, Giel J M Hutschemaekers
OBJECTIVE: Treatment effects in psychotherapy outcome research are generally based on the reduction of symptoms. Standard inclusion of other beneficial treatment effects such as remoralization (increase of hope, self-efficacy, well-being) might lead to more elaborate findings in the field of psychotherapy. On the other hand, it is also possible that symptom reduction and remoralization always go hand in hand in the experience of patients. The present study sought to experimentally test this assumption...
September 14, 2016: Journal of Clinical Psychology
Irene Bighelli, Carlotta Trespidi, Mariasole Castellazzi, Andrea Cipriani, Toshi A Furukawa, Francesca Girlanda, Giuseppe Guaiana, Markus Koesters, Corrado Barbui
BACKGROUND: A panic attack is a discrete period of fear or anxiety that has a rapid onset, reaches a peak within 10 minutes and in which at least four of 13 characteristic symptoms are experienced, including racing heart, chest pain, sweating, shaking, dizziness, flushing, stomach churning, faintness and breathlessness. Panic disorder is common in the general population with a lifetime prevalence of 1% to 4%. The treatment of panic disorder includes psychological and pharmacological interventions...
September 12, 2016: Cochrane Database of Systematic Reviews
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