Panic Disorder

Key points

• Panic disorder: recurrent unexpected panic attacks + persistent worry about further attacks or their implications (≥ 1 month).
• Panic attack: abrupt surge of intense fear — palpitations, chest pain, dyspnoea, dizziness, derealisation/depersonalisation, fear of dying.
• Management: CBT first-line; SSRI (sertraline) if pharmacological.
• Warn patients SSRIs may transiently increase anxiety initially.
• Exclude phaeochromocytoma/hyperthyroidism/hypoglycaemia in atypical presentations.