General measures In the event of a panic attack: stay calm! Do not be infected by or downplay the person’s anxiety. Convey security and safety. Monitoring of the patient; in case of acute suicidality (suicide risk): hospitalization. Nutritional medicine Nutritional counseling based on nutritional analysis Nutritional recommendations according to a mixed diet taking into account … Panic Disorder: Therapy
Pathogenesis (development of disease) Panic attacks can be triggered by severe stressful situations. This often involves a combination of psychophysiological and psychosocial components. The affected person does not experience more stress than the normal population; he or she only evaluates the situations more negatively. Etiology (causes) Biographical causes Genetic burden At least four variants of … Panic Disorder: Causes
The medical history (history of illness) represents an important component in the diagnosis of panic disorder. Family history Are there frequent mental health problems in your family? Social history Is there any evidence of psychosocial stress or strain due to your family situation? Do you live alone? Current medical history/systemic history (somatic and psychological complaints) … Panic Disorder: Medical History
Cardiovascular (I00-I99). Myocardial infarction (heart attack) DD Panic attack. Psyche – nervous system (F00-F99; G00-G99) Organic anxiety disorders Primary anxiety disorders Psychiatric anxiety disorders Other differential diagnoses Withdrawal or intoxication syndromes DD Panic attack.
The following are the most important diseases or complications that can be caused by panic disorder: Psyche – Nervous System (F00-F99; G00-G99). Alcohol abuse (alcohol dependence) Depression Insomnia (sleep disorders) Symptoms and abnormal clinical and laboratory findings, not elsewhere classified (R00-R99). Suicidality (suicide risk). Further Addictions, especially to medications (sleeping pills). Fear of anxiety Limitation … Panic Disorder: Consequential Diseases
A comprehensive clinical examination is the basis for selecting further diagnostic steps: General physical examination – including blood pressure, pulse, body weight, height; furthermore: Inspection (viewing). Skin and mucous membranes [sweating?, tremor (shivering)?, cyanosis (cyanosis)?] Pupillary reaction? Paresis (paralysis)? Testing of the sensorium (Latin “totality of all the senses”). Auscultation (listening) of the heart Auscultation … Panic Disorder: Examination
1st order laboratory parameters – obligatory laboratory tests. Small blood count Differential blood count TSH (thyroid-stimulating hormone) to determine thyroid function. Fasting glucose (blood glucose levels) Depending on previous results, special laboratory tests are performed.
Therapy target Improvement of the symptomatology Reduction in the number of panic attacks Therapy recommendations The most important pillar of therapy for panic disorder is psychotherapy. Acute therapy: benzodiazepines; use only short-term (due todanger of dependence)! Continuous therapy: Selective serotonin reuptake inhibitors (SSRIs): citalopram, escitalopram, paroxetine, sertraline [first choice]. Selective serotonin–norepinephrine reuptake inhibitors (SSNRIs): venlafaxine … Panic Disorder: Drug Therapy
Optional medical device diagnostics – depending on the results of the history, physical examination, laboratory diagnostics, and obligatory medical device diagnostics – for differential diagnostic clarification or to exclude complications. Electrocardiogram (ECG; recording of the electrical activities of the heart muscle) – for suspected structural heart disease.
The following symptoms and complaints may indicate panic disorder: Repeated sudden onset (within minutes) of anxiety attacks with primarily physical symptoms such as: Feeling of suffocation, tightness in the throat, pressure in the head. Dry mouth (xerostomia) Palpitations (heart stuttering), tachycardia (heartbeat too fast: > 100 beats per minute). Blood pressure increase Dyspnea (shortness of … Panic Disorder: Symptoms, Complaints, Signs
