Introduction: Panic disorder occurs in up to 3% of the adult population at some time, and is associated with other psychiatric and personality disorders, and with drug and alcohol abuse. The risk of suicide and attempted suicide has been found to be higher in people with panic disorder than in people with other psychiatric illness, including depression.
Methods and outcomes: We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of non-drug treatments for panic disorder? What are the effects of drug treatments for panic disorder? What are the effects of combined drug and psychological treatments for panic disorder? We searched: Medline, Embase, The Cochrane Library, and other important databases up to June 2007 (Clinical Evidence reviews are updated periodically, please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA).
Results: We found 36 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions.
Conclusions: In this systematic review we present information relating to the effectiveness and safety of the following interventions: applied relaxation, benzodiazepines, breathing retraining, brief dynamic psychotherapy, buspirone, client-centred therapy, cognitive behavioural therapy (CBT) (alone or plus drug treatments), cognitive restructuring, couple therapy, exposure (external or interoceptive), insight-orientated therapy, monoamine oxidase inhibitors (MAOIs), psychoeducation, selective serotonin reuptake inhibitors (SSRIs), self-help, and tricyclic antidepressants (imipramine).