Which factors should be assessed in suspected panic disorder?

Updated: Mar 27, 2019
  • Author: Nita V Bhatt, MD, MPH; Chief Editor: David Bienenfeld, MD  more...
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Assess precipitating events, suicidal ideation or plan, phobias, agoraphobia, and obsessive-compulsive behavior. Exclude involvement of alcohol, illicit drugs (eg, cocaine, amphetamine, phencyclidine, amyl nitrate, lysergic acid diethylamide [LSD], yohimbine, 3,4-methylenedioxymethamphetamine [MDMA, or ecstasy]), cannabis, and medications (eg, caffeine, theophylline, sympathomimetics, anticholinergics).

Consider symptomatology of other medical disorders, which may manifest with anxiety as a primary symptom.

  • Angina and myocardial infarction (eg, dyspnea, chest pain, palpitations, diaphoresis)

  • Cardiac dysrhythmias (eg, palpitations, dyspnea, syncope)

  • Mitral valve prolapse

  • Pulmonary embolus (eg, dyspnea, hyperpnea, chest pain)

  • Asthma (eg, dyspnea, wheezing)

  • Hyperthyroidism (eg, palpitations, diaphoresis, tachycardia, heat intolerance)

  • Hypoglycemia

  • Pheochromocytoma (eg, headache, diaphoresis, hypertension)

  • Hypoparathyroidism (eg, muscle cramps, paresthesias)

  • Transient ischemic attacks (TIAs)

  • Seizure disorders

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