What is the role of cognitive-behavioral therapy (CBT) in the management of panic disorder?

Updated: Mar 21, 2018
  • Author: Mohammed A Memon, MD; Chief Editor: Randon S Welton, MD  more...
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Psychotherapy is recommended for patients with panic disorder who prefer nonpharmacologic management and who are able and willing to take the time and effort to participate in weekly (or sometimes alternate weekly) sessions and between-session practices. [55] The strongest available evidence is for CBT. [55, 56]

CBT, with or without pharmacotherapy, is the treatment of choice for panic disorder, and it should be considered for all patients. [33] This therapeutic modality has higher efficacy and lower cost, dropout rates, and relapse rates than do pharmacologic treatments. CBT may include countering anxious beliefs, exposure to fear cues, changing anxiety-maintaining behaviors, and preventing relapse. [55]

It is important to identify the frequency and nature of the panic disorder symptoms as well as the triggers of panic symptoms for effective management. [55] The patient’s symptomatic status should be monitored at each session, such as with the use of rating scales, and patients can also self-monitor by keeping a daily diary of panic symptoms. [55]

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