How are persistent or recurrent symptoms managed in the treatment of panic disorder?

Updated: Mar 21, 2018
  • Author: Mohammed A Memon, MD; Chief Editor: Randon S Welton, MD  more...
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Despite the effectiveness of standard management for panic disorder in a majority of affected patients, some individuals with good treatment responses may have persistent or recurrent symptoms following remission. [55] Symptomatic fluctuations are not uncommon during treatment and symptoms may recur following remission. Provide patients with response plans in such situations. [55]

Cognitive-behavioral therapy (CBT) with cognitive restructuring, relaxation techniques, breathing exercises, hypnotic suggestion, and interoceptive exposure may prevent recurrence. Pharmacotherapy and dietary modification (e.g., 5-hydroxytryptophan or inositol supplementation [38] ) may also prevent recurrence, as may exercise. [39]

A study suggested that patients who give a high importance to religion and religious practices have improved panic symptoms and fewer recurrences. [40] Internet-based CBT and virtual reality exposure therapy are promising possibilities for recurrence prevention. [41]

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