The American Psychiatric Association Practice Guideline for the Treatment of Patients With Panic Disorder: Recommendations and Controversies

Fredric N. Busch, MD and Barbara L. Milrod, MD

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In This Article

Future Directions

The final section of the guideline, "Future Directions," decribes some of the issues and controversies raised in the initial section of this paper. The guideline notes that there is relatively little information on optimal ways of treating patients with comorbid disorders, despite increasing evidence of comorbidity. Although current treatments have been demonstrated to be effective at blocking panic attacks, many patients continue to suffer from associated forms of the illness, such as anticipatory anxiety and phobic avoidance. There are few long-term studies on how long treatment should last to produce a more sustained result. In addition, further research is needed as to which patients may respond better to CBT, medication, or both. Further research on psychodynamic treatments is also required.

Although these problems are noted, there is little discussion about how they affect the degree of confidence with which recommendations are made in the guideline. The treatments described require further testing, particularly over the long term, before the clinical validity of the recommendations made in the guideline can be established. In these authors' opinions, the guideline should include a statement noting the preliminary nature of the recommendations that are made.

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