Korean J Psychopharmacol.  2009 Jan;20(1):32-39.

Korean Medication Algorithm for Panic Disorder 2008: Initial Treatment Strategies

Affiliations
  • 1Department of Psychiatry, Chonbuk National University Medical School, Jeonju, Korea.
  • 2Department of Psychiatry, Inje University College of Medicine, Seoul, Korea.
  • 3Department of Psychiatry, Sungkyunkwan University School of Medicine, Seoul, Korea.
  • 4Department of Psychiatry, Pochon CHA University College of Medicine, Seongnam, Korea.
  • 5Department of Psychiatry, Yonsei University College of Medicine, Seoul, Korea. spr88@yuhs.ac

Abstract


OBJECTIVE
The Korean Association of Anxiety Disorders developed a Korean treatment algorithm for panic disorder to help clinicians make treatment decisions. This study investigated a consensus about initial treatment strategies as part of developing a medication algorithm for panic disorders in Korea.
METHODS
Based on current treatment algorithms published by the American Psychiatric Association, the National Institute for Clinical Excellence, and the Canadian Psychiatric Association, we developed questionnaires about initial treatment strategies for patients with panic disorder. Fifty-four experts in panic disorder answered the questionnaires. We classified expert opinions into three categories (first-, second-, and third-line treatment strategies) by chi-square tests.
RESULTS
Antidepressants and anxiolytics were recommended as first-line strategies for the initial treatment of panic disorder. A combination of medical treatment and cognitive-behavioral therapy was also recommended for more severe cases. Paroxetine, escitalopram, alprazolam, and clonazepam were preferred from among many anti-panic drugs. The mean starting dose of anti-panic drugs in the initial treatment for panic disorder was relatively lower than that for such other psychiatric illnesses as major depressive disorder.
CONCLUSION
These results, reflecting recent studies and clinical experiences, may provide guidelines about initial treatment strategies for panic disorder.

Keyword

Panic disorder; Algorithm; Initial treatment
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