J Korean Med Assoc.  2018 Aug;61(8):493-499. 10.5124/jkma.2018.61.8.493.

Korean guidelines for the treatment of panic disorder

• Suh HS
• Lee JH
• Gim MS
• Kim MK

• KMID: 2428824
• DOI: http://doi.org/10.5124/jkma.2018.61.8.493

Abstract

The Korean Association of Anxiety Disorders developed a Korean guideline for the treatment of panic disorders in 2018 to help clinicians make treatment decisions. This study investigated the consensus about treatment strategies for initial and maintenance treatment, non-responsive cases, comorbid conditions, and psychotherapy in patients with panic disorder. The executive committee developed questionnaires about treatment strategies for patients with panic disorder based on guidelines, algorithms, and clinical trials previously published in foreign countries and Korea. Seventy-two 61% of 112 experts on a committee reviewing panic disorders responded to the questionnaires. We classified the consensus of expert opinions into 3 categories (first-line, second-line, and third-line treatment strategies) and identified the treatment of choice according using the chi-square test and 95% confidence intervals. This study presents useful information about the consensus among Korean experts regarding pharmacotherapy and cognitive behavior therapy for patients with panic disorder.

Keyword

Panic disorder; Guideline; Pharmacotherapy; Cognitive therapy

MeSH Terms

Anxiety Disorders
Cognitive Therapy
Consensus
Drug Therapy
Expert Testimony
Humans
Korea
Panic Disorder*
Panic*
Psychotherapy

Figure

• 

  Figure 1 Initial and maintenance treatment strategies for panic disorder. AD, antidepressant; BZD, benzodiazepine; CBT, cognitive behavioral therapy.

• 

  Figure 2 Treatment strategies for panic disorder: comorbidity and treatment-resistance. AD, antidepressant; BZD, benzodiazepine; CBT, cognitive behavioral therapy; SSRI, selective serotonin reuptake inhibitor; SNRI, serotonin norepinephrine reuptake inhibitor; TCA, tricyclic antidepressant.

Reference

1. Executive Committee for Korean Medication Algorithm for Panic Disorder. Korean medication algorithm project for panic disorder 2008. Seoul: ML Communication;2008.

2. Development Committee for Korean Guidelines for Panic Disorder. Korean guidelines for the treatment of panic disorder 2018. Seoul: Eims International;2018.

3. American Psychiatric Association. Practice guideline for the treatment of patients with panic disorder [Internet]. Washington, DC: American Psychiatric Association;2009. cited 2018 Jul 29. Available from: https://psychiatryonline.org/pb/assets/raw/sitewide/practice_guidelines/guidelines/panicdisorder.pdf.

4. National Institute for Health and Care Excellence. Generalised anxiety disorder and panic disorder in adults: management [Internet]. London: National Institute for Health and Care Excellence;2011. cited 2018 Jul 29. Available from: https://www.nice.org.uk/guidance/cg113.

5. National Institute for Health and Care Excellence. Panic disorder overview [Internet]. London: National Institute for Health and Care Excellence;2016. cited 2018 Jul 29. Available from: https://pathways.nice.org.uk/pathways/panic-disorder.

6. Katzman MA, Bleau P, Blier P, Chokka P, Kjernisted K, Van Ameringen M, Antony MM, Bouchard S, Brunet A, Flament M, Grigoriadis S, Mendlowitz S, O'Connor K, Rabheru K, Richter PM, Robichaud M, Walker JR. Canadian Anxiety Guidelines Initiative Group on behalf of the Anxiety Disorders Association of Canada/Association Canadienne des troubles anxieux and McGill University. Canadian clinical practice guidelines for the management of anxiety, posttraumatic stress and obsessive-compulsive disorders. BMC Psychiatry. 2014; 14:Suppl 1. S1.

7. Baldwin DS, Anderson IM, Nutt DJ, Allgulander C, Bandelow B, den Boer JA, Christmas DM, Davies S, Fineberg N, Lidbetter N, Malizia A, McCrone P, Nabarro D, O'Neill C, Scott J, van der Wee N, Wittchen HU. Evidence-based pharmacological treatment of anxiety disorders, post-traumatic stress disorder and obsessive-compulsive disorder: a revision of the 2005 guidelines from the British Association for Psychopharmacology. J Psychopharmacol. 2014; 28:403–439.