Anxiety and Panic Disorders

Abstract

Anxiety is one of the major causes of distress and is often overlooked or minimized by doctors and the general public. Moreover, there is accumulating evidence that patients with panic disorder have a high risk of suicide attempts. The classification of anxiety has become progressively refined over the past decade, with a number of discrete syndromes being characterized. The major division is between those disorders characterized by sudden surges of anxiety (panic attacks) and those without. The syndrome of repeated panic attacks is called panic disorder. Often, panic disorder leads to avoidance behavior—agoraphobia. Current drug treatments for panic disorder are antidepressants (tricyclics or monoamine oxidase inhibitors) or potent benzodiazepines such as alprazolam. The state characterized by morbid worrying is called generalized anxiety disorder, and is treated either with benzodiazepines or buspirone. At present, these two conditions are the main targets for new drug development. However, there is growing interest in phobic conditions (especially social phobia) and stress-related anxiety—posttraumatic stress disorder, both of which may respond to the newer antidepressants or monoamine oxidase inhibitors.