Panic Attack

Description

• Characteristic, acute episodes of physical symptoms and intense fear that rapidly peak within 10 min and resolve in ∼20 min
• There may be a nonfearful variant in medical patients

• Recurrent, unexpected panic attacks with ≥1 mo of persistence:
  • Concerns about having another attack
  • Worry about the implications or consequences of the attacks
  • Behavioral change, such as phobic avoidance, related to the attacks
  • Agoraphobia = anxiety related to being in places where escape is difficult
• Episodic, recurrent, or chronic attacks
• Frequently comorbid with depression, substance abuse, disability, suicidal tendency

• Probably genetic
• Family history of panic or anxiety is common
• Altered serotonin- and benzodiazepine-receptor function

Etiology

Mechanism
Limbic system, norepinephrine release, other neurotransmitters (e.g., serotonin) implicated, leading to “fight-or-flight” response

Risk Factors

• Major life events in the year preceding onset
• Family history of panic or anxiety
• Childhood shyness or separation anxiety
• May develop in the course of predisposing physical illness or cocaine abuse:
  • May persist after the illness or substance use has resolved
• Twice as common in women