Panic disorder and agoraphobia. In acute panic attacks,
reassurance of the patient may be suffi cient in most
cases. In severe attacks, short-acting benzodiazepines
may be needed (e.g., melting tablets). SSRIs and
venlafaxine are the fi rst-line treatments for panic disorder.
After remission, treatment should continue for
at least several months in order to prevent relapses.
SSRIs, venlafaxine, TCAs, benzodiazepines and
other drugs have shown long-term effi cacy in these
studies. Regarding SSRIs and SNRIs, the same doses
are usually prescribed in the maintenance treatment
as in the acute treatment phase.
A combination of CBT and medication treatment
has been shown to have the best treatment outcomes.
Exposure therapy is used to treat agoraphobia, and
CBT was developed for treating spontaneous panic
attacks. Exercise seems to have some effect in panic
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82 B. Bandelow et al.
disorder; however, this effect seems to be less pronounced
than the effect of medication.