Managing Panic Disorder in Primary Care 

About

Panic disorder is a relatively common condition that can significantly impair quality of life. It is characterized by recurrent, unexpected panic attacks, accompanied by persistent worry about their recurrence and significant changes in behavior to avoid it. A panic attack is a sudden onset of intense fear or discomfort which peaks within minutes. Recognizable symptoms of a panic attack include palpitations, sweating, trembling, shortness of breath, and chest pain. Because these symptoms often mimic acute medical conditions, patients frequently present first to primary care or emergency settings seeking urgent help. Therefore, timely recognition and appropriate management in the primary care setting are important to improve patient outcomes and reduce unnecessary healthcare costs.

Panic disorder is classified as an anxiety disorder in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Its development is influenced by a combination of genetic, biological, and environmental factors. The disorder may coexist with other psychiatric conditions, such as depression, generalized anxiety disorder, or substance use disorder, and can also overlap with certain medical conditions, complicating diagnosis and management. These factors underscore the need for a careful and structured approach in primary care.

Management of panic disorder in primary care should be guided by available resources and interventions. First-line options may include psychological therapy, pharmacological therapy, or a combination of both. Treatment approaches include psychoeducation and cognitive behavioral therapy (CBT) for psychological therapy, and selective serotonin reuptake inhibitors (SSRIs) or serotonin–norepinephrine reuptake inhibitors (SNRIs) for pharmacological therapy. Selecting the appropriate strategy should consider patient preference, clinical presentation, and the accessibility of interventions to ensure effective and individualized care.

This e-learning module aims to equip primary care providers with the knowledge and skills to recognize, assess, and manage panic disorders. It focuses on identifying key symptoms, understanding risk factors and comorbidities, and applying evidence-based psychological and pharmacological interventions. By the end of this module, learners will be able to make informed decisions regarding treatment selection, referral to specialist care, and patient support in navigating available care options.