Panic disorder as a chronic illness

Panic disorder is a chronic illness that waxes and wanes, and the prognosis is worse with comorbid agoraphobia, depression, or personality disorder. Both medication and cognitive-behavioral therapy have been found helpful in acute treatment trials of panic disorder. However, recent studies suggest that therapeutic gains are lost in many instances when treatment is stopped after short-term medication or cognitive-behavioral therapy. Thus, maintenance treatment appears necessary for many panic patients. Patients appear relatively stable during medication maintenance, but studies of maintenance psychosocial treatment for panic disorder have not yet been reported. Whether combined medication and psychosocial treatment lead to more durable effects after treatment discontinuation than are seen with individual treatments also remains to be determined.