ISSN 2586-0151 (Print)
ISSN 2586-0046 (Online)
Volume 14, Number 2 (2/2018)
Original Article <page. 53-62 >

Korean Guidelines for the Treatment of Panic Disorder 2018 : Initial and Maintenance Treatment Strategies for the Pharmacological Treatment of Panic Disorder

Min-Kyoung Kim, MD, PhD1;Jae-Hon Lee, MD, PhD2;Minsook Gim, MD, PhD3;Won Kim MD, PhD4;Eunsoo Moon MD, PhD5;Ho-Jun Seo, MD, PhD6;Bon-Hoon Koo MD, PhD7;Jong-Chul Yang, MD, PhD8;Kang Soo Lee, MD, PhD1;Sang-Hyuk Lee, MD, PhD1;Chan-Hyung Kim, MD, PhD9;Bum-Hee Yu, MD, PhD10; and Ho-Suk Suh, MD, PhD1;

1;Department of Psychiatry, CHA University School of Medicine, Seoul, 2;Department of Psychiatry, National Rehabilitation Center, Seoul, 3;Department of Psychiatry, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, 4;Department of Psychiatry, Seoul Paik Hospital, Inje University College of Medicine, Seoul, 5;Department of Psychiatry, Pusan National University School of Medicine, Busan, 6;Department of Psychiatry, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, 7;Department of Psychiatry, College of Medicine, Yeungnam University, Daegu, 8;Department of Psychiatry, Chonbuk National University Hospital, Jeonju, 9;Department of Psychiatry, Yonsei University College of Medicine, Severance Hospital, Seoul, 10;Dr. Yu's Psychiatric Clinic, Seoul, Korea

Objective : The Korean Association of Anxiety Disorders developed Korean guidelines for treatment of panic disorder (PD) 2018. In this paper, we discussed the consensus among psychiatrists, regarding initial and maintenance treatment strategies for pharmacological treatment of PD in Korea.

Methods : Based on current treatment guidelines published by the American Psychiatric Association, the National Institute for Clinical Excellence, and the Canadian Psychiatric Association, we developed questionnaires pertinent to initial and maintenance treatment strategies for pharmacological treatment of PD. Seventy-two experts in PD answered questionnaires. We classified expert opinions into three categories, first, second, and third-line treatment strategies, by analyzing the 95% confidence interval.

Results : Antidepressants, benzodiazepine anxiolytics, and cognitive-behavioral therapy (CBT) were recommended as treatments of choice (ToC), and first-line strategies for initial treatment of PD. Escitalopram, paroxetine, sertraline, and venlafaxine were preferred from among many anti-panic drugs. Mean starting dose of anti-panic drugs for initial treatment of PD was relatively lower, than that for other psychiatric illnesses such as major depressive disorder. In the case of maintenance treatment of PD, antidepressants and CBT were selected as ToC and first-line strategies. Patients were typically examined every four weeks during treatment, to review effectiveness and side effects of the drug. Pharmacotherapy was generally continued for one year or more.

Conclusion : This study provides information about consensus among Korean experts regarding pharmacological treatment strategies for patients with panic disorder.


Key words : Panic disorder;Treatment guidelines;Pharmacological treatment;Initial treatment;Maintenance treatment.

Anxiety and Mood

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